Highlights
- •Troponin and BNP correlate with disease severity and symptoms in HCM.
- •These markers predict clinical risk independently of established risk factors.
- •These markers can be used for risk stratification and guidance of medical therapy.
Abstract
The diagnosis of hypertrophic cardiomyopathy (HCM) is based on clinical, echocardiographic
and in some cases genetic findings. However, prognostication remains limited except
in the subset of patients with high-risk indicators for sudden cardiac death. Additional
methods are needed for risk stratification and to guide clinical management in HCM.
We reviewed the available data regarding natriuretic peptides and troponins in HCM.
Plasma levels of natriuretic peptides, and to a lesser extent serum levels of troponins,
correlate with established disease markers, including left ventricular thickness,
symptom status, and left ventricular hemodynamics by Doppler measurements. As a reflection
of left ventricular filling pressure, natriuretic peptides may provide an objective
measure of the efficacy of a specific therapy. Both natriuretic peptides and troponins
predict clinical risk in HCM independently of established risk factors, and their
prognostic power is additive. Routine measurement of biomarker levels therefore may
be useful in the clinical evaluation and management of patients with HCM.
Keywords
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References
- Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine.J. Am. Coll. Cardiol. 2010; 64: 83-99
- Effect of B-type natriuretic peptide-guided treatment of chronic heart failure on total mortality and hospitalization: an individual patient meta-analysis.Eur. Heart J. 2014; 35: 1559-1567
- Essential biochemistry and physiology of (NT-pro)BNP.Eur. J. Heart Fail. 2004; 6: 257-260
- Pro-B-type natriuretic peptide-1-108 processing and degradation in human heart failure.Circ. Heart Fail. 2015; 8: 89-97
- Late sodium current inhibition reverses electromechanical dysfunction in human hypertrophic cardiomyopathy.Circulation. 2013; 127: 575-584
- Coronary flow reserve in hypertrophic cardiomyopathy: relation with microvascular dysfunction and pathophysiological characteristics.Neth. Hear. J. 2007; 15: 209-215
- B-type natriuretic peptide and survival in hypertrophic cardiomyopathy.J. Am. Coll. Cardiol. 2013; 61: 2456-2460
- Serum cardiac troponin I is related to increased left ventricular wall thickness, left ventricular dysfunction, and male gender in hypertrophic cardiomyopathy.Clin. Cardiol. 2010; 33: E1-E7
- Usefulness of B-type natriuretic peptide assay in the assessment of symptomatic state in hypertrophic cardiomyopathy.Circulation. 2004; 109: 984-989
- Marked expression of plasma brain natriuretic peptide is a special feature of hypertrophic obstructive cardiomyopathy.J. Am. Coll. Cardiol. 1996; 28: 1234-1242
- Ventricular expression of brain natriuretic peptide in hypertrophic cardiomyopathy.Circulation. 1993; 88: 372-380
- Interaction of myocytes and nonmyocytes is necessary for mechanical stretch to induce ANP/BNP production in cardiocyte culture.J. Cardiovasc. Pharmacol. 1998; 31: S357-S359
- Natriuretic peptides in the regulation of cardiovascular physiology and metabolic events.J. Am. Heart Assoc. 2015; 4
- Hypertrophic cardiomyopathy: histopathological features of sudden death in cardiac troponin T disease.Circulation. 2001; 104: 1380-1384
- The case for myocardial ischemia in hypertrophic cardiomyopathy.J. Am. Coll. Cardiol. 2009; 54: 866-875
- The coronary circulation and blood flow in left ventricular hypertrophy.J. Mol. Cell. Cardiol. 2012; 52: 857-864
- Intramural (“small vessel”) coronary artery disease in hypertrophic cardiomyopathy.J. Am. Coll. Cardiol. 1986; 8: 545-557
- Spatial relationship between coronary microvascular dysfunction and delayed contrast enhancement in patients with hypertrophic cardiomyopathy.J. Nucl. Med. 2008; 49: 1090-1096
- Comparison of secretion pattern between A-type and B-type natriuretic peptides in patients with old myocardial infarction.J. Am. Coll. Cardiol. 1995; 25: 1105-1110
- Coronary microvascular ischemia in hypertrophic cardiomyopathy — a pixel-wise quantitative cardiovascular magnetic resonance perfusion study.J. Cardiovasc. Magn. Reson. 2014; 16: 49
- Prognostic value of quantitative contrast-enhanced cardiovascular magnetic resonance for the evaluation of sudden death risk in patients with hypertrophic cardiomyopathy.Circulation. 2014; 130: 484-495
