Impact of Plasma Kynurenine Level on Functional Capacity and Outcome in Heart Failure - Results From Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF).

Konishi, Masaaki; Ebner, Nicole; Springer, Jochen; Schefold, Joerg C.; Doehner, Wolfram; Dschietzig, Thomas Bernd; Anker, Stefan D; von Haehling, Stephan (2016). Impact of Plasma Kynurenine Level on Functional Capacity and Outcome in Heart Failure - Results From Studies Investigating Co-morbidities Aggravating Heart Failure (SICA-HF). Circulation journal, 81(1), pp. 52-61. Japanese Circulation Society 10.1253/circj.CJ-16-0791

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BACKGROUND Kynurenine is a circulating metabolite from the essential amino acid tryptophan. Accelerated degradation of kynurenine in skeletal muscle has been reported to provide an anti-inflammatory effect. The aim of this study was to investigate the association between blood kynurenine and muscle mass/function in patients with heart failure (HF), in whom diseased muscle mass/function plays a pathophysiological role.Methods and Results:Plasma kynurenine was assessed in 249 patients with HF (67±11 years, 21% women) and in 45 controls from the SICA-HF study. Kynurenine was higher in 173 HF patients with reduced ejection fraction (EF) and in 76 patients with preserved EF than controls (3.5±1.5, 3.4±1.3, and 2.4±1.1 μmol/L, P<0.001). In HF patients, kynurenine had an inverse association with handgrip strength (r=-0.26, P<0.01), peak oxygen consumption (r=-0.29, P<0.01), 6-min walk distance (r=-0.23, P<0.01), and had a positive association with kidney and liver function parameters. No correlation was observed between kynurenine and lean mass. On multivariable linear regression analysis, a significant association was noted between kynurenine and peak oxygen consumption even after adjustment for age, gender, BMI, and hemoglobin (β=-0.23, P<0.001). Patients with higher kynurenine were at higher risk of death (adjusted HR, 1.46 per 1 μmol/L, P<0.01). CONCLUSIONS In stable HF patients, plasma kynurenine was inversely correlated with muscle strength and functional capacity as well as with liver and kidney function.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Schefold, Joerg C.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1346-9843

Publisher:

Japanese Circulation Society

Language:

English

Submitter:

Mirella Aeberhard

Date Deposited:

09 Jan 2017 14:08

Last Modified:

09 Jan 2017 14:08

Publisher DOI:

10.1253/circj.CJ-16-0791

PubMed ID:

27904018

BORIS DOI:

10.7892/boris.92560

URI:

https://boris.unibe.ch/id/eprint/92560

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