Do troponin and B-natriuretic peptide detect cardiomyopathy in transthyretin amyloidosis?
OBJECTIVE
Cardiomyopathy is a well known complication in familial amyloidotic polyneuropathy (FAP). Troponin T and B-natriuretic peptide (BNP) have been shown to be excellent markers for heart complications in AL-amyloidosis. The aim of the study was to investigate troponin T, troponin I and BNP as markers for myocardial damage and failure in FAP.


METHODS
Retrospective investigation of patients with FAP.


METHODS
Tertiary referral centre.


METHODS
Twenty-nine patients who had been submitted for evaluation of FAP.


METHODS
Two-dimensional M-mode and Doppler echocardiography and strain echocardiographic examination. Measurement of Troponin T, troponin I and BNP.


RESULTS
Troponin T was detectable in only three patients who all had abnormal interventricular septal (IVS) thickness. Troponin I was abnormal in six patients (21%), of which only two had an increased IVS thickness. The heart function was generally well preserved in the patients in spite of hypertrophy of the IVS in 14 patients. BNP was elevated in 22 patients (76%), and it correlated significantly with IVS thickness and basal septal strain.


CONCLUSIONS
Transthyretin amyloid seems to be less harmful to myocytes than that of AL amyloid as evaluated by serum troponin T and I as well as by echocardiography. BNP appears to be a sensitive marker for cardiomyopathy in FAP, and could prove valuable for follow-up purposes as has been shown for AL-amyloidosis patients.
Suhr
O B
OB
Department of Public Health and Clinical Medicine, Umeå University Hospital, Umeå, Sweden. ole.suhr@medicin.umu.se
Anan
I
I
Backman
C
C
Karlsson
A
A
Lindqvist
P
P
Mörner
S
S
Waldenström
A
A
D000328:Adult; D000368:Aged; D000682:Amyloid / Q000502:physiology; D028227:Amyloid Neuropathies, Familial / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011228:Prealbumin / Q000502:physiology; D012189:Retrospective Studies; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*; D014463:Ultrasonography
D000682:Amyloid; D015415:Biomarkers; D011228:Prealbumin; D019210:Troponin I; D020107:Troponin T; C076571:transthyretin-related amyloid fibril protein, human; D020097:Natriuretic Peptide, Brain