Related Experiment Video

Updated: Aug 13, 2025

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
05:16

Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure

Published on: June 10, 2025

170

Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart

Luca Crisanti1, Gabriele Valli2, Elisa Cennamo1

  • 1Postgraduate School of Emergency Medicine, Sapienza University of Rome, 00189 Rome, Italy.

Medicina (Kaunas, Lithuania)
|January 21, 2023
PubMed

Insights

High-sensitivity cardiac troponin (hs-cTnI) is negatively related to left ventricular ejection fraction (LVEF) in acute heart failure (AHF) patients. Elevated hs-cTnI indicates higher risk of adverse outcomes, regardless of LVEF, in AHF without acute coronary syndrome.

Area of Science:

  • Cardiology
  • Biomarkers
  • Acute Heart Failure

Background:

  • Acute heart failure (AHF) management lacks clear evidence on the relationship between high-sensitivity cardiac troponin I (hs-cTnI) and left ventricular ejection fraction (LVEF).
  • Understanding this relationship is crucial for risk stratification in AHF patients presenting to the emergency department (ED).

Purpose of the Study:

  • To investigate the association between hs-cTnI levels and LVEF in patients with AHF.
  • To determine the prognostic value of hs-cTnI in predicting adverse outcomes in AHF, stratified by LVEF.

Main Methods:

  • Retrospective analysis of 386 AHF patients admitted to EDs in Rome, Italy.
  • Patients were categorized based on LVEF (preserved vs. reduced) and hs-cTnI levels (positive vs. negative).
  • Exclusion of patients with acute coronary syndrome (ACS).

Main Results:

  • A significant negative correlation was observed between positive hs-cTnI tests and LVEF.
  • Patients with elevated hs-cTnI, irrespective of LVEF (preserved or reduced), had a higher likelihood of adverse outcomes (ICU admission, in-ED death).
  • Reduced LVEF was associated with a higher level of care upon discharge.

Conclusions:

  • In AHF patients without ACS, hs-cTnI is negatively associated with LVEF, but elevated levels occur even with preserved LVEF.
  • hs-cTnI serves as a reliable biomarker for myocardial injury and a risk stratification tool in AHF, independent of LVEF.
  • Further prospective studies are warranted to validate these findings.

Keywords:
acute heart failureemergency departmenthigh-sensitivity troponin Ileft ventricular ejection fractionrisk stratification

More Related Videos

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach07:49

Author Spotlight: Investigating HR-Dependent Cardiac Function in Mouse Models Through a Novel Atrial-Pacing Approach

Published on: July 21, 2023

1.5K
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction14:19

Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction

Published on: October 14, 2016

11.6K

Related Concept Videos

Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
19
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
20
Pathophysiology of Heart Failure01:17

Pathophysiology of Heart Failure

Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.7K
Heart Failure IV: Classification and Diagnostic Evaluation01:30

Heart Failure IV: Classification and Diagnostic Evaluation

Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
24
Heart Failure VI: Adjunct Therapies01:22

Heart Failure VI: Adjunct Therapies

Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
22
Heart Failure I: Introduction01:27

Heart Failure I: Introduction

Heart failure refers to a clinical syndrome caused by structural or functional cardiac disorders that prevent the heart from pumping an adequate amount of blood to meet the body's metabolic needs. This condition often arises from myocardial infarction or ischemia, leading to decreased cardiac output, reduced tissue perfusion, impaired gas exchange, fluid volume imbalance, and decreased functional ability.Heart failure can result from disruptions in the mechanisms that regulate cardiac output...
34