Cardiac myosin binding protein C correlate with cardiac troponin I during an exercise training program in patients
E Riveland1,2, A Ushakova3, T Valborgland2
1Department of Cardiology, Stavanger University Hospital, Stavanger, Norway.
Insights
Cardiac myosin binding protein C (cMyC) levels correlate with high-sensitivity troponin I (hs-cTnI) in chronic heart failure patients undergoing exercise. This suggests cMyC may indicate subclinical myocardial damage during training.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Cardiac myosin binding protein C (cMyC) is an emerging biomarker for myocardial injury, detected earlier and cleared faster than cardiac troponins.
- cMyC demonstrates discriminatory power similar to high-sensitivity troponins in diagnosing myocardial infarction and is linked to outcomes in acute heart failure.
- The relationship between cMyC and cardiac troponins in chronic heart failure patients during exercise training remains unclear.
Purpose of the Study:
- To investigate the association between cardiac myosin binding protein C (cMyC) and high-sensitivity troponin I (hs-cTnI) in patients with symptomatic chronic heart failure with reduced ejection fraction (HFrEF).
- To evaluate changes in cMyC and hs-cTnI levels during a 12-week exercise training program in HFrEF patients.
Main Methods:
- A post hoc analysis of the multicentre randomized SMARTEX trial involving symptomatic heart failure patients.
- Patients were assigned to high-intensity interval training, moderate continuous training, or a control group for 12 weeks.
- Serum levels of cMyC and hs-cTnI were measured at baseline and 12 weeks, with statistical analyses including Bland-Altman plots and linear regression.
Main Results:
- No significant differences in cMyC level changes were observed between the exercise intervention and control groups.
- A significant correlation was found between the changes in log-transformed cMyC and log-transformed hs-cTnI levels (R = 0.52, P < 0.001).
- A 10% increase in cMyC levels was associated with an approximate 5% rise in hs-cTnI levels.
Conclusions:
- Changes in cMyC levels are significantly associated with hs-cTnI levels in symptomatic chronic HFrEF patients during a 12-week exercise program.
- This association suggests that cMyC may serve as a future biomarker for detecting subclinical myocardial damage in this patient population.
- The findings contribute to understanding the role of novel biomarkers in monitoring cardiac health during rehabilitation.
Background:
Cardiac myosin binding protein C (cMyC) is an emerging new biomarker of myocardial injury rising earlier and cleared faster than cardiac troponins. It has discriminatory power similar to high-sensitive troponins in diagnosing myocardial infarction in patients presenting with chest pain. It is also associated with outcome in patients with acute heart failure. It is currently unclear how it relates to cardiac troponins in patients with chronic heart failure undergoing exercise training.
Methods And Results:
This is a post hoc analysis of symptomatic heart failure patients in the multicentre randomized SMARTEX trial. Patients were randomized to one of three arms: high-intensity interval training, moderate continuous training and recommendation of regular exercise serving as control group (CG) for 12 weeks. As the training load in the two intervention arms was similar, these patients were merged and constituted the intervention group (IG). Clinical data and measurements were obtained at baseline and at 12 weeks. In 205 patients, serum was available for cMyC testing and in 196 patients, serum was available for hs-cTni testing. Due to non-normal distribution, cMyC and hs-cTnI measurements were log-transformed. A Bland-Altman plot was employed to evaluate the agreement of cMyC with hs-cTnI measurements. Lastly, a linear regression model was applied. No significant differences were observed in the change of cMyC levels between the groups throughout the intervention period (∆ cMyC IG: -0.5 [IQR: -3.4; 2.1] vs. ∆ cMyC CG: -0.7 [IQR: -2.7; 2.6]). The change in log hs-cTnI was significantly correlated with the change in log cMyC during the 12-week intervention period, with a Pearson correlation coefficient of R = 0.52 (95% CI 0.37-0.66, P < 0.001). For every 10% increase in cMyC levels, hs-cTnI levels rose by approximately 5%.
Conclusions:
Changes in levels of the novel biomarker cMyC were significantly associated with hs-cTnI serum levels in patients with symptomatic chronic HFrEF during a structured 12-week exercise training programme. This may indicate that cMyC has a role as a future marker of subclinical myocardial damage.
More Related Videos
07:40Impact of High-intensity Interval Exercise and Moderate-Intensity Continuous Exercise on the Cardiac Troponin T Level at an Early Stage of Training
Published on: October 10, 2019
08:29Assessment of Myofilament Ca2+ Sensitivity Underlying Cardiac Excitation-contraction Coupling
Published on: August 1, 2016
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:29Pathophysiology of Cardiac Performance