Serum Levels of High-Sensitivity Troponin T: A Novel Marker for Cardiac Remodeling in Hypertrophic Cardiomyopathy

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• 作者：Victoria Moreno ; Diana Herná ; ndez-Romero ; Juan Antonio Vilchez ; Antonio Garcí ; a-Honrubia ; Francisco Cambronero ; Teresa Casas ; Josefa Gonzá ; lez ; Pedro Martí ; nez ; Vicente Climent ; Gonzal
• 关键词：Hypertrophic cardiomyopathy ; troponin and cardiac remodeling
• 刊名：Journal of Cardiac Failure
• 出版年：2010
• 出版时间：December 2010
• 年：2010
• 卷：16
• 期：12
• 页码：950-956
• 全文大小：166 K

文摘

Background

Hypertrophic cardiomyopathy (HCM) is characterized by inappropriate hypertrophy, small-vessel coronary artery disease, myocyte disarray, and increased interstitial fibrosis. High-sensitivity troponin T (hs-TnT) could be a reliable indicator of myocardial remodeling, a proposed prognostic marker in HCM. Therefore we hypothesized that increased hs-TnT levels are related to different variables associated with myocardial remodeling, such as the presence of fibrosis assessed with cardiac magnetic resonance imaging (MRI).

Methods and Results

We included 95 hemodynamically stable HCM patients, 72 male, aged 45.7 ± 14.2 years, and 45 healthy control subjects with similar age and gender. A complete history and clinical examination was performed, including 12-lead electrocardiogram (ECG), echocardiography, 24-hour ECG-Holter monitoring, symptom-limited treadmill exercise test, and late gadolinium enhancement in cardiac MRI. Risk factors for sudden death were evaluated. A blinded cardiac MRI was performed with late gadolinium enhancement study. Serum hs-TnT levels were assayed. A high proportion (42 % ) of hemodynamically stable patients studied showed increased levels of hs-TnT. The hs-TnT levels were raised in patients with severe dyspnea: New York Heart Association (NYHA) functional class ≥3 (P = .020), outflow obstruction (P = .013), systolic dysfunction (P = .037), abnormal blood pressure response (P = .036), and presence of gadolinium enhancement (P = .021). The hs-TnT levels correlated positively with the maximum left ventricular wall thickness (r = 0.47; P < .001), left atrial diameter (r = 0.36, P = .014), and outflow gradient (r = 0.28; P = .008).

Conclusions

A high proportion of hemodynamically stable patients show increased levels of hs-TnT. We observed that raised hs-TnT serum levels are associated with different conditions related to the severity of the disease.