Cardiac Biomarker Responses to Dobutamine Stress Echocardiography in Healthy Volunteers and Patients with Coronary Artery Disease

[摘要] To the Editor:Cardiac stress testing provides important diagnostic and prognostic information in ischemic heart disease (1). The sensitivity and specificity of stress testing are limited, however (2). If a circulating biomarker could reliably reflect the short-lived ischemia that occurs with stress testing and if differences in marker-release patterns could be associated with grades of risk for negative outcomes, one would expect the sensitivity, specificity, and overall utility of stress testing to improve substantially. High-sensitivity cardiac troponin assays have potential to be earlier markers of myocardial ischemia (3, 4). B-type natriuretic peptide signal peptide (BNPsp)1 is a recently discovered circulating biomarker (5). In the setting of ST-segment elevation myocardial infarction, BNPsp concentrations increase early, preceding myoglobin peaks. BNPsp has not been reported to date in less extreme forms of cardiac ischemia.We document the release of BNPsp, N-terminal pro–B-type natriuretic peptide (NT-proBNP), and troponin T as measured with a high-sensitivity assay (hsTnT) during dobutamine stress echocardiography (DSE) in patients with coronary artery disease (CAD) and in healthy volunteers. Blood samples were collected from 16 CAD patients and 10 healthy volunteers just before DSE and serially for 4 h. Plasma BNPsp was measured with a locally developed RIA (5). hsTnT and NT-proBNP concentrations were measured with commercially available Elecsys assays (Roche Diagnostics). …

[学科分类] 过敏症与临床免疫学