Dilated cardiomyopathy laboratory findings
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]
Overview
The majority of dilated cardiomyopathy lab workup is targeted towards detecting the cause (such as thyroid function tests, toxicology screening, and genetic counselling) or assessing the cardiac complications of the condition. Other biomarkers that are under investigation include serum uric acid, Ca-125, soluble ST2, and Growth and differentiation factor-15.
Laboratory Findings
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Most of the laboratory workup for dilated cardiomyopathy is usually targeted towards detecting the cause.[1]
- Thyroid function tests
- Comprehensive metabolic panel
- Workup for anemia (CBC and iron studies)
- Urine toxicology screening
- Some drugs as cocaine and amphetamine increase the risk of dilated cardiomyopathy
- Genetic screening
- Usually reserved as the last step.
- May identify genetic/inherited causes of dilated cardiomyopathy.
Other laboratory investigations may target the severity of the condition or its effect on the cardiac function.
- Cardiac biomarkers (troponin and CK-MB)
- Brain natriuretic peptide (BNP)
Other biomarkers currently under investigation include:
- Uric acid (persistently elevated)
- Osteopontin
- Serum carbohydrate antigen-125 (Ca-125)[2]
- Pro-inflammatory cytokines (as tumor necrosis factor-α and interleukin-6)[3]
- Soluble ST2 (sST2): A cytokine released by cardiac fibroblasts and vascular endothelial cells upon biomechanical stress
- A recent study found that sST2 can predict the risk of heart failure in dilated cardiomyopathy.[4]
- Growth and differentiation factor-15 (GDF-15)
- Showed a negative correlation with left ventricular ejection fraction and a positive correlation with NYHA heart failure class.[5]
- Serum immunoglobulin free light chain (FLC) κ and λ
- Associated with the risk of heart failure and mortality in dilated cardiomyopathy patients.[6]
References
- ↑ Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK (2016). "The Diagnosis and Evaluation of Dilated Cardiomyopathy". J Am Coll Cardiol. 67 (25): 2996–3010. doi:10.1016/j.jacc.2016.03.590. PMID 27339497.
- ↑ Karaca O, Guler GB, Guler E, Gunes HM, Alizade E, Agus HZ; et al. (2012). "Serum carbohydrate antigen 125 levels in nonischemic dilated cardiomyopathy: a useful biomarker for prognosis and functional mitral regurgitation". Congest Heart Fail. 18 (3): 144–50. doi:10.1111/j.1751-7133.2011.00260.x. PMID 22587744.
- ↑ Bielecka-Dabrowa A, Wierzbicka M, Dabrowa M, Goch A (2008). "New methods in laboratory diagnostics of dilated cardiomyopathy". Cardiol J. 15 (4): 388–95. PMID 18698552.
- ↑ Lichtenauer M, Jirak P, Wernly B, Paar V, Rohm I, Jung C; et al. (2017). "A comparative analysis of novel cardiovascular biomarkers in patients with chronic heart failure". Eur J Intern Med. 44: 31–38. doi:10.1016/j.ejim.2017.05.027. PMID 28579310.
- ↑ Nair N, Gongora E (2018). "Correlations of GDF-15 with sST2, MMPs, and worsening functional capacity in idiopathic dilated cardiomyopathy: Can we gain new insights into the pathophysiology?". J Circ Biomark. 7: 1849454417751735. doi:10.1177/1849454417751735. PMC 5777561. PMID 29375722.
- ↑ Jackson CE, Haig C, Welsh P, Dalzell JR, Tsorlalis IK, McConnachie A; et al. (2015). "Combined Free Light Chains Are Novel Predictors of Prognosis in Heart Failure". JACC Heart Fail. 3 (8): 618–25. doi:10.1016/j.jchf.2015.03.014. PMID 26251088.