American Journal of Cardiology
American Journal of Cardiology
5 years ago

Usefulness of Urinary N-Terminal Fragment of Titin to Predict Mortality in Dilated Cardiomyopathy

Titin is associated with myocardial stiffness and hypertrophy, and mutations in its gene have been identified in cardiac myopathies such as dilated cardiomyopathy (DC). It has recently been reported that in damaged muscle, the N-terminal fragment of titin (Titin-N) is cleaved by calpain-3, and urinary Titin-N could be a marker of sarcomere damage. We aimed to investigate the impact of urinary Titin-N on prognosis of DC. We measured urinary levels of Titin-N/creatinine ratio (U-TN/Cr; pmol/mg/dl) in 102 DC patients, and followed up all the patients (mean 1,167 days). The patients were divided into three groups based on the U-TN/Cr: 1st (U-TN/Cr < 3.35, n=34), 2nd (3.35 ≤ U-TN/Cr < 7.26, n=34) and 3rd (7.26 ≤ U-TN/Cr, n=34) tertiles. In the Kaplan-Meier analysis, cardiac and all-cause mortality progressively increased from the 1st to 2nd and 3rd groups (P < 0.05, respectively). In the Cox proportional hazard analyses, U-TN/Cr was a predictor of cardiac and all-cause mortality in DC patients (P < 0.05, respectively). Urinary Titin-N, a novel marker of sarcomere damage, can identify high risk DC patients.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914918301929

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