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Tetranectin as a potential biomarker in heart failure with ejection fraction >45%: A prospective cohort study Cover

Tetranectin as a potential biomarker in heart failure with ejection fraction >45%: A prospective cohort study

Open Access
|Jul 2025

Figures & Tables

Table 1

Baseline Characteristics of Patients with HF with EF > 45%, Stratified by NYHA Class

Variable (Units), Mean (SD) or Median (IQR)Overall Population (n = 116)G1 (NYHA I, n = 48)G2 (NYHA II, n = 37)G3 (NYHA III–IV, n = 31)
Age (years), mean (SD)59.76 (13.5)53.17 (11.2)64.38 (12.8)64.77 (13.9)
Female sex, n (%)48 (41.4%)20 (41.7%)16 (43.2%)12 (38.7%)
BMI (kg/m2), median (IQR)29.39 (25.59–34.55)29.07 (25.65–34.22)29.39 (25.59–34.55)30.93 (23.18–35.32)
CKD, n (%)43 (37%)14 (29%)14 (38%)15 (48%)
Total Cholesterol (mg/dL), median (IQR)245 (200–275)238 (195–278)250 (200–275)245 (210–276)
Diabetes, n (%)87 (75.0%)36 (75.0%)28 (75.7%)23 (74.2%)
Beta-blockers, n (%)79 (68%)31 (65%)26 (70%)22 (71%)
ACE/ARBs, n (%)72 (62%)29 (60%)23 (62%)20 (65%)
Diuretics, n (%)60 (52%)19 (40%)20 (54%)21 (68%)
SGLT2 Inhibitors, n (%)25 (22%)7 (15%)9 (24%)9 (29%)
MRAs, n (%)32 (28%)10 (20%)11 (30%)11 (35%)
NT-proBNP (pg/mL), median (IQR)446 (303–819)318 (207–454)500 (320–737)716 (483–947)
E/A Ratio, median (IQR)1.2 (0.9–1.8)0.9 (0.8–1.2)1.3 (1.0–1.6)1.8 (1.4–2.2)
E/e’ Ratio, median (IQR)12 (9–16)9 (8–11)13 (10–15)16 (14–18)
GLS (%), mean (SD)−17.16 (2.8)−18.54 (2.9)−17.05 (2.5)−15.48 (2.1)
LAS (%), median (IQR)26 (19–41)35 (27–44)25 (19–29)21 (17–27)
LVEF (%), mean (SD)51.91 (4.5)55.83 (4.2)50.00 (3.8)48.71 (3.2)
TETRA (ng/mL), median (IQR)34.0 (21.5–55.3)48.9 (34.4–64.0)33.2 (21.5–51.2)27.6 (18.9–37.1)

[i] SD = Standard Deviation; IQR = Interquartile Range; BMI = Body Mass Index; CKD = Chronic Kidney Disease; SGLT2 = Sodium-Glucose Cotransporter-2; MRA = Mineralocorticoid Receptor Antagonist; LAS = Left Atrial Reservoir Strain; GLS = Global Longitudinal Strain; LVEF = Left Ventricular Ejection Fraction; TETRA = Tetranectin.

Figure 1.

Distribution of Serum Tetranectin by NYHA Class.

Table 2

Effect Sizes (Cohen’s d) for Pairwise Comparisons of TETRA Levels Across NYHA Classes

ComparisonTETRA (Cohen’s d)
G1 vs. G22.43
G1 vs. G33.19
G2 vs. G31.96
Table 3

Group Differences in Clinical and Echocardiographic Variables Across NYHA Classes

Variable (Units)Test Statistic (F or H)p-value
Age (years)F = 12.547<0.001
NT-proBNP (pg/mL)H = 58.324<0.001
E/e’ RatioH = 45.8720.003
LAVI (mL/m2)H = 39.2140.025
LAS (%)H = 42.135<0.001
GLS (%)F = 8.9760.009
LVEF (%)F = 10.3420.017
Figure 2.

Scatter Plot with Regression Line Illustrating the Relationship Between Serum Tetranectin and NT-proBNP in HF with EF > 45% Patients.

Table 4

Spearman’s Rank Correlations Between TETRA and Clinical/Echocardiographic Variables

VariableSpearman’s rhop-value
NT-proBNP (pg/mL)−0.66<0.001
E/e’ Ratio−0.580.003
LAVI (mL/m2)−0.520.010
LAS (%)0.550.005
GLS (%)0.480.024
LVEF (%)0.450.038
Figure 3.

Kaplain-Meier Curves by NYHA Class in HFpEF Patients.

Table 5

Univariate and Multivariate Cox Models for TETRA and All-Cause Mortality

OutcomeModelHR (per 10 ng/mL decrease)95% CIp-value
All-Cause MortalityUnivariable1.381.06–1.810.045
Multivariable1.220.94–1.860.112
DOI: https://doi.org/10.2478/rjim-2025-0014 | Journal eISSN: 2501-062X (formerly 1220-4749) | Journal ISSN: 1220-4749
Language: English, Romanian
Page range: 251 - 262
Submitted on: May 22, 2025
Published on: Jul 26, 2025
Published by: N.G. Lupu Internal Medicine Foundation
In partnership with: Paradigm Publishing Services

© 2025 Paula Alexandra Vulciu, Luminita Pilat, Norberth-Istvan Varga, Voicu Dascau, Calin Popa, Maria-Daniela Mot, Paula Irina Barata, Imola Donath Miklos, Maria Puschita, published by N.G. Lupu Internal Medicine Foundation
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.