Persistent elevation of CK-MB (≥2.5%) in hypertrophic cardiomyopathy patients was associated with a higher incidence of heart failure (55% vs 9%) and heart failure deaths over a 20-year follow-up.
Cohort (n=77)
No
Does persistent elevation of cardiac enzymes predict adverse left ventricular remodeling and heart failure death in patients with hypertrophic cardiomyopathy?
Persistent elevation of cardiac enzymes, particularly CK-MB, in HCM patients is associated with progressive adverse LV remodeling and increased risk of heart failure death.
Absolute Event Rate: 54.5% vs 9.1%
BACKGROUND: To better understand the evolution of typical hypertrophic cardiomyopathy (HCM) to heart failure (HF), we investigated the relationship between serum biochemical abnormalities and changes in left ventricular (LV) remodeling. METHODS AND RESULTS: Seventy-seven HCM patients were followed for 20 years. Creatine kinase (CK), CK-MB, lactate dehydrogenase (LDH), LDH-1, troponin T and myosin light chain-1 (MLC-1) were measured. Abnormal CK-MB elevation was observed in 64% of HCM patients. LDH-1 was not significantly different compared with the control subjects. Troponin T elevation was observed in 3 HCM patients and MLC-1 elevation was not observed. According to median CK-MB, HCM patients were divided into 2 groups: group H (CK-MB ≥2.5%, n=33) and group L (CK-MB <2.5%, n=44). During the follow-up period in group H, LV end-diastolic dimension increased (P<0.0001), fractional shortening decreased (P<0.0004), and left atrial dimension increased (P<0.0001). The markers reflecting LV hypertrophy were significantly decreased. In group L, LV end-diastolic dimension increased (P<0.02) and left atrial dimension increased (P<0.0001). HF was observed in 18 patients in group H and in 4 in group L. There were 14 HF deaths in group H and 2 in group L, and 3 sudden cardiac deaths in group H. CONCLUSIONS: Persistent elevation of cardiac enzymes in HCM patients indicates ongoing myocardial injury, ultimately resulting in death by HF.
Hamada et al. (Sun,) conducted a cohort in Hypertrophic cardiomyopathy (n=77). Elevated CK-MB (≥2.5%) vs. Normal CK-MB (<2.5%) was evaluated on Incidence of heart failure. Persistent elevation of CK-MB (≥2.5%) in hypertrophic cardiomyopathy patients was associated with a higher incidence of heart failure (55% vs 9%) and heart failure deaths over a 20-year follow-up.
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