High-sensitive troponin-T in adult congenital heart disease.

Abstract

BACKGROUND:

Adult congenital heart disease (ACHD) patients are at risk of late complications including arrhythmias, heart failure and sudden death. High-sensitive troponin-T (hs-TnT) is the standard for diagnosing acute coronary syndrome, but is also associated with cardiac function and prognosis in other cardiac diseases. We aimed to describe hs-TnT level in ACHD patients, and determine its relationship with cardiac function and other biomarkers.

METHODS:

Consecutive ACHD patients, visiting the outpatient clinic, underwent echocardiography, exercise testing and venipuncture on the same day.

RESULTS:

In total 587 patients were included (median age 33 [IQR 25-41] years, 58% male, 90% NYHA class I). hs-TnT was above the detection limit of 5 ng/L in 241 patients (41%), of whom 47 (8%) had hs-TnT levels above the 99th percentile of normal of 14 ng/L. hs-TnT levels were highest in patients with a systemic RV or pulmonary hypertension. Patients with normal or non-detectable hs-TnT were younger (32 [IQR 24-40] years) than patient with elevated hs-TnT (42 [IQR 36-60] years, p<0.001). The prevalence of hs-TnT ≥14 ng/L was higher in patients with NYHA ≥II (36%, p<0.001), systemic systolic dysfunction (38%, p<0.001), non-sinus rhythm (43%, p<0.001) and elevated pulmonary pressures (39%, p<0.001). hs-TnT was correlated with NT-proBNP (r=0.400, p<0.001).

CONCLUSIONS:

hs-TnT above the 99th percentile of normal is observed in a non-trivial portion of stable ACHD patients, especially in those with a systemic RV or elevated pulmonary pressures. Since this biomarker of myocardial damage is related to NT-proBNP and ventricular function, its potential predictive value in ACHD patients seems promising and further investigation of underlying mechanisms is warranted.

• Authors: Jannet A Eindhoven, Jolien W Roos-Hesselink, Annemien E van den Bosch, Isabella Kardys, Jin M Cheng, Jesse F Veenis, Judith A A E Cuypers, Maarten Witsenburg, Ron H N van Schaik, Eric Boersma
• Journal: International journal of cardiology (Int J Cardiol) Vol. 184 Pg. 405-411 (Apr 01 2015) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 25746495 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Biomarkers
• Peptide Fragments
• Troponin T
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain

Topics

• Adult
• Arrhythmias, Cardiac (diagnosis, etiology)
• Biomarkers (blood)
• Death, Sudden, Cardiac (etiology, prevention & control)
• Echocardiography (methods)
• Electrocardiography
• Exercise Test
• Female
• Heart Defects, Congenital (blood, diagnosis, physiopathology)
• Heart Failure (diagnosis, etiology)
• Humans
• Male
• Natriuretic Peptide, Brain (blood)
• Peptide Fragments (blood)
• Predictive Value of Tests
• Prognosis
• Troponin T (blood)
• Ventricular Function