PMID- 12398964
OWN - NLM
STAT- MEDLINE
DCOM- 20021209
LR  - 20191210
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 90
IP  - 9
DP  - 2002 Nov 1
TI  - Relation of circulating cardiac myosin light chain 1 isoform in stable severe 
      congestive heart failure to survival and treatment with flosequinan.
PG  - 969-73
AB  - The myocardial contractile protein myosin light chain 1 isoform (MLC-1) is 
      released into the circulation during myocyte necrosis and could thus be a marker 
      of low-grade myocardial damage and of poor prognosis in patients with heart 
      failure. Two hundred eighteen patients with stable heart failure (ejection 
      fraction [EF] <35%) and in New York Heart Association (NYHA) class III to IV had 
      MLC-1 measured at baseline and 1 month after being randomized to the direct 
      vasodilator flosequinan or placebo. Patients were followed a mean of 302 +/- 142 
      days. The prognostic value of an increase in MLC-1 above the 98th percentile of 
      normal controls was compared with that of conventional prognostic variables in 
      heart failure. MLC-1 was increased in over half of patients at baseline and 1 
      month, and this was associated with increased age, NYHA class IV, and renal 
      insufficiency. By Kaplan-Meier survival analysis, patients with a baseline 
      increase in MLC-1 had a greater mortality (26%) than those without an increase 
      (15%) (p = 0.043). A significant interaction among MLC-1, survival, and treatment 
      was found (p = 0.043). In the placebo group, MLC-1 was associated with increased 
      mortality (29% vs 12%, p = 0.025), whereas there was no significant difference 
      among patients receiving flosequinan. In a multivariate logistic regression model 
      including age, treatment, and left ventricular (LV) ejection fraction, the MLC-1 
      chain was most predictive of mortality (p = 0.049). Thus, circulating MLC-1 is 
      elevated in over half of patients with stable severe heart failure, and this 
      increase is associated with a poor prognosis. Flosequinan treatment eliminates 
      this association, highlighting the complexity of the relation between cardiac 
      myocyte damage, drug treatment, and mortality.
FAU - Hansen, Mark S
AU  - Hansen MS
AD  - Division of Cardiology of the University Health Network and Mount Sinai Hospital, 
      Toronto, Ontario, Canada.
FAU - Stanton, Eric B
AU  - Stanton EB
FAU - Gawad, Yehia
AU  - Gawad Y
FAU - Packer, Milton
AU  - Packer M
FAU - Pitt, Bertram
AU  - Pitt B
FAU - Swedberg, Karl
AU  - Swedberg K
FAU - Rouleau, Jean L
AU  - Rouleau JL
CN  - Canadian PROFILE investigators
LA  - eng
PT  - Clinical Trial
PT  - Comparative Study
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
RN  - 0 (Biomarkers)
RN  - 0 (Myosin Light Chains)
RN  - 0 (Quinolines)
RN  - 0 (Vasodilator Agents)
RN  - 6NB119DLU7 (flosequinan)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/blood
MH  - Double-Blind Method
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*blood/*drug therapy/mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myosin Light Chains/*blood/*drug effects
MH  - North America
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Quinolines/*therapeutic use
MH  - Scandinavian and Nordic Countries
MH  - Severity of Illness Index
MH  - Stroke Volume/drug effects/physiology
MH  - Survival Analysis
MH  - Treatment Outcome
MH  - Vasodilator Agents/*therapeutic use
EDAT- 2002/10/26 04:00
MHDA- 2002/12/10 04:00
CRDT- 2002/10/26 04:00
PHST- 2002/10/26 04:00 [pubmed]
PHST- 2002/12/10 04:00 [medline]
PHST- 2002/10/26 04:00 [entrez]
AID - S0002914902026632 [pii]
AID - 10.1016/s0002-9149(02)02663-2 [doi]
PST - ppublish
SO  - Am J Cardiol. 2002 Nov 1;90(9):969-73. doi: 10.1016/s0002-9149(02)02663-2.