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Potential Prognostic Impact of High-Sensitivity C-Reactive Protein in the Analysis of Whole-Heart Myocardial
Karolina Melinyte-Ankudavice1,2, Gabriele Jakuskaite1,2, Gryte Galnaitiene3
1Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Insights
High-sensitivity C-reactive protein (hs-CRP) levels strongly correlate with early left atrial strain changes in non-ischemic dilated cardiomyopathy (NIDCM) patients. This finding may help predict heart failure progression.
Area of Science:
- Cardiology
- Biomarkers
- Cardiac Mechanics
Background:
- Non-ischemic dilated cardiomyopathy (NIDCM) is a significant cause of heart failure (HF).
- Detailed investigation of whole-heart mechanics and morphometry is crucial for understanding NIDCM.
- Existing biomarkers require evaluation for their association with early cardiac changes.
Purpose of the Study:
- To investigate the relationship between commonly used biomarkers and early alterations in whole-heart myocardial mechanics and morphometry in NIDCM patients.
- To identify predictive biomarkers for early changes in cardiac function.
Main Methods:
- Prospective single-center study with 98 NIDCM patients at diagnosis and 42 at 1-year follow-up.
- Cardiac magnetic resonance imaging (CMR) used for whole-heart myocardial mechanics and morphometry analysis.
- Assessment of biomarkers including hs-CRP, troponin I, BNP, and others at diagnosis.
Main Results:
- High-sensitivity C-reactive protein (hs-CRP) showed the strongest correlation with 1-year changes in left atrial global longitudinal strain (LA GLS) (r = -0.659, P < .001).
- An hs-CRP cut-off value of 3.6 mg/L predicted reduced LA GLS with 100% sensitivity and 87% specificity (AUC = 0.833).
- Other biomarkers had weaker associations, primarily with left heart parameters.
Conclusions:
- In NIDCM patients, key heart failure biomarkers are linked to early changes in left-heart mechanics and morphometrics.
- Initial hs-CRP levels demonstrate the strongest relationship with early LA GLS changes, suggesting its prognostic value.
Background:
Non-ischemic dilated cardiomyopathy (NIDCM) remains a significant part of heart failure (HF) origin, requiring more detailed investigation of the whole heart. This study aimed to examine the commonly used biomarkers in clinical practice and their relationship with early alterations in whole-heart myocardial mechanics and morphometry in patients with NIDCM.
Methods:
In this prospective single-center study, 98 patients (mean age 49.5 ± 10.1 years; 69.4% male) were included in the final sample during the first phase, when the diagnosis of NIDCM was made. After 1 year, 42 patients were evaluated during the second follow-up phase. The cardiac magnetic resonance was used to analyze whole-heart myocardial mechanics and morphometry. Biomarkers (troponin I, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), brain natriuretic peptide, suppression of tumorigenicity 2, and neutrophil to lymphocyte were assessed at the time of the diagnosis.
Results:
The strongest correlations were observed between hs-CRP levels and left atrial (LA) global longitudinal strain (GLS) changes after 1 year (r = -.659, P < .001). It was revealed that the cut-off value of 3.6 mg/l of hs-CRP can prognosticate to find a reduced LA GLS with a sensitivity of 100% and specificity of 87% (AUC, 0.833; 95% CI, 0.65-1.008; P < .001).Other biomarkers had weaker associations with myocardial mechanics and morphometry; relationships were established only with left heart parameters.
Conclusion:
In NIDCM patients, the main biomarkers of HF are related to early changes in left-heart myocardial mechanics and morphometrics. The strongest relationship was between the initial levels of hs-CRP and early changes in LA GLS.
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