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Highly sensitive cardiac troponin T in heart failure: comparison with echocardiographic parameters and natriuretic
Atsushi Kusumoto1, Masaaki Miyata, Takuro Kubozono
1Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
Insights
Highly sensitive cardiac troponin T (hs-TnT) correlates with cardiac dysfunction in heart failure patients. Elevated hs-TnT may indicate ongoing myocardial injury, impacting cardiac function and predicting outcomes.
Area of Science:
- Cardiology
- Biomarkers
- Heart Failure Research
Background:
- Cardiac troponin T is a known marker for cardiomyocyte injury and predictor of adverse outcomes in chronic heart failure.
- The clinical significance of highly sensitive cardiac troponin T (hs-TnT) in assessing cardiac dysfunction remains less understood.
Purpose of the Study:
- To evaluate the correlation between hs-TnT levels and echocardiographic parameters in heart failure patients.
- To assess the relationship between hs-TnT and natriuretic peptide levels in individuals with heart failure.
Main Methods:
- Analysis of 283 out- or in-patients with B-type natriuretic peptide (BNP) ≥20 pg/mL and echocardiography.
- Simultaneous measurement of hs-TnT, BNP, N-terminal pro-BNP (NT-proBNP), creatinine, and echocardiographic parameters including LVEF and Tei indices.
- Linear and multiple variable regression analyses to determine independent correlations.
Main Results:
- Hs-TnT demonstrated significant correlations with multiple echocardiographic parameters, including left ventricular ejection fraction (LVEF), E/E', and right ventricular (RV) Tei index.
- Hs-TnT independently correlated with LVEF, E/E', RV Tei index, and estimated glomerular filtration rate (eGFR).
- Strong correlations were observed between hs-TnT and both BNP and NT-proBNP levels, independent of age, sex, and eGFR.
Conclusions:
- Hs-TnT levels are significantly correlated with echocardiographic indicators of cardiac dysfunction in heart failure.
- Elevated hs-TnT in heart failure patients may reflect ongoing, minor myocardial injury contributing to cardiac dysfunction.
- Hs-TnT serves as a valuable biomarker for assessing cardiac dysfunction and potential myocardial injury in heart failure management.
Background:
Circulating cardiac troponin T is a marker of cardiomyocyte injury, and predicts adverse outcomes in patients with chronic heart failure. However, the significance of highly sensitive cardiac troponin T (hs-TnT) in cardiac dysfunction remains uncertain. The purpose of this study is to evaluate the correlation between hs-TnT and echocardiographic parameters or natriuretic peptides in patients with heart failure.
Methods And Results:
We analyzed 283 consecutive out- or in-patients who had B-type natriuretic peptide (BNP) ≥20 pg/mL and were examined by echocardiography (mean age 66.5±13.9 years old; 159 males). Hs-TnT, BNP, N-terminal pro-BNP (NT-proBNP), and creatinine levels were measured simultaneously. LVEDD (left ventricular end-diastolic dimension), LVEF (left ventricular ejection fraction), E', E/E', left ventricular (LV) Tei index, and right ventricular (RV) Tei index were determined with echocardiography. The linear regression analyses demonstrated that loghs-TnT correlated with LVEDD (R=0.242, p<0.0001), LVEF (R=-0.369, p<0.0001), E' (R=-0.447, p<0.0001), E/E' (R=0.364, p<0.0001), LV Tei index (R=0.303, p<0.0001), RV Tei index (R=0.443, p<0.0001), and estimated glomerular filtration rate (eGFR) (R=-0.489, p<0.0001). Using multiple variable regression analysis, loghs-TnT independently correlated with LVEF, E/E', RV Tei index, and eGFR. Furthermore, loghs-TnT significantly correlated with logBNP (R=0.567, p<0.0001) or logNT-proBNP (R=0.647, p<0.0001). Multiple variable regression analysis demonstrated that loghs-TnT independently correlated with logBNP, age, and eGFR, or with logNT-proBNP, age, sex, and eGFR.
Conclusions:
The hs-TnT correlated with cardiac dysfunction evaluated by echocardiography and natriuretic peptides in patients with heart failure. The elevation of hs-TnT levels in heart failure may represent cardiac dysfunction due to minor and ongoing myocardial injury.
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