ArticleCureus2025
The Role of Myocardial Fibrosis and Bioenergetic Dysfunction in Heart Failure Prognosis: A Study Protocol.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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10 authors.
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Abstract
Introduction The blockage of the renin-angiotensin-aldosterone and sympathetic nervous systems is fundamental in heart failure (HF) treatment; nonetheless, other mechanisms related to myocardial fibrosis and bioenergetic dysfunction also have a relevant role in the genesis and progression of this syndrome. We aim to stratify the short-term outcome of patients hospitalized with acute decompensated heart failure (ADHF) in New York Heart Association (NYHA) class III or IV based on myocardial fibrosis biomarkers galectin-3 (Gal-3), suppression of tumorigenicity 2 (ST2) and growth differentiation factor15 (GDF-15), and bioenergetic dysfunction markers (absolute iron deficiency and functional iron deficiency). Secondary endpoints were evaluation of short-term prognosis through early HF readmission and all-cause mortality (up to 90 days after hospital discharge), annual heart failure readmission and all-cause mortality, and annual risk for major adverse cardiovascular events (MACE), namely fatal and non-fatal stroke and fatal and non-fatal myocardial infarction, and cardiorenal syndrome. Material and methods This cohort prospective observational unicentric study had two arms (left ventricular ejection fraction (LVEF)> 40% and ≤ 40%). A total of 128 participants were included, with 64 per group. Gal-3, ST2, and GDF-15 will be assessed in vitroin serum and plasma, and iron kinetics will be evaluated in plasma. Kaplan-Meier survival estimates will be calculated for each endpoint. A univariate Cox propor-tional hazards model will be performed to achieve hazard ratios and 95% confidence intervals for each variable. Results We expect to establish a relation between high values of fibrosis biomarkers, absolute and functional iron deficiency, and impaired short-term outcome in patients admitted due to ADHF. Conclusions This study may yield knowledge regarding the role of myocardial fibrosis and bioenergetic dysfunction in HF short-term prognosis.
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