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Cardiac troponin I and ventricular arrhythmia in patients with chronic heart failure

Z Liu1, L Cui, Y Wang

  • 1Shandong University, Shandong Provincial Hospital, 324 Jingwu Weiqi Road, Jinan 250021, China. liuzunqi69@sina.com

European Journal of Clinical Investigation
|June 27, 2006
PubMed

Insights

Detectable serum cardiac troponin I (cTnI) in chronic heart failure (CHF) patients is linked to more frequent ventricular dysrhythmias. This finding may help identify patients at higher risk for ventricular tachycardia.

Area of Science:

  • Cardiology
  • Biomarkers
  • Electrophysiology

Background:

  • Ventricular dysrhythmias and elevated cardiac troponin I (cTnI) are common in chronic heart failure (CHF).
  • The direct relationship between serum cTnI levels and the severity of ventricular arrhythmias in CHF patients was previously unclear.
  • The underlying mechanisms driving ventricular arrhythmias in CHF patients remain incompletely understood.

Purpose of the Study:

  • To investigate the association between detectable serum cTnI and the severity of ventricular dysrhythmias in patients with CHF.
  • To determine if serum cTnI can identify a subgroup of CHF patients at increased risk for ventricular arrhythmias, particularly ventricular tachycardia.

Main Methods:

  • A cohort of 218 patients with CHF was analyzed, excluding those with acute myocardial infarction or myocarditis.
  • Patients were stratified into cTnI-positive (>0.5 ng mL(-1)) and cTnI-negative (<=0.5 ng mL(-1)) groups.
  • Ventricular dysrhythmia severity was quantified using 24-hour Holter monitoring, assessing measures like hourly ventricular pairs, repetitive ventricular beats, and ventricular tachycardia frequency.

Main Results:

  • Patients with detectable cTnI levels exhibited significantly higher mean hourly ventricular pairs, repetitive ventricular beats, and 24-hour ventricular tachycardia episodes.
  • Multivariate analysis confirmed an independent positive relationship between cTnI levels and the frequency of ventricular pairs, repetitive beats, and ventricular tachycardia.
  • Detectable cTnI was independently associated with a 2.31-fold increased risk of developing ventricular tachycardia (adjusted OR: 2.31; 95% CI, 1.22-2.65; P = 0.003).

Conclusions:

  • Detectable serum cTnI is closely associated with an increased occurrence of ventricular dysrhythmias in patients with CHF.
  • Serum cTnI can identify a subgroup of CHF patients with a higher burden of ventricular arrhythmias, including ventricular tachycardia.
  • Minimal myocardial injury, indicated by detectable serum cTnI, may represent an abnormal substrate contributing to ventricular dysrhythmias in CHF.
Abstract

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