Association of Serum Zinc Level With Prognosis in Patients With Heart Failure
•Zinc is an intracellular ion, stored mainly in the skeletal muscles and bones, and is associated with cell growth and differentiation as a catalytic and structural cofactor.•Zinc-deficient heart failure (HF) patients experience high cardiac and all-cause mortality accompanied by ongoing myocardial...
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| Veröffentlicht in: | Journal of cardiac failure 2018-06, Vol.24 (6), p.375-383 |
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| creator | Yoshihisa, Akiomi Abe, Satoshi Kiko, Takatoyo Kimishima, Yusuke Sato, Yu Watanabe, Shunsuke Kanno, Yuki Miyata-Tatsumi, Makiko Misaka, Tomofumi Sato, Takamasa Suzuki, Satoshi Oikawa, Masayoshi Kobayashi, Atsushi Yamaki, Takayoshi Kunii, Hiroyuki Nakazato, Kazuhiko Ishida, Takafumi Takeishi, Yasuchika |
| description | •Zinc is an intracellular ion, stored mainly in the skeletal muscles and bones, and is associated with cell growth and differentiation as a catalytic and structural cofactor.•Zinc-deficient heart failure (HF) patients experience high cardiac and all-cause mortality accompanied by ongoing myocardial damage (troponin I), inflammation (C-reactive protein), fewer micronutrients (sodium, magnesium, calcium, and iron), and impaired exercise capacity.•Based on these findings, an interventional trial of zinc repletion should be considered to improve outcomes in HF.
Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF).
We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc |
| doi_str_mv | 10.1016/j.cardfail.2018.02.011 |
| format | Article |
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Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF).
We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc <75, n = 322), and third (zinc <62, n = 323) tertiles. We examined cardiac function and exercise capacity and followed up on all patients. Although cardiac function did not differ among the 3 groups, peak oxygen consumption was significantly lower in the third tertile than in the first and second tertiles (peak oxygen consumption, 14.2 vs 15.9 and 15.2 mL/kg/min, P = .010). In the Kaplan-Meier analysis (mean duration of follow-up 1103 days), cardiac and all-cause mortality was highest in the third tertile compared with the first and second tertiles. In the Cox proportional hazard analysis, serum zinc level was a predictor of cardiac and all-cause mortality. In the subgroup analysis, there were no interactions concerning associations between serum zinc levels with prognosis and other important variables, including age, gender, comorbidities, medications, other micronutrient levels, B-type natriuretic peptide, and left ventricular ejection fraction. The associations between zinc levels with mortality were consistent in all subgroups.
Decreased serum zinc levels are associated with high mortality, accompanied by impaired exercise capacity.</description><identifier>ISSN: 1071-9164</identifier><identifier>EISSN: 1532-8414</identifier><identifier>DOI: 10.1016/j.cardfail.2018.02.011</identifier><identifier>PMID: 29501920</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Biomarkers - blood ; cardiac function ; Echocardiography ; exercise capacity ; Exercise Tolerance - physiology ; Female ; Heart Failure - blood ; Heart Failure - epidemiology ; Heart Failure - physiopathology ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Humans ; Japan - epidemiology ; Male ; Middle Aged ; Morbidity - trends ; Prognosis ; Prospective Studies ; Serum zinc levels ; Stroke Volume - physiology ; Survival Rate - trends ; Ventricular Function, Left - physiology ; Zinc - blood</subject><ispartof>Journal of cardiac failure, 2018-06, Vol.24 (6), p.375-383</ispartof><rights>2018 The Author(s)</rights><rights>Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-3a44690e4306b8512e7692c30bd61f5ccb4cc97ab46d7cf73c508fe2dbbcd01e3</citedby><cites>FETCH-LOGICAL-c416t-3a44690e4306b8512e7692c30bd61f5ccb4cc97ab46d7cf73c508fe2dbbcd01e3</cites><orcidid>0000-0001-5574-6617</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.cardfail.2018.02.011$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29501920$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yoshihisa, Akiomi</creatorcontrib><creatorcontrib>Abe, Satoshi</creatorcontrib><creatorcontrib>Kiko, Takatoyo</creatorcontrib><creatorcontrib>Kimishima, Yusuke</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Watanabe, Shunsuke</creatorcontrib><creatorcontrib>Kanno, Yuki</creatorcontrib><creatorcontrib>Miyata-Tatsumi, Makiko</creatorcontrib><creatorcontrib>Misaka, Tomofumi</creatorcontrib><creatorcontrib>Sato, Takamasa</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Yamaki, Takayoshi</creatorcontrib><creatorcontrib>Kunii, Hiroyuki</creatorcontrib><creatorcontrib>Nakazato, Kazuhiko</creatorcontrib><creatorcontrib>Ishida, Takafumi</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><title>Association of Serum Zinc Level With Prognosis in Patients With Heart Failure</title><title>Journal of cardiac failure</title><addtitle>J Card Fail</addtitle><description>•Zinc is an intracellular ion, stored mainly in the skeletal muscles and bones, and is associated with cell growth and differentiation as a catalytic and structural cofactor.•Zinc-deficient heart failure (HF) patients experience high cardiac and all-cause mortality accompanied by ongoing myocardial damage (troponin I), inflammation (C-reactive protein), fewer micronutrients (sodium, magnesium, calcium, and iron), and impaired exercise capacity.•Based on these findings, an interventional trial of zinc repletion should be considered to improve outcomes in HF.
Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF).
We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc <75, n = 322), and third (zinc <62, n = 323) tertiles. We examined cardiac function and exercise capacity and followed up on all patients. Although cardiac function did not differ among the 3 groups, peak oxygen consumption was significantly lower in the third tertile than in the first and second tertiles (peak oxygen consumption, 14.2 vs 15.9 and 15.2 mL/kg/min, P = .010). In the Kaplan-Meier analysis (mean duration of follow-up 1103 days), cardiac and all-cause mortality was highest in the third tertile compared with the first and second tertiles. In the Cox proportional hazard analysis, serum zinc level was a predictor of cardiac and all-cause mortality. In the subgroup analysis, there were no interactions concerning associations between serum zinc levels with prognosis and other important variables, including age, gender, comorbidities, medications, other micronutrient levels, B-type natriuretic peptide, and left ventricular ejection fraction. The associations between zinc levels with mortality were consistent in all subgroups.
Decreased serum zinc levels are associated with high mortality, accompanied by impaired exercise capacity.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>cardiac function</subject><subject>Echocardiography</subject><subject>exercise capacity</subject><subject>Exercise Tolerance - physiology</subject><subject>Female</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - epidemiology</subject><subject>Heart Failure - physiopathology</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Morbidity - trends</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Serum zinc levels</subject><subject>Stroke Volume - physiology</subject><subject>Survival Rate - trends</subject><subject>Ventricular Function, Left - physiology</subject><subject>Zinc - blood</subject><issn>1071-9164</issn><issn>1532-8414</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1r3DAQhkVJaDbb_oWgYy92R7Is27cuS9ItbGkgCYVehDwet1q81kayA_n31bJJrjlpQM87Hw9jVwJyAUJ_3eVoQ9dbN-QSRJ2DzEGID2whykJmtRLqLNVQiawRWl2wyxh3AFArqD6yC9mUIBoJC_ZzFaNHZyfnR-57fkdh3vM_bkS-pSca-G83_eO3wf8dfXSRu5HfJpjGKZ6-NmTDxG_SInOgT-y8t0Okzy_vkj3cXN-vN9n21_cf69U2QyX0lBVWKd0AqQJ0W5dCUqUbiQW0nRZ9idgqxKayrdJdhX1VYAl1T7JrW-xAULFkX059D8E_zhQns3cRaRjsSH6OJik5nqpqlVB9QjH4GAP15hDc3oZnI8AcVZqdeVV5zNUGpEkqU_DqZcbc7ql7i726S8C3E0Dp0idHwURMYpA6Fwgn03n33oz_DsyH2g</recordid><startdate>201806</startdate><enddate>201806</enddate><creator>Yoshihisa, Akiomi</creator><creator>Abe, Satoshi</creator><creator>Kiko, Takatoyo</creator><creator>Kimishima, Yusuke</creator><creator>Sato, Yu</creator><creator>Watanabe, Shunsuke</creator><creator>Kanno, Yuki</creator><creator>Miyata-Tatsumi, Makiko</creator><creator>Misaka, Tomofumi</creator><creator>Sato, Takamasa</creator><creator>Suzuki, Satoshi</creator><creator>Oikawa, Masayoshi</creator><creator>Kobayashi, Atsushi</creator><creator>Yamaki, Takayoshi</creator><creator>Kunii, Hiroyuki</creator><creator>Nakazato, Kazuhiko</creator><creator>Ishida, Takafumi</creator><creator>Takeishi, Yasuchika</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5574-6617</orcidid></search><sort><creationdate>201806</creationdate><title>Association of Serum Zinc Level With Prognosis in Patients With Heart Failure</title><author>Yoshihisa, Akiomi ; Abe, Satoshi ; Kiko, Takatoyo ; Kimishima, Yusuke ; Sato, Yu ; Watanabe, Shunsuke ; Kanno, Yuki ; Miyata-Tatsumi, Makiko ; Misaka, Tomofumi ; Sato, Takamasa ; Suzuki, Satoshi ; Oikawa, Masayoshi ; Kobayashi, Atsushi ; Yamaki, Takayoshi ; Kunii, Hiroyuki ; Nakazato, Kazuhiko ; Ishida, Takafumi ; Takeishi, Yasuchika</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-3a44690e4306b8512e7692c30bd61f5ccb4cc97ab46d7cf73c508fe2dbbcd01e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>cardiac function</topic><topic>Echocardiography</topic><topic>exercise capacity</topic><topic>Exercise Tolerance - physiology</topic><topic>Female</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - epidemiology</topic><topic>Heart Failure - physiopathology</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Morbidity - trends</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Serum zinc levels</topic><topic>Stroke Volume - physiology</topic><topic>Survival Rate - trends</topic><topic>Ventricular Function, Left - physiology</topic><topic>Zinc - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshihisa, Akiomi</creatorcontrib><creatorcontrib>Abe, Satoshi</creatorcontrib><creatorcontrib>Kiko, Takatoyo</creatorcontrib><creatorcontrib>Kimishima, Yusuke</creatorcontrib><creatorcontrib>Sato, Yu</creatorcontrib><creatorcontrib>Watanabe, Shunsuke</creatorcontrib><creatorcontrib>Kanno, Yuki</creatorcontrib><creatorcontrib>Miyata-Tatsumi, Makiko</creatorcontrib><creatorcontrib>Misaka, Tomofumi</creatorcontrib><creatorcontrib>Sato, Takamasa</creatorcontrib><creatorcontrib>Suzuki, Satoshi</creatorcontrib><creatorcontrib>Oikawa, Masayoshi</creatorcontrib><creatorcontrib>Kobayashi, Atsushi</creatorcontrib><creatorcontrib>Yamaki, Takayoshi</creatorcontrib><creatorcontrib>Kunii, Hiroyuki</creatorcontrib><creatorcontrib>Nakazato, Kazuhiko</creatorcontrib><creatorcontrib>Ishida, Takafumi</creatorcontrib><creatorcontrib>Takeishi, Yasuchika</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cardiac failure</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshihisa, Akiomi</au><au>Abe, Satoshi</au><au>Kiko, Takatoyo</au><au>Kimishima, Yusuke</au><au>Sato, Yu</au><au>Watanabe, Shunsuke</au><au>Kanno, Yuki</au><au>Miyata-Tatsumi, Makiko</au><au>Misaka, Tomofumi</au><au>Sato, Takamasa</au><au>Suzuki, Satoshi</au><au>Oikawa, Masayoshi</au><au>Kobayashi, Atsushi</au><au>Yamaki, Takayoshi</au><au>Kunii, Hiroyuki</au><au>Nakazato, Kazuhiko</au><au>Ishida, Takafumi</au><au>Takeishi, Yasuchika</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Serum Zinc Level With Prognosis in Patients With Heart Failure</atitle><jtitle>Journal of cardiac failure</jtitle><addtitle>J Card Fail</addtitle><date>2018-06</date><risdate>2018</risdate><volume>24</volume><issue>6</issue><spage>375</spage><epage>383</epage><pages>375-383</pages><issn>1071-9164</issn><eissn>1532-8414</eissn><abstract>•Zinc is an intracellular ion, stored mainly in the skeletal muscles and bones, and is associated with cell growth and differentiation as a catalytic and structural cofactor.•Zinc-deficient heart failure (HF) patients experience high cardiac and all-cause mortality accompanied by ongoing myocardial damage (troponin I), inflammation (C-reactive protein), fewer micronutrients (sodium, magnesium, calcium, and iron), and impaired exercise capacity.•Based on these findings, an interventional trial of zinc repletion should be considered to improve outcomes in HF.
Zinc is an essential cofactor for energy transfer and physiological heart function, has antioxidant properties, and is involved in multiple signaling pathways. We aimed to investigate the associations between serum zinc levels with prognosis, as well as underlying cardiac function and exercise capacity, in patients with heart failure (HF).
We measured serum zinc levels in 968 consecutive hospitalized patients with decompensated HF, who were divided into 3 groups based on serum zinc levels (µg/dL): first (zinc ≥75, n = 323), second (62≤ zinc <75, n = 322), and third (zinc <62, n = 323) tertiles. We examined cardiac function and exercise capacity and followed up on all patients. Although cardiac function did not differ among the 3 groups, peak oxygen consumption was significantly lower in the third tertile than in the first and second tertiles (peak oxygen consumption, 14.2 vs 15.9 and 15.2 mL/kg/min, P = .010). In the Kaplan-Meier analysis (mean duration of follow-up 1103 days), cardiac and all-cause mortality was highest in the third tertile compared with the first and second tertiles. In the Cox proportional hazard analysis, serum zinc level was a predictor of cardiac and all-cause mortality. In the subgroup analysis, there were no interactions concerning associations between serum zinc levels with prognosis and other important variables, including age, gender, comorbidities, medications, other micronutrient levels, B-type natriuretic peptide, and left ventricular ejection fraction. The associations between zinc levels with mortality were consistent in all subgroups.
Decreased serum zinc levels are associated with high mortality, accompanied by impaired exercise capacity.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29501920</pmid><doi>10.1016/j.cardfail.2018.02.011</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-5574-6617</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biomarkers - blood cardiac function Echocardiography exercise capacity Exercise Tolerance - physiology Female Heart Failure - blood Heart Failure - epidemiology Heart Failure - physiopathology Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Humans Japan - epidemiology Male Middle Aged Morbidity - trends Prognosis Prospective Studies Serum zinc levels Stroke Volume - physiology Survival Rate - trends Ventricular Function, Left - physiology Zinc - blood |
| title | Association of Serum Zinc Level With Prognosis in Patients With Heart Failure |
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