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Elevated circulating cardiac troponin I in patients with cirrhosis
D Pateron1, P Beyne, T Laperche
1Laboratoire d'Hémodynamique Splanchnique et de Biologie Vasculaire INSERM, Hôpital Beaujon, Clichy, France.
Insights
Patients with cirrhosis often have unexplained cardiac issues. This study found elevated cardiac troponin I in 32% of patients, indicating subclinical myocardial damage, particularly in alcoholic cirrhosis.
Area of Science:
- Cardiology
- Hepatology
- Biochemistry
Background:
- Cirrhosis patients can present with unexplained cardiac abnormalities.
- Cardiac troponin I is a specific biomarker for myocardial injury.
Purpose of the Study:
- To investigate cardiac troponin I levels in patients with cirrhosis and normal ECG.
- To identify potential correlations between troponin I levels and cardiac function or cirrhosis severity.
Main Methods:
- Evaluated 32 cirrhosis patients (22 alcoholic) with normal ECG.
- Performed hemodynamic investigations and echocardiography for left ventricular function and mass.
- Measured serum cardiac troponin I, creatine kinase MB mass, and myoglobin.
Main Results:
- Elevated cardiac troponin I (32%) observed, while other markers remained normal.
- Abnormal troponin I correlated with decreased stroke-volume index and left ventricular mass.
- No relation found between troponin I and cirrhosis severity or portal hypertension.
Conclusions:
- A high prevalence of elevated cardiac troponin I exists in cirrhosis patients, especially those with alcoholic cirrhosis.
- Elevated troponin I suggests subclinical left ventricular myocardial damage.
- Findings may relate to impaired left ventricular adaptation in cirrhosis and alcoholic cardiomyopathy.
Abstract:
It has been shown that certain patients with cirrhosis have asymptomatic cardiac abnormalities that have not yet been explained. Thus, cardiac troponin I, a specific marker of myocardial injury, has been measured in patients with cirrhosis without previous cardiac disease. Thirty-two consecutive patients (age 49 +/- 11) with cirrhosis and normal ECG were selected, 22 of which were alcoholic. Hemodynamic investigations were performed. Left ventricular function and mass were evaluated by echocardiography. Serum creatine kinase MB mass, myoglobin, and cardiac troponin I concentrations were measured. Cardiac troponin I concentrations were elevated in 10 patients (32%) (range 0.06-0.25 microg/L) whereas creatine kinase MB mass and myoglobin were normal in all patients. Abnormal troponin I values were not related to the severity of cirrhosis, to the degree of portal hypertension, or to other hemodynamic values. In contrast, elevated serum cardiac troponin I concentrations were related to a decreased stroke-volume index (P <. 05) and a decreased left ventricular mass (P <.05). These results show a high prevalence of slightly elevated serum cardiac troponin I in patients with cirrhosis, especially in those with alcoholic cirrhosis. Elevated troponin I is associated with subclinical left ventricular myocardial damage. These findings may be linked to a lack of left ventricular adaptation in certain patients with cirrhosis and alcoholic cardiomyopathy.