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

• Published in: Journal of cardiac failure Vol. 16; no. 12; pp. 950 - 956
• Main Authors: Moreno, Victoria, MD, Hernández-Romero, Diana, PhD, Vilchez, Juan Antonio, MD, García-Honrubia, Antonio, MD, Cambronero, Francisco, MD, PhD, Casas, Teresa, PhD, González, Josefa, MD, Martínez, Pedro, PhD, Climent, Vicente, MD, PhD, de la Morena, Gonzalo, MD, PhD, Valdés, Mariano, MD, PhD, Marín, Francisco, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2010
• Subjects: Adult; Biomarkers - blood; Cardiomyopathy, Hypertrophic - blood; Cardiomyopathy, Hypertrophic - diagnosis; Cardiovascular; Female; Humans; Hypertrophic cardiomyopathy; Male; Middle Aged; Severity of Illness Index; troponin and cardiac remodeling; Troponin T - blood; Hypertrophic cardiomyopathy; troponin and cardiac remodeling
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2010.07.245

Abstract 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.