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High sensitivity troponin T in adult congenital heart disease.
Rybicka, Justyna; Dobrowolski, Piotr; Lipczynska, Magdalena; Kowalik, Ewa; Klisiewicz, Anna; Hoffman, Piotr; Szymanski, Piotr.
Afiliación
  • Rybicka J; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland. Electronic address: jrybicka@ikard.pl.
  • Dobrowolski P; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland.
  • Lipczynska M; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland.
  • Kowalik E; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland.
  • Klisiewicz A; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland.
  • Hoffman P; Adult Congenital Heart Disease Department, Institute of Cardiology, Warsaw, Poland.
  • Szymanski P; Acquired Valve Disease Department, Institute of Cardiology, Warsaw, Poland.
Int J Cardiol ; 195: 7-14, 2015 Sep 15.
Article en En | MEDLINE | ID: mdl-26011405
BACKGROUND: High sensitivity troponin T (hsTnT) assays enable us to detect chronic heart failure (CHF). Adult congenital heart disease (ACHD) patients are classified as being in at least stage B of CHF. The purpose of the study was to assess hsTnT levels in ACHD patients and determine its clinical significance. METHODS: This is a prospective cross-sectional study. We assessed hsTnT in 131 ACHD patients and in 30 healthy controls. All ACHD patients underwent routine clinical and echocardiographic evaluation and had hsTnT and N-terminal brain natriuretic peptide (NT-pro-BNP) level measurements. RESULTS: The cut-off value defining an abnormal hsTnT level was established as >0.005 ng/mL. 35.1% (n=46) of ACHD patients had abnormal hsTnT compared to 6.7% (n=2) of healthy controls (p=0.002). The prevalence of elevated hsTnT did not differ between simple and complex and between non-cyanotic and cyanotic congenital heart disease (CHD). The sensitivity and specificity of hsTnT for the detection of moderate or severe (significant) systemic ventricular dysfunction was 78.6% and 69.8%, respectively (OR 8.49; CI 95% 2.23-32.30; p<0,0001) whereas for significant pulmonary ventricular dysfunction it was 66.7% and 68.2%, respectively (OR 4.29; CI 95% 1.56-11.79; p=0.003). In multivariate logistic regression models elevated hsTnT, but not NT-pro-BNP, was independently associated with both significant systemic ventricular dysfunction (p=0.004) and significant pulmonary ventricular dysfunction (p=0.011). CONCLUSIONS: A troponin leak is observed in a substantial number of ACHD patients and is associated with significant systemic and pulmonary ventricular impairment. Compared to NT-pro-BNP, hsTnT is a more specific independent predictor of ventricular dysfunction in ACHD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Troponina T / Cardiopatías Congénitas Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2015 Tipo del documento: Article Pais de publicación: Países Bajos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Troponina T / Cardiopatías Congénitas Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Cardiol Año: 2015 Tipo del documento: Article Pais de publicación: Países Bajos