- Measurements of baseline and follow-up concentrations of cardiac troponin-T and brain natriuretic peptide in patients with heart failure from various etiologies.Heart Vessel. 2006; 21: 344-349
- Combined measurements of cardiac troponin I and brain natriuretic peptide are useful for predicting adverse outcomes in hypertrophic cardiomyopathy.Circ. J. 2011; 75: 919-926
- Significance of high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy.J. Am. Coll. Cardiol. 2013; 62: 1252-1259
- Serum levels of high-sensitivity troponin T: a novel marker for cardiac remodeling in hypertrophic cardiomyopathy.J. Card. Fail. 2010; 16: 950-956
- Usefulness of serum cardiac troponins T and I to predict cardiac molecular changes and cardiac damage in patients with hypertrophic cardiomyopathy.Int. Heart J. 2013; 54: 202-206
- Relation of highly sensitive cardiac troponin T in hypertrophic cardiomyopathy to left ventricular mass and cardiovascular risk.Am. J. Cardiol. 2014; 113: 1240-1245
- Prevalence and determinants of elevated high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy.J. Cardiol. 2014; 63: 140-144
- Usefulness of brain natriuretic peptide levels in the clinical evaluation of patients with hypertrophic cardiomyopathy.Am. J. Cardiol. 2007; 100: 712-714
- Usefulness of N-terminal pro-B-type natriuretic peptide to predict clinical course in patients with hypertrophic cardiomyopathy.Am. J. Cardiol. 2006; 98: 1504-1506
- Significance of brain natriuretic peptide in the evaluation of symptoms and the degree of left ventricular diastolic dysfunction in patients with hypertrophic cardiomyopathy.Hell. J. Cardiol. 2006; 47: 344-351
- Prognostic values of highly sensitive cardiac troponin T and B-type natriuretic peptide for clinical features in hypertrophic obstructive cardiomyopathy: a cross-sectional study.BMJ Open. 2014; 4e005968
- Usefulness of N-terminal pro-B-type natriuretic peptide levels to predict exercise capacity in hypertrophic cardiomyopathy.Am. J. Cardiol. 2006; 98: 515-519
- Significance and determinants of cardiac troponin I in patients with obstructive hypertrophic cardiomyopathy.Am. J. Cardiol. 2015; 116: 1744-1751
- Prognostic value of N-terminal pro-brain natriuretic peptide in outpatients with hypertrophic cardiomyopathy.Am. J. Cardiol. 2013; 112: 1190-1196
- Plasma amino-terminal pro-B-type natriuretic peptide quantification in hypertrophic cardiomyopathy.Am. Heart J. 2005; 150: 1228-1232
- Left atrial remodelling in hypertrophic cardiomyopathy: relation with exercise capacity and biochemical markers of tissue strain and remodelling.Int. J. Clin. Pract. 2009; 63: 1465-1471
- Tissue doppler imaging and plasma BNP levels to assess the prognosis in patients with hypertrophic cardiomyopathy.J. Am. Soc. Echocardiogr. 2011; 24: 1020-1025
- Increased brain natriuretic peptide secretion is a marker of disease progression in nonobstructive hypertrophic cardiomyopathy.J. Card. Fail. 2007; 13: 380-388
- Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy.Circulation. 2001; 104: 2517-2524
- Association of elevated plasma B-type natriuretic peptide levels with paroxysmal atrial fibrillation in patients with nonobstructive hypertrophic cardiomyopathy.Clin. Biochem. 2008; 41: 134-139
- Relation between serum N-terminal pro-brain natriuretic peptide and prognosis in patients with hypertrophic cardiomyopathy.Eur. Heart J. 2013; 34: 2529-2537
- Symptomatic ventricular tachyarrhythmia is associated with delayed gadolinium enhancement in cardiac magnetic resonance imaging and with elevated plasma brain natriuretic peptide level in hypertrophic cardiomyopathy.J. Cardiol. 2008; 52: 146-153
- Use of a highly-sensitive cardiac troponin I assay in a screening population for hypertrophic cardiomyopathy: a case-referent study.BMC Cardiovasc. Disord. 2013; 13: 70
- Usefulness of high-sensitivity cardiac troponin T and brain natriuretic peptide as biomarkers of myocardial fibrosis in patients with hypertrophic cardiomyopathy.Am. J. Cardiol. 2013; 112: 867-872
- Effect of losartan on left ventricular diastolic function in patients with nonobstructive hypertrophic cardiomyopathy.Am. J. Cardiol. 2005; 96: 1563-1567
- Impact of chronic use of cibenzoline on left ventricular pressure gradient and left ventricular remodeling in patients with hypertrophic obstructive cardiomyopathy.J. Cardiol. 2015;
Article info
Publication history
Published online: May 14, 2016
Accepted:
May 12,
2016
Received:
April 9,
2016
Identification
Copyright
© 2016 Elsevier Ireland Ltd. All rights reserved.
