Nikolova AP, et al. - Researchers sought to ascertain whether a cardiac bridging integrator 1 (cBIN1)-derived score is an effective diagnostic biomarker of heart failure with preserved ejection fraction (HFpEF). Findings suggested the probability of plasma cBIN1 score (CS), a marker of transverse tubule dysfunction, to act as a biomarker of cardiomyocyte remodeling, having the potential to help in the diagnosis of HFpEF.

Methods

• Authors, in this cohort study, sought to determine the cBIN1 score (CS) from enzyme-linked immunoabsorbent assay–measured plasma cBIN1 concentrations from study participants in an ambulatory heart failure clinic at Cedars-Sinai Medical Center.
• They recruited consecutive patients with a confirmed diagnosis of heart failure with preserved ejection fraction (HFpEF; defined by a left ventricular ejection fraction ≥50%) from July 2014 to November 2015 and compared them with age-matched and sex-matched healthy volunteers with no known cardiovascular diagnoses and participants with risk factors for heart failure but no known HFpEF.
• They obtained the baseline characteristics and 1-year longitudinal clinical information through electronic medical records.
• They conducted data analysis from November 2016 to November 2017.
• Experts evaluated the ability of the CS and N-terminal pro-B-type natriuretic peptide (NT-proBNP) results to differentiate patients with HFpEF, healthy control participants, and control participants with risk factors for heart failure.
• Furthermore, the association of the CS with future cardiovascular hospitalizations was explored.

Results

• As per data, a total of 52 consecutive patients with a confirmed diagnosis of HFpEF were enrolled (mean [SD] age, 57 [15] years; 33 [63%] male).
• Findings suggested significantly higher CS values in the patients with HFpEF (median [interquartile range (IQR)], 1.85 [1.51-2.28]) than in the 2 control cohorts (healthy control participants: median [IQR], -0.03 [-0.48 to 0.41]; control participants with risk factors only: median [IQR], -0.08 [-0.75 to 0.42]; P < .001).
• Results demonstrated that, for patients with HFpEF, the CS outperforms NT-proBNP when the comparator group was either healthy control participants (CS: area under curve [AUC], 0.98 [95% CI, 0.96-1.00]; NT-proBNP level: AUC, 0.93 [95% CI, 0.88-0.99];P < .001) or those with risk factors (CS: AUC, 0.98 [95% CI, 0.97-1.00]; NT-proBNP: AUC, 0.93 [95% CI, 0.88-0.99];P < .001).
• Compared with patients with CS scores under 1.80, those with HFpEF with CS greater than or equal to 1.80 have a hazard ratio of 3.8 (95% CI, 1.3-11.2; P=.02) for hospitalizations; as revealed by Kaplan-Meier analysis of 1-year cardiovascular hospitalizations adjusted for age, sex, body mass index, and NT-proBNP levels.