SERUM cardiac‐specific biomarkers and atrial fibrillation in myotonic dystrophy type I

Abstract

Introduction The aim of the present study was to evaluate the role of high‐sensitivity cardiac troponin I, N terminal pro‐B‐type natriuretic peptide (NT‐proBNP), creatine kinase‐MB mass concentration (CK‐MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients. Materials and methods The study enrolled 60 consecutive DM1 patients (age 50.3 ± 7.3 years, 34 male) who underwent pacemaker (PM) implantation for cardiac rhythm abnormalities and 60 PM recipients whose age and sex matched served as control group. All DM1 patients underwent a 12‐lead electrocardiogram, 2D color Doppler echocardiogram, biomarkers measurements and device interrogation at implantation, 1 month after and every 6 months thereafter for a minimum of 2‐year follow‐up. Results The study population was divided into two groups according to the presence of AF (AF group vs non‐AF group). The AF group was older (47.3 ± 8 vs 38.6 ± 7 years, P = .03) and showed higher serum levels of NT‐proBNP (151 ± 38.4 vs 107.3 ± 24.2 pg/mL, P < .001) and CP (18.9 ± 4.5 vs 7 ± 2.3 P < .001) than non‐AF Group. NT‐proBNP (P < .001) and CP (P < .001) were found to be an independent predictor of AF. Based on the receiver‐operating characteristics curve analysis, the cut‐off value for NT‐proBNP that best predicted AF event in DM1 patients was 123 pg/ml (sensitivity of 83.3% and specificity of 86.5%); the cut‐off value for CP that best predicted AF event in DM1 patients was 9 pmol/L (sensitivity of 89% and specificity of 87%). Conclusion NT‐proBNP and CP represent two independent predictors of AF onset in DM1 population with conduction disturbances underwent PM implantation.

Cardiac Pathology in Myotonic Dystrophy Type 1

“…A recent, intriguing study found that increased levels of serum NT-proBNP and copeptin (a C-terminus peptide generated from pre pro-peptide of arginine vasopressin), two tests used in monitoring heart failure, might be predictors of Afib onset in a DM1 population, suggesting a potential for identifying patients requiring more frequent monitoring and follow-up [ 40 ]. Other groups have also reported that elevated NT-pro-BNP levels are an independent predictor of cardiac conduction abnormalities [ 41 ].…”