CARDIOVASCULAR MEDICINE Circulating concentrations of cardiac proteins indicate the severity of congestive heart failure

Objective: To test the hypothesis that myocardium specific proteins may be useful markers for evaluating the severity of congestive heart failure. Methods: Serum concentrations of myosin light chain I (MLC-I), heart fatty acid binding protein (H-FABP), creatine kinase isoenzyme MB (CK-MB), and troponin T (TnT) and plasma concentrations of brain natriuretic peptide (BNP) were determined in 48 patients with acute deterioration of congestive heart failure, both before and after effective treatment. Results: Before treatment, MLC-I (mean (SEM) 3.2 (2.2) mg/l), H-FABP (9.0 (3.5) mg/l), TnT (30 (21) ng/ l), and BNP (761 (303) ng/l) were higher than the normal reference range, and concentrations of CK-MB (5.4 (2.9) mg/l) were near normal. Treatment of congestive heart failure with conventional medication significantly decreased the concentrations of MLC-I (1.2 (0.3) mg/l, p , 0.0001), H-FABP (6.0 (2.0) mg/l, p , 0.0001), CK-MB (2.9 (1.5) mg/l, p , 0.0001), TnT (9 (1) ng/l, p , 0.001), and BNP (156 (118) ng/l, p , 0.0001). The decreases in H-FABP and CK-MB concentrations after treatment correlated with the decrease in BNP concentrations (p , 0.05). The absolute concentrations of MLC-I, H-FABP, CKMB, and TnT correlated positively with those of BNP (p , 0.01). Conclusions: These findings suggest that MLC-I, H-FABP, CK-MB, and TnT may be used as reliable markers for the evaluation of the severity of congestive heart failure.