A Multielement Ionomic Dysregulation Pattern Is Associated with NT-proBNP and Cardiorenal Burden in Patients with Cardiovascular Disease
10 affiliations
- 1College of Medicine, Korea University, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea
- 2College of Medicine, Inje University, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
- 3Department of Precision Medicine in Medical, Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90134 Palermo, Italy
- 4Department of Research, IRCCS ISMETT, 90127 Palermo, Italy
- 5Thoracic Research Center, Collegium Medicum, Nicolaus Copernicus University, 85-067 Bydgoszcz, Poland
- 6Department of Cardiac Surgery, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 02-507 Warszawa, Poland
- 7Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznan, Poland
- 8Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznan, Poland
- 9Department of Trace Analysis, Faculty of Chemistry, Adam Mickiewicz University, 61-614 Poznan, Poland
- 10Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ½ Długa, 61-848 Poznan, Poland
Abstract
Background: Cardiovascular hemodynamic stress may be associated with alterations in the circulating ionome. We investigated whether a hypothesis-driven multielement composite, the congestion-associated ionomic dysregulation score (CIDS; higher copper and strontium and lower rubidium and iron), was associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiorenal–hematologic burden. Methods: This retrospective, single-center, cross-sectional study included 192 patients undergoing cardiovascular evaluation or treatment. Serum trace elements were quantified by inductively coupled plasma mass spectrometry, and CIDS was calculated from standardized element concentrations. Results: Higher CIDS was associated with higher NT-proBNP (ρ = 0.416, FDR-adjusted p < 0.001), worse New York Heart Association (NYHA) functional status (ρ = 0.370, p < 0.001), lower hemoglobin (ρ = −0.287, p < 0.001), lower eGFR (ρ = −0.191, p = 0.012), and higher uric acid (ρ = 0.241, p = 0.002). In the common complete-case sample, each 1-SD increase in CIDS was associated with higher log-transformed NT-proBNP after multivariable adjustment (β = 0.276, 95% CI 0.077–0.475; HC3-robust p = 0.007), and model R2 increased from 0.368 to 0.407. The observed ΔR2 exceeded the median from randomly weighted composites but did not clearly exceed the permutation null distribution (empirical p = 0.063). The referral-stratified estimates differed in magnitude (β = 0.179 versus 0.569), without a significant interaction (p = 0.171). Conclusions: CIDS was associated with myocardial stress and cardiorenal–hematologic burden in this cohort, but the single-center, cross-sectional findings do not establish causality, unique superiority over alternative composites, or external biomarker validity. Because CIDS was standardized internally within this cohort, no externally applicable reference values or clinical cutoffs can currently be defined.
Related
- Analytical Validation of a Multielement ICP-MS Method for Human Serum and Its Application to Trace Element Biomonitoring in Hemodialysis Patients.
- Multielement Composition and in Vitro Bioaccessibility in Brazilian Edible Floral Supplement Capsules Containing Dandelion and Hibiscus
- A Greener Acid-free Microwave-Assisted Digestion Method for Multielement Analysis of Fish Tissues by ICP–MS
- Aqueous Humor Reveals Proteolytic Dysregulation of the TGF-β Scaffolding Axis in Primary Open-Angle Glaucoma: an Integrated Shotgun and N-terminomic Profiling
- Integrated Immune Profiling Identifies Treatment-Associated Immune Patterns in Patients with B-Cell Hematological Malignancies.
BibTeX
@article{kang2026multielement,
title = {{A Multielement Ionomic Dysregulation Pattern Is Associated with NT-proBNP and Cardiorenal Burden in Patients with Cardiovascular Disease}},
author = {Minseung Kang and Siwon Baek and Giuseppe Maria Raffa and Calogera Pisano and Vincenzo Nuzzi and Mariusz Kowalewski and Beata Krasińska and Piotr Suwalski and Yvgen Spasenenko and Antonio Segreto and Katarzyna Gabriel and Andrzej Tykarski and Zbigniew Krasiński and Julia Frąckowiak and Marek Jemielity and Tomasz Urbanowicz and Anetta Hanć},
journal = {Molecules},
year = {2026},
month = oct,
doi = {10.3390/molecules31203588},
url = {https://www.mdpi.com/1420-3049/31/20/3588},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - A Multielement Ionomic Dysregulation Pattern Is Associated with NT-proBNP and Cardiorenal Burden in Patients with Cardiovascular Disease
AU - Minseung Kang
AU - Siwon Baek
AU - Giuseppe Maria Raffa
AU - Calogera Pisano
AU - Vincenzo Nuzzi
AU - Mariusz Kowalewski
AU - Beata Krasińska
AU - Piotr Suwalski
AU - Yvgen Spasenenko
AU - Antonio Segreto
AU - Katarzyna Gabriel
AU - Andrzej Tykarski
AU - Zbigniew Krasiński
AU - Julia Frąckowiak
AU - Marek Jemielity
AU - Tomasz Urbanowicz
AU - Anetta Hanć
PY - 2026
DA - 2026/10/01
JO - Molecules
DO - 10.3390/molecules31203588
UR - https://www.mdpi.com/1420-3049/31/20/3588
AB - Background: Cardiovascular hemodynamic stress may be associated with alterations in the circulating ionome. We investigated whether a hypothesis-driven multielement composite, the congestion-associated ionomic dysregulation score (CIDS; higher copper and strontium and lower rubidium and iron), was associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiorenal–hematologic burden. Methods: This retrospective, single-center, cross-sectional study included 192 patients undergoing cardiovascular evaluation or treatment. Serum trace elements were quantified by inductively coupled plasma mass spectrometry, and CIDS was calculated from standardized element concentrations. Results: Higher CIDS was associated with higher NT-proBNP (ρ = 0.416, FDR-adjusted p < 0.001), worse New York Heart Association (NYHA) functional status (ρ = 0.370, p < 0.001), lower hemoglobin (ρ = −0.287, p < 0.001), lower eGFR (ρ = −0.191, p = 0.012), and higher uric acid (ρ = 0.241, p = 0.002). In the common complete-case sample, each 1-SD increase in CIDS was associated with higher log-transformed NT-proBNP after multivariable adjustment (β = 0.276, 95% CI 0.077–0.475; HC3-robust p = 0.007), and model R2 increased from 0.368 to 0.407. The observed ΔR2 exceeded the median from randomly weighted composites but did not clearly exceed the permutation null distribution (empirical p = 0.063). The referral-stratified estimates differed in magnitude (β = 0.179 versus 0.569), without a significant interaction (p = 0.171). Conclusions: CIDS was associated with myocardial stress and cardiorenal–hematologic burden in this cohort, but the single-center, cross-sectional findings do not establish causality, unique superiority over alternative composites, or external biomarker validity. Because CIDS was standardized internally within this cohort, no externally applicable reference values or clinical cutoffs can currently be defined.
SN - 1420-3049
ER -