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

Wilfried Dinh12*, Werner Nickl2, Reiner Füth1, Mark Lankisch1, Georg Hess3, Dietmar Zdunek4, Thomas Scheffold1, Michael Coll Barroso2, Klaus Tiroch1, Dan Ziegler56 and Melchior Seyfarth1

Author Affiliations

1 Department of Cardiology, Witten/Herdecke University, HELIOS Klinikum Wuppertal, Germany

2 CoroVital, Institute for Sports Medicine, Germany

3 Medical Department, University Mainz, Germany

4 Roche Diagnostics GmbH, Mannheim, Germany

5 Institute for Clinical Diabetology, German Diabetes Center at the Heinrich-Heine University, Leibniz Center for Diabetes Research, Düsseldorf, Germany

6 Department of Metabolic Diseases, University Hospital, Düsseldorf, Germany

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BMC Cardiovascular Disorders 2011, 11:41  doi:10.1186/1471-2261-11-41

Published: 5 July 2011



High sensitive troponin T (hsTnT) and heart fatty acid binding protein (hFABP) are both markers of myocardial injury and predict adverse outcome in patients with systolic heart failure (SHF). We tested whether hsTnT and hFABP plasma levels are elevated in patients with heart failure with normal ejection fraction (HFnEF).


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.