Heart failure & cardiomyopathiesRandomised controlled trial
Circulating Endotrophin Predicts Myocardial Fibrosis Burden and Is Sensitive to Antifibrotic Therapy
- trial
- randomized
- prespecified time points
Authors' conclusion
In patients with heart failure with preserved ejection fraction, treatment with pirfenidone was associated with a sustained reduction in circulating levels of endotrophin from 13 weeks. Circulating endotrophin was also independently associated with both baseline myocardial ECV and change in myocardial ECV. Endotrophin shows high potential as a circulating biomarker reflective of myocardial fibrosis burden and sensitive to change in myocardial fibrosis over time.
Study context
- Population
- Patients with heart failure with preserved ejection fraction and extracellular volume (ECV) ≥27% (PIROUETTE trial); non-randomized patients with ECV <27% for baseline peptide levelsrandomized patients with ECV ≥27%, 13 non-randomized patients with ECV <27% also measured at baseline · randomized, ECV ≥27% 94 · not randomized, ECV <27% 13
- Participants
- 94 patients
- Comparison
- pirfenidone or placebo
- ECV <27%n = 13
Primary result
As reported in the abstract
Treatment with pirfenidone was associated with a significant reduction in log endotrophin
P = 0.034
Further findings
Change in myocardial ECV and change in log endotrophin
- R2
- 0.14
- P
- P = 0.031
- After multivariable adjustment
Baseline ECV and baseline log endotrophin
- R2
- 0.30
- P
- P = 0.022
- After multivariable adjustment
Other collagen-derived circulating peptides
- Pirfenidone had no effect on the levels of other collagen-derived circulating peptides
- no associations between their levels and change in myocardial ECV or baseline ECV
Original publication
Summarised from the published abstract; every number is checked against it