Valvular heart diseasePrognostic Usefulness of Circulating High-Sensitivity Troponin T in Aortic Stenosis and Relation to Echocardiographic Indexes of Cardiac Function and Anatomy
Section snippets
Methods
Fifty-seven patients referred to a cardiothoracic center (Oslo University Hospital, Rikshospitalet, Oslo, Norway) for presurgical evaluation were consecutively included in the study. All patients had a diagnosis of moderate to severe AS. A complete echocardiographic study was performed per standard views and guidelines6 by Vivid 7 (GE Vingmed, Horten, Norway). Images were stored in Echopac (GE Vingmed) and later processed and evaluated by an experienced researcher (T.E.) blinded to biomarker
Results
Patient characteristics are presented in Table 1. Patients were elderly, had slightly impaired renal function, and were clinical stable. A large proportion of patients had significant co-morbidities. Echocardiography confirmed the diagnosis of AS in all patients, and most patients had evidence of moderate to severe AS with myocardial hypertrophy but with relatively preserved left atrial and ventricular dimensions (Table 2). Furthermore, patients exhibited evidence of diastolic dysfunction, and
Discussion
The main results of this study are that (1) TnT levels are universally detectable by the new highly sensitive assay in patients with moderate and severe AS, (2) LV mass and systolic function, expressed as fractional shortening, are independent determinants of hs-cTnT levels in patients with AS, and (3) high hs-cTnT levels are associated with a poor prognosis in AS.
The increased diagnostic and prognostic accuracy of the hs-cTnT assay versus the established cTnT assay has recently been reported
Acknowledgment
We acknowledge the contribution by Lillian Lundeby, BSc, Oslo University Hospital, Rikshospitalet, to the collection of blood samples and data collection. We are also grateful to the physicians and technicians at the Department of Cardiology, Oslo University Hospital, Rikshospitalet, who contributed to the echocardiographic and angiographic examinations, and Siri Mortensen, BSc, and Line Bugge Klem Steffarud, BSc, at the Center of Laboratory Medicine, Akershus University Hospital for skillful
References (19)
- et al.
Recommendations for chamber quantification: a report from the American Society of Echocardiography's Guidelines and Standards Committee and the Chamber Quantification Writing Group, developed in conjunction with the European Association of Echocardiography, a branch of the European Society of Cardiology
J Am Soc Echocardiogr
(2005) - et al.
Association between high-sensitivity cardiac troponin T levels and the predicted cardiovascular risk in middle-aged men without overt cardiovascular disease
Am Heart J
(2010) Valvular aortic stenosis: Disease severity and timing of intervention
J Am Coll Cardiol
(2006)- et al.
Analytical validation of a high-sensitivity cardiac troponin T assay
Clin Chem
(2010) New features of troponin testing in different clinical settings
J Intern Med
(2010)- et al.
Prevalence and determinants of troponin T elevation in the general population
Circulation
(2006) - et al.
A sensitive cardiac troponin T assay in stable coronary artery disease
N Engl J Med
(2009) - et al.
Association of serial measures of cardiac troponin T using a sensitive assay with incident heart failure and cardiovascular mortality in older adults
JAMA
(2010) - et al.
A method of comparing the areas under receiver operating characteristic curves derived from the same cases
Radiology
(1983)
Cited by (0)
This study was supported by the University of Oslo, Oslo, Norway. Dr. Omland has received lecture fees and grant support from Roche Diagnostics, Basel, Switzerland.