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Several cardiac biomarkers including brain natriuretic peptide (BNP) and NT-pro BNP have been used as predictors of prognosis and negative remodeling in DCM. In the present study, we aimed to evaluate the prognostic value of Tenascin-C (TN-C) in dilated cardiomyopathy (DCM). We also aimed to investigate whether TN-C level can be used to determine reverse remodeling in patient with DCM.
Sixty-six patients with DCM were followed-up for 12 months after initiation of medical treatment including carvedilol, ramipril (candesartan if ramipril was not tolerated), spironolactone and furosemide. Tenascin-C and NT pro-BNP measurements and transthoracic echocardiography was performed at baseline and at 12 months.
At 12 months, a significant improvement in NYHA class (2.57±0.6 vs. 1.87±0.5, p<0.0001), left ventricular end-diastolic volume (217±47 vs. 203 ± 48, p<0.0001), left ventricular ejection fraction (29.1±5.5 vs. 30.9±3.8, p<0.0001), NT pro-BNP (2019±558 vs. 1462±805, p<0.0001) and Tenascin-C (76±19 vs. 48±28, p<0.0001) values were observed, when compared with baseline. Importantly, decrease in Tenascin-C values were correlated with increase in LVEF. Tenascin-C (odds ratio (OR): 1.896, <95% confidence interval (CI) 1.543-2.670; p=0.02), DM (OR: 2.456, <95% Cl 1.987-3.234; p=0.01) and HT (OR: 2.106, <95% Cl 1.876-2.897; p=0.03) were independent predictors of mortality in patients with DCM.
Reverse ventricular remodeling obtained with carvedilol, ramipril/candesartan and spironolactone is associated with decreases in LVEDV, LVESV, Tenascin-C levels and NT pro-BNP levels. Consequently, Tenascin-C may be used to evaluate reverse remodeling in patients with DCM.