Serum myostatin level is associated with myocardial scar burden by SPECT myocardial perfusion imaging.

Background: Myostatin is a negative regulator of skeletal muscle and myocardial mass. The relationship between myocardial ischemia and scar burden and levels of myostatin has not been established.

Methods: We enrolled symptomatic patients with heart failure (HF) with a left ventricular ejection fraction (LVEF) < 45 % and controls (LVEF ≥ 45 %). Serum levels of myostatin were measured. Single-photon emission computed tomography (SPECT) imaging was interpreted, and summed scores of 17 stress and rest image segments in 5-point scale produced the summed stress score (SSS) and summed rest score (SRS), respectively. The summed difference score (SDS) was calculated as the difference between the SSS and SRS.

Results: Ninety-six patients with HF and 103 controls were enrolled. The levels of myostatin were higher in the HF group. In linear regression analysis, myostatin level was positively correlated with SSS (β coefficient = 6.840, p = 0.013) and SRS (β coefficient = 5.557, p = 0.026), but not correlated with SDS. The areas under the receiver operating characteristic curves of myostatin levels for SSS ≥ 8 and SSS ≥ 13 were 0.6813 ± 0.04854 (p < 0.001) and 0.7498 ± 0.04402 (p < 0.001), respectively.

Conclusion: Serum levels of myostatin were correlated with the extent of myocardial scarring as defined by SPECT imaging. Serum levels of myostatin may be a predictor of myocardial scar burden.