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High-Sensitive Cardiac Troponin T and Systemic Right Ventricular Area Predict Outcomes in Adults With Congenitally

Ewa Kowalik1, Anna Klisiewicz1, Mirosław Kowalski1

  • 1Department of Congenital Heart Diseases, Institute of Cardiology, Warsaw, Poland.

The Canadian Journal of Cardiology
|September 2, 2018
PubMed

Insights

Detectable high-sensitivity troponin T (hsTnT) and systemic right ventricular end-diastolic (sRVED) area predict adverse events in adults with congenitally corrected transposition of the great arteries (ccTGA). These simple screening tools can guide patient follow-up and improve outcomes.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Cardiovascular Medicine

Background:

  • Congenitally corrected transposition of the great arteries (ccTGA) is a rare condition where the right ventricle supports systemic circulation.
  • This anomaly increases the risk of adverse clinical events over time.
  • Identifying high-risk individuals is crucial for improving outcomes in ccTGA patients.

Purpose of the Study:

  • To identify screening tools for risk stratification of morbidity and mortality in adults with ccTGA.
  • To determine predictors of adverse clinical outcomes in this patient population.

Main Methods:

  • Prospective observational study involving 51 adult patients with ccTGA.
  • Baseline assessments included ECG, laboratory tests, echocardiography, and cardiopulmonary exercise testing.
  • Cox proportional hazards regression analysis identified determinants of composite clinical endpoints.

Main Results:

  • During a median follow-up of 3.15 years, 19 patients experienced 39 clinical events.
  • Detectable high-sensitivity troponin T (hsTnT) was a significant predictor of adverse outcomes (HR=6.25, P=0.02).
  • Echocardiography-derived systemic right ventricular end-diastolic (sRVED) area also predicted adverse outcomes (HR=1.05, P=0.02).

Conclusions:

  • A combination of detectable hsTnT and increased sRVED area are the best predictors of adverse clinical events in adults with ccTGA.
  • These findings can guide follow-up strategies due to the wide availability and simplicity of these risk determinants.
  • This approach aids in managing patients with this complex congenital heart defect.
Abstract

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