Blood gene differential expression of heart failure patients with systemic iron deficiency: pathways and impact on clinical outcomes
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ABSTRACT: Background: a considerable numeer of patients with heart failure (HF) present systemic iron deficiency (ID), which is related with worse prognosis and a significant decline in quality of life. The mechanisms that underlay the crosstatlk between myocardial performance, neurohormonal activation and heart metabolism are still to be uncovered. Nonetheless, previous experimental studies have already revealed the potential links between iron, mitochondrial metabolism and heart function. Objectives: The present research attempts to investigate the mechanisms that link HF and ID and to identify potential biomarkers of disease prognosis by determning the gene expression pattern through mRNA transcriptome and PCR analyses. Results: The transcriptome of a first cohort of HF patients was analysed according to the presence of ID, underscoring 1128 overexpressed transcripts in patients with iron dysregulation, which permitted to identify 22 genes involved in biological pathways that could be related to HF and the cellular iron regulation and metabolism. From these 22 selected genes, 6 were found differentially expressed by PCR in a new wider cohort of patients, and comprehensive statistical studies identifying specific genetic patterns in three genes that correlate with prognostic outcomes. Briefly, a genetic expression pattern of the smal integral membrane protein 20 and the sirtuin 7 towards decreased expression (higher Δct) was significantly associated with an increased risk of death and the combined end-point of death and HF hospitalization and the composite. Similarly, the intermediate Δct gene expression pattern of mitochondrial ferritin was also associated of both of previous determined outcomes. Conclusions: Patients with HF present different standards of gene expression according to systemic iron status that involve paramount myocardial metabolic pathways implicated in myocardial function and correlate with prognosis. The study highlights the importance of iron regulation in the comprehensive approach to the treatment of myocardial disease.
ORGANISM(S): Homo sapiens
PROVIDER: GSE175739 | GEO | 2021/11/17
REPOSITORIES: GEO
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