Tenascin- C: A Promising Marker in Identifying Patients with Cardiovascular and Pulmonary Remodeling

Objectives: Our aim was to study serum levels of tenascin-C (TnC ) in patients with pulmonary hypertension and left ventricular hypertrophy in order to explore its diagnostic utility for cardiac remodeling among elderly patients admitted at Ain Shams University hospitals, Egypt. Methods: A case control study was conducted on 279 elderly selected from Ain Shams University Hospital. They were classified into 3groups; (Group I): 105 cases suffering from pulmonary hypertension (PH), (Group II):114 cases suffering from systemic hypertension and (Group III): 60 apparently healthy subjects serving as control group. Group I was classified according to WHO classification into 4 classes. Group I was reclassified according to the disease severity into 2 subgroups. Group II was reclassified into 2 subgroups according to presence or absence of concomitant left ventricular hypertrophy (LVH). All subjects were subjected to history taking, clinical examination, echocardiograhic measurements (for cases only), TnC assay by enzyme linked immunosorbent assay (ELISA) and lipid profile. Results: Serum tenascin-C showed a highly significant elevation in PH and LVH cases than controls (p<0.001). In addition, (ROC) curve analysis revealed a superior performance of TnC in discrimination of PH cases from healthy controls at cut-off value of 0.3ng/mL with sensitivity (91.4%), specificity (100%). Moreover, the diagnostic performance of TnC in discriminating PH patient’s subgroups was best at cut-off value of 4.3ng/mL with sensitivity (89.3%), specificity (85.7%).Conclusion: Serum TnC is a promising diagnostic marker for identifying patients with tissue remodeling in PH and LVH.