Vol. 7, Issue 1, Part B (2025)

Background: Osteopontin is a protein that is typically expressed at low levels under normal physiological conditions, but its expression significantly increases as heart function deteriorates. It plays a central role in the cardiac remodeling response following myocardial infarction and is markedly upregulated in both hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM). Once elevated, osteopontin triggers various physiological changes in the myocardium, including angiogenesis, cytokine production, myofibroblast differentiation, extracellular matrix deposition, and cardiomyocyte hypertrophy. Collectively, these changes alter the structure of the heart, impair its function, and elevate the risk of heart failure.

Objectives: The aim of this study was to evaluate the potential correlation between plasma osteopontin levels and the presence and severity of heart failure, as classified by the New York Heart Association (NYHA) functional classification.

Methods: A case-control study was conducted at Ibn-Al Bitar Cardiology Center, Baghdad Medical City, and Ibn Al-Nafees Hospital. It included 74 patients diagnosed with heart failure and 70 control subjects without heart failure. The study period spanned one year, from January 2022 to January 2023.

Results: The mean osteopontin level was significantly higher in heart failure patients (672 ng/mL) compared to controls (317 ng/mL) with a highly significant difference (P=0.007). Among heart failure types, the DCM group showed a slightly higher mean (701 ng/mL) than the ischemic cardiomyopathy group (643 ng/mL), but the difference was not statistically significant (P=0.359).

Conclusions: Osteopontin is markedly elevated in heart failure patients and correlates with NYHA class, suggesting its potential role in diagnosis and monitoring regardless of etiology.