Endogenous Ouabain: An Old Cardiotonic Steroid as a New Biomarker of Heart Failure and a Predictor of Mortality after Cardiac Surgery

Marco Simonini, Simona Pozzoli, Elena Bignami, Nunzia Casamassima, Elisabetta Messaggio, Chiara Lanzani, Elena Frati, Irene Maria Botticelli, Francesco Rotatori, Ottavio Alfieri, Alberto Zangrillo, Paolo Manunta

Research output: Contribution to journalArticlepeer-review


Cardiovascular diseases remain the main cause of mortality and morbidity worldwide; primary prevention is a priority for physicians. Biomarkers are useful tools able to identify high-risk individuals, guide treatments, and determine prognosis. Our aim is to investigate Endogenous Ouabain (EO), an adrenal stress hormone with hemodynamic effects, as a valuable biomarker of heart failure. In a population of 845 patients undergoing elective cardiac surgery, we have investigated the relationships between EO and echocardiography parameters/plasmatic biomarker of cardiac function. EO was found to be correlated negatively with left ventricular EF (p=0.001), positively with Cardiac End-Diastolic Diameter (p=0.047), and positively with plasmatic NT-proBNP level (p=0.02). Moreover, a different plasmatic EO level (both preoperative and postoperative) was found according to NYHA class (p=0.013). All these results have been replicated on an independent cohort of patients (147 subjects from US). Finally, a higher EO level in the immediate postoperative time was indicative of a more severe cardiological condition and it was associated with increased perioperative mortality risk (p=0.023 for 30-day morality). Our data suggest that preoperative and postoperative plasmatic EO level identifies patients with a more severe cardiovascular presentation at baseline. These patients have a higher risk of morbidity and mortality after cardiac surgery.

Original languageEnglish
Article number714793
JournalBioMed Research International
Publication statusPublished - 2015

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Immunology and Microbiology(all)


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