High sensitive troponin T and heart fatty acid binding protein: Novel biomarker in heart failure with normal ejection fraction?: A cross-sectional study

We analyzed hsTnT, hFABP and N-terminal brain natriuretic peptide in 130 patients comprising 49 HFnEF patients, 51 patients with asymptomatic left ventricular diastolic dysfunction (LVDD), and 30 controls with normal diastolic function. Patients were classified to have HFnEF when the diagnostic criteria as recommended by the European Society of Cardiology were met.Levels of hs TnT and hFABP were significantly higher in patients with asymptomatic LVDD and HFnEF (both p < 0.001) compared to controls. The hsTnT levels were 5.6 [0.0-9.8] pg/ml in LVDD vs. 8.5 [3.9-17.5] pg/ml in HFnEF vs. <0.03 [< 0.03-6.4] pg/ml in controls; hFABP levels were 3029 [2533-3761] pg/ml in LVDD vs. 3669 [2918-4839] pg/ml in HFnEF vs. 2361 [1860-3081] pg/ml in controls. Furthermore, hsTnT and hFABP levels were higher in subjects with HFnEF compared to LVDD (p = 0.015 and p = 0.022).In HFnEF patients, hsTnT and hFABP are elevated independent of coronary artery disease, suggesting that ongoing myocardial damage plays a critical role in the pathophysiology. A combination of biomarkers and echocardiographic parameters might improve diagnostic accuracy and risk stratification of patients with HFnEF.Nearly half of the patients with symptoms and signs of heart failure have a normal ejection fraction(EF) [1,2], a condition termed "heart failure with normal ejection fraction" (HFnEF). The overall mortality in patients with HFnNF is similar to that in patients with systolic heart failure (SHF) [1,3]. Furthermore, asymptomatic left ventricular diastolic dysfunction (LVDD), which is considered as a precursor of HFnEF, is a powerful and independent predictor of death [4]. Nevertheless, randomized trials in patients with HFnEF have failed to demonstrate a reduction in mortality [5]. This is presumably related to the considerable heterogeneity among patients with HFnEF and the lower proportion of specific heart failure related death in this population [6]. It is likely that the non-cardiovascular mortality