title: Elevated Cardiac Enzymes in Hypertrophic Cardiomyopathy Patients With Heart Failure - A 20-Year Prospective Follow-up Study.
abstract: BACKGROUND
  To better understand the evolution of typical hypertrophic cardiomyopathy (HCM) to heart failure (HF), we investigated the relationship between serum biochemical abnormalities and changes in left ventricular (LV) remodeling.
  
  
  RESULTS
  Seventy-seven HCM patients were followed for 20 years. Creatine kinase (CK), CK-MB, lactate dehydrogenase (LDH), LDH-1, troponin T and myosin light chain-1 (MLC-1) were measured. Abnormal CK-MB elevation was observed in 64% of HCM patients. LDH-1 was not significantly different compared with the control subjects. Troponin T elevation was observed in 3 HCM patients and MLC-1 elevation was not observed. According to median CK-MB, HCM patients were divided into 2 groups: group H (CK-MB ≥2.5%, n=33) and group L (CK-MB <2.5%, n=44). During the follow-up period in group H, LV end-diastolic dimension increased (P<0.0001), fractional shortening decreased (P<0.0004), and left atrial dimension increased (P<0.0001). The markers reflecting LV hypertrophy were significantly decreased. In group L, LV end-diastolic dimension increased (P<0.02) and left atrial dimension increased (P<0.0001). HF was observed in 18 patients in group H and in 4 in group L. There were 14 HF deaths in group H and 2 in group L, and 3 sudden cardiac deaths in group H.
  
  
  CONCLUSIONS
  Persistent elevation of cardiac enzymes in HCM patients indicates ongoing myocardial injury, ultimately resulting in death by HF.
authors.affiliation: Division of Cardiology, Uwajima City Hospital.
authors.forename: Mareomi
authors.initials: M
authors.lastname: Hamada
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtani
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Ikeda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006332:Cardiomegaly / Q000097:blood / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood / Q000473:pathology; D006801:Humans; D007527:Isoenzymes / Q000097:blood; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009124:Muscle Proteins / Q000097:blood*; D009219:Myosin-Light-Chain Kinase / Q000097:blood*; D011446:Prospective Studies; D020107:Troponin T / Q000097:blood*
chemical_list: D007527:Isoenzymes; D009124:Muscle Proteins; D020107:Troponin T; D007770:L-Lactate Dehydrogenase; C409667:lactate dehydrogenase 1; D009219:Myosin-Light-Chain Kinase