Pop GAM, Cramer E, Timmermans J, Bos H, Verheugt FWA

Language: English
References: 12
Page: 415-418
PDF size: 80.98 Kb.

ABSTRACT

Purpose of the work: In patients with hypertrophic cardiomyopathy ischemia may occur due to massive heart weight, myocyte disarray or small vessel disease. We detected elevated troponin levels in some of these patients and hypothesized that troponin release would rise after exercise and diminish after betablockade. Methods and results: In 5 of 7 young patients (6 males) with hypertrophic cardiomyopathy and no overt coronary artery disease we found elevated troponin levels after physical exercise; the peak was between 6 and 9 hours and levels returned to pre-exercise values within 24 hours. Troponin release was consistently diminished after use of a betablocker. Conclusions: Increased troponin release may be present in patients with hypertrophic cardiomyopathy and is temporarily enhanced by exercise and diminishes with betablockade.

REFERENCES

1. Hamm CW, Ravkilde J, Gerhardt W, Jorgensen P, Peheim E, Ljungdahl L, Goldmann B, Katus HA: The prognostic value of serum troponin T in unstable angina. N Engl J Med 1992; 327: 146-150.

2. Hamwi SM, Sharma AK, Weissman NJ, Apple S, Canos DA, Pinnow EE, Lindsay J: Troponin-I elevation in patients with increased left ventricular mass. Am J Cardiol 2003; 92: 88-90.

3. Connolly DJ, Cannata J, Boswood A, Archer J, Groves EA, Neiger R: Cardiac troponin I in cats with hypertrophic cardiomyopathy. J Feline Med Surg 2003; 5: 209-216.

4. Cecchi F, Olivotto I, Gistri R, Lorenzoni R, Chiriatti G, Girolami F, Torricelli F, Camici PG: Coronary microvascular dysfunction and prognosis in hypertrophic cardiomyopathy. N Engl J Med 2003; 349: 1027-1035.

5. Spirito P, Bellone P, Harris KM, Bernabo P, Bruzzi P, Maron BJ: Magnitude of left ventricular hypertrophy and risk of sudden death in hypertrophic cardiomyopathy. N Engl J Med 2000; 342: 1778-1785.

6. Varnava AM, Elliott PM, Mahon N, Davies MJ, McKenna WJ: Relation between myocyte disarray and outcome in hypertrophic cardiomyopathy. Am J Cardiol 2001; 88: 275-9.

7. van der Laarse A: Hypothesis: troponin degradation is one of the factors responsible for deterioration of left ventricular function in heart failure. Cardiovasc Res 2002; 56: 8-14.

8. Wu AH, Ford L: Release of cardiac troponin in acute coronary syndromes: ischemia or necrosis? Review. Clin Chim Acta 1999; 284(2): 161-74.

9. Gobel FL, Norstrom LA, Nelson RR, Jorgensen CR, Wang Y: The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris. Circulation 1978; 57: 549-556.

10. CIBIS-II Investigators and Committees. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomized trial. Lancet 1999; 353: 9-13.

11. MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: metoprolol CR/XL randomized intervention trial in congestive heart failure (MERIT-HF). Lancet 1999; 353: 2001-2007.

12. Traverse JH, Altman JD, Kinn J, Duncker DJ, Bache RJ: Effect of beta-adrenergic receptor blockade on blood flow to collateral-dependent myocardium during exercise. Circulation 1995; 91: 1560-7.