Serum cardiac troponin I is related to increased left ventricular wall thickness, left ventricular dysfunction, and male gender in hypertrophic cardiomyopathy.
ABSTRACT Serum cardiac troponin I (cTnI) is a sensitive and specific marker of myocardial injury. However, a systematic evaluation of cTnI in hypertrophic cardiomyopathy (HCM) patients has not been performed.
The purpose of this study is to evaluate cTnI and determine its relationship to clinical features in HCM.
We studied serum cTnI in 162 consecutive HCM patients.
Serum cTnI ranged from 0.01 to 0.83 ng/mL (mean, 0.068 +/- 0.100 ng/mL) and was higher in male patients (P < .001), those with atrial fibrillation (P = .033), and left ventricular (LV) systolic dysfunction (P = .046). Serum cTnI values were also correlated with maximum LV wall thickness (r = 0.30, P < .001), LV end-systolic diameter (r = 0.20, P = .012), and E/Ea (peak early transmitral filling velocity/early diastolic mitral annulus velocity; r = 0.24, P = .004). Serum cTnI levels were not significantly different among New York Heart Association (NYHA) functional class and there was no difference between patients with or without LV outflow tract obstruction; although B-type natriuretic peptide (BNP) levels showed significant difference in those variables. Serum cTnI had very weak correlation with BNP values (r = 0.18, P = .023). Multivariate analysis revealed an independent relationship between cTnI and maximum LV wall thickness, E/Ea, and male gender.
In patients with HCM, serum cTnI was associated with important clinical indices such as maximum LV wall thickness, LV dysfunction, and male gender. Serum cTnI seemed to have clinical significance different from that of BNP and may not be reflecting cardiac load but the LV remodeling process in HCM.
SourceAvailable from: Morimasa Takayama[Show abstract] [Hide abstract]
ABSTRACT: Objectives Although B-type natriuretic peptide (BNP) and highly sensitive cardiac troponin T (cTnT) are useful for the evaluation of clinical features in various cardiovascular diseases, there are comparatively few data regarding the utility of these parameters in patients with hypertrophic obstructive cardiomyopathy (HOCM). The goal of this study was to assess the association between BNP, cTnT and clinical parameters in patients with HOCM. Design Cross-sectional survey Settings The relationship between BNP, cTnT and clinical end points and echocardiographic data was investigated. Participants This study included 102 consecutive outpatients with HOCM who were clinically stable. Results BNP was significantly associated with both maximum left ventricular (LV) wall thickness (r=0.28; p=0.003), and septal peak early transmitral filling velocity/peak early diastolic mitral annulus velocity (r=0.51; p=0.0001). No statistically significant associations were seen between cTnT and any echocardiographic parameters, but the presence of atrial fibrillation (AF) was associated with a high level of cTnT (p=0.01). Conclusions BNP is useful for monitoring clinical parameters and as a reflection of both LV systolic/diastolic function and increased LV pressure in patients with HOCM. A high level of serum cTnT is associated with the presence of AF.BMJ Open 09/2014; 4(9):e005968. DOI:10.1136/bmjopen-2014-005968 · 2.06 Impact Factor
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ABSTRACT: The transcriptome is subject to multiple changes during pathogenesis, including the use of alternate 5' start-sites that can affect transcription levels and output. Current RNA sequencing techniques can assess mRNA levels, but do not robustly detect changes in 5' start-site use. Here, we developed a transcriptome sequencing strategy that detects genome-wide changes in start-site usage (5'RNA-Seq) and applied this methodology to identify regulatory events that occur in hypertrophic cardiomyopathy (HCM). Compared with transcripts from WT mice, 92 genes had altered start-site usage in a mouse model of HCM, including four-and-a-half LIM domains protein 1 (Fhl1). HCM-induced altered transcriptional regulation of Fhl1 resulted in robust myocyte expression of a distinct protein isoform, a response that was conserved in humans with genetic or acquired cardiomyopathies. Genetic ablation of Fhl1 in HCM mice was deleterious, which suggests that Fhl1 transcriptional changes provide salutary effects on stressed myocytes in this disease. Because Fhl1 is a chromosome X-encoded gene, stress-induced changes in its transcription may contribute to gender differences in the clinical severity of HCM. Our findings indicate that 5'RNA-Seq has the potential to identify genome-wide changes in 5' start-site usage that are associated with pathogenic phenotypes.The Journal of clinical investigation 02/2014; 124(3). DOI:10.1172/JCI70108 · 13.77 Impact Factor
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ABSTRACT: Elevated cardiac Troponin can be seen in patients with left ventricular (LV) hypertrophy and in asymptomatic individuals with a high a priori risk of cardiovascular disease (CVD). In hypertrophic cardiomyopathy (HC) troponin can be detected as well, but little is known about the contribution of LV mass on the one hand, and the long-term risk of CVD on the other. In an observational single center study of 62HCpatients,without a history of CVD, we assess the Framingham Heart 10-year risk scores (FH10yrs), LV mass index (LVMI)using MRI, and highly-sensitive cardiac troponin T(hs-cTnT).Hs-cTnT (>3ng/L) is detectable in 74% of patients (46/62). Hs-cTnT is elevated in 26% (16/62) of patients (≥ the 99th percentile reference limit of 14 ng/L). Between 3 and 14ng/L, patients are older, more often have hypertension, and the FH10yrsis higher. Hs-cTnT correlates positively with LVMI (p<0.001), and maximal wall thickness (p<0.001). In addition, LVMI and hypertension are independently associated with increasing hs-cTnT concentrations in linear regression. Using multivariable binary logistic regressionboth LVMI and FH10yrs are independently associated with a detectable hs-cTnT. In contrast,only LVMIis associated with an elevated hs-cTnT.In conclusion, hs-cTnT is detectable in three quarters, and elevated in a quarter of our patients with HC. Whereas a detectable hs-cTnT is associated with both LV mass and CVD risk, an elevated hs-cTnT relates to LV mass only. This indicates that hypertrophy more than the risk of CVD seems the most important drive for hs-cTnT to occur in these patients.The American journal of cardiology 04/2014; DOI:10.1016/j.amjcard.2013.12.033 · 3.43 Impact Factor