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The fate of sulfate in chronic heart failure

The fate of sulfate in chronic heart failure
The fate of sulfate in chronic heart failure
New leads to advance our understanding of heart failure (HF) pathophysiology are urgently needed. Previous studies have linked urinary sulfate excretion to a favourable cardiovascular risk profile. Sulfate is not only the end-product of hydrogen sulfide metabolism, but is also directly involved in various (patho)physiological processes, provoking scientific interest in its renal handling. This study investigates sulfate clearance in chronic HF (CHF) patients and healthy individuals and considers its relationship with disease outcome. Parameters related to renal sulfate handling were determined in and compared between 96 previously characterized CHF patients and sex-matched healthy individuals. Among patients, sulfate clearance was analysed for associations with clinical and outcome parameters. In CHF patients, plasma sulfate concentrations are significantly higher, whereas 24-h urinary excretion, fractional excretion and clearance of sulfate are significantly lower, compared to healthy individuals. Among patients, sulfate clearance is independently associated with diuretics use, creatinine clearance and 24-h urinary sodium excretion. Sulfate clearance is associated with favourable disease outcome (HR per SD increase 0.38 (95% CI 0.23-0.63), P<0.001). Although significance was lost after adjustment for creatinine clearance, the decrease of sulfate clearance in patients is independent of this parameter, indicating that sulfate clearance is not merely a reflection of renal function. This exploratory study reveals aberrant sulfate clearance as a potential contributor to CHF pathophysiology, with reduced levels in patients and a positive association with favourable disease outcome. Further research is needed to unravel the nature of its involvement and to determine its potential as a biomarker and target for therapy.
0363-6135
1-28
Koning, Anne
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Meijers, Wouter
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Minovic, Isidor
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Post, Adrian
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Feelisch, Martin
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Pasch, Andreas
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Leuvenink, Henri
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Boer, Rudolf
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Bakker, Stephan
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van Goor, Harry
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Koning, Anne
fd7e43e0-8061-4ef9-a64a-bd86a39ad494
Meijers, Wouter
07a99542-5a00-4ce6-b5ac-db51664e52ce
Minovic, Isidor
c9c081a5-b3ad-4b06-b09a-3261de2810d1
Post, Adrian
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Feelisch, Martin
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Pasch, Andreas
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Leuvenink, Henri
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Boer, Rudolf
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Bakker, Stephan
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van Goor, Harry
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Koning, Anne, Meijers, Wouter, Minovic, Isidor, Post, Adrian, Feelisch, Martin, Pasch, Andreas, Leuvenink, Henri, Boer, Rudolf, Bakker, Stephan and van Goor, Harry (2016) The fate of sulfate in chronic heart failure. American Journal of Physiology: Heart and Circulatory Physiology, 1-28. (doi:10.1152/ajpheart.00645.2016).

Record type: Article

Abstract

New leads to advance our understanding of heart failure (HF) pathophysiology are urgently needed. Previous studies have linked urinary sulfate excretion to a favourable cardiovascular risk profile. Sulfate is not only the end-product of hydrogen sulfide metabolism, but is also directly involved in various (patho)physiological processes, provoking scientific interest in its renal handling. This study investigates sulfate clearance in chronic HF (CHF) patients and healthy individuals and considers its relationship with disease outcome. Parameters related to renal sulfate handling were determined in and compared between 96 previously characterized CHF patients and sex-matched healthy individuals. Among patients, sulfate clearance was analysed for associations with clinical and outcome parameters. In CHF patients, plasma sulfate concentrations are significantly higher, whereas 24-h urinary excretion, fractional excretion and clearance of sulfate are significantly lower, compared to healthy individuals. Among patients, sulfate clearance is independently associated with diuretics use, creatinine clearance and 24-h urinary sodium excretion. Sulfate clearance is associated with favourable disease outcome (HR per SD increase 0.38 (95% CI 0.23-0.63), P<0.001). Although significance was lost after adjustment for creatinine clearance, the decrease of sulfate clearance in patients is independent of this parameter, indicating that sulfate clearance is not merely a reflection of renal function. This exploratory study reveals aberrant sulfate clearance as a potential contributor to CHF pathophysiology, with reduced levels in patients and a positive association with favourable disease outcome. Further research is needed to unravel the nature of its involvement and to determine its potential as a biomarker and target for therapy.

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2016 AJPHeart-in press.pdf - Accepted Manuscript
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Accepted/In Press date: 26 November 2016
e-pub ahead of print date: 6 December 2016
Organisations: Clinical & Experimental Sciences

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Local EPrints ID: 405126
URI: https://eprints.soton.ac.uk/id/eprint/405126
ISSN: 0363-6135
PURE UUID: 1a24a22b-d583-462b-9ffd-a1d09106e5a9
ORCID for Martin Feelisch: ORCID iD orcid.org/0000-0003-2320-1158

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Date deposited: 27 Jan 2017 11:45
Last modified: 10 Dec 2019 06:14

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Contributors

Author: Anne Koning
Author: Wouter Meijers
Author: Isidor Minovic
Author: Adrian Post
Author: Martin Feelisch ORCID iD
Author: Andreas Pasch
Author: Henri Leuvenink
Author: Rudolf Boer
Author: Stephan Bakker
Author: Harry van Goor

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