Elevated Inflammatory Plasma Biomarkers in Patients With Fabry Disease: A Critical Link to Heart Failure With Preserved Ejection Fraction

Background Because systemic inflammation and endothelial dysfunction lead to heart failure with preserved ejection fraction, we characterized plasma levels of inflammatory and cardiac remodeling biomarkers in patients with Fabry disease (FD). Methods and Results Plasma biomarkers were studied in multicenter cohorts of patients with FD (n=68) and healthy controls (n=40). Plasma levels of the following markers of inflammation and cardiac remodeling were determined: tumor necrosis factor (TNF), TNF receptor 1 (TNFR1) and 2 (TNFR2), interleukin‐6, matrix metalloprotease‐2 (MMP‐2), MMP‐8, MMP‐9, galectin‐1, galectin‐3, B‐type natriuretic peptide (BNP), midregional pro–atrial natriuretic peptide (MR‐proANP), and globotriaosylsphingosine. Clinical profile, cardiac magnetic resonance imaging, and echocardiogram were reviewed and correlated with biomarkers. Patients with FD had elevated plasma levels of BNP, MR‐proANP, MMP‐2, MMP‐9, TNF, TNFR1, TNFR2, interleukin‐6, galectin‐1, globotriaosylsphingosine, and analog...