1532-84142332017MarJ Card FailClinical Correlates and Prognostic Value of Proenkephalin in Acute and Chronic Heart Failure.231239231-23910.1016/j.cardfail.2016.09.007S1071-9164(16)31141-1Proenkephalin (pro-ENK) has emerged as a novel biomarker associated with both renal function and cardiac function. However, its clinical and prognostic value have not been well evaluated in symptomatic patients with heart failure.The association between pro-ENK and markers of renal function was evaluated in 95 patients with chronic heart failure who underwent renal hemodynamic measurements, including renal blood flow (RBF) and glomerular filtration rate (GFR) with the use of ¹³¹I-Hippuran and ¹²⁵I-iothalamate clearances, respectively. The association between pro-ENK and clinical outcome in acute heart failure was assessed in another 1589 patients. Pro-ENK was strongly correlated with both RBF (P < .001) and GFR (P < .001), but not with renal tubular markers. In the acute heart failure cohort, pro-ENK was a predictor of death through 180 days, heart failure rehospitalization through 60 days, and death or cardiovascular or renal rehospitalization through day 60 in univariable analyses, but its predictive value was lost in a multivariable model when other renal markers were entered in the model.In patients with chronic and acute heart failure, pro-ENK is strongly associated with glomerular function, but not with tubular damage. Pro-ENK provides limited prognostic information in patients with acute heart failure on top of established renal markers.Copyright © 2016 Elsevier Inc. All rights reserved.MatsueYuyaYDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.Ter MaatenJozine MJMDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.StruckJoachimJSphingotec GmbH, Hennigsdorf, Germany.MetraMarcoMUniversity of Brescia, Brescia, Italy.O'ConnorChristopher MCMInova Heart and Vascular Institute, Falls Church, Virginia.PonikowskiPiotrPClinical Military Hospital, Medical University, Wroclaw, Poland.TeerlinkJohn RJRUniversity of California San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California.CotterGadGMomentum Research, Durham, North Carolina.DavisonBethBMomentum Research, Durham, North Carolina.ClelandJohn GJGUniversity of Hull, Kingston upon Hull, United Kingdom.GivertzMichael MMMBrigham and Women's Hospital, Boston, Massachusetts.BloomfieldDaniel MDMMerck Research Laboratories, Rahway, New Jersey.DittrichHoward CHCCardiovascular Research Center, University of Iowa Carver College of Medicine, Iowa City, Iowa.van VeldhuisenDirk JDJDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.van der MeerPeterPDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.DammanKevinKDepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.VoorsAdriaan AAADepartment of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. Electronic address: a.a.voors@umcg.nl.engJournal ArticleMulticenter StudyRandomized Controlled Trial20160920