Abstrakt
The natural history of hypertrophic cardiomyopathy (HCM) varies from an asymptomatic and benign clinical course to sudden premature death. Therefore, the new markers are searched with the aim to detect risk patients and improve their prognosis.
The aim of this study was to test a cardiac multimarker testing strategy in detection of initial structural changes in patients with nonobstructive hypertrophic cardiomyopathy (HCM). In the group of 47 patients with nonobstructive HCM (58.4 +- 12.4 years, 12 emales) the mean left ventricle mass was 344.8 +- 129.9 g, the mean left ventricle mass index was 171.4 +- 60.2 g.m-2.
We observed increased concentration of cardiac markers in peripheral blood: high sensitivity troponin T (hsTnT): median: 9 ng/L (IQR: 5 - 16 ng/L), vs. controls: 7 (5 - 9) ng/L, p 0.03; creatine kinase MB isoenzyme (CK MB): 2 (1.4 - 2.7) μg/L vs. 1.6 (1.1 - 2.2) μg/L, p 0.04; myoglobin 46.4 (33.3 - 65.2) μg/L vs. 35.6 (22.8 - 43.7) μg/L, p 0.001; heart type of fatty acid binding protein (hFABP): 1.8 (1.4 - 3.3) μg/L vs. 1.6 (1.3 - 2.1) μg/L, p 0.05; glycogen phosphorylase BB (GPBB): 3.9 (2.5 - 6.3) μg/L vs. 2.3 (1.9 - 4.2) μg/L, p 0.001. The analysis of the associations of left ventricle mass index and cardiac markers revealed its significant association with hFABP (r = 0.41, 95% CI: 0.07-0.66, p 0.01), CKMB (r = 0.33, 95% CI: 0.11-0.59, p 0.05), and with hsTnT (r = 0.39, 95%CI: 0.12 - 0.62, p 0.008).
This study indicates potential clinical use of the multimarker testing in diagnosis and screening of the hypertrophic cardiomyopathy.