Association between preoperative peripheral blood mononuclear cell gene expression profiles, early postoperative organ function recovery potential and long-term survival in advanced heart failure patients undergoing mechanical circulatory support

术前外周血单个核细胞基因表达谱与机械循环支持晚期心力衰竭患者术后早期器官功能恢复潜力及长期生存的关系

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作者:Galyna Bondar, Ryan Togashi, Martin Cadeiras, Joanna Schaenman, Richard K Cheng, Lindsay Masukawa, Josephine Hai, Tra-Mi Bao, Desai Chu, Eleanor Chang, Maral Bakir, Sophie Kupiec-Weglinski, Victoria Groysberg, Tristan Grogan, Joseph Meltzer, Murray Kwon, Maura Rossetti, David Elashoff, Elaine Reed, 

Background

Multiorgan dysfunction syndrome contributes to adverse outcomes in advanced heart failure (AdHF) patients after mechanical circulatory support (MCS) implantation and is associated with aberrant leukocyte activity. We tested the hypothesis that preoperative peripheral blood mononuclear cell (PBMC) gene expression profiles (GEP) can predict early postoperative improvement or non-improvement in patients undergoing MCS implantation. We believe this information may be useful in developing prognostic biomarkers.

Conclusions

In AdHF patients following MCS implantation, preoperative PBMC-GEP predicts early changes in organ function scores and correlates with long-term outcomes. Therefore, gene expression lends itself to outcome prediction and warrants further studies in larger longitudinal cohorts.

Results

Out of 28 MCS-surgery patients alive 8 days postoperatively, one-year survival was 88% in Group I and 27% in Group II. We identified 28 preoperative DEGs between Group I and II, with an average 93% prediction accuracy. Out of 105 DEGs identified preoperatively between year 1 survivors and non-survivors, 12 genes overlapped with the 28 predictive genes. Conclusions: In AdHF patients following MCS implantation, preoperative PBMC-GEP predicts early changes in organ function scores and correlates with long-term outcomes. Therefore, gene expression lends itself to outcome prediction and warrants further studies in larger longitudinal cohorts.

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