Tenascin-C as Predictor of Left Ventricular Remodeling and Mortality in Patients


ŞARLI B. , TOPSAKAL R. , Kaya E. G. , AKPEK M. , LAM Y. Y. , KAYA M.

JOURNAL OF INVESTIGATIVE MEDICINE, cilt.61, ss.728-732, 2013 (SCI İndekslerine Giren Dergi) identifier identifier identifier

  • Cilt numarası: 61 Konu: 4
  • Basım Tarihi: 2013
  • Dergi Adı: JOURNAL OF INVESTIGATIVE MEDICINE
  • Sayfa Sayıları: ss.728-732

Özet

Background: Several cardiac biomarkers, especially brain natriuretic peptide (BNP) and N-terminal (NT)-proBNP, have been used as predictors of prognosis and negative remodeling in DCM. In the present study, we aimed to evaluate the prognostic value of tenascin-C in dilated cardiomyopathy (DCM) and whether it can be used to determine reverse remodeling in patients with DCM.

Background:

 

Several cardiac biomarkers, especially brain natriuretic

peptide (BNP) and N-terminal (NT)-proBNP, have been used as predictors

of prognosis and negative remodeling in DCM. In the present

study, we aimed to evaluate the prognostic value of tenascin-C in dilated

cardiomyopathy (DCM) and whether it can be used to determine reverse

remodeling in patients with DCM.

Methods:

 

Sixty-six patients with DCM were followed up for

12 months after initiation of medical treatment including carvedilol,

ramipril (candesartan if ramipril was not tolerated), spironolactone, and

furosemide. Tenascin-C and NT-proBNP measurements and transthoracic

echocardiography were performed at baseline and at 12 months.

Results:

 

At 12 months, a significant improvement in New York Heart

Association class (2.57

 

T 0.6 vs. 1.87 T 0.5; P G 0.0001), left ventricular

end-diastolic volume (217

 

T 47 vs 203 T 48; P G 0.0001), left ventricular

ejection fraction (29.1

 

T 5.5 vs 30.9 T 3.8; P G 0.0001), NT-proBNP

(2019

 

T 558 vs 1462 T 805; P G 0.0001), and tenascin-C (76 T 19 vs

48

 

T 28; P G 0.0001) values were observed, compared with baseline.

Importantly, decrease in tenascin-C values were correlated with increase

in left ventricular ejection fraction. Tenascin-C (odds ratio [OR],

1.896;

 

G95% confidence interval [CI], 1.543Y2.670; P = 0.02), diabetes

mellitus (OR, 2.456; G95% CI, 1.987

 

Y3.234; P = 0.01) and hypertension

(OR: 2.106,

 

G95% CI, 1.876Y2.897; P = 0.03) were independent

predictors of mortality in patients with DCM.

Conclusion:

 

Reverse ventricular remodeling obtained with carvedilol,

ramipril/candesartan, and spironolacton is associated with decreases in

left ventricular end-diastolic volume, left ventricular end-systolic volume,

tenascin-C levels, and NT-proBNP levels. Consequently, tenascin-C

may be used to evaluate reverse remodeling in patients with DCM.