Exercise dynamics of cardiac biomarkers and hemoconcentration in patients with chronic systolic heart failure
Abstract
Cardiac troponin, natriuretic peptides, adrenomedullin, and copeptin capture different pathophysiological mechanisms and can be employed in the diagnosis and monitoring of patients with heart failure (HF). The mid-regional fragment of proadrenomedullin, copeptin, the mid-regional fragment of the precursor of the atrial natriuretic peptide and N-terminal pro B-type natriuretic peptide are more stable than biologically active peptides and are, thus, used as surrogates.
Cardiac troponin can be measured by highly sensitive cTnI assay based on single molecule counting (sm-cTnI), which allows measurement of plasma cTnI concentrations in all healthy individuals. Concentration of multiple biomarkers can significantly change upon exercise, which can be caused both by exercise-induced hemoconcentration and by various specific mechanisms such as increased myocardial stress.
Whether the biomarker levels drawn after exercise provide additional prognostic information beyond resting levels remains unclear. The goal of this study was to analyze the dynamics of a set of biomarkers during exercise and to assess whether biomarker measurement immediately after exercise provides better prognostic information than the baseline values.