Abstract 10893: Cardiac Troponin T Release is Correlated with Diastolic Load in Patients with Nonischemic Heart Failure
Background: Cardiac troponin T (cTnT) is established as a specific biomarker of ongoing myocardial damage and predicts adverse outcome in patients with heart failure (HF). As is well known that epicardial coronary artery disease increases cTnT level by myocardial ischemia. However, it is not fully understood the mechanism underlying cTnT release in nonischemic HF patients because cTnT was detectable in only a small fraction by standard cTnT assay and affected by renal function. We evaluated cTnT release by novel highly sensitive assay and identified the affecting factors.
Methods: We evaluated 53 nonischemic HF patients (HF group: mean age 61±16 years, ejection fraction: 44±12 %, male 34) and 19 non-HF patients without significant coronary artery disease as a control group. We sampled from aortic root (Ao) and coronary sinus (CS) simultaneously during cardiac catheterization, and measured serum cTnT levels using Elecsys-2010 Troponin T hs STAT kit (Roche Diagnostics) and plasma B-type natriuretic peptide (BNP) levels using MI02 Shionogi BNP kit (Shionogi). cTnT and BNP extracted from heart were describe as the differences between Cs and Ao of cTnT levels (Δ cTnT) and BNP levels (Δ BNP), respectively.
Results: cTnT was detectable (cTnT>0.003 ng/mL) in 47 HF patients (92%) and 11 non-HF patients (58%) by highly sensitive assay. The ΔcTnT and ΔBNP in HF group were significantly higher than those in control group (ΔcTnT: 0.0022 [0.0012-0.0044] ng/mL vs. 0.0011 [0.0007-0.0015] ng/mL; p=0.01, ΔBNP: 188 [90-355] pg/mL vs. 21 [4-66] pg/mL; p<0.001). Δ cTnT positively correlated with Δ BNP (ρ=0.39, p=0.007), and left ventricular end-diastolic pressure (ρ=0.36, p=0.01). Inflammatory markers (C-reactive protein, interleukin-6, and tumor necrosis factor alpha), and oxidant stress marker (8-hydroxy-2-deoxyguanosine) did not correlate with cTnT release in this study.
Conclusions: cTnT release was increased and correlated with the diastolic load and the production of BNP in nonischemic HF patients. Increased wall stress might be one of the causes of cTnT release in failing myocardium.
- © 2011 by American Heart Association, Inc.