Circulating levels of myocardial proteins predict future deterioration of congestive heart failure.
BACKGROUND
This study was designed to test whether circulating levels of myocardium-specific proteins serve as useful markers for the prognosis of patients with congestive heart failure.


RESULTS
Seventy-eight patients with congestive heart failure from dilated cardiomyopathy but in a stable condition were enrolled, and their blood was sampled for measurements of myosin light chain-I (MLC-I), troponin T (TnT), heart fatty-acid-binding protein (H-FABP), and creatine kinase isoenzyme MB (CK-MB). The patients were then followed up for 951 +/- 68 days, with the endpoint being acute deterioration. A univariate analysis revealed that MLC-I, TnT, H-FABP, and CK-MB were significant predictors for acute deterioration of heart failure. Application of the Kaplan-Meier method using cutoff values determined by analysis of receiver operating characteristics curves demonstrated that the incidence of acute deterioration was significantly higher in patients with higher values of MLC-I (61.9%), TnT (52.4%), H-FABP (50.0%), or CK-MB (38.6%) than in those with lower values of these markers (15.8%, 20.4%, 13.6%, and 16.1%, respectively).


CONCLUSIONS
Increased circulating levels of the specific myocardial proteins are related to a higher probability of future acute deterioration of congestive heart failure in patients in a stable condition associated with dilated cardiomyopathy.
Sugiura
Tomonori
T
Department of Internal Medicine, Enshu General Hospital, Hamamatsu, Shizuoka, Japan.
Takase
Hiroyuki
H
Toriyama
Takayuki
T
Goto
Takatoshi
T
Ueda
Ryuzo
R
Dohi
Yasuaki
Y
D000367:Age Factors; D000368:Aged; D015415:Biomarkers / Q000097:blood / Q000378:metabolism*; D002311:Cardiomyopathy, Dilated / Q000097:blood / Q000150:complications / Q000378:metabolism; D052279:Creatine Kinase, MB Form / Q000097:blood / Q000378:metabolism; D050556:Fatty Acid-Binding Proteins / Q000097:blood / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D018994:Myosin Light Chains / Q000097:blood / Q000378:metabolism; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000378:metabolism; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012372:ROC Curve; D020107:Troponin T / Q000097:blood / Q000378:metabolism
D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins; D018994:Myosin Light Chains; D020107:Troponin T; C076659:myosin light chain I; D020097:Natriuretic Peptide, Brain; D052279:Creatine Kinase, MB Form