Hypertrophic Cardiomyopathy: The Time-Synchronized Relationship between Ischemia and Left Ventricular Dysfunction Assessed by Highly Sensitive Troponin I and NT-proBNP

Abstract EN

The aim of this study was to compare NT-proBNP using the absolute values and NT-proBNP/ULN values that were standardized by age and gender between three subgroups: those without ischemia (negative hs-troponin I and no anginal pain (hsTnI-/AP-)), those with painless ischemia (hsTnI+/AP-), and those with painful ischemia (hsTnI+/AP+).

Additionally, echocardiographic parameters were compared in these three subgroups.

The absolute value of NT-proBNP was significantly higher in the painful ischemia subgroup (hsTnI-/AP- vs.

hsTnI+/AP- vs.

hsTnI+/AP+: 502 (174-833) vs.

969 (363-1346) vs.

2053 (323-3283) pg/ml; p=0.018 for the whole-model analysis).

The standardized value of NT-proBNP/ULN was gradually increased (hsTnI-/AP- vs.

hsTnI+/AP- vs.

hsTnI+/AP+: 3.61+0.63 vs.

6.90+1.31 vs.

9.35+1.87; p=0.001 for the whole-model analysis).

In the comparison between subgroups (hsTnI-/AP- vs.

hsTnI+/AP- vs.

hsTnI+/AP+), two echocardiographic parameters increased significantly.

The left ventricular maximum wall thickness (LVMWT) at diastole was 1.99±0.08 cm vs.

2.28±0.13 cm vs.

2.49±0.15 cm (p=0.004 for the whole-model analysis).

The maximal gradient of the provoked left ventricular outflow tract (LVOT) gradient increased significantly in only the painful-ischemia subgroup (11 (7-30) mmHg vs.

12 (9.35-31.5) mmHg vs.

100 (43-120) mmHg).

In conclusion, both painless ischemia and painful ischemia are associated with a gradual, significant increase in NT-proBNP/ULN in comparison to the double-negative hsTnI/AP subgroup.

In contrast, NT-proBNP is significantly higher in only the subgroup with painful ischemia.