Troponin, B-type natriuretic peptides and outcomes in severe heart failure

Differences between ischemic and dilated cardiomyopathies

Wayne L. Miller, Karen A. Hartman, Mary F. Burritt, John C Jr. Burnett, Allan S Jaffe

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Background: Ischemic (ISCM) and idiopathic dilated (IDCM) cardiomyopathies have different responses to therapy and outcomes. Both may demonstrate elevations in troponin and B-type natriuretic peptides, but biomarker levels have not been reported to differ as a function of the etiology of heart failure (HF). Accordingly, we compared these biomarkers in patients with chronic HF. Hypothesis: Biomarker levels of troponin T, troponin I, B-type natriuretic peptide (BNP), and N-terminal prohormone brain natriuretic peptide (NT-proBNP) are quantitatively different between ischemic and idiopathic dilated etiologies of chronic HF. Methods: Forty patients (27 male, 68 ± 2 years; LVEF 25 ± 1%; NYHA Class III-IV) admitted to hospital for acute HF were studied. Biomarkers were drawn at admission prior to treatment intervention. Results: Of the 40 patients, 27 had ISCM and 13 IDCM. Baseline clinical characteristics were similar with the exception of GFR. cTnT, cTnI, and BNP levels were higher in ISCM patients (cTnT: 0.373 ± 0.145 vs. 0.064 ± 0.016 ng/mL, p < 0.05; cTnI: 2.02 ± 0.76 vs. 0.21 ± 0.11 ng/mL, p < 0.05; BNP: 776 ± 91 vs. 532 ± 85 pg/mL, p < 0.05). Cardiovascular mortality during follow up (10 ± 1 months) was 48% in patients with ISCM and 23% with IDCM (p < 0.05). Conclusions: Patients with acutely decompensated chronic HF have elevations in troponin and BNP. These elevations, as well as mortality are significantly higher in patients with ISCM compared to IDCM. The differential levels in biomarkers may be due to differences in disease pathogenesis, and fit with the adverse prognosis in these patients.

Original languageEnglish (US)
Pages (from-to)245-250
Number of pages6
JournalClinical Cardiology
Volume30
Issue number5
DOIs
StatePublished - May 2007

Fingerprint

Troponin
Brain Natriuretic Peptide
Dilated Cardiomyopathy
Heart Failure
Biomarkers
Troponin T
Troponin I
Mortality
Therapeutics

Keywords

  • BNP
  • Cardiomyopathy
  • Heart failure
  • NT-proBNP
  • Outcomes
  • Troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Troponin, B-type natriuretic peptides and outcomes in severe heart failure : Differences between ischemic and dilated cardiomyopathies. / Miller, Wayne L.; Hartman, Karen A.; Burritt, Mary F.; Burnett, John C Jr.; Jaffe, Allan S.

In: Clinical Cardiology, Vol. 30, No. 5, 05.2007, p. 245-250.

Research output: Contribution to journalArticle

@article{cb1e5064c95e42439ef7450894934fd3,
title = "Troponin, B-type natriuretic peptides and outcomes in severe heart failure: Differences between ischemic and dilated cardiomyopathies",
abstract = "Background: Ischemic (ISCM) and idiopathic dilated (IDCM) cardiomyopathies have different responses to therapy and outcomes. Both may demonstrate elevations in troponin and B-type natriuretic peptides, but biomarker levels have not been reported to differ as a function of the etiology of heart failure (HF). Accordingly, we compared these biomarkers in patients with chronic HF. Hypothesis: Biomarker levels of troponin T, troponin I, B-type natriuretic peptide (BNP), and N-terminal prohormone brain natriuretic peptide (NT-proBNP) are quantitatively different between ischemic and idiopathic dilated etiologies of chronic HF. Methods: Forty patients (27 male, 68 ± 2 years; LVEF 25 ± 1{\%}; NYHA Class III-IV) admitted to hospital for acute HF were studied. Biomarkers were drawn at admission prior to treatment intervention. Results: Of the 40 patients, 27 had ISCM and 13 IDCM. Baseline clinical characteristics were similar with the exception of GFR. cTnT, cTnI, and BNP levels were higher in ISCM patients (cTnT: 0.373 ± 0.145 vs. 0.064 ± 0.016 ng/mL, p < 0.05; cTnI: 2.02 ± 0.76 vs. 0.21 ± 0.11 ng/mL, p < 0.05; BNP: 776 ± 91 vs. 532 ± 85 pg/mL, p < 0.05). Cardiovascular mortality during follow up (10 ± 1 months) was 48{\%} in patients with ISCM and 23{\%} with IDCM (p < 0.05). Conclusions: Patients with acutely decompensated chronic HF have elevations in troponin and BNP. These elevations, as well as mortality are significantly higher in patients with ISCM compared to IDCM. The differential levels in biomarkers may be due to differences in disease pathogenesis, and fit with the adverse prognosis in these patients.",
keywords = "BNP, Cardiomyopathy, Heart failure, NT-proBNP, Outcomes, Troponin",
author = "Miller, {Wayne L.} and Hartman, {Karen A.} and Burritt, {Mary F.} and Burnett, {John C Jr.} and Jaffe, {Allan S}",
year = "2007",
month = "5",
doi = "10.1002/clc.20075",
language = "English (US)",
volume = "30",
pages = "245--250",
journal = "Clinical Cardiology",
issn = "0160-9289",
publisher = "John Wiley and Sons Inc.",
number = "5",

}

TY - JOUR

T1 - Troponin, B-type natriuretic peptides and outcomes in severe heart failure

T2 - Differences between ischemic and dilated cardiomyopathies

AU - Miller, Wayne L.

