Follistatin-Like 1 in Chronic Systolic Heart Failure: A Marker of Left Ventricular Remodeling
Open accessAbstract
BACKGROUND: Follistatin-like 1 (FSTL1) is an extracellular glycoprotein found in human serum. Recent work suggests that FSTL1 is secreted in response to ischemic injuries and that its overexpression is protective in the heart and vasculature. METHODS AND RESULTS: We examined serum FSTL1 levels in patients with chronic heart failure with left ventricular (LV) ejection fraction <40% (n=86). The sample was separated into three tertiles of patients with low, medium, and high FSTL1 levels. Serum FSTL1 was increased 56% above age- and sex-matched healthy controls. Diabetes mellitus, brain natriuretic peptide level, left atrial size, LV posterior wall thickness, LV end-diastolic diameter, and LV mass were significant determinants of FSTL1 serum levels by bivariate analysis. After controlling for significant covariates, FSTL1 levels predicted LV hypertrophy (as measured by LV mass index) by multivariate linear regression analysis (P<0.001). Unadjusted survival analysis demonstrated increased mortality in patients with increasing FSTL1 levels (P=0.09). After adjusting for significant parameters, patients with increased FSTL1 remained at the highest risk of death (hazard ratio, 1.028; 95% CI, 0.98 to 1.78; P=0.26). To determine whether elevated FSTL1 levels may be derived from the myocardium, FSTL1 protein expression was measured in explanted failing (n=18) and nonfailing (n=7) human hearts. LV failing hearts showed 2.5-fold higher FSTL1 protein levels over nonfailing control hearts (P<0.05). CONCLUSIONS: Elevated serum FSTL1 in patients with heart failure was associated with LV hypertrophy. Further studies on the role of FSTL1 as a biomarker in chronic systolic heart failure are warranted.
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High concentrations of FSTL1 are seen in patients with systolic and diastolic heart failure.
“high concentrations of FSTL1 are seen in patients with systolic and diastolic heart failure (196, 197)”
From Muscle–Organ Crosstalk: The Emerging Roles of Myokines (2020) · cites this paper as [196]
Circulating levels of FSTL1 may work as a biomarker.
“Circulating levels of FSTL1 may work as a biomarker as high concentrations of FSTL1 are seen in patients with systolic and diastolic heart failure (196, 197), and as FSTL1 levels exhibit prognostic significance in the acute coronary syndrome (198).”
From Muscle–Organ Crosstalk: The Emerging Roles of Myokines (2020) · cites this paper as [196]
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Muscle–Organ Crosstalk: The Emerging Roles of Myokines
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“Circulating levels of FSTL1 may work as a biomarker as high concentrations of FSTL1 are seen in patients with systolic and diastolic heart failure (196, 197), and as FSTL1 levels exhibit prognostic significance in the acute coronary syndrome (198).”
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Self-citation
- Authors
- El-Armouche, A., Ouchi, N., Tanaka, K., Doros, G., Wittköpper, K., Schulze, T., Eschenhagen, T., Walsh, K., & Sam, F.
- Affiliations
- From the Department of Pharmacology, University Medical Center Göttingen, Göttingen, Germany (A.E.-A., K.W.); Whitaker Cardiovascular Institute (N.O., K.T., K.W., F.S.) and Cardiovascular Section and Evans Department of Medicine (F.S.), Boston University School of Medicine, and Biostatistics Department (G.D.), Boston University School of Public Health, Boston, MA; and Department of Experimental and Clinical Pharmacology (T.S., T.E.), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- Boston University (US)
- Venue
- Circulation Heart Failure
- Published
- 2011-09
- Volume
- 4
- Issue
- 5
- Pages
- 621-627
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- PMC
- PMC3178753
- OpenAlex
- W2755172250
- Cited by
- 76
- References
- 19
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 4 · 2022: 4 · 2021: 3 · 2020: 6 · 2019: 6 · 2018: 5 · 2017: 8 · 2016: 9 · 2015: 1 · 2014: 4 · 2013: 3 · 2012: 6
- FWCI
- 3.07
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- GoeScholar The Publication Server of the Georg-August-Universität Göttingen (Georg-August-Universität Göttingen) (submittedVersion, cc-by)
- GRO (submittedVersion, cc-by)
- Funders
- National Heart, Lung, and Blood Institute (R01HL079099, R01HL116591, HL-102631, HL 079099, R21HL102631)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Fibrosis and Remodeling
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- FSTL1, chronic systolic heart failure, left ventricular hypertrophy, serum biomarkers, mortality risk, myocardial protein expression, left ventricular mass, diabetes mellitus, brain natriuretic peptide
- MeSH terms
- Adult, Aged, Chronic Disease, Echocardiography, Female, Heart Ventricles, Humans, Male, Middle Aged, Myocardium, Stroke Volume, Biomarkers, Survival Rate, Case-Control Studies, Ventricular Remodeling, Follistatin-Related Proteins, Heart Failure, Systolic
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