Assessing the Effects of Diet and Behavior on Cardiovascular Disease: The Role of Biomarkers in Understanding Biology and Mechanism

Two biomarkers in widespread clinical use offer the opportunity to better understand the direct effects of alcohol on the myocardium. Because high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro- brain natriuretic peptide (NT-proBNP) are released directly from myocardial tissue, they provide us with a highly specific measure of cardiomyocyte damage (in the case of hs-cTnT) and myocardial stress (in the case of NTproBNP). NT-proBNP is the stable N-terminal fragment of the prohormone for cardiac B-type natriuretic peptide and has been robustly associated with myocardial mass, hypertrophy and clinical heart failure, as well as atherothrombotic events such as myocardial infarction and stroke (11, 12). Because cardiac troponin and natriuretic peptides are markers of future cardiovascular risk, as well as being released directly from myocardial tissue in response to injury or stress, these biomarkers offer the opportunity to advance our understanding of the direct effects of alcohol consumption on the myocardium.