Increased C reactive protein, cardiac troponin I and GLS are associated with myocardial inflammation in patients with non-ischemic heart failure

Sci Rep. 2021 Feb 4;11(1):3008. doi: 10.1038/s41598-021-82592-8.

Abstract

Inflammatory cardiomyopathy diagnosed by endomyocardial biopsy (EMB) is common in non-ischemic heart failure (HF) and might be associated with adverse outcome. We aimed to identify markers predicting myocardial inflammation in HF. We screened 517 patients with symptomatic non-ischemic HF who underwent EMB; 397 patients (median age 54 [IQR 43/64], 28.7% females) were included in this study. 230 patients were diagnosed with myocardial inflammation, defined as ≥ 7.0 CD3+ lymphocytes/mm2 and/or ≥ 35.0 Mac1 macrophages/mm2 and were compared to 167 inflammation negative patients. Patients with myocardial inflammation were more often smokers (52.4% vs. 39.8%, p = 0.013) and had higher C-reactive protein (CRP) levels (5.4 mg/dl vs. 3.7 mg/dl, p = 0.003). In logistic regression models CRP ≥ 8.15 mg/dl (OR 1.985 [95%CI 1.160-3.397]; p = 0.012) and Troponin I (TnI) ≥ 136.5 pg/ml (OR 3.011 [1.215-7.464]; p = 0.017) were independently associated with myocardial inflammation, whereas no association was found for elevated brain natriuretic peptide (OR 1.811 [0.873-3.757]; p = 0.111). In prognostic performance calculation the highest positive predictive value (90%) was detected for the combination of Global longitudinal strain (GLS) ≥ -13.95% and TnI ≥ 136.5 pg/ml (0.90 (0.74-0.96)). Elevated CRP, TnI and GLS in combination with TnI can be useful to detect myocardial inflammation. Smoking seems to predispose for myocardial inflammation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Biomarkers / blood
  • C-Reactive Protein / genetics*
  • Female
  • Genetic Predisposition to Disease
  • Glutaminase / blood*
  • Heart Failure / blood*
  • Heart Failure / genetics
  • Heart Failure / pathology
  • Humans
  • Inflammation / blood*
  • Inflammation / genetics
  • Inflammation / pathology
  • Male
  • Middle Aged
  • Myocardial Infarction / blood
  • Myocardial Infarction / genetics
  • Myocardial Infarction / pathology
  • Myocardium / metabolism
  • Myocardium / pathology
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Smoking / adverse effects
  • Troponin I / blood*
  • Troponin I / genetics

Substances

  • Biomarkers
  • Troponin I
  • C-Reactive Protein
  • GLS protein, human
  • Glutaminase