Integrating Inflammatory and Cardiac Stress Markers for Improved Diagnostic Accuracy and Risk Stratification in Obstructive Hypertrophic Cardiomyopathy: A Review

Abstract

Background: Obstructive hypertrophic cardiomyopathy (OHCM) is a common genetic cardiac disorder characterized by asymmetric ventricular hypertrophy and left ventricular outflow tract obstruction. Current diagnostic strategies primarily rely on imaging and hemodynamic assessments, which, while effective, often fail to capture underlying pathophysiological mechanisms. Biomarkers such as inflammatory mediators—interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP)—along with cardiac stress markers—B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP)—have shown promise as adjunct tools.

Material and Methods: This review synthesizes evidence from PubMed, Scopus, and Embase (up to 2022) on the role of combining inflammatory and cardiac stress markers in OHCM. Emphasis is placed on studies evaluating their diagnostic accuracy, prognostic relevance, and correlation with adverse outcomes. Comparative analyses were made between single-marker and multimarker approaches.

Conclusion: Evidence suggests that integrating inflammatory biomarkers with cardiac stress markers significantly enhances diagnostic precision and risk stratification in OHCM. Elevated IL-6 and TNF-α are strongly associated with myocardial fibrosis and arrhythmogenic substrate, whereas BNP and NT-proBNP correlate with symptom burden, hemodynamic gradients, and progression to heart failure. A multimarker approach offers superior predictive accuracy compared to individual biomarkers or imaging alone. Future studies should focus on establishing standardized multimarker panels and validating their clinical utility in large, prospective cohorts.