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Open access

Cerasela Mihaela Goidescu, Florin Petru Anton, Daniel Corneliu Leucuța, Petru Adrian Mircea and Luminița Animarie Vida-Simiti

Abstract

Background: Apelin is a potent endogenous inotropic peptide with a major role in counteracting the aldosterone and angiotensin II and their negative effects on the cardiovascular system. The exact role of apelin in the patho-physiology of this disease is not well understood. We aimed to investigate the possible associations of apelin-13 with clinical and paraclinical characteristics in HF patients as well as studying its dynamics during the course of the heart failure.

Method: We performed a prospective observational cohort single-center study. We compared the baseline serum levels of apelin-13 and NT-proBNP level in 53 heart failure patients (acute heart failure, chronic compensated heart failure and chronic decompensated heart failure). We divided the patients according to the apelin-13 level: above and below the median, and we analyzed the relationship between serum apelin-13 and the clinical, echocardiographic, electrocardiographic and biological parameters. Twenty patients were followed-up (after an average time interval of 9 months), investigating the same parameters.

Results: The median of apelin-13 was 495pg/mL (IQR 276-845pg/mL). We found strong, negative correlation between the serum levels of apelin-13 and NT-proBNP (Spearman rho= −0.83, p<0.001). For the reassessed patients the median apelin level was significantly higher at follow-up (460 pg/mL, IQR 342-871 pg/mL) as compared with the baseline level (395 pg/mL, IQR 270-603 pg/mL), p=0.019, and maintained the negative correlation with NT-proBNP level (Spearman’s rho −0.7, p<0.001. The Low Apelin-13 group have higher NT-proBNP levels and also contains all the patients in NYHA IV class heart failure, 71% of the acute HF patients, and 7 of 8 patients who died before follow-up.

Conclusion: Apelin-13 was negatively correlated with NT-proBNP. The Low Apelin-13 group contained the majority of the patients with a negative outcome (death before follow-up), most of the patients who presented with acute HF and all the patients in NYHA IV class.

Open access

Dana Mihaela Ciobanu, Cornelia Gabriela Bala, Ioan Andrei Veresiu, Petru Adrian Mircea and Gabriela Roman

Abstract

Background and Aim: Type 2 diabetes (T2DM) has been associated with hypertension (HTN) and elevated high-sensitivity C-reactive protein (hsCRP), but the possible implication of blood pressure (BP) variability in increasing hsCRP in T2DM are incompletely understood. We aimed to assess the association between hsCRP and BP variability during 24-hour ambulatory BP monitoring in T2DM and healthy control subjects.

Material and Method: The cross-sectional study included data from T2DM patients with normal BP (n=9), controlled HTN (n=46), uncontrolled HTN (n=20), and healthy controls (n=11). HsCRP was assessed using ELISA technique. All subjects underwent 24-hour ambulatory BP monitoring; BP variability was calculated using standard deviation.

Results: We found that hsCRP was associated with daytime and 24-hours systolic and diastolic BP variability. Higher hsCRP were observed in T2DM patients with uncontrolled HTN and high BP variability compared to the other three groups. In multiple regression analysis, hsCRP was predicted by daytime and 24-hour diastolic BP variability.

Conclusions: Our findings suggest that high hsCRP was associated with increased ambulatory BP variability in T2DM and control subjects. The contribution of both hsCRP and BP variability to cardiovascular risk stratification in T2DM needs to be evaluated in prospective studies.