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Int J Cardiol. 2015 Apr 15;185:177-85. doi: 10.1016/j.ijcard.2015.03.046. Epub 2015 Mar 4.

Biomarkers of cardiomyocyte injury and stress identify left atrial and left ventricular remodelling and dysfunction: A population-based study.

Author information

1
Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain.
2
The Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium.
3
Department of Biochemistry, University of Navarra Clinic, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona Spain.
4
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK.
5
Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain; Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, University of Navarra, IdiSNA-Navarra Institute for Health Research, Pamplona, Spain. Electronic address: jadimar@unav.es.
6
The Studies Coordinating Centre, Research Unit of Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium; Department of Epidemiology, University of Maastricht, Maastricht, The Netherlands. Electronic address: jan.staessen@med.kuleuven.be.

Abstract

BACKGROUND/OBJECTIVES:

The validation of effective screening tools for the identification of patients with subclinical myocardial remodelling is a major clinical need. Thus, we explored the associations of circulating biomarkers of cardiomyocyte injury and stress with subclinical cardiac remodelling and dysfunction, and with biomarkers reflecting collagen turnover.

METHODS:

We randomly recruited 727 subjects from a general population (51.2% women; mean age 51.3 years). Measurements included echocardiographic left atrial (LA) and left ventricular (LV) structure and function, quantification of high sensitivity cardiac Troponin T (hs-cTnT), NT-proBNP, and biomarkers of collagen types I and III turnover.

RESULTS:

In unadjusted and adjusted analyses, the prevalence of LA enlargement (LAE), LV hypertrophy (LVH) and LV diastolic dysfunction (LVDD) increased with higher hs-cTnT (P ≤ 0.031). NT-proBNP was independently associated with LVDD (P=0.009). Both biomarkers combined yielded significant integrated discrimination and net reclassification improvements (P ≤ 0.014 and P ≤ 0.009, respectively) for LAE, LVH and LVDD, over the conventional risk factors, and were independently and positively associated with biomarkers of collagen type I turnover. In a sensitivity analysis, after excluding participants with previous cardiac diseases, our findings remained consistent.

CONCLUSIONS:

Our population-based study suggested that subclinical LV and LA remodelling were associated with hs-cTnT, and that, in combination with NT-proBNP, hs-cTnT showed incremental diagnostic utility over the conventional risk factors. Both biomarkers were associated with biomarkers of collagen type I turnover. Thus, biomarkers of cardiomyocyte microinjury and hemodynamic stress may stimulate fibrosis-related mechanisms and facilitate the diagnosis of subclinical LA and LV remodelling and dysfunction in the general population.

KEYWORDS:

Collagen metabolism; Diastolic dysfunction; Left atrial remodelling; Left ventricular remodelling; NT-proBNP; hs-cTnT

PMID:
25796005
DOI:
10.1016/j.ijcard.2015.03.046
[Indexed for MEDLINE]

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