Abstract 15957: Highly Sensitive Cardiac Troponin T in Patients with Hypertrophic Cardiomyopathy is Independently Associated with the Magnitude of Left Ventricular Mass and the Risk of a First Cardiovascular Event
Background: Elevated concentrations of highly sensitive cardiac troponin T (hsTnT) have been associated with left ventricular mass in patients with hypertrophic cardiomyopathy (HCM). HsTnT has also been associated with an increased cardiovascular risk in healthy individuals according to the Framingham risk score (FRS). We sought to assess whether the association of hsTnT with left ventricular mass was independent of the risk of a first cardiovascular event using the FRS in patients with clinical HCM.
Methods: We included 69 patients with a clinical diagnosis of HCM without a history of coronary artery disease. In 50% of patients a typical HCM mutation was found. At baseline, clinical variables to determine the FRS score were assessed for each patient. In addition, cardiac hsTnT (Roche Diagnostics) was determined and standard magnetic resonance imaging was performed to assess left ventricular mass index (LVMI) and maximum wall thickness (MWT). In multivariable analysis the association between a detectable hsTnT (>3ng/L) and abovementioned variables were investigated.
Results: Of the 69 patients 67% had a hsTnT level >3ng/L. Both LVMI and FRS were strongly associated with a detectable hsTnT in univariable analysis (p<0.001). Other factors that were significantly associated with hsTnT were: absence of genetic mutation (p=0.01); MWT (p=0.01); age (p=0.03); hypertension (p=0.01); creatinin level (p=0.05). After multivariable adjustment only LVMI (OR 1.2; 95% CI 1.1-1.3; p=0.001) and FRS (OR 1.08; 95% CI 1.02- 1.15; p=0.013) remained significantly associated with a detectable hsTnT. In the subset of clinical HCM patients with a known genetic mutation, the association between LVMI and a detectable troponin remained independent, whereas the association between FRS and hsTnT was lost.
Conclusion: Both left ventricular mass index and the Framingham Risk Score (FRS) are independently associated with a detectable hsTnT in patients with HCM. Interestingly, in clinical HCM patients with a known genetic mutation, highly cardiac sensitive troponin T does not depend on the risk profile for a first cardiovascular event. This might suggest different etiologies of troponin release in HCM patients.
- © 2012 by American Heart Association, Inc.