CARDIOVASCULAR MEDICINE

Circulating concentrations of cardiac proteins indicate the severity of congestive heart failure

T Goto¹, H Takase¹, T Toriyama¹, T Sugiura¹, K Sato², R Ueda³, Y Dohi³

¹ Department of Internal Medicine, Enshu General Hospital, Hamamatsu, Japan
² Department of Internal Medicine, Johoku Hospital, Nagoya, Japan
³ Internal Medicine and Molecular Science, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan

Correspondence to:
Correspondence to:
Dr Y Dohi
Internal Medicine and Molecular Science, Graduate School of Medical Sciences, Nagoya City University, Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; ydohi{at}med.nagoya-cu.ac.jp

Objective: To test the hypothesis that myocardium specific proteins may be useful markers for evaluating the severity of congestive heart failure.

Methods: Serum concentrations of myosin light chain I (MLC-I), heart fatty acid binding protein (H-FABP), creatine kinase isoenzyme MB (CK-MB), and troponin T (TnT) and plasma concentrations of brain natriuretic peptide (BNP) were determined in 48 patients with acute deterioration of congestive heart failure, both before and after effective treatment.

Results: Before treatment, MLC-I (mean (SEM) 3.2 (2.2) µg/l), H-FABP (9.0 (3.5) µg/l), TnT (30 (21) ng/l), and BNP (761 (303) ng/l) were higher than the normal reference range, and concentrations of CK-MB (5.4 (2.9) µg/l) were near normal. Treatment of congestive heart failure with conventional medication significantly decreased the concentrations of MLC-I (1.2 (0.3) µg/l, p < 0.0001), H-FABP (6.0 (2.0) µg/l, p < 0.0001), CK-MB (2.9 (1.5) µg/l, p < 0.0001), TnT (9 (1) ng/l, p < 0.001), and BNP (156 (118) ng/l, p < 0.0001). The decreases in H-FABP and CK-MB concentrations after treatment correlated with the decrease in BNP concentrations (p < 0.05). The absolute concentrations of MLC-I, H-FABP, CK-MB, and TnT correlated positively with those of BNP (p < 0.01).

Conclusions: These findings suggest that MLC-I, H-FABP, CK-MB, and TnT may be used as reliable markers for the evaluation of the severity of congestive heart failure.

Keywords: brain natriuretic peptide; creatine kinase isoenzyme MB; heart fatty acid binding protein; myosin light chain I; troponin T

Abbreviations: BNP, brain natriuretic peptide; CHF, congestive heart failure; CK-MB, creatine kinase isoenzyme MB; H-FABP, heart fatty acid binding protein; MLC-I, myosin light chain I; NYHA, New York Heart Association; TnT, troponin T

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