Circulating Proteome Analysis Identifies Reduced Inflammation After Initiation of Hemodynamic Support with Either Veno-Arterial Extracorporeal Membrane Oxygenation or Impella in Patients with Cardiogenic Shock
Journal of Cardiovascular Translational Research(2024)
Abstract
In-hospital mortality associated with cardiogenic shock (CS) remains high despite the use of percutaneous assist devices. We sought to determine whether support with VA-ECMO or Impella in patients with CS alters specific components of the plasma proteome. Plasma samples were collected before device implantation and 72 h after initiation of support in 11 CS patients receiving ECMO or Impella. SOMAscan was used to detect 1305 circulating proteins. Sixty-seven proteins were changed after ECMO (18 upregulated and 49 downregulated, p < 0.05), 38 after Impella (10 upregulated and 28 downregulated, p < 0.05), and only eight proteins were commonly affected. Despite minimal protein overlap, both devices were associated with markers of reduced inflammation and increased apoptosis of inflammatory cells. In summary, ECMO and Impella are associated with reduced expression of inflammatory markers and increased markers of inflammatory cell death. These circulating proteins may serve as novel targets of therapy or biomarkers to tailor AMCS use. Patients with refractory cardiogenic shock (CS) present with increased levels of circulating proteins related to inflammation, apoptosis, and necrosis and decreased levels of circulating proteins related to angiogenesis. After 72 h of acute mechanical circulatory support (AMCS), there is reduction of circulating proteins related to inflammation, while proteins related to apoptosis and necrosis remain elevated.
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Key words
Cardiogenic shock,Proteomics,Inflammation,Mechanical circulatory support,Heart failure
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