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Monocyte subsets distribution predicts mortality in patients with acute heart failure

Session Poster Session 4

Speaker Konstantin A Krychtiuk

Event : Heart Failure 2018

  • Topic : heart failure
  • Sub-topic : Acute Heart Failure: Biomarkers
  • Session type : Poster Session

Authors : KA Krychtiuk (Vienna,AT), M Lenz (Vienna,AT), SP Kastl (Vienna,AT), K Huber (Vienna,AT), J Wojta (Vienna,AT), G Heinz (Vienna,AT), WS Speidl (Vienna,AT)

Authors:
KA Krychtiuk1 , M Lenz1 , SP Kastl1 , K Huber2 , J Wojta1 , G Heinz1 , WS Speidl1 , 1Medical University of Vienna, Department of Internal Medicine II, Division of Cardiology - Vienna - Austria , 2Wilhelminen Hospital, 3rd Department of Internal Medicine, Cardiology and Emergency Medicine - Vienna - Austria ,

Citation:

Background

The pathogenesis of acute heart failure (AHF) includes a strong activation of the innate immune system. Monocytes are a heterogenous cell population and act as key regulators of innate immunity. According to their surface expression pattern of CD14, CD16 and CCR-2 they can be distinguished into at least three cell populations, namely classical monocytes (CD14++CD16-; CM), intermediate monocytes (CD14++CD16+CCR2+; IM) and non-classical monocytes (CD14+CD16++CCR2-; NCM).

Purpose

The aim of this prospective, observational study was to analyze whether monocyte subset distribution is associated with 30-day survival in patients with AHF.

Methods

We included 81 patients with acute heart failure admitted to a cardiac ICU. Blood was taken at admission and after 72 hours and monocyte subset distribution was analyzed by flow cytometry.

Results

Median age was 64 IQR 50-74 years and 77.8 % of patients were male. Median NT-proBNP was 4896 IQR 1370-14008 pg/mL and 30-day mortality was 33.3%. Monocyte subset distribution at day 0 was not associated with mortality. In contrast, compared to 30-day survivors, patients that did not survive showed a significantly higher percentage of IM (4.2 IQR 2.1-7.7 % vs 7.7 3.9-12.4 %; p<0.05) and a lower percentage of CM (90.7 IQR 85.4-92.1 % vs. 87.2 IQR 79.2-89.0 %). Patients in the lowest tertile of CM showed a 8.9-fold increased mortality risk as compared to patients in the third tertile independent of age, sex, creatinine and NT-proBNP levels.

Conclusion

Monocyte subset distribution is associated with 30-day mortality in AHF patients requiring ICU admission. Thus, activation of the innate immune system may play a major role in the pathophysiology and outcome of this disease.

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