TY - JOUR ID - enlighten267942 UR - https://eprints.gla.ac.uk/267942/ IS - 6 A1 - Nath, Mintu A1 - Romaine, Simon P.R. A1 - Koekemoer, Andrea A1 - Hamby, Stephen A1 - Webb, Thomas R. A1 - Nelson, Christopher P. A1 - Castellanos-Uribe, Marcos A1 - Papakonstantinou, Manolo A1 - Anker, Stefan D. A1 - Lang, Chim C. A1 - Metra, Marco A1 - Zannad, Faiez A1 - Filippatos, Gerasimos A1 - van Veldhuisen, Dirk J. A1 - Cleland, John G. A1 - Ng, Leong L. A1 - May, Sean T. A1 - Marelli-Berg, Federica A1 - Voors, Adriaan A. A1 - Timmons, James A. A1 - Samani, Nilesh J. Y1 - 2022/06// N2 - Aims Chronic Heart Failure (CHF) is a systemic syndrome with a poor prognosis and a need for novel therapies. We investigated whether whole-blood transcriptomic profiling can provide new mechanistic insights into cardiovascular (CV) mortality in CHF. Methods and Results Transcriptome profiles were generated at baseline from 944 CHF patients from the BIOSTAT-CHF Study - of whom 626 survived and 318 died from a CV cause during a follow-up of 21 months. Multivariable analysis, including adjustment for cell count, identified 1,153 genes (6.5%) that were differentially expressed between those that survived or died and strongly related to a validated clinical risk score for adverse prognosis. The differentially expressed genes mainly belonged to 5 non-redundant pathways: Adaptive immune response, proteasome-mediated ubiquitin-dependent protein catabolic process, T-cell co-stimulation, positive regulation of T-cell proliferation and erythrocyte development. These five pathways were selectively related (RV coefficients >0.20) with seven circulating protein biomarkers of CV mortality (FGF23, sST2, adrenomedullin, hepcidin, pentraxin-3, WFDC2 and IL-6) revealing an intricate relationship between immune and iron homeostasis. The pattern of survival-associated gene expression matched with 29 perturbagen-induced transcriptome signatures in the iLINCS drug-repurposing database, identifying drugs, approved for other clinical indications, that were able to reverse in vitro the molecular changes associated with adverse prognosis in CHF. Conclusion Systematic modeling of the whole blood protein-coding transcriptome defined molecular pathways that provide a link between clinical risk factors and adverse cardiovascular prognosis in CHF, identifying both established and new potential therapeutic targets. PB - Wiley JF - European Journal of Heart Failure VL - 24 SN - 1388-9842 TI - Whole blood transcriptomic profiling identifies molecular pathways related to cardiovascular mortality in heart failure SP - 1009 AV - public EP - 1019 ER -