Year
2020
Season
Spring
Paper Type
Master's Thesis
College
Brooks College of Health
Degree Name
Master of Science in Health Science (MSH)
Department
Clinical & Applied Movement Sciences
NACO controlled Corporate Body
University of North Florida. Department of Clinical & Applied Movement Sciences
First Advisor
Dr. James R. Churilla
Second Advisor
Dr. Michael R. Richardson
Third Advisor
Dr. Tammie M. Johnson
Fourth Advisor
Dr. Robert J. Chilton
Fifth Advisor
Dr. Clinton A. Brawner
Department Chair
Dr. James R. Churilla
College Dean
Dr. Curt L. Lox
Abstract
Purpose Examine the relationships between high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and soluble tumor necrosis factor-α receptor-1 (sTNF-R1) and the cumulative risk of heart failure with reduced (HFrEF) and preserved (HFpEF) ejection fractions in a diverse, population-based sample. Methods Study sample included 6,814 adult (45-84 years of age) men and women who participated in the Multi-Ethnic Study of Atherosclerosis and were free of cardiovascular disease at baseline. Cox regression was used to calculate the hazard ratios (HR) associated with elevated baseline hs-CRP (> 3-10 mg/L), IL-6 (> 75th percentile) and sTNF-R1 (> 75th percentile) and risk of overall HF, HFrEF (ejection fraction [EF] < 50%), and HFpEF (EF ≥ 50%). Results During ~11.2 years of follow-up there were 178 incident HF diagnoses. Elevated hs-CRP, IL-6 and sTNF-R1 were associated with a significant increased risk of HF overall (HR 1.76; 95% Confidence interval [CI] 1.22-2.52, HR 1.57; 95% 1.07-2.30, and HR 1.91; 95% CI 1.08-3.38, respectively). Elevated hs-CRP was a significant predictor in both HFrEF and HFpEF (HR 2.05; 95% CI 1.26-3.35, and HR 1.89; 95% CI 1.09-3.28, respectively). Baseline IL-6 concentrations were significantly associated with increased risk of HFrEF in nonsmokers only (HR 2.33; 95% CI 1.04-5.23) and of HFpEF in African Americans only (HR 5.89; 95% CI 1.52-22.80).Conclusions In a diverse sample of U.S. adults, elevated hs-CRP, IL-6 and sTNF-R1 were significant predictors of HF. Furthermore, both hs-CRP and IL-6 were significant predictors in HFrEF and HFpEF.
Suggested Citation
Stone, Michelle Lynne, "Biomarkers of Inflammation in Heart Failure Patients with Reduced and Preserved Ejection Fractions: Multi-Ethnic Study of Atherosclerosis" (2020). UNF Graduate Theses and Dissertations. 943.
https://digitalcommons.unf.edu/etd/943
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