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Leakage of cardiac troponin I in aortic valve stenosis

M Kupari1, S Eriksson, H Turto

  • 1Division of Cardiology, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. markku.kupari@hus.fi

Journal of Internal Medicine
|August 24, 2005
PubMed

Insights

Detectable cardiac troponin I (cTnI) in aortic valve stenosis (AS) patients is common and linked to heart failure (HF). Measuring cTnI may help detect early signs of deterioration in AS patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Heart Failure Research

Background:

  • Aortic valve stenosis (AS) leads to cardiomyocyte degeneration and heart failure (HF).
  • Ongoing myocyte damage in AS is a key factor in HF development.
  • Detecting myocyte damage through circulating biomarkers is crucial for managing AS.

Purpose of the Study:

  • To investigate if circulating cardiac troponin I (cTnI) concentrations can detect ongoing myocyte damage in patients with AS.
  • To assess the association between detectable cTnI levels and the presence of HF in AS patients.
  • To determine if transcardiac gradients of cTnI correlate with left ventricular (LV) systolic function.

Main Methods:

  • A cross-sectional cohort study involving 131 adult patients with isolated AS undergoing echocardiography and cardiac catheterization.
  • Blood samples were collected from the aortic root and, in a subset of 49 patients, from the coronary sinus.
  • Sensitive immunoassays were used to determine cTnI concentrations.

Main Results:

  • 56% of AS patients had detectable aortic cTnI, with 23% exceeding the reference limit for healthy individuals.
  • Detectable cTnI was associated with a higher prevalence of HF (42% vs. 19%, P = 0.004).
  • A transcardiac cTnI gradient (> or =5 ng L(-1)) was observed in 27% of AS patients, correlating with lower LV ejection fractions (P = 0.011).

Conclusions:

  • Detectable circulating cTnI is frequent in AS and moderately associated with HF.
  • Leakage of cTnI into the coronary sinus is linked to impaired LV systolic function.
  • Monitoring cTnI levels may offer a method to identify early clinical deterioration in AS.
Abstract

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