ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

Q: What does this research mean for the field?

Specific electrocardiogram parameters, including cQTi, pathological Q waves, and complex premature ventricular contractions, significantly correlate with cardiac biomarker levels such as NT-proBNP and hs-cTnI in patients with acute heart failure. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Adriana Chetran; Alexandru Dan Costache; Carmen Iulia Ciongradi; Ștefania-Teodora Duca; Ovidiu Mitu; Victorița Șorodoc; Corina Cianga; Cristina Tuchiluş; Ivona Mitu; Raluca Mitea; Minerva Codruța Bădescu; Irina Afrăsânie; Bogdan Huzum; Ștefana Maria Moisă; Cristian Sorin Prepeliuc; Mihai Roca; Irina Iuliana Costache

doi:10.3390/diagnostics12123037

December 3, 2022DiagnosticsOpen Access

ECG and Biomarker Profile in Patients with Acute Heart Failure: A Pilot Study

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Why the study?

The authors sought to investigate which ECG parameters correlate with usual cardiac biomarkers in patients with acute heart failure to support future research on their combined prognostic value.

Do specific ECG parameters correlate with cardiac biomarkers in patients with acute heart failure?

Structured PICO

Do specific ECG parameters correlate with cardiac biomarkers in patients with acute heart failure?

P

Population

49 patients with acute heart failure and 31 participants in the control group, from Romania (total n=80).

I

Intervention

Measurement of cardiac biomarkers (NT-proBNP, hs-cTnI, CK-MB) combined with 12-lead ECG and 24-hour Holter monitoring

C

Comparator

Control group (n=31)

O

Outcome

Correlation between ECG parameters and cardiac biomarkers (NT-proBNP, hs-cTnI)surrogate

Specific ECG parameters, such as cQTi, pathological Q waves, and complex PVCs, correlate with elevated cardiac biomarkers in acute heart failure, supporting the combined use of ECG and biomarkers for diagnosis and risk stratification.

Implication

May support combined ECG-biomarker assessment in AHF; leaves open impact on risk stratification or outcomes.

Abstract

Background: Biomarkers, electrocardiogram (ECG) and Holter ECG are basic, accessible and feasible cardiac investigations. The combination of their results may lead to a more complex predictive model that may improve the clinical approach in acute heart failure (AHF). The main objective was to investigate which ECG parameters are correlated with the usual cardiac biomarkers (prohormone N-terminal proBNP, high-sensitive cardiac troponin I) in patients with acute heart failure, in a population from Romania. The relationship between certain ECG parameters and cardiac biomarkers may support future research on their combined prognostic value. Methods: In this prospective case-control study were included 49 patients with acute heart failure and 31 participants in the control group. For all patients we measured levels of prohormone N-terminal proBNP (NT-proBNP), high-sensitive cardiac troponin I (hs-cTnI) and MB isoenzyme of creatine phosphokinase (CK-MB) and evaluated the 12-lead ECG and 24 h Holter monitoring. Complete clinical and paraclinical evaluation was performed. Results: NT-proBNP level was significantly higher in patients with AHF (p < 0.001). In patients with AHF, NT-proBNP correlated with cQTi (p = 0.027), pathological Q wave (p = 0.029), complex premature ventricular contractions (PVCs) (p = 0.034) and ventricular tachycardia (p = 0.048). Hs-cTnI and CK-MB were correlated with ST-segment modification (p = 0.038; p = 0.018) and hs-cTnI alone with complex PVCs (p = 0.031). Conclusions: The statistical relationships found between cardiac biomarkers and ECG patterns support the added value of ECG in the diagnosis of AHF. We emphasize the importance of proper ECG analysis of more subtle parameters that can easily be missed. As a non-invasive technique, ECG can be used in the outpatient setting as a warning signal, announcing the acute decompensation of HF. In addition, the information provided by the ECG complements the biomarker results, supporting the diagnosis of AHF in cases of dyspnea of uncertain etiology. Further studies are needed to confirm long-term prognosis in a multi-marker approach.