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Cardiac troponin I in aortic valve disease
José Pedro L Nunes1, J M Mota Garcia, Rui M B Farinha
1Department of Cardiology, Hospital São João, Faculdade de Medicina da Universidade do Porto, 4200, Porto, Portugal. jplnunes@med.up.pt <jplnunes@med.up.pt>
Background:
Plasma cardiac troponin I levels may be higher than normal in conditions other than ischemic heart disease. We aimed at measuring troponin I levels in aortic valve patients, in which increased values for left ventricular dimensions and pressure are frequently found.
Methods:
Plasma levels of troponin I, creatine kinase (CK) and the MB fraction of the same enzyme were measured in a group of 25 clinically stable aortic valve patients. Echocardiographic study was performed in all patients; hemodynamic and coronary angiographic study was performed in 19 patients. Troponin I was also measured in a control population (n=305).
Results:
The mean value for troponin I was found to be higher in aortic valve patients (0.07+/-0.02 ng/ml), when compared to controls (0.01+/-0.02 ng/ml; P<0.05). Significant correlations were found between troponin I and both creatine kinase and its MB fraction. When the 25 patients were divided into two groups, with lower (up to 0.04 ng/ml; 12 patients) and higher (0.05 ng/ml or greater; 13 patients) values for troponin I, patients with higher values were found to have greater mean left ventricular wall thickness (9.9+/-0.3 mm, n=11, vs. 12.1+/-0.3 mm, n=13) and pulmonary artery systolic pressures (36.6+/-2.5 mmHg, n=7, vs. 53.7+/-3.4 mmHg, n=9).
Conclusions:
We conclude that slightly raised plasma levels of cardiac troponin I are relatively common in aortic valve patients with no evidence of ischemia. Higher left ventricular wall thickness and pulmonary artery systolic pressure may be related to slightly raised troponin I plasma levels.