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Canadian Journal of Cardiology

Clinical Significance of Circulating Cardiomyocyte-Specific Cell-Free DNA in Patients With Heart Failure: A Proof-of-Concept Study

Published:October 19, 2019DOI:https://doi.org/10.1016/j.cjca.2019.10.016

      Abstract

      We investigated clinical significance of cell-free DNA (cfDNA) in heart failure. This study enrolled 32 heart failure patients and 28 control subjects. Total cfDNA levels were not different between groups (P = 0.343). Bisulfite-digital polymerase chain reaction using the unmethylated FAM101A locus demonstrated that cardiomyocyte-specific cfDNA was significantly elevated in heart failure patients compared with control subjects (median 0.99 [interquartile range 0.77-1.98] vs 0 [0-0.91] copies/mL; P = 0.003). Cardiomyocyte-specific cfDNA significantly discriminated heart failure patients from control subjects (area under the receiver operating characteristic curve, 0.716; P = 0.003) and was positively correlated with troponin I (r = 0.438; P = 0.003) but not with B-type natriuretic peptide (r = 0.275; P = 0.058). cfDNA may be a novel biomarker to measure cardiomyocyte death in heart failure.

      Résumé

      Nous avons étudié l’importance clinique de l’ADN acellulaire (ADNa) dans l’insuffisance cardiaque chez 32 patients présentant une insuffisance cardiaque et 28 sujets témoins. Les concentrations totales en ADNa ne différaient pas entre les groupes (p = 0,343). L’analyse par réaction de polymérisation en chaîne (PCR) numérique au bisulfite ciblant le locus non méthylé FAM101A a démontré que l’ADNa issu de cardiomyocytes était significativement plus élevé chez les patients présentant une insuffisance cardiaque que chez les sujets témoins (médiane de 0,99 [intervalle écart : 0,77-1,98] vs 0 [0-0,91] copies/ml; p = 0,003). L’ADNa de cardiomyocytes a permis de différencier de manière significative les patients présentant une insuffisance cardiaque des sujets témoins (aire sous la courbe ROC [receiver operating characteristic] : 0,716; p = 0,003) et était corrélé positivement avec le taux de troponine I (r = 0,438; p = 0,003), mais pas avec le taux du peptide natriurétique de type B (r = 0,275; p = 0,058). L’ADNa pourrait servir de nouveau biomarqueur pour mesurer la mort des cardiomyocytes chez les patients présentant une insuffisance cardiaque.
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      Linked Article

      • Cardiomyocyte-Specific Cell-Free DNA as a Heart Failure Biomarker?
        Canadian Journal of CardiologyVol. 36Issue 6
        • Preview
          Despite significant advances in the management of heart failure, this disease remains a main cause of mortality and disability. Heart failure affects 1%-2% of the adult population in developed countries and this prevalence rises to more than 10% after 70 years of age.1 Owing to the ageing of the population, the prevalence of heart failure is expected to continue to increase. The health care costs of heart failure also show a continuing rise and represent a significant burden for society.2 Overall, heart failure is a serious public health issue which requires efforts from the research community to develop new drugs and biomarkers to allow movement toward personalized health care.
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