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Published in: BMC Cardiovascular Disorders 1/2016

Open Access 01-12-2016 | Research article

Biomarkers of cardiovascular injury and stress are associated with increased frequency of ventricular ectopy: a population-based study

Authors: Julia Brox Skranes, Gunnar Einvik, Silje Kjeka Namtvedt, Anna Randby, Harald Hrubos-Strøm, Jon Brynildsen, Tor-Arne Hagve, Virend K. Somers, Helge Røsjø, Torbjørn Omland

Published in: BMC Cardiovascular Disorders | Issue 1/2016

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Abstract

Background

Asymptomatic ventricular arrhythmias are common and associated with increased risk of cardiovascular mortality. Cardiac troponins, natriuretic peptides and C–reactive protein (CRP) are also predictive of adverse cardiovascular events in the general population, but limited information is available on the relationship between these biomarkers and ventricular ectopy in a community-based population.
The objectives were to evaluate the associations between ventricular ectopic activity and N-terminal pro-B-type natriuretic peptide (NT-proBNP), high sensitivity-troponin I (hs-TnI) and hs-CRP in a community-based setting.

Methods

We performed a 24 h Holter-recording and blood sampling in 498 subjects. Premature ventricular complexes (PVC) were classified as frequent at >5/h and the presence of any bigeminy, trigeminy or non-sustained ventricular tachycardia were classified as complex ventricular ectopy. The associations between biomarkers and ventricular arrhythmias were investigated by univariate and multivariate logistic regression analyses.

Results

Frequent PVC’s and complex ventricular ectopy were detected in 46 (9%) and 47 (9%) participants respectively, and were associated with significantly (p < 0.001) higher concentrations of NT-proBNP and hs-TnI. The association between NT-proBNP and both frequent PVC’s (p = 0.020) and complex ventricular ectopy (p = 0.001) remained significant after adjusting for conventional risk markers in multivariate analyses.

