726-2 The Role of Myocardial Catecholamine: Promising or Proved in Diagnosis and Prognosis of Primary Heart Muscle Diseases?

The role of myocardial catecholamine concentration (MCC) in diagnosis and outcome of primary heart muscle diseases (HMD) is still incompletely defined. To elucidate this problem we analyzed diagnostic utility of MCC measurements in pts with biopsy proven myocarditis (BPM), hypertrophic cardiomyopathy (HCM), and idiopathic dilated cardiomyopathy (DCM). as well as MCC prognostic impact in DCM. Our study group consisted of 86 pts, 20 of them with BPM (80% males, aged 18–42 yrs), 34 HCM pts (64% males, aged 29–54 yrs) and 32 pts with DCM (75% males, aged 21–56 yrs). At the initial assessment all pts underwent cardiac catheterization and endomyocardial biopsy (EMB). Myocardial norepinephrine (MNEC). epinephrine (MEC). and dopamine (MDC) concentrations were measured in EMB samples using catechol-O-methyl-transferase radioenzymatic method. Obtained values (ng/g of fresh myocardial tissue ft) are shown in the table below: MNEC MEC MDC BPM 415.4 ± 71.1 † 57.3 ± 48 † 76.6 ± 9.2 ns HCM 781.0 ± 125.1 ** 91.3 ± 13.1 ** 78.1 ± 9.3 ns DCM 262.2 ± 68.9 † 36.9 ± 7.1 ‡ 72.6 ± 12.1 ns † -p l 001 (BPM vs. DCM); ** -p l 001 (HCM vs. BPM); † -p l 0.01 (HCM vS. DCM). In addition, we analyzed the effect of MNEC and MEC on the five years survival of 31 DCM pts. Survival (18/31) was significantly better in pts with higher MNEC (411.8 ± 43.4 ng/g ft survivors vs. 278.5 ± 75.7 ng/g ft non-survivors, p l 0.01) and MEC (55.3 ± 4.5 ng/g ft survivors vs. 39.2 ± 9.3 ng/g ft non-survivors, p l 0.01). Univariate and multivariate analysis demonstrated that both MNEC and MEC predicted long-term survival independently and their low concentrations were associated with increased mortality. In conclusion, these data indicate that MCC measurements may be helpful as a complementary tool in diagnostic evaluation of pts with HMD. Furthermore, MNEC and MEC should be considered as valuable prognostic markers of the long-term survival of DCM pts.