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Cardiac Troponin T Concentrations, Reversible Myocardial Ischemia, and Indices of Left Ventricular Remodeling in Patients with Suspected Stable Angina Pectoris: a DOPPLER-CIP Substudy.
Myhre, Peder L; Omland, Torbjørn; Sarvari, Sebastian I; Ukkonen, Heikki; Rademakers, Frank; Engvall, Jan E; Hagve, Tor-Arne; Nagel, Eike; Sicari, Rosa; Zamorano, Jose L; Monaghan, Mark; D'hooge, Jan; Edvardsen, Thor; Røsjø, Helge.
Afiliación
  • Myhre PL; Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
  • Omland T; Division of Cardiovascular Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
  • Sarvari SI; Division of Medicine, Akershus University Hospital, Lørenskog, Norway and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
  • Ukkonen H; Department of Cardiology, Oslo University Hospital, Rikshospitalet and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
  • Rademakers F; Department of Medicine, Turku University Hospital, Turku, Finland.
  • Engvall JE; Department of Cardiovascular Sciences, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Hagve TA; Department of Clinical Physiology Linköping University, Linköping, Sweden and Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
  • Nagel E; Division of Diagnostics and Technology, Akershus University Hospital, Lørenskog and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
  • Sicari R; Kings College Hospital, Department of Non-invasive Cardiology, Denmark Hill, London, UK.
  • Zamorano JL; CNR, Istituto di Fisiologia Clinica, Pisa, Italy.
  • Monaghan M; Hospital Universitario Ramón y Cajal, Cardiovascular Imaging Unit, Madrid, Spain.
  • D'hooge J; Kings College Hospital, Department of Non-invasive Cardiology, Denmark Hill, London, UK.
  • Edvardsen T; Department of Cardiovascular Sciences, University Hospitals Leuven and KU Leuven, Leuven, Belgium.
  • Røsjø H; Department of Cardiology, Oslo University Hospital, Rikshospitalet and Center for Heart Failure Research, University of Oslo, Oslo, Norway.
Clin Chem ; 64(9): 1370-1379, 2018 09.
Article en En | MEDLINE | ID: mdl-29959147
BACKGROUND: Cardiac troponin T concentrations measured with high-sensitivity assays (hs-cTnT) provide important prognostic information for patients with stable coronary artery disease (CAD). However, whether hs-cTnT concentrations mainly reflect left ventricular (LV) remodeling or recurrent myocardial ischemia in this population is not known. METHODS: We measured hs-cTnT concentrations in 619 subjects with suspected stable CAD in a prospectively designed multicenter study. We identified associations with indices of LV remodeling, as assessed by cardiac MRI and echocardiography, and evidence of myocardial ischemia diagnosed by single positron emission computed tomography. RESULTS: Median hs-cTnT concentration was 7.8 ng/L (interquartile range, 4.8-11.6 ng/L), and 111 patients (18%) had hs-cTnT concentrations above the upper reference limit (>14 ng/L). Patients with hs-cTnT >14 ng/L had increased LV mass (144 ± 40 g vs 116 ± 34 g; P < 0.001) and volume (179 ± 80 mL vs 158 ± 44 mL; P = 0.006), lower LV ejection fraction (LVEF) (59 ± 14 vs 62 ± 11; P = 0.006) and global longitudinal strain (14.1 ± 3.4% vs 16.9 ± 3.2%; P < 0.001), and more reversible perfusion defects (P = 0.001) and reversible wall motion abnormalities (P = 0.008). Age (P = 0.009), estimated glomerular filtration rate (P = 0.01), LV mass (P = 0.003), LVEF (P = 0.03), and evidence of reversible myocardial ischemia (P = 0.004 for perfusion defects and P = 0.02 for LV wall motion) were all associated with increasing hs-cTnT concentrations in multivariate analysis. We found analogous results when using the revised US upper reference limit of 19 ng/L. CONCLUSIONS: hs-cTnT concentrations reflect both LV mass and reversible myocardial ischemia in patients with suspected stable CAD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Miocárdica / Troponina T / Remodelación Ventricular / Angina de Pecho Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Chem Asunto de la revista: QUIMICA CLINICA Año: 2018 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Isquemia Miocárdica / Troponina T / Remodelación Ventricular / Angina de Pecho Tipo de estudio: Clinical_trials / Prognostic_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Chem Asunto de la revista: QUIMICA CLINICA Año: 2018 Tipo del documento: Article País de afiliación: Noruega Pais de publicación: Reino Unido