Conclusion

Increased level of NT-proBNP was independently associated with ventricular ectopy, whereas no independent association was observed between hs-TnI and hs-CRP levels and ventricular ectopy in this community-based sample.
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Literature
1.
go back to reference Omland T. New features of troponin testing in different clinical settings. J Intern Med. 2010;268(3):207–17.CrossRefPubMed Omland T. New features of troponin testing in different clinical settings. J Intern Med. 2010;268(3):207–17.CrossRefPubMed
2.
go back to reference Omland T. Advances in congestive heart failure management in the intensive care unit: B-type natriuretic peptides in evaluation of acute heart failure. Crit Care Med. 2008;36(1 Suppl):S17–27.CrossRefPubMed Omland T. Advances in congestive heart failure management in the intensive care unit: B-type natriuretic peptides in evaluation of acute heart failure. Crit Care Med. 2008;36(1 Suppl):S17–27.CrossRefPubMed
3.
go back to reference de Lemos JA. Increasingly sensitive assays for cardiac troponins: a review. JAMA. 2013;309(21):2262–9.CrossRefPubMed de Lemos JA. Increasingly sensitive assays for cardiac troponins: a review. JAMA. 2013;309(21):2262–9.CrossRefPubMed
4.
go back to reference Omland T, de Lemos JA, Sabatine MS, Christophi CA, Rice MM, Jablonski KA, Tjora S, Domanski MJ, Gersh BJ, Rouleau JL, et al. A sensitive cardiac troponin T assay in stable coronary artery disease. N Engl J Med. 2009;361(26):2538–47.CrossRefPubMedPubMedCentral Omland T, de Lemos JA, Sabatine MS, Christophi CA, Rice MM, Jablonski KA, Tjora S, Domanski MJ, Gersh BJ, Rouleau JL, et al. A sensitive cardiac troponin T assay in stable coronary artery disease. N Engl J Med. 2009;361(26):2538–47.CrossRefPubMedPubMedCentral
5.
go back to reference Omland T. Cardiac troponins: a tool for a personalized medicine strategy in stable coronary artery disease? J Am Coll Cardiol. 2014;63(4):355–7.CrossRefPubMed Omland T. Cardiac troponins: a tool for a personalized medicine strategy in stable coronary artery disease? J Am Coll Cardiol. 2014;63(4):355–7.CrossRefPubMed
6.
go back to reference de Lemos JA, Drazner MH, Omland T, Ayers CR, Khera A, Rohatgi A, Hashim I, Berry JD, Das SR, Morrow DA, et al. Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA. 2010;304(22):2503–12.CrossRefPubMed de Lemos JA, Drazner MH, Omland T, Ayers CR, Khera A, Rohatgi A, Hashim I, Berry JD, Das SR, Morrow DA, et al. Association of troponin T detected with a highly sensitive assay and cardiac structure and mortality risk in the general population. JAMA. 2010;304(22):2503–12.CrossRefPubMed
7.
go back to reference Saunders JT, Nambi V, de Lemos JA, Chambless LE, Virani SS, Boerwinkle E, Hoogeveen RC, Liu X, Astor BC, Mosley TH, et al. Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study. Circulation. 2011;123(13):1367–76.CrossRefPubMedPubMedCentral Saunders JT, Nambi V, de Lemos JA, Chambless LE, Virani SS, Boerwinkle E, Hoogeveen RC, Liu X, Astor BC, Mosley TH, et al. Cardiac troponin T measured by a highly sensitive assay predicts coronary heart disease, heart failure, and mortality in the Atherosclerosis Risk in Communities Study. Circulation. 2011;123(13):1367–76.CrossRefPubMedPubMedCentral
8.
go back to reference Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, Wolf PA, Vasan RS. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med. 2004;350(7):655–63.CrossRefPubMed Wang TJ, Larson MG, Levy D, Benjamin EJ, Leip EP, Omland T, Wolf PA, Vasan RS. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med. 2004;350(7):655–63.CrossRefPubMed
9.
go back to reference Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, Rumley A, Lowe GDO, Pepys MB, Gudnason V. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350(14):1387–97.CrossRefPubMed Danesh J, Wheeler JG, Hirschfield GM, Eda S, Eiriksdottir G, Rumley A, Lowe GDO, Pepys MB, Gudnason V. C-reactive protein and other circulating markers of inflammation in the prediction of coronary heart disease. N Engl J Med. 2004;350(14):1387–97.CrossRefPubMed
10.
go back to reference Wang TJ, Wollert KC, Larson MG, Coglianese E, McCabe EL, Cheng S, Ho JE, Fradley MG, Ghorbani A, Xanthakis V, et al. Prognostic utility of novel biomarkers of cardiovascular stress: the Framingham Heart Study. Circulation. 2012;126(13):1596–604.CrossRefPubMed Wang TJ, Wollert KC, Larson MG, Coglianese E, McCabe EL, Cheng S, Ho JE, Fradley MG, Ghorbani A, Xanthakis V, et al. Prognostic utility of novel biomarkers of cardiovascular stress: the Framingham Heart Study. Circulation. 2012;126(13):1596–604.CrossRefPubMed
