BACKGROUND: Myocarditis might be associated with increased markers of myocardial injury. However, data on novel biomarkers, such as high-sensitive Troponin T (hs-TnT) or Copeptin, are lacking. This study aimed to determine the diagnostic and prognostic utility of biomarkers in patients with suspected myocarditis. METHODS: Seventy patients with clinically suspected myocarditis (age 43.4 ± 14 years, 76 % male, ejection fraction 36.9 ± 17.8) underwent endomyocardial biopsy (EMB) and were followed for 7.5 (2-21) months. At the time of EMB, blood samples to evaluate concentrations of hs-TnT, Copeptin, NT-proBNP and mid-regional pro-adrenomedullin (MR-proADM) were collected. RESULTS: According to EMB, 6 patients were diagnosed with acute myocarditis (AM) and 36 patients with chronic myocarditis (CM). In 28 patients, EMB revealed no myocardial inflammation (NM). Acute myocarditis was associated with the highest concentrations of hs-TnT compared to other groups (AM 262.9 pg/ml (61.4-884.2); CM 20.4 pg/ml (15.6-20.4); NM 19.5 pg/ml (13.8-50.7); p < 0.0001). No significant differences existed in the Copeptin, NT-proBNP, and MR-proADM concentrations between the groups. The concentration of hs-TnT was significantly higher in myocarditis when myocardial viral genome was detected (37.4 pg/ml (21.9-163.6) vs. 20 pg/ml (14-44.4); p = 0.042). During follow-up, only NT-proBNP in the highest quartile (>4,225 ng/ml) was predictive for cardiac death or heart transplantation (hazard ratio 9.2; 95% confidence interval 1.7-50; p = 0.011). CONCLUSIONS: Biopsy-proven acute and viral myocarditis is associated with elevated concentrations of hs-TnT. Elevated hs-TnT is highly suggestive of acute myocarditis, if other causes of increased myocardial necrosis markers such as myocardial infarction have been systematically excluded.
BACKGROUND:Myocarditis might be associated with increased markers of myocardial injury. However, data on novel biomarkers, such as high-sensitive Troponin T (hs-TnT) or Copeptin, are lacking. This study aimed to determine the diagnostic and prognostic utility of biomarkers in patients with suspected myocarditis. METHODS: Seventy patients with clinically suspected myocarditis (age 43.4 ± 14 years, 76 % male, ejection fraction 36.9 ± 17.8) underwent endomyocardial biopsy (EMB) and were followed for 7.5 (2-21) months. At the time of EMB, blood samples to evaluate concentrations of hs-TnT, Copeptin, NT-proBNP and mid-regional pro-adrenomedullin (MR-proADM) were collected. RESULTS: According to EMB, 6 patients were diagnosed with acute myocarditis (AM) and 36 patients with chronic myocarditis (CM). In 28 patients, EMB revealed no myocardial inflammation (NM). Acute myocarditis was associated with the highest concentrations of hs-TnT compared to other groups (AM 262.9 pg/ml (61.4-884.2); CM 20.4 pg/ml (15.6-20.4); NM 19.5 pg/ml (13.8-50.7); p < 0.0001). No significant differences existed in the Copeptin, NT-proBNP, and MR-proADM concentrations between the groups. The concentration of hs-TnT was significantly higher in myocarditis when myocardial viral genome was detected (37.4 pg/ml (21.9-163.6) vs. 20 pg/ml (14-44.4); p = 0.042). During follow-up, only NT-proBNP in the highest quartile (>4,225 ng/ml) was predictive for cardiac death or heart transplantation (hazard ratio 9.2; 95% confidence interval 1.7-50; p = 0.011). CONCLUSIONS: Biopsy-proven acute and viral myocarditis is associated with elevated concentrations of hs-TnT. Elevated hs-TnT is highly suggestive of acute myocarditis, if other causes of increased myocardial necrosis markers such as myocardial infarction have been systematically excluded.
