Journal of cardiac failure, 23 4 2025, Pages S1071-9164(25)00236-2 The Association between Serially Measured Circulating Biomarker Patterns and Pulmonary Artery Pressures measured by Invasive Hemodynamic Monitoring. de Jong MBL, Allach Y, Kamar SA, Clephas PRD, Brunner-La Rocca HP, Handoko ML, van de Halm VP, Kok WEM, Asselbergs FW, van Kimmenade R, Beeres SLMA, Rienstra M, Szymanski MK, de Boer RA, Kardys I, Brugts JJ
Aims
Invasive hemodynamic monitoring devices provide relevant insights into the remote hemodynamic status of heart failure (HF) patients. Additionally, circulating biomarkers have been advocated as additive in HF management by offering prognostic information and therapeutic targets. However, limited data exist correlating serially measured biomarkers to hemodynamic pressures provided by invasive sensors. This study aims to investigate the association between serial biomarker patterns and pulmonary artery (PA) pressure dynamics in HF patients.
Methods and results
This study is a sub study of the MONITOR-HF trial (NTR7673), a prospective investigator-initiated multicenter randomized clinical trial conducted in chronic HF (CHF) patients. Blood samples were collected at baseline and 3, 6 and 12 months follow up, and 92 proteins (OLINK CV-III panel) were measured. The primary endpoint was the average mean PA pressure (mPAP) during the week preceding blood sample collection, in patients who received an invasive PA pressure sensor. Linear mixed models were used to evaluate the association between serial biomarker levels and mPAP, adjusting for sex and age, and correcting for multiple testing. This study included 165 patients who had a median age of 68 [IQR 61 - 75] years and were predominantly male (78%). Fifteen biomarkers were significantly associated with the 7-day average mPAP, with thirteen biomarkers maintaining consistent associations across different lag-times. The strongest associations were found between mPAP and N-terminal pro b-type natriuretic peptide (NT-proBNP), pulmonary surfactant protein D (PSP-D), insulin like growth factor binding protein 7 (IGFBP-7) and matrix metalloproteinase-2 (MMP-2).
Conclusion
We found a consistent association between invasive hemodynamic pressures and thirteen serially measured blood biomarkers in CHF patients. These results, which use unique information obtained from PA pressure sensors, could deepen the understanding and therapy guidance of congestive HF.
