Cardiac troponin T: a noninvasive marker for heart transplant rejection?

Diagnosis of acute rejection remains a major concern in heart transplant recipients. Currently, endomyocardial biopsy is the gold standard for detecting rejection. Given the risks and cost of endomyocardial biopsy, a noninvasive marker for rejection would be ideal. Cardiac troponin T (cTnT) is an es...

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Bibliographic Details
Published inThe Journal of heart and lung transplantation Vol. 17; no. 4; p. 395
Main Authors Alexis, J D, Lao, C D, Selter, J G, Courtney, M C, Correa, D K, Lansman, S L, Kushwaha, S S, Gass, A L
Format Journal Article
LanguageEnglish
Published United States 01.04.1998
Subjects
Acute Disease
Animals
Biomarkers - analysis
Biomarkers - blood
Biopsy - economics
Costs and Cost Analysis
Disease Models, Animal
Female
Graft Rejection - blood
Graft Rejection - classification
Graft Rejection - diagnosis
Heart Transplantation
Humans
Ischemia - physiopathology
Male
Middle Aged
Myocardium - chemistry
Myocardium - pathology
Necrosis
Rats
Risk Factors
Time Factors
Troponin - analysis
Troponin - blood
Troponin T
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Summary:Diagnosis of acute rejection remains a major concern in heart transplant recipients. Currently, endomyocardial biopsy is the gold standard for detecting rejection. Given the risks and cost of endomyocardial biopsy, a noninvasive marker for rejection would be ideal. Cardiac troponin T (cTnT) is an established marker of myocyte damage, and a rat transplantation model of heart transplant rejection has suggested that cTnT may be of value in detecting rejection. The cTnT levels were measured in 90 transplant recipients (67 men and 23 women) at the time of endomyocardial biopsy. There were a total of 256 cTnT levels and 256 biopsy samples. The cTnT levels were compared by use of International Society of Heart and Lung Transplantation rejection grades. Only one of the 12 grade 3 biopsy specimens had a corresponding elevated cTnT level. Of the 29 biopsy specimens with myocyte necrosis (grade 2 or grade 3), three had a corresponding elevated cTnT. The cTnT levels were elevated during the first 1 to 2 months after transplantation. There was no correlation between ischemic time and cTnT levels. CTnT is an insensitive marker of acute rejection, both early and late after heart transplantation. Elevation of cTnT after transplantation does not seem to be directly related to ischemic time.
ISSN:1053-2498
1557-3117