Differentiating cardiac troponin levels during cardiac myosin inhibition or cardiac myosin activation treatments: drug effect or the canary in the coal mine?

Lee, M. M. Y. and Masri, A. (2023) Differentiating cardiac troponin levels during cardiac myosin inhibition or cardiac myosin activation treatments: drug effect or the canary in the coal mine? Current Heart Failure Reports, 20, pp. 504-518. (doi: 10.1007/s11897-023-00620-2) (PMID:37875744) (PMCID:PMC10746589) (Early Online Publication)

Abstract

Purpose of Review: Cardiac myosin inhibitors (CMIs) and activators are emerging therapies for hypertrophic cardiomyopathy (HCM) and heart failure with reduced ejection fraction (HFrEF), respectively. However, their effects on cardiac troponin levels, a biomarker of myocardial injury, are incompletely understood. Recent Findings: In patients with HCM, CMIs cause substantial reductions in cardiac troponin levels which are reversible after stopping treatment. In patients with HFrEF, cardiac myosin activator (omecamtiv mecarbil) therapy cause modest increases in cardiac troponin levels which are reversible following treatment cessation and not associated with myocardial ischaemia or infarction. Summary: Transient changes in cardiac troponin levels might reflect alterations in cardiac contractility and mechanical stress. Such transient changes might not indicate cardiac injury and do not appear to be associated with adverse outcomes in the short to intermediate term. Longitudinal changes in troponin levels vary depending on the population and treatment. Further research is needed to elucidate mechanisms underlying changes in troponin levels.

• Item Type: Articles
• Status: Early Online Publication
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Lee, Matthew
• Authors: Lee, M. M. Y., and Masri, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
• Journal Name: Current Heart Failure Reports
• Publisher: Springer
• ISSN: 1546-9530
• ISSN (Online): 1546-9549
• Published Online: 25 October 2023
• Copyright Holders: Copyright © 2023 The Author(s)
• First Published: First published in Current Heart Failure Reports 20:504–518
• Publisher Policy: Reproduced under a Creative Commons license