Abstract 17017: High-Sensitivity Troponin T is Associated with Worse Diastolic Function and Greater LV Mass among Elderly Persons in the Community without Prevalent Cardiovascular Disease
Introduction: High-sensitivity troponin T (hsTn-T) is associated with LV hypertrophy, reduced ejection fraction (EF), and incident heart failure (HF). However, the majority of HF cases in the elderly have preserved EF and the relationship of hsTn-T with diastolic dysfunction is not known.
Hypothesis: We hypothesized that higher hsTn-T is associated with worse diastolic function among elderly persons without prevalent cardiovascular disease (CVD).
Methods: Same day echocardiography and hsTn-T were performed in 4,304 elderly participants in the Atherosclerosis Risk in Communities (ARIC) study who were free of prevalent CVD. LV structure (wall thickness, volumes, mass), systolic function (EF), and diastolic function (early diastolic relaxation velocity [e’], E wave/e’ ratio, left atrial volume index [LAVi]) were assessed in a core laboratory. Echocardiographic measures were compared across five gender-specific categories of hsTn-T in analyses adjusting for age, gender, race, field center, hypertension, diabetes, chronic kidney disease, smoking, body mass index, systolic blood pressure, and kidney function.
Results: Mean age was 76±5 years, 62% were women, 79% white, 79% had hypertension, and 34% diabetes. Mean LVEF was 66±5%, with median hsTn-T 10 ng/L (IQR 7-14) . In multivariable models, higher hsTn-T category was associated with greater LV mass index due to both greater LV wall thickness and volume, and worse measures of LV diastolic function, including E’, the E/E’ ratio and LAVi (adjusted p value for all associations <0.001; Table). All associations remained significant after additional adjustment for NT-proBNP, and diastolic measures remained associated with hsTn-T after further adjustment for LVMi. There was no association between hsTn-T category and LVEF.
Conclusions: Among elderly persons without prevalent CVD, higher hsTn-T is independently associated with worse LV diastolic function in addition to greater LV structural remodeling.
Author Disclosures: A.M. Shah: None. C.M. Ballantyne: None. D. Kitzman: None. K. Matsushita: None. S. Konety: None. K. Butler: None. S.D. Solomon: None.
- © 2014 by American Heart Association, Inc.