Cardiac proteins reveal CHF severity

Several circulating cardiac proteins may reflect the severity of congestive heart failure (CHF), researchers report in the journal Heart.

Several circulating cardiac proteins may reflect the severity of congestive heart failure (CHF), researchers report in the journal Heart. The Japanese team found that serum concentrations of myosin light chain I (MLC0I), heart fatty acid binding protein (H-FABP), creatine kinase isoenzyme MB (CK-MB), and troponin T (TnT) all decreased with treatment for CHF. T Goto (Enshu General Hospital, Hamamatsu) and colleagues examined the utility of myocardium specific proteins as markers for CHF severity, after realizing myocardial structure is altered in CHF. Changes in levels of these proteins were compared with those of the neurohormone brain natriuretic peptide (BNP), which has already been shown to predict left ventricular function and prognosis. The study included 48 consecutive patients at single hospital, who were hospitalized with acute CHF deterioration associated with cardiomyopathy. Twenty-seven patients were men, and the average age in the group was 69 years. All participants had a left ventricular ejection fraction of less than 50% on 2-D echocardiography, and symptomatic HF of New York Heart Association class II to IV. Prior to treatment, Goto’s team report that patients had higher than normal levels of MLC-I, H-FABP, TnT, and BNP, although levels of CK-MB were close to normal. Following conventional, intensive CHF medical treatment, consisting of intravenous diuretics, catecholamines, carperitide, or phosphodiesterase inhibitors, there was a significant decrease in levels of MLC-I, from a mean of 3.2 to 1.2 g/l, H-FABP, from 9.0 to 6.0 g/l, and CK-MB, from 5.4 to 2.9 g/l (p<0.0001 in all cases). Levels of TnT also decreased, from a mean of 30 to 9 ng/l (p<0.001), as did those of BNP, from 761 to 156 ng/l (p<0.0001). Goto and team note that decreases in H-FABP and CK-MB concentrations after treatment correlated with the decrease in BNP concentrations, and that absolute concentrations of all four cardiac proteins correlated positively with those of BNP (p<0.01). While acknowledging the small number of patients in the study, they conclude that the correlation of the cardiac protein markers with BNP "shows that cardiac proteins may serve as reliable markers for the evaluation of the severity of CHF or the effect of treatment of CHF." The team adds: "Since BNP concentrations do not appear to indicate the severity of CHD in some cases, measurement of the circulating concentrations of these cardiac proteins in combination with BNP may provide more useful information than measurements of BNP concentrations alone in the management of patient with CHF."(Source: www.incirculation.net)