Admission hypoxia-inducible factor 1[alpha] levels and in-hospital mortality in patients with acute decompensated heart failure

• Published in: BMC cardiovascular disorders 2015-07, Vol.15
• Main Authors: Li, Gang, Lu, Wei-hua, Wu, Xiao-wei, Cheng, Jian, Ai, Rong, Zhou, Zi-hua, Tang, Zhong-zhi
• Format: Article
• Language: English
• Subjects: Cardiac patients; Care and treatment; Health aspects; Heart; Medical research; Medicine, Experimental; Patient outcomes
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-015-0073-6

Background Hypoxia-inducible factor 1 (HIF-1) is a critical regulator for cellular oxygen balance. Myocardial hypoxia can induce the increased expression of HIF-1[alpha]. Our goals were to evaluate the value of HIF-1[alpha] in predicting death of patients with acute decompensated heart failure (ADHF) and describe the in vivo relationship between serum HIF-1[alpha] and N-terminal-pro-brain natriuretic peptide (NT-proBNP) levels. Method We included 296 patients who were consecutively admitted to the emergency department for ADHF. The primary end point was in-hospital death. The patients were categorized as HFrEF (patients with reduced systolic function) and HFpEF (patients with preserved systolic function) groups. Results In our patients, the median admission HIF-1[alpha] level was 2.95 [+ or -] 0.85 ng/ml. The HIF-1[alpha] level was elevated significantly in HFrEF patients and deceased patients compared with HFpEF patients and patients who survived. The HIF-1[alpha] level was positively correlated with NT-proBNP and cardiac troponin T levels, and negatively correlated with left ventricular ejection fraction and systolic blood pressure. Kaplan-Meier curves revealed a significant increase in in-hospital mortality in ADHF patients with higher HIF-1[alpha] levels. Multivariable Cox regression analysis showed that HIF-1[alpha] levels were not correlated with the short-term prognosis of ADHF patients. Conclusions This is the first study to evaluate the circulating levels of HIF-1[alpha] in ADHF patients. Serum HIF-1[alpha] levels may reflect a serious state in patients with ADHF. Due to the limitations of the study, serum HIF-1[alpha] levels were not correlated with the in-hospital mortality based on regression analysis. Further studies are needed to demonstrate the diagnostic and/or prognostic role of HIF-1[alpha] as a risk biomarker in patients with ADHF. Keywords: Hypoxia-inducible factor 1[alpha], Acute decompensated heart failure, N-terminal-pro-brain natriuretic peptide, In-hospital mortality