Detection of Soluble ED-A+Fibronectin and Evaluation as Novel Serum Biomarker for Cardiac Tissue Remodeling

Abstract

Background and Aims. Fibronectin containing the extra domain A (ED-A+Fn) was proven to serve as a valuable biomarker for cardiac remodeling. The study was aimed at establishing an ELISA to determine ED-A+Fn in serum of heart failure patients.Methods. ED-A+Fn was quantified in serum samples from 114 heart failure patients due to ischemic (ICM,n=44) and dilated (DCM,n=39) cardiomyopathy as well as hypertensive heart disease (HHD,n=31) compared to healthy controls (n=12).Results. In comparison to healthy volunteers, heart failure patients showed significantly increased levels of ED-A+Fn (p<0.001). In particular in ICM patients there were significant associations between ED-A+Fn serum levels and clinical parameters, for example, increased levels with rising NYHA class (p=0.013), a negative correlation with left ventricular ejection fraction (p=0.026,r: −0.353), a positive correlation with left atrial diameter (p=0.008,r: 0.431), and a strong positive correlation with systolic pulmonary artery pressure (p=0.002,r: 0.485). In multivariate analysis, ED-A+Fn was identified as an independent predictor of an ischemic heart failure etiology.Conclusions. The current study could clearly show that ED-A+Fn is a promising biomarker in cardiovascular diseases, especially in heart failure patients due to an ICM. We presented a valid ELISA method, which could be applied for further studies investigating the value of ED-A+Fn.