Melinyte-Ankudavice Karolina, Jakuskaite Gabriele, Galnaitiene Gryte, Darge Gabriele, Ereminiene Egle, Sakalyte Gintare, Plisiene Jurgita, Jurkevicius Renaldas
Department of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Laboratory of Clinical Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Clin Med Insights Cardiol. 2025 Sep 16;19:11795468251369240. doi: 10.1177/11795468251369240. eCollection 2025.
Non-ischemic dilated cardiomyopathy (NIDCM) remains a significant part of heart failure (HF) origin, requiring more detailed investigation of the whole heart. This study aimed to examine the commonly used biomarkers in clinical practice and their relationship with early alterations in whole-heart myocardial mechanics and morphometry in patients with NIDCM.
In this prospective single-center study, 98 patients (mean age 49.5 ± 10.1 years; 69.4% male) were included in the final sample during the first phase, when the diagnosis of NIDCM was made. After 1 year, 42 patients were evaluated during the second follow-up phase. The cardiac magnetic resonance was used to analyze whole-heart myocardial mechanics and morphometry. Biomarkers (troponin I, C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), brain natriuretic peptide, suppression of tumorigenicity 2, and neutrophil to lymphocyte were assessed at the time of the diagnosis.
The strongest correlations were observed between hs-CRP levels and left atrial (LA) global longitudinal strain (GLS) changes after 1 year ( = -.659, < .001). It was revealed that the cut-off value of 3.6 mg/l of hs-CRP can prognosticate to find a reduced LA GLS with a sensitivity of 100% and specificity of 87% (AUC, 0.833; 95% CI, 0.65-1.008; < .001).Other biomarkers had weaker associations with myocardial mechanics and morphometry; relationships were established only with left heart parameters.
In NIDCM patients, the main biomarkers of HF are related to early changes in left-heart myocardial mechanics and morphometrics. The strongest relationship was between the initial levels of hs-CRP and early changes in LA GLS.
非缺血性扩张型心肌病（NIDCM）仍是心力衰竭（HF）病因的重要组成部分，需要对整个心脏进行更详细的研究。本研究旨在探讨临床实践中常用的生物标志物及其与NIDCM患者全心心肌力学和形态学早期改变的关系。
在这项前瞻性单中心研究中，第一阶段最终样本纳入了98例患者（平均年龄49.5±10.1岁；69.4%为男性），此时确诊为NIDCM。1年后，在第二次随访阶段对42例患者进行了评估。采用心脏磁共振成像分析全心心肌力学和形态学。在诊断时评估生物标志物（肌钙蛋白I、C反应蛋白（CRP）、高敏CRP（hs-CRP）、脑钠肽、抑瘤素2和中性粒细胞与淋巴细胞比值）。
观察到1年后hs-CRP水平与左心房（LA）整体纵向应变（GLS）变化之间的相关性最强（r = -0.659，P < 0.001）。结果显示，hs-CRP的截断值为3.6mg/l时，可预测LA GLS降低，灵敏度为100%，特异性为87%（AUC，0.833；95%CI，0.65 - 1.008；P < 0.001）。其他生物标志物与心肌力学和形态学的关联较弱；仅与左心参数建立了关系。
在NIDCM患者中，HF的主要生物标志物与左心心肌力学和形态学的早期变化有关。hs-CRP的初始水平与LA GLS的早期变化之间的关系最为密切。
