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High T2-weighted signal intensity is associated with elevated troponin T in hypertrophic cardiomyopathy

Dh Frank Gommans1, G Etienne Cramer1, Jeannette Bakker2

  • 1Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.

Heart (British Cardiac Society)
|August 11, 2016
PubMed

Insights

Areas of high signal intensity (HighT2) on cardiovascular magnetic resonance (CMR) indicate active injury in hypertrophic cardiomyopathy (HCM). HighT2 is strongly associated with elevated cardiac troponin, supporting its role as a marker of myocyte injury.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Biomarkers

Background:

  • Areas of high signal intensity (HighT2) on T2-weighted cardiovascular magnetic resonance (CMR) are observed in hypertrophic cardiomyopathy (HCM).
  • HighT2 is hypothesized to represent active tissue injury in HCM patients.

Purpose of the Study:

  • To investigate the association between HighT2 on CMR and cardiac troponin levels in HCM patients.
  • To evaluate HighT2 as an indicator of active myocyte injury in hypertrophic cardiomyopathy.

Main Methods:

  • Outpatient HCM patients underwent 1.5T CMR including T2-weighted, cine, and late gadolinium enhancement (LGE) imaging.
  • Left ventricular (LV) function, mass, and LGE extent were assessed.
  • Highly sensitive cardiac troponin T (hs-cTnT) was measured, with elevated levels defined as ≥14 ng/L and detectable levels as >3 ng/L.

Main Results:

  • HighT2 was present in 28% of HCM patients.
  • Elevated hs-cTnT was significantly more common in patients with HighT2 (54%) compared to those without (14%) (p<0.001).
  • The extent of HighT2 correlated with hs-cTnT concentrations (Spearman's ρ: 0.42, p<0.001).

Conclusions:

  • HighT2 is observed in a quarter of HCM patients and is associated with elevated hs-cTnT.
  • The strong association and high negative predictive value of undetectable hs-cTnT for HighT2 support its role in indicating recent myocyte injury.
Abstract

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