Related Experiment Videos
Diagnostic value of troponin T for alterations in left ventricular mass and function in dialysis patients
Francesca Mallamaci1, Carmine Zoccali, Saverio Parlongo
1CNR Centre of Clinical Physiology and Division of Nephrology, Reggio Calabria, Italy.
Insights
Cardiac troponin T (cTnT) can help identify left ventricular hypertrophy (LVH) and rule out systolic dysfunction in hemodialysis patients. This cardiac biomarker shows promise for screening LV alterations in end-stage renal disease (ESRD).
Area of Science:
- Cardiology
- Nephrology
- Biomarkers
Background:
- Cardiac troponin T (cTnT) correlates with left ventricular (LV) mass and systolic dysfunction severity in heart disease.
- End-stage renal disease (ESRD) patients often exhibit cardiac abnormalities, including LV hypertrophy (LVH) and systolic dysfunction.
Purpose of the Study:
- To evaluate the diagnostic utility of cTnT for identifying LVH and LV systolic dysfunction.
- To assess cTnT's role in clinically stable hemodialysis patients without heart failure.
Main Methods:
- Cross-sectional study involving a large group of hemodialysis patients.
- Analysis of serum cTnT levels in relation to LV mass and systolic function.
- Multiple logistic regression models to identify independent correlates of LVH and systolic dysfunction.
Main Results:
- cTnT levels were significantly higher in patients with LVH and LV systolic dysfunction.
- cTnT and systolic pressure were strong correlates of LVH; cTnT was a significant correlate of LV systolic dysfunction.
- Positive predictive value of cTnT for LVH was 87%, negative predictive value for LV dysfunction was 93%.
Conclusions:
- cTnT demonstrates good diagnostic potential for identifying LVH and excluding LV systolic dysfunction in ESRD patients without heart failure.
- cTnT may serve as a useful screening tool for LV mass and function alterations in stable hemodialysis patients.
Background:
Cardiac troponin T (cTnT) is related to left ventricular (LV) mass in patients with end-stage renal disease (ESRD). Furthermore, cTnT reflects the severity of systolic dysfunction in patients with heart diseases. We tested the diagnostic value of cTnT for left ventricular hypertrophy (LVH) and LV systolic dysfunction in a large group of clinically stable hemodialysis patients without heart failure.
Results:
CTnT was significantly (P < 0.001) higher in patients with LVH than in those with normal LV mass. In a multiple logistic regression model, adjusting for potential confounders (including cardiac ischemia), systolic pressure and cTnT (both P = 0.003) were the strongest correlates of LVH. Similarly, cTnT was significantly higher (P = 0.005) in patients with systolic dysfunction than in those with normal LV function and in a multiple logistic regression model cTnT ranked as the second independent correlate of this alteration after male sex. Serum cTnT had a high positive prediction value for the diagnosis of LVH (87%) but its negative prediction value was relatively low (44%). The positive predictive value of cTnT for LV dysfunction was low (25%) while its negative predictive value was high (93%). A combined analysis including systolic pressure (for the diagnosis of LVH) and sex (for the diagnosis of LV systolic dysfunction) augmented the diagnostic estimates to an important extent (95% positive prediction value for LVH and 98% negative prediction value for LV systolic dysfunction).
Conclusions:
CTnT has a fairly good diagnostic potential for the identification of LVH and for the exclusion of LV systolic dysfunction in patients with ESRD without heart failure. This marker may be useful for the screening of alterations in LV mass and function in clinically stable hemodialysis patients.