11.
go back to reference Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, et al. Executive summary: heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399–410.CrossRefPubMed Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Blaha MJ, Dai S, Ford ES, Fox CS, Franco S, et al. Executive summary: heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399–410.CrossRefPubMed
12.
go back to reference Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125(8):1043–52.CrossRefPubMed Myerburg RJ, Junttila MJ. Sudden cardiac death caused by coronary heart disease. Circulation. 2012;125(8):1043–52.CrossRefPubMed
13.
go back to reference Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, McAnulty JH, Gunson K, Jui J, Chugh SS. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol. 2006;47(6):1161–6.CrossRefPubMed Stecker EC, Vickers C, Waltz J, Socoteanu C, John BT, Mariani R, McAnulty JH, Gunson K, Jui J, Chugh SS. Population-based analysis of sudden cardiac death with and without left ventricular systolic dysfunction: two-year findings from the Oregon Sudden Unexpected Death Study. J Am Coll Cardiol. 2006;47(6):1161–6.CrossRefPubMed
14.
go back to reference Simpson Jr RJ, Cascio WE, Schreiner PJ, Crow RS, Rautaharju PM, Heiss G. Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2002;143(3):535–40.CrossRefPubMed Simpson Jr RJ, Cascio WE, Schreiner PJ, Crow RS, Rautaharju PM, Heiss G. Prevalence of premature ventricular contractions in a population of African American and white men and women: the Atherosclerosis Risk in Communities (ARIC) study. Am Heart J. 2002;143(3):535–40.CrossRefPubMed
15.
go back to reference Massing MW, Simpson Jr RJ, Rautaharju PM, Schreiner PJ, Crow R, Heiss G. Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality (from the Atherosclerosis Risk In Communities cohort). Am J Cardiol. 2006;98(12):1609–12.CrossRefPubMed Massing MW, Simpson Jr RJ, Rautaharju PM, Schreiner PJ, Crow R, Heiss G. Usefulness of ventricular premature complexes to predict coronary heart disease events and mortality (from the Atherosclerosis Risk In Communities cohort). Am J Cardiol. 2006;98(12):1609–12.CrossRefPubMed
16.
go back to reference Ataklte F, Erqou S, Laukkanen J, Kaptoge S. Meta-analysis of ventricular premature complexes and their relation to cardiac mortality in general populations. Am J Cardiol. 2013;112(8):1263–70.CrossRefPubMed Ataklte F, Erqou S, Laukkanen J, Kaptoge S. Meta-analysis of ventricular premature complexes and their relation to cardiac mortality in general populations. Am J Cardiol. 2013;112(8):1263–70.CrossRefPubMed
17.
go back to reference Sajadieh A, Nielsen OW, Rasmussen V, Ole Hein H, Hansen JF. Increased ventricular ectopic activity in relation to C-reactive protein, and NT-pro-brain natriuretic peptide in subjects with no apparent heart disease. Pacing Clin Electrophysiol. 2006;29(11):1188–94.CrossRefPubMed Sajadieh A, Nielsen OW, Rasmussen V, Ole Hein H, Hansen JF. Increased ventricular ectopic activity in relation to C-reactive protein, and NT-pro-brain natriuretic peptide in subjects with no apparent heart disease. Pacing Clin Electrophysiol. 2006;29(11):1188–94.CrossRefPubMed
18.
go back to reference Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131(7):485–91.CrossRefPubMed Netzer NC, Stoohs RA, Netzer CM, Clark K, Strohl KP. Using the Berlin Questionnaire to identify patients at risk for the sleep apnea syndrome. Ann Intern Med. 1999;131(7):485–91.CrossRefPubMed
19.
go back to reference Hrubos-Strom H, Randby A, Namtvedt SK, Kristiansen HA, Einvik G, Benth J, Somers VK, Nordhus IH, Russell MB, Dammen T, et al. A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea. The Akershus Sleep Apnea Project (ASAP). J Sleep Res. 2011;20(1 Pt 2):162–70.CrossRefPubMed Hrubos-Strom H, Randby A, Namtvedt SK, Kristiansen HA, Einvik G, Benth J, Somers VK, Nordhus IH, Russell MB, Dammen T, et al. A Norwegian population-based study on the risk and prevalence of obstructive sleep apnea. The Akershus Sleep Apnea Project (ASAP). J Sleep Res. 2011;20(1 Pt 2):162–70.CrossRefPubMed
20.
