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.
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.
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
T 558 vs 1462 T 805; P G 0.0001), and tenascin-C (76 T 19 vs
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],
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
G95% CI, 1.876Y2.897; P = 0.03) were independent
predictors of mortality in patients with DCM.
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.