Abstract 17217: High Sensitive Cardiac Troponin T is Useful as an Early Biomarker for Discrimination of Left Ventricular Geometry: The Japan Morning Surge - Home Blood Pressure (J-HOP) LVH Study

Abstract

Background: High sensitive cardiac troponin T (Hs-cTnT) and N-terminal pro-brain-type natriuretic peptide (NT-proBNP) have been reported to be an independent prognostic biomarker. We investigated whether Hs-cTnT and NT-proBNP could be considered as a useful diagnostic biomarker for discrimination of pathological cardiac phenotypes that occurs as pressure overload or volume overload, which, in turn, are high risk of cardiovascular events.

Methods: In 1356 patients recruited for the J-HOP study with one or more cardiovascular risk factors, we performed measurement of Hs-cTnT and NT-proBNP and echocardiography, and excluded the patients with left ventricular (LV) dysfunction (ejection fraction < 50%).

Results: Multiple linear regression analysis, adjusted by age, sex, body mass index, and cardiovascular risk factors, and blood pressure level, revealed that Hs-cTnT was independently associated with relative wall thickness (RWT) (β=0.09, P=0.002) and LV mass index (LVMI) (β=0.13, P<0.001), but was not with end-diastolic left ventricular diameter (EDLVD). Otherwise, NT-pro BNP was independently associated with EDLVD (β=0.17, P<0.001) and LVMI (β=0.26, P<0.001), but was not with RWT. There was significant difference in Hs-cTnT level between normal LV geometry group (n=471) and concentric LV remodeling group (n=410) (4.51 [95%CI: 4.29, 4.78] pg/ml vs. 4.96 [95%CI: 4.70, 5.24] pg/ml, p=0.013), but this difference was not found in NT-proBNP level. When patients were placed into quintiles based on Hs-cTnT and NT-proBNP levels, the highest Hs-cTnT category had increased likelihood of concentric LV change (RWT>0.42) compared with those in the lowest (Q1+Q2) (odds ratio [95%CI]: 1.65 [1.17-2.32], P=0.004). However, this association was not found in quintiles of NT-proBNP.

Conclusion: Our data suggest that Hs-cTnT might be closely associated with pressure overload characterized by concentric remodeling and hypertrophy, while NT-proBNP might be associated with volume overload. In addition, Hs-cTnT might be considered as a useful biomarker for clinical manifestations in the early stage of hypertension.