o:1698 Analiza biomarkera miokardnog remodelovanja i njihov značaj u proceni kliničkih parametara kod pacijenata sa hroničnom srčanom slabošću The analysis of cardiac remodeling biomarkers and their significance in the assesment of clinical parameters in patients with chronic heart failure : doctoral dissertation sr Introduction. Heart failure (HF) is a heterogeneous clinical syndrome characterized by signs and symptoms caused by structural and/or functional cardiac abnormalities, resulting in reduced cardiac output or elevated intracardiac pressures during stress or rest. Cardiac remodeling biomarkers which are currently supported with relevant evidence regarding their monitoring and prognostic accuracy in chronic HF include: the soluble suppressor of tumorigenicity 2 (sST2), galectin-3, growth differentiation factor (GDF)-15 and syndecan-1. Aim of the study. We established new objectives: by reflecting different pathophysiological processes in the course of HF progression, our hypothesis was that concentrations of cardiac remodeling biomarkers (sST2, galectin-3, GDF-15, syndecan-1) and BNP may vary significantly according to patients` classification based on the left ventricular ejection fraction (LVEF). Afterwards, we sought to assess the possible correlations of these biomarkers with relevant clinical, laboratory, and echocardiographic characteristics in the HF subgroups with: reduced, mid-range and preserved ejection fraction. Finally, we wanted to establish which biomarkers may be considered as predictors (independent and after multivariable adjustments) of changes in different clinical and echocardiographic parameters. Patients and methods. This cross-sectional, single-center study was conducted at the Institute for Treatment and Rehabilitation „Niska Banja”, Niska Banja, and included 77 patients previously diagnosed with chronic heart failure, regardless of etiology. The diagnosis of HF was clinically confirmed according to current ESC 2016 guidelines. All patients underwent complete medical history assessment, physical examination, standard 12-lead electrocardiography, blood sampling, echocardiography and exercise stress test and afterwards the results were analyzed according to the stratification based on the ejection fraction category. Results. We found that plasma concentrations of four cardiac remodeling biomarkers were highest in HFrEF and lowest in HFpEF, p<0.001. In HFpEF, remodeling biomarkers independently correlated with LVMI: sST2 (p=0.002), galectin-3 (p<0.001), GDF-15 (p=0.011), syndecan-1 (p=0.006), whereas galectin-3 correlated after multivariable adjustments (p=0.001). Independent correlates of septum/posterior wall diameters, in HFpEF, were: sST2 (p=0.019; p=0.026), galectin-3 (p=0.011; p=0.009), GDF-15 (p=0.007; p=0.001), syndecan-1 (p=0.005; p=0.002). In HFrEF, only sST2, adjusted, correlated with LVMI (p=0.010), whereas BNP independently correlated with LVMI (p=0.002), and EF (p=0.001). GDF-15 correlated with diastolic dysfunction in HFpEF (p=0.046) and HFrEF (p=0.024). Conclusion. Cardiac remodeling biomarkers may be potential circulating markers of LV hypertrophy in HFpEF, which may help initiate the timely recognition of high-risk patients for disease progression. Beleška o autoru: list 160;Bibliografija: listovi 138-152. Datum odbrane: 30.10.2020. Pathophysiology 27723529 91552101 8112 91552100 27723529 2021-05-06T09:38:42.053Z 45 no 46 mentor Valentina T. 1977- Mitić 2020 63 mentor Dijana- 1976 Stojanović 2020 63 predsednik komisije Vladmila Bojanić 2020 63 član komisije Dijana Stojanović 2020 63 član komisije Marina Deljanin-Ilić 2020 63 član komisije Gordana Kocić 2020 63 član komisije Branko Beleslin 2020 160 listova 3313425 http://phaidrabg.bg.ac.rs/o:1698 no yes 4 2021-05-06T09:38:42.320Z 70 BNP, EF, galektin-3, GDF-15, sindekan-1, sST2,srčana insuficijencija sa očuvanom EF, srčana insuficijencija sa graničnom EF, srčana insuficijencija sa redukovanom EF BNP, ejection fraction, galectin-3, GDF-15, HFpEF, HFmrEF, HFrEF, sST2, syndekan-1 616.12-008.46-036.1-074(043.3) B 530 1738 18A05 2020