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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

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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.

Graphical Abstract

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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Data Availability

All data is available upon reasonable request to the corresponding author.

Abbreviations

CS:

Cardiogenic shock

ECMO:

Extra-corporeal membrane oxygenator

AMCS:

Acute mechanical circulatory support

IKBKB:

Inhibitor of nuclease factor kappa B kinase subunit beta

NF-kB:

Nuclear factor kappa B

CxCL3:

Chemokine (C-X-C motif) ligand 3

STUB1:

STIP1 homology and U-box containing protein 1

HSPA8:

Heat shock protein 8

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Funding

This work was supported by a grant from the National Institutes of Health (R01HL139785-01 and R01HL133215-01) to N.K.K and by the Beals Goodfellow Research Award, Boston, MA, USA to N.A.D

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Authors and Affiliations

  1. Division of Cardiology, Department of Internal Medicine, Tufts Medical Center, Boston, MA, USA

    Nikolaos A. Diakos, Lija Swain, Shreyas Bhave, Xiaoying Qiao, Jillian Haywood, Siya Goel, Shiva Annamalai, Michele Esposito, Haval Chweich, Anthony Faugno & Navin K. Kapur

  2. Department of Cardiology, The Texas Heart Institute, Houston, TX, USA

    Nikolaos A. Diakos

  3. Beth Israel Deaconess Medical Center Genomics, Proteomics, Bioinformatics and Systems Biology Center, Boston, USA

    Towia Libermann

  4. Interventional Research Laboratories, Division of Cardiology, The Cardiovascular Center for Research and Innovation (CVCRI), Molecular Cardiology Research Institute, Tufts Medical Center, Boston, MA, USA

    Navin K. Kapur

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  1. Nikolaos A. Diakos
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Correspondence to Navin K. Kapur.

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Ethics Approval and Consent to Participate

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration on 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of Interest

Dr Navin Kapur has received consultant/speaker honoraria and institutional research grants from Abbott, Abiomed, Boston Scientific, Getinge, LivaNova, Medtronic, MD Start, and preCARDIA.

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Associate Editor Rupak Mukherjee oversaw the review of this article

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Diakos, N.A., Swain, L., Bhave, S. et al. 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. J. of Cardiovasc. Trans. Res. (2024). https://doi.org/10.1007/s12265-024-10501-1

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