Key result
High serum activin A levels (>435 pg/mL) were significantly associated with an increased risk of new-onset heart failure or death within 3 years (OR 8.16) compared to low levels (<305 pg/mL).
Why the study?
Activin A is involved in inflammation and myocardial fibrosis, but its relationship with diastolic dysfunction remained unclear.
Does elevated serum Activin A correlate with the incidence of diastolic dysfunction and heart failure in patients with preserved ejection fraction?
Cohort (n=209)
No
Does elevated serum Activin A correlate with the incidence of diastolic dysfunction and heart failure in patients with preserved ejection fraction?
Odds Ratio: 8.16 (95% CI 1.59–42.01)
Absolute Event Rate: 27.1% vs 2.9%
p-value: p=0.012
May support activin A for HF risk stratification; leaves open causality and needs prospective validation.
BACKGROUND: Diastolic dysfunction (DD) is a characteristic of heart failure with preserved ejection fraction (HFpEF), which is thought to be caused by cardiac hypertrophy or fibrosis. Activin A is involved in the inflammatory response and myocardial fibrosis, but the relationship between the activin A level and DD remains unclear. METHODS AND RESULTS: A total of 209 patients with stable angina were enrolled. Serum activin A levels were assessed, and echocardiography and cross-sectional analysis were performed. Among the subjects (65% male; mean age, 70±13 years), 84 (40%) subjects had DD. The subjects were divided into tertiles based on activin A levels. Patients in the high activin A group had enhanced left ventricular mass indexes, medial E/e' ratios, left atrial diameter, and right ventricular systolic pressure compared with those in the lower activin A groups (all P<0.001). Prevalence of DD (P=0.001), HFpEF at enrollment (P=0.007), and the composite endpoints including new-onset heart failure (HF) or death within 3 years (P<0.001) correlated positively with high activin A levels. After adjusting for confounding factors, high activin A levels remained significantly associated with DD (P=0.036) and the composite endpoints (P=0.012). CONCLUSIONS: Enhanced serum activin A levels were associated with the incidence of DD and development of HF.
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Tsai et al. (2019) conducted a cohort in Stable angina with preserved ejection fraction (n=209). High serum activin A levels (>435 pg/mL) vs. Low serum activin A levels (<305 pg/mL) was evaluated on Composite of new-onset heart failure or death within 3 years (OR 8.16, 95% CI 1.59-42.01, p=0.012). High serum activin A levels (>435 pg/mL) were significantly associated with an increased risk of new-onset heart failure or death within 3 years (OR 8.16) compared to low levels (<305 pg/mL).
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