Clinical ResearchCeramide Is Upregulated and Associated With Mortality in Patients With Chronic Heart Failure
Section snippets
Study subjects and data collection
The study was carried out between 2008 and 2013, and we consecutively recruited patients from the Department of Cardiovascular Medicine of Xiangya Hospital, Changsha, China with symptoms of heart failure (HF), aged ≥18 years, and with a left ventricular ejection fraction (LVEF) of ≤50%. During the next observation period of at least 3 months after hospital discharge, patients were excluded from the present study if they clinically deteriorated and needed to change medication regimens. Finally,
Results
One hundred four healthy individuals and 423 patients with CHF and reduced left ventricular systolic function were enrolled. All patients in this study were receiving standard medical treatment during a mean follow-up period of 4.4 years (interquartile range, 3.5-5.3 years).
Discussion
To our knowledge, this study shows for the first time, that ceramide levels are increased and associated with NYHA functional classes in patients with CHF and reduced left ventricular function. Furthermore, this study revealed the prognostic value of plasma ceramide levels as a predictor of mortality in patients with CHF, and the potential use of ceramide to improve prognostic discrimination and risk reclassification beyond other parameters.
Several studies have revealed the relationship between
Conclusions
Plasma ceramide was upregulated and correlated with severity in a large cohort of Chinese patients with CHF and reduced left ventricular function. Ceramide level in plasma is an independent risk factor of mortality in patients with CHF, and can provide additional predictive value after conventional risk assessment.
Acknowledgements
Jingjia Yu and Wei Pan contributed equally to this work.
The authors thank the staff of the Department of Cardiovascular Disease of Xiangya Hospital for their assistance with enrolling patients and sample collection.
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2022, Pharmacology and TherapeuticsCitation Excerpt :The accumulation of ceramide drives apoptosis and myocardial hypertrophy (Drosatos, 2016; Rodríguez-Calvo et al., 2007; Yaguchi, Nagashima, Izumi, & Okamoto, 2003; Zhou et al., 2000). Cardiomyocyte ceramide is markedly elevated in the failing right ventricles of humans with pulmonary hypertension, and plasma ceramide levels correlate with both severity and mortality in patients with heart failure (Brittain et al., 2016; Yu et al., 2015). Ceramides derived from adipose tissue have also been shown to be modifiable regulators of vascular redox state in obese humans, and are tied to an increase in cardiac mortality in patients with advanced atherosclerosis (Akawi et al., 2021).
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