Potential Prognostic Impact of High-Sensitivity C-Reactive Protein in the Analysis of Whole-Heart Myocardial Mechanics and Morphometry: Prospective CMR-Based Study.

Background: 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.

Methods: 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.

Results: The strongest correlations were observed between hs-CRP levels and left atrial (LA) global longitudinal strain (GLS) changes after 1 year (r = -.659, P < .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; P < .001).Other biomarkers had weaker associations with myocardial mechanics and morphometry; relationships were established only with left heart parameters.

Conclusion: 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.