Key result
Patients with heart failure with preserved ejection fraction had significantly higher plasma vWF levels (15.43 ng/mL) compared to non-heart failure patients (13.24 ng/mL) and healthy controls (10.28 ng/mL).
Why the study?
HFpEF is associated with endothelial damage and inflammation, and von Willebrand factor is a biomarker of endothelial dysfunction, prompting investigation into their association.
Are elevated von Willebrand factor (vWF) levels associated with HFpEF and correlated with inflammatory markers?
Observational (n=272)
No
Are elevated von Willebrand factor (vWF) levels associated with HFpEF and correlated with inflammatory markers?
Absolute Event Rate: 15.43% vs 13.24%
p-value: p=<0.001
Elevated von Willebrand factor (vWF) levels are associated with HFpEF severity and positively correlate with inflammatory markers, suggesting a role for endothelial dysfunction in HFpEF pathogenesis.
Elevated vWF may mark endothelial dysfunction in HFpEF; hypothesis-generating for biomarker and therapeutic studies.
Heart failure with preserved ejection fraction (HFpEF) is associated with endothelial damage and inflammation. In addition, von Willebrand factor (vWF) has been discovered as a biomarker of endothelial dysfunction. Therefore, the study aims to investigate the association between vWF level and HFpEF. Moreover, we analyzed a potential correlation between vWF and inflammatory factors, such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and interleukin (IL)-6. We recruited altogether 272 hospitalized patients from The Fifth Affiliated Hospital of Xinjiang Medical University, 88 of whom were HFpEF patients, 88 were non-heart failure patients, and 96 were healthy controls from the medical examination center of the hospital. Enzyme-linked immunosorbent assay and double antibody sandwich immunochromatography were used for testing vWF, tissue plasminogen activator, galectin-3, nitric oxide, TNF-α, IL-6, and CRP. The HFpEF group's levels of vWF, IL-6, TNF-α, CRP, tissue plasminogen activator, galectin-3, and nitric oxide were statistically higher than those of non-heart failure and healthy control ones (F = 403.563, 21.825, 20.678, 39.609, 35.411, 86.407, 74.605; all P = .000). the highest level of vWF was observed in class IV (New York Heart Association) of HFpEF patients and the significant difference is <.05 (P < .001). An increasing level of vWF were shown in groups (CRP: CRP >3 mg/L group and CRP ≤3 mg/L group; IL-6: IL-6 <7.0 pg/mL group and IL-6 ≥7.0 pg/mL group; TNF-α: TNF-α <5.5 pg/mL group and TNF-α ≥5.5 pg/mL group) with higher level of IL-6, TNF-α, CRP. A multiple regression analysis regarding the relationship of vWF and inflammation markers was performed among the HFpEF patients. Further, statistical significance of the analysis remained after adjusting variables such as body mass index, low-density lipoprotein cholesterol, total cholesterol, coronary artery disease, and type 2 diabetes mellitus (β = 0.406, t = 4.579, P < .001; β = 0.323, t = 3.218, P < .001; β = 0.581, t = 6.922, P < .001). Our study shows that elevated vWF levels are associated with HFpEF, and it may serve as a potential biomarker for HFpEF severity. We also found that increased vWF levels are positively correlated to IL-6, TNF-α, and CRP, which may provide a clue for further researching the pathogenesis of HFpEF.
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Abudoukelimu et al. (2022) conducted an observational in Heart failure with preserved ejection fraction (HFpEF) (n=272). Heart failure with preserved ejection fraction (HFpEF) vs. Non-heart failure patients and healthy controls was evaluated on Plasma von Willebrand factor (vWF) levels (ng/mL) (p=<0.001). Patients with heart failure with preserved ejection fraction had significantly higher plasma vWF levels (15.43 ng/mL) compared to non-heart failure patients (13.24 ng/mL) and healthy controls (10.28 ng/mL).