Authors: Francesco De Cobelli; Maurizio Pieroni; Antonio Esposito; Cristina Chimenti; Elena Belloni; Renata Mellone; Tamara Canu; Gianluca Perseghin; Carlo Gaudio; Attilio Maseri; Andrea Frustaci; Alessandro Del Maschio Journal: J Am Coll Cardiol Date: 2006-03-29 Impact factor: 24.094
Authors: Garrick C Stewart; Javier Lopez-Molina; Raju V S R K Gottumukkala; Gregg F Rosner; Mary S Anello; Jonathan L Hecht; Gayle L Winters; Robert F Padera; Kenneth L Baughman; Myra A Lipes Journal: Circ Heart Fail Date: 2010-11-19 Impact factor: 8.790
Authors: Ingrid Kindermann; Christine Barth; Felix Mahfoud; Christian Ukena; Matthias Lenski; Ali Yilmaz; Karin Klingel; Reinhard Kandolf; Udo Sechtem; Leslie T Cooper; Michael Böhm Journal: J Am Coll Cardiol Date: 2012-02-28 Impact factor: 24.094
Authors: Till Keller; Stergios Tzikas; Tanja Zeller; Ewa Czyz; Lars Lillpopp; Francisco M Ojeda; Alexander Roth; Christoph Bickel; Stephan Baldus; Christoph R Sinning; Philipp S Wild; Edith Lubos; Dirk Peetz; Jan Kunde; Oliver Hartmann; Andreas Bergmann; Felix Post; Karl J Lackner; Sabine Genth-Zotz; Viviane Nicaud; Laurence Tiret; Thomas F Münzel; Stefan Blankenberg Journal: J Am Coll Cardiol Date: 2010-05-11 Impact factor: 24.094
Authors: T Morgera; A Di Lenarda; L Dreas; B Pinamonti; F Humar; R Bussani; F Silvestri; D Chersevani; F Camerini Journal: Am Heart J Date: 1992-08 Impact factor: 4.749
Authors: B Lauer; C Niederau; U Kühl; M Schannwell; M Pauschinger; B E Strauer; H P Schultheiss Journal: J Am Coll Cardiol Date: 1997-11-01 Impact factor: 24.094
Authors: Ali Yilmaz; Ingrid Kindermann; Michael Kindermann; Felix Mahfoud; Christian Ukena; Anastasios Athanasiadis; Stephan Hill; Heiko Mahrholdt; Matthias Voehringer; Michael Schieber; Karin Klingel; Reinhard Kandolf; Michael Böhm; Udo Sechtem Journal: Circulation Date: 2010-08-16 Impact factor: 29.690
Authors: Jasper Boeddinghaus; Tobias Reichlin; Thomas Nestelberger; Raphael Twerenbold; Yvette Meili; Karin Wildi; Petra Hillinger; Maria Rubini Giménez; Janosch Cupa; Lukas Schumacher; Marie Schubera; Patrick Badertscher; Sydney Corbière; Karin Grimm; Christian Puelacher; Zaid Sabti; Dayana Flores Widmer; Nicolas Schaerli; Nikola Kozhuharov; Samyut Shrestha; Tobias Bürge; Patrick Mächler; Michael Büchi; Katharina Rentsch; Òscar Miró; Beatriz López; F Javier Martin-Sanchez; Esther Rodriguez-Adrada; Beata Morawiec; Damian Kawecki; Eva Ganovská; Jiri Parenica; Jens Lohrmann; Andreas Buser; Dagmar I Keller; Stefan Osswald; Christian Mueller Journal: Clin Res Cardiol Date: 2017-02-01 Impact factor: 5.460
Authors: Christine S Zuern; Britta Walker; Martina Sauter; Malte Schaub; Madhumita Chatterjee; Karin Mueller; Dominik Rath; Sebastian Vogel; Roland Tegtmeyer; Peter Seizer; Tobias Geisler; Reinhard Kandolf; Florian Lang; Karin Klingel; Meinrad Gawaz; Oliver Borst Journal: Clin Res Cardiol Date: 2015-05-26 Impact factor: 5.460
Authors: Dirk Westermann; Johannes Tobias Neumann; Nils Arne Sörensen; Stefan Blankenberg Journal: Nat Rev Cardiol Date: 2017-04-06 Impact factor: 32.419
Authors: Christoph Sinning; Francisco Ojeda; Philipp S Wild; Renate B Schnabel; Michael Schwarzl; Sevenai Ohdah; Karl J Lackner; Norbert Pfeiffer; Matthias Michal; Maria Blettner; Thomas Munzel; Tibor Kempf; Kai C Wollert; Kari Kuulasmaa; Stefan Blankenberg; Veikko Salomaa; Dirk Westermann; Tanja Zeller Journal: Clin Res Cardiol Date: 2016-12-21 Impact factor: 5.460
Authors: Arnt V Kristen; Johannes Rinn; Ute Hegenbart; David Lindenmaier; Corina Merkle; Christoph Röcken; Stefan Hardt; Evangelos Giannitsis; Hugo A Katus Journal: Clin Res Cardiol Date: 2014-10-21 Impact factor: 5.460
Authors: Julius L Katzmann; Peter Schlattmann; Angelos G Rigopoulos; Ewa Noutsias; Boris Bigalke; Matthias Pauschinger; Carsten Tschope; Daniel Sedding; P Christian Schulze; Michel Noutsias Journal: Heart Fail Rev Date: 2020-03 Impact factor: 4.214
Authors: Ulf K Radunski; Gunnar K Lund; Dennis Säring; Sebastian Bohnen; Christian Stehning; Bernhard Schnackenburg; Maxim Avanesov; Enver Tahir; Gerhard Adam; Stefan Blankenberg; Kai Muellerleile Journal: Clin Res Cardiol Date: 2016-07-07 Impact factor: 5.460
Authors: Amy R Kontorovich; Nihir Patel; Arden Moscati; Felix Richter; Inga Peter; Enkhsaikhan Purevjav; Simina Ramona Selejan; Ingrid Kindermann; Jeffrey A Towbin; Michael Bohm; Karin Klingel; Bruce D Gelb Journal: JACC Basic Transl Sci Date: 2021-07-26