AU - Hartman, Karen A.

AU - Burritt, Mary F.

AU - Burnett, John C Jr.

AU - Jaffe, Allan S

PY - 2007/5

Y1 - 2007/5

N2 - Background: Ischemic (ISCM) and idiopathic dilated (IDCM) cardiomyopathies have different responses to therapy and outcomes. Both may demonstrate elevations in troponin and B-type natriuretic peptides, but biomarker levels have not been reported to differ as a function of the etiology of heart failure (HF). Accordingly, we compared these biomarkers in patients with chronic HF. Hypothesis: Biomarker levels of troponin T, troponin I, B-type natriuretic peptide (BNP), and N-terminal prohormone brain natriuretic peptide (NT-proBNP) are quantitatively different between ischemic and idiopathic dilated etiologies of chronic HF. Methods: Forty patients (27 male, 68 ± 2 years; LVEF 25 ± 1%; NYHA Class III-IV) admitted to hospital for acute HF were studied. Biomarkers were drawn at admission prior to treatment intervention. Results: Of the 40 patients, 27 had ISCM and 13 IDCM. Baseline clinical characteristics were similar with the exception of GFR. cTnT, cTnI, and BNP levels were higher in ISCM patients (cTnT: 0.373 ± 0.145 vs. 0.064 ± 0.016 ng/mL, p < 0.05; cTnI: 2.02 ± 0.76 vs. 0.21 ± 0.11 ng/mL, p < 0.05; BNP: 776 ± 91 vs. 532 ± 85 pg/mL, p < 0.05). Cardiovascular mortality during follow up (10 ± 1 months) was 48% in patients with ISCM and 23% with IDCM (p < 0.05). Conclusions: Patients with acutely decompensated chronic HF have elevations in troponin and BNP. These elevations, as well as mortality are significantly higher in patients with ISCM compared to IDCM. The differential levels in biomarkers may be due to differences in disease pathogenesis, and fit with the adverse prognosis in these patients.

AB - Background: Ischemic (ISCM) and idiopathic dilated (IDCM) cardiomyopathies have different responses to therapy and outcomes. Both may demonstrate elevations in troponin and B-type natriuretic peptides, but biomarker levels have not been reported to differ as a function of the etiology of heart failure (HF). Accordingly, we compared these biomarkers in patients with chronic HF. Hypothesis: Biomarker levels of troponin T, troponin I, B-type natriuretic peptide (BNP), and N-terminal prohormone brain natriuretic peptide (NT-proBNP) are quantitatively different between ischemic and idiopathic dilated etiologies of chronic HF. Methods: Forty patients (27 male, 68 ± 2 years; LVEF 25 ± 1%; NYHA Class III-IV) admitted to hospital for acute HF were studied. Biomarkers were drawn at admission prior to treatment intervention. Results: Of the 40 patients, 27 had ISCM and 13 IDCM. Baseline clinical characteristics were similar with the exception of GFR. cTnT, cTnI, and BNP levels were higher in ISCM patients (cTnT: 0.373 ± 0.145 vs. 0.064 ± 0.016 ng/mL, p < 0.05; cTnI: 2.02 ± 0.76 vs. 0.21 ± 0.11 ng/mL, p < 0.05; BNP: 776 ± 91 vs. 532 ± 85 pg/mL, p < 0.05). Cardiovascular mortality during follow up (10 ± 1 months) was 48% in patients with ISCM and 23% with IDCM (p < 0.05). Conclusions: Patients with acutely decompensated chronic HF have elevations in troponin and BNP. These elevations, as well as mortality are significantly higher in patients with ISCM compared to IDCM. The differential levels in biomarkers may be due to differences in disease pathogenesis, and fit with the adverse prognosis in these patients.

KW - BNP

KW - Cardiomyopathy

KW - Heart failure

KW - NT-proBNP

KW - Outcomes

KW - Troponin

UR - http://www.scopus.com/inward/record.url?scp=34249074722&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34249074722&partnerID=8YFLogxK

U2 - 10.1002/clc.20075

DO - 10.1002/clc.20075

M3 - Article

VL - 30

SP - 245

EP - 250

JO - Clinical Cardiology

JF - Clinical Cardiology

SN - 0160-9289

IS - 5

ER -