Why the study?
The study was conducted to investigate the potential predictive value of irisin for improved left ventricular ejection fraction in discharged patients with known HFrEF.
Do elevated serum irisin levels predict improved left ventricular ejection fraction in patients discharged with HFrEF?
Do elevated serum irisin levels predict improved left ventricular ejection fraction in patients discharged with HFrEF?
Elevated baseline serum irisin levels (≥ 10.8 ng/mL) independently predict improvement in left ventricular ejection fraction at 3 months in patients discharged with HFrEF.
Irisin may support HFimpEF risk stratification in HFrEF; leaves open clinical adoption pending prospective validation.
Background: The purpose of the study is to investigate a possible predictive value of irisin for improved left ventricular (LV) ejection fraction (EF) in discharged patients with known heart failure with reduced ejection fraction (HFrEF). Methods: We included in the study 313 patients who were discharged with HFrEF (at admission, LVEF ≤ 40%) and monitored for 3 months. HF with improved LVEF (HFimpEF) was characterized as a >40% increase in LVEF on transthoracic B-mode echocardiography within 3 months of follow-up. Circulating biomarkers including NT-proBNP and irisin were detected at baseline and after 3 months of observation. By the third month, 117 (37.4%) patients had HFimpEF, whereas 196 individuals were categorized as having persistent HFrEF. Results: We found that HFimpEF was related to lower LV end-diastolic dimensions and concentrations of NT-proBNP and higher left atrial volume index (LAVI) and irisin concentrations than those with persistent HFrEF. The most balanced cut-offs of irisin and NT-proBNP concentrations (improved LVEF versus non-improved LVEF) were 10.8 ng/mL and 1540 pmol/L, respectively. Multivariate regression analysis showed that atrial fibrillation (odds ratio [OR] = 0.95; p = 0.010), LAVI < 39 mL/m2 (OR = 1.23; p = 0.001), irisin levels ≥ 10.8 ng/mL (OR = 1.73; p = 0.001), and NT-proBNP < 1540 pmol/mL (OR = 1.47; p = 0.001) independently predicted HFimpEF. The discriminative ability of irisin ≥ 10.8 ng/mL was better than NT-proBNP < 1540 pmol/mL; the predictive ability of irisin alone was not improved by the combined model (irisin added to NT-proBNP). Conclusions: serum irisin ≥ 10.8 ng/mL predicted HFimpEF independently of natriuretic peptide in HFrEF patients.
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Berezin et al. (2025) studied this question.
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