go back to reference Rosjo H, Kravdal G, Hoiseth AD, Jorgensen M, Badr P, Roysland R, Omland T. Troponin I measured by a high-sensitivity assay in patients with suspected reversible myocardial ischemia: data from the Akershus Cardiac Examination (ACE) 1 study. Clin Chem. 2012;58(11):1565–73.CrossRefPubMed Rosjo H, Kravdal G, Hoiseth AD, Jorgensen M, Badr P, Roysland R, Omland T. Troponin I measured by a high-sensitivity assay in patients with suspected reversible myocardial ischemia: data from the Akershus Cardiac Examination (ACE) 1 study. Clin Chem. 2012;58(11):1565–73.CrossRefPubMed
21.
go back to reference Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41.CrossRefPubMed Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41.CrossRefPubMed
22.
go back to reference Sokolow M, Lyon TP. The ventricular complex in right ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949;38(2):273–94.CrossRefPubMed Sokolow M, Lyon TP. The ventricular complex in right ventricular hypertrophy as obtained by unipolar precordial and limb leads. Am Heart J. 1949;38(2):273–94.CrossRefPubMed
23.
go back to reference Namtvedt SK, Randby A, Einvik G, Hrubos-Strom H, Somers VK, Rosjo H, Omland T. Cardiac arrhythmias in obstructive sleep apnea (from the Akershus Sleep Apnea Project). Am J Cardiol. 2011;108(8):1141–6.CrossRefPubMed Namtvedt SK, Randby A, Einvik G, Hrubos-Strom H, Somers VK, Rosjo H, Omland T. Cardiac arrhythmias in obstructive sleep apnea (from the Akershus Sleep Apnea Project). Am J Cardiol. 2011;108(8):1141–6.CrossRefPubMed
24.
go back to reference Chin CW, Shah AS, McAllister DA, Joanna Cowell S, Alam S, Langrish JP, Strachan FE, Hunter AL, Maria Choy A, Lang CC, et al. High-sensitivity troponin I concentrations are a marker of an advanced hypertrophic response and adverse outcomes in patients with aortic stenosis. Eur Heart J. 2014;35(34):2312–21.CrossRefPubMedPubMedCentral Chin CW, Shah AS, McAllister DA, Joanna Cowell S, Alam S, Langrish JP, Strachan FE, Hunter AL, Maria Choy A, Lang CC, et al. High-sensitivity troponin I concentrations are a marker of an advanced hypertrophic response and adverse outcomes in patients with aortic stenosis. Eur Heart J. 2014;35(34):2312–21.CrossRefPubMedPubMedCentral
25.
go back to reference Einvik G, Rosjo H, Randby A, Namtvedt SK, Hrubos-Strom H, Brynildsen J, Somers VK, Omland T. Severity of obstructive sleep apnea is associated with cardiac troponin I concentrations in a community-based sample: data from the akershus sleep apnea project. Sleep. 2014;37(6):1111–6.PubMedPubMedCentral Einvik G, Rosjo H, Randby A, Namtvedt SK, Hrubos-Strom H, Brynildsen J, Somers VK, Omland T. Severity of obstructive sleep apnea is associated with cardiac troponin I concentrations in a community-based sample: data from the akershus sleep apnea project. Sleep. 2014;37(6):1111–6.PubMedPubMedCentral
26.
go back to reference Seth N, Kaplan R, Bustamante E, Kulkarni C, Subacius H, Rosenthal JE, Passman R. Clinical significance of nonsustained ventricular tachycardia on routine monitoring of pacemaker patients. Pacing Clin Electrophysiol. 2015;38(8):980–8.CrossRefPubMed Seth N, Kaplan R, Bustamante E, Kulkarni C, Subacius H, Rosenthal JE, Passman R. Clinical significance of nonsustained ventricular tachycardia on routine monitoring of pacemaker patients. Pacing Clin Electrophysiol. 2015;38(8):980–8.CrossRefPubMed
27.
go back to reference Dukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, Stein PK, Psaty BM, Sotoodehnia N, Gottdiener JS, et al. Ventricular ectopy as a predictor of heart failure and death. J Am Coll Cardiol. 2015;66(2):101–9.CrossRefPubMedPubMedCentral Dukes JW, Dewland TA, Vittinghoff E, Mandyam MC, Heckbert SR, Siscovick DS, Stein PK, Psaty BM, Sotoodehnia N, Gottdiener JS, et al. Ventricular ectopy as a predictor of heart failure and death. J Am Coll Cardiol. 2015;66(2):101–9.CrossRefPubMedPubMedCentral
Metadata
Title
Biomarkers of cardiovascular injury and stress are associated with increased frequency of ventricular ectopy: a population-based study
Authors
Julia Brox Skranes
Gunnar Einvik
Silje Kjeka Namtvedt
Anna Randby
Harald Hrubos-Strøm
Jon Brynildsen
Tor-Arne Hagve
Virend K. Somers
Helge Røsjø
Torbjørn Omland
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2016
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/s12872-016-0407-z

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