Prognostic Value and Determinants of High-Sensitivity Cardiac Troponin T in Patients With a Systemic Right Ventricle:...

Area of Science:

• Cardiology
• Biomarkers
• Cardiac Imaging

Background:

• Systemic right ventricle (SRV) physiology presents unique challenges in cardiac assessment.
• The role of high-sensitivity cardiac troponin T (hs-cTnT) in SRV patients is not well-defined.
• Understanding SRV determinants and prognostic markers is crucial for patient management.

Purpose of the Study:

• To investigate the correlation between hs-cTnT levels and biventricular function in SRV patients.
• To evaluate the prognostic value of hs-cTnT for adverse cardiovascular events in this population.
• To compare the prognostic performance of hs-cTnT with established markers like RVEF and peak oxygen uptake.

Main Methods:

• Analysis of 98 patients from the SERVE trial (NCT03049540).
• Correlation of baseline hs-cTnT with biventricular volumes/function assessed by cardiac MRI/CT using regression models.
• Prognostic value assessed using Cox models, survival analysis, and concordance statistics for a composite outcome (arrhythmia, HF hospitalization, death).

Main Results:

• hs-cTnT concentrations showed significant correlation with right ventricular end-systolic volume index (r=+0.368) and right ventricular ejection fraction (RVEF) (r=-0.381).
• Elevated hs-cTnT levels (2x and 4x reference) were associated with significantly increased risk for the composite outcome (HRs 2.89 and 4.42, respectively).
• Prognostic performance of hs-cTnT was comparable to RVEF and predicted peak oxygen uptake (concordance statistics ~0.71-0.72).

Conclusions:

• hs-cTnT is a significant correlate of RV structure and function in SRV patients.
• hs-cTnT demonstrates valuable prognostic capability in SRV, on par with RVEF and peak oxygen uptake.
• These findings support the utility of hs-cTnT as a biomarker in SRV management.