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Plasma somatostatin in advanced heart failure: association with cardiac filling pressures and outcome

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@article{8269c1db04b649919a82322d187036a7,
title = "Plasma somatostatin in advanced heart failure: association with cardiac filling pressures and outcome",
abstract = "BACKGROUND: Somatostatin inhibits intestinal motility and hormonal secretion and is a potent arterial vasoconstrictor of the splanchnic blood flow. It is unknown if somatostatin concentrations are associated with central hemodynamic measurements in patients with advanced heart failure (HF).METHODS: A prospective study of HF patients with a left ventricular ejection fraction (LVEF) <45% referred to right heart catheterization (RHC) for evaluation for heart transplantation (HTX) or left ventricular assist device (LVAD).RESULTS: Fifty-three patients were included with mean LVEF 18 ± 8% and majority in NYHA-class III-IV (79%). Median plasma somatostatin concentration was 18 pmol/L. In univariable regression analysis, log(somatostatin) was associated with increased central venous pressure (CVP; r2 = 0.14, p = 0.003) and a reduced cardiac index (CI; r2 = 0.15, p = 0.004). When adjusted for selected clinical variables (age, gender, LVEF, eGFR and BMI), log(somatostatin) remained a significant predictor of CVP (p = 0.044). Increased somatostatin concentrations predicted mortality in multivariable models (hazard ratio: 5.2 [1.2-22.2], p = 0.026) but not the combined endpoint of death, LVAD implantation or HTX.CONCLUSIONS: Somatostatin concentrations were associated with CVP and CI in patients with HF. The pathophysiological mechanism may be related to congestion and/or hypoperfusion of the intestine. Somatostatin was an independent predictor of mortality in advanced HF.",
keywords = "Heart failure, Gastrointestinal function, Right heart catheterization, Hemodynamics, Somatostatin",
author = "Tania Deis and Louise Balling and Kasper Rossing and S{\o}ren Boesgaard and Kistorp, {Caroline Michaela} and Emil Wolsk and G{\o}tze, {Jens Peter} and Rehfeld, {Jens Federik} and Finn Gustafsson",
note = "{\textcopyright} 2020 S. Karger AG, Basel.",
year = "2020",
month = dec,
doi = "10.1159/000510284",
language = "English",
volume = "145",
pages = "769--778",
journal = "HeartDrug",
issn = "0008-6312",
publisher = "S./Karger AG",
number = "12",

}

RIS

TY - JOUR

T1 - Plasma somatostatin in advanced heart failure

T2 - association with cardiac filling pressures and outcome

AU - Deis, Tania

AU - Balling, Louise

AU - Rossing, Kasper

AU - Boesgaard, Søren

AU - Kistorp, Caroline Michaela

AU - Wolsk, Emil

AU - Gøtze, Jens Peter

AU - Rehfeld, Jens Federik

AU - Gustafsson, Finn

N1 - © 2020 S. Karger AG, Basel.

PY - 2020/12

Y1 - 2020/12

N2 - BACKGROUND: Somatostatin inhibits intestinal motility and hormonal secretion and is a potent arterial vasoconstrictor of the splanchnic blood flow. It is unknown if somatostatin concentrations are associated with central hemodynamic measurements in patients with advanced heart failure (HF).METHODS: A prospective study of HF patients with a left ventricular ejection fraction (LVEF) <45% referred to right heart catheterization (RHC) for evaluation for heart transplantation (HTX) or left ventricular assist device (LVAD).RESULTS: Fifty-three patients were included with mean LVEF 18 ± 8% and majority in NYHA-class III-IV (79%). Median plasma somatostatin concentration was 18 pmol/L. In univariable regression analysis, log(somatostatin) was associated with increased central venous pressure (CVP; r2 = 0.14, p = 0.003) and a reduced cardiac index (CI; r2 = 0.15, p = 0.004). When adjusted for selected clinical variables (age, gender, LVEF, eGFR and BMI), log(somatostatin) remained a significant predictor of CVP (p = 0.044). Increased somatostatin concentrations predicted mortality in multivariable models (hazard ratio: 5.2 [1.2-22.2], p = 0.026) but not the combined endpoint of death, LVAD implantation or HTX.CONCLUSIONS: Somatostatin concentrations were associated with CVP and CI in patients with HF. The pathophysiological mechanism may be related to congestion and/or hypoperfusion of the intestine. Somatostatin was an independent predictor of mortality in advanced HF.

AB - BACKGROUND: Somatostatin inhibits intestinal motility and hormonal secretion and is a potent arterial vasoconstrictor of the splanchnic blood flow. It is unknown if somatostatin concentrations are associated with central hemodynamic measurements in patients with advanced heart failure (HF).METHODS: A prospective study of HF patients with a left ventricular ejection fraction (LVEF) <45% referred to right heart catheterization (RHC) for evaluation for heart transplantation (HTX) or left ventricular assist device (LVAD).RESULTS: Fifty-three patients were included with mean LVEF 18 ± 8% and majority in NYHA-class III-IV (79%). Median plasma somatostatin concentration was 18 pmol/L. In univariable regression analysis, log(somatostatin) was associated with increased central venous pressure (CVP; r2 = 0.14, p = 0.003) and a reduced cardiac index (CI; r2 = 0.15, p = 0.004). When adjusted for selected clinical variables (age, gender, LVEF, eGFR and BMI), log(somatostatin) remained a significant predictor of CVP (p = 0.044). Increased somatostatin concentrations predicted mortality in multivariable models (hazard ratio: 5.2 [1.2-22.2], p = 0.026) but not the combined endpoint of death, LVAD implantation or HTX.CONCLUSIONS: Somatostatin concentrations were associated with CVP and CI in patients with HF. The pathophysiological mechanism may be related to congestion and/or hypoperfusion of the intestine. Somatostatin was an independent predictor of mortality in advanced HF.

KW - Heart failure

KW - Gastrointestinal function

KW - Right heart catheterization

KW - Hemodynamics

KW - Somatostatin

U2 - 10.1159/000510284

DO - 10.1159/000510284

M3 - Journal article

C2 - 33027795

VL - 145

SP - 769

EP - 778

JO - HeartDrug

JF - HeartDrug

SN - 0008-6312

IS - 12

ER -

ID: 61389471