TY - JOUR T1 - Biomarkers of cardiovascular stress and fibrosis in preclinical hypertrophic cardiomyopathy JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2017-000615 VL - 4 IS - 2 SP - e000615 AU - Jennifer E Ho AU - Ling Shi AU - Sharlene M Day AU - Steven D Colan AU - Mark W Russell AU - Jeffrey A Towbin AU - Mark V Sherrid AU - Charles E Canter AU - John Lynn Jefferies AU - Anne Murphy AU - Matthew Taylor AU - Luisa Mestroni AU - Allison L Cirino AU - Lynn A Sleeper AU - Peter Jarolim AU - Begoña Lopez AU - Arantxa Gonzalez AU - Javier Diez AU - E John Orav AU - Carolyn Y Ho A2 - , Y1 - 2017/11/01 UR - http://openheart.bmj.com/content/4/2/e000615.abstract N2 - Objective Sarcomeric gene mutation carriers without overt left ventricular hypertrophy (G+/LVH−) can harbour subclinical changes in cardiovascular structure and function that precede the development of hypertrophic cardiomyopathy (HCM). We sought to investigate if circulating biomarkers of cardiovascular stress and collagen metabolism among G+/LVH− individuals, measured at rest and following exercise provocation, yield further insights into the underlying biology of HCM.Methods We studied 76 individuals with overt HCM, 50 G+/LVH− individuals and 41 genotype-negative related controls enrolled in a cross-sectional, multicentre observational study (HCMNet). Biomarkers of cardiac stress (N-terminal pro-B-type natriuretic peptide, NT-proBNP; high-sensitivity troponin I, hsTnI; soluble ST2) and fibrosis (carboxy-terminal propeptide of procollagen type I; C-terminal telopeptide of type I collagen; galectin-3; periostin) were measured.Results Individuals with overt HCM had elevated NT-proBNP and hsTnI compared with G+/LVH− subjects and controls at rest, along with an exaggerated increase in NT-proBNP and hsTnI in response to exercise. We found no detectable differences in resting or exercise-provoked biomarker profiles of cardiovascular stress and fibrosis among G+/LVH− individuals compared with healthy controls despite subtle echocardiographic differences in cardiac structure and function.Conclusion Dynamic exercise testing exaggerated resting differences in natriuretic peptides and troponin elevations among individuals with overt HCM. In contrast, we found no differences in biomarker profiles of cardiovascular stress and fibrosis among G+/LVH− individuals compared with controls even after maximal exercise provocation. Our findings highlight the need for continued investigation into early phenotypes of sarcomeric gene mutations and the evolution of HCM. ER -