High sensitivity troponin T in adult congenital heart disease. (15th September 2015)

• Record Type: Journal Article
• Authors: Rybicka, Justyna; Dobrowolski, Piotr; Lipczyńska, Magdalena; Kowalik, Ewa; Klisiewicz, Anna; Hoffman, Piotr; Szymański, Piotr
• Is Part Of: International journal of cardiology. Volume 195(2015)
• Page Start: 7
• Page End: 14
• Publication Date: 2015-09-15
• Subjects: High sensitivity troponin T -- Adult congenital heart disease -- ACHD -- Ventricular dysfunction; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2015.05.077
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: 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.