High-sensitive cardiac troponin T (hs-cTnT) assay as serum biomarker to predict cardiac risk in myotonic dystrophy: A case-control study

Valaperta, Rea; Gaeta, Maddalena; Cardani, Rosanna; Lombardi, Fortunata; Rampoldi, Benedetta; Siena, Claudia De; Mori, Francesca; Fossati, Barbara; Gaia, Paola; Ferraro, Ottavia Eleonora; Villani, Simona; Iachettini, Sara; Piccoli, Marco; Cirillo, Federica; Pusineri, Enrico; Meola, Giovanni; Costa, Elena

doi:10.1016/j.cca.2016.10.026

Cited by 15 publications

(15 citation statements)

References 27 publications

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“…Evidence of subclinical cardiac pathology in asymptomatic DM1 patients come also from basic research studies (20)(21)(22). Recently, Valaperta et al (20) found that blood levels of circulating cardiac Troponin T (cTnT), a serological biomarker of cardiac injury, were significantly higher in asymptomatic DM1 patients compared to healthy subjects.…”

Section: Introductionmentioning

confidence: 99%

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

et al. 2020

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Introduction: To evaluate myocardial strain and extracellular volume in myotonic dystrophy type 1 (DM1) patients as potential imaging biomarkers of subclinical cardiac pathology. Materials and methods:We retrospectively analyzed 9 DM1 patients without apparent cardiac disease who had undergone cardiac magnetic resonance at our center. Patients were age-and sex-matched with healthy controls. The Mann-Whitney U test was used to compare cardiac strain between the two groups. The t-test was used to compare the extracellular volume obtained in DM1 patients with that in healthy subject. Spearman's ρ was used for studying the associations among imaging parameters.Results: Global cardiac strain (median −19.1%; IQR −20.5%, −16.5%) in DM1 patients was lower (p = 0.011) than that in controls (median−21.7%; IQR−22.7%,-21.3%). Global extracellular volume in DM1 patients (median 32.3%; IQR 29.3%,36.8%) was significantly (p = 0.008) higher than that reported in literature in healthy subjects (median 25.6%; IQR 19.9%,31.9%). Global cardiac strain showed a strong, positive correlation with septal strain (ρ = 0.767, p = 0.016) and with both global (ρ = 0.733 p = 0.025) and septal extracellular volume (ρ = 0.767, p = 0.016). Discussion:The increase in cardiac extracellular volume and decrease in strain are signs of early cardiac pathology in DM1. Physicians dealing with DM1 may take into consideration cardiac magnetic resonance as a screening tool to identify early cardiac involvement in this condition.

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Section: Introductionmentioning

confidence: 99%

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

et al. 2020

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“…Skeletal muscle biopsy revealed expression of cTnT at the mRNA level in both healthy and DM1 muscle, and expression at protein level was detected by M7 detector antibody, though negative with 5D8 capture antibody. No measures of cTnI in this cohort were above the given cut-off value (26 ng/L; the non-sex adjusted population 99 th centile), and there were only two patients with manifest left ventricular impairment, limiting analysis with respect to heart muscle disease [44]. …”

Section: Discussionmentioning

confidence: 99%

Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study

et al. 2017

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ObjectiveHigh sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1).Methods117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records. Follow up was for a mean of 23 months.ResultsFifty five females and 62 males (mean age 47.7 years) were included. Complete data were available for ECG in 107, echocardiography in 53. Muscle Impairment Rating Scale score was recorded for all patients. A highly significant excess (p = 0.0007) of DM1 patients presented with cTnI levels greater than the 99th centile of the range usually observed in the general population (9 patients; 7.6%). Three patients with elevated troponin were found to have left ventricular systolic dysfunction (LVSD), compared with four of those with normal range cTnI (33.3% versus 3.7%; p = 0.001). Sixty two patients had a cTnI level < 5ng/L, of whom only one had documented evidence of LVSD. Elevated cTnI was not predictive of severe conduction abnormalities on ECG, or presence of a cardiac device, nor did cTnI level correlate with muscle strength expressed by Muscle Impairment Rating Scale score.ConclusionsPlasma cTnI is highly elevated in some ambulatory patients with DM1 and shows promise as a tool to aid cardiac risk stratification, possibly by detecting myocardial involvement. Further studies with larger patient numbers are warranted to assess its utility in this setting.

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“…On multivariable analysis, NT‐proBNP and CP were independently associated with incident paroxysmal AF in DM1 population. Increased levels of cardiac‐specific serum biomarkers in DM1 patients compared with controls have been previously reported . In a recent case‐control study, Valperta et al suggested that the hs‐cTnT might represent a helpful serum biomarker to predict cardiac risk in DM disease, below our ability to detect it with conventional measures.…”

Section: Discussionmentioning

confidence: 97%

“…Increased levels of cardiac‐specific serum biomarkers in DM1 patients compared with controls have been previously reported . In a recent case‐control study, Valperta et al suggested that the hs‐cTnT might represent a helpful serum biomarker to predict cardiac risk in DM disease, below our ability to detect it with conventional measures. More recently, Hamilton et al in a multicenter study including 117 DM1 patients followed for a mean of 23 months demonstrated that elevated serum hs‐cTnI levels were associated with left ventricular systolic dysfunction, but did not correlate with advanced conducting system disease on surface ECG.…”

Section: Discussionmentioning

confidence: 97%

“…Increased levels of cardiac-specific serum biomarkers in DM1 patients compared with controls have been previously reported. [11][12][13][14][15] In a recent case-control study, Valperta et al 14 Abbreviations: CI, confidence interval; CP, copeptin; HR, hazard ratio; LAD, left atrium diameter; NT-proBNP, N terminal pro-B-type natriuretic peptide.…”

Section: Discussionmentioning

confidence: 99%

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SERUM cardiac‐specific biomarkers and atrial fibrillation in myotonic dystrophy type I

Russo

Rago

Atripaldi

et al. 2019

Cardiovasc electrophysiol

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Introduction The aim of the present study was to evaluate the role of high‐sensitivity cardiac troponin I, N terminal pro‐B‐type natriuretic peptide (NT‐proBNP), creatine kinase‐MB mass concentration (CK‐MB mass) and copeptin (CP) in predicting incident atrial fibrillation (AF) in myotonic dystrophy type 1 (DM1) patients. Materials and methods The study enrolled 60 consecutive DM1 patients (age 50.3 ± 7.3 years, 34 male) who underwent pacemaker (PM) implantation for cardiac rhythm abnormalities and 60 PM recipients whose age and sex matched served as control group. All DM1 patients underwent a 12‐lead electrocardiogram, 2D color Doppler echocardiogram, biomarkers measurements and device interrogation at implantation, 1 month after and every 6 months thereafter for a minimum of 2‐year follow‐up. Results The study population was divided into two groups according to the presence of AF (AF group vs non‐AF group). The AF group was older (47.3 ± 8 vs 38.6 ± 7 years, P = .03) and showed higher serum levels of NT‐proBNP (151 ± 38.4 vs 107.3 ± 24.2 pg/mL, P < .001) and CP (18.9 ± 4.5 vs 7 ± 2.3 P < .001) than non‐AF Group. NT‐proBNP (P < .001) and CP (P < .001) were found to be an independent predictor of AF. Based on the receiver‐operating characteristics curve analysis, the cut‐off value for NT‐proBNP that best predicted AF event in DM1 patients was 123 pg/ml (sensitivity of 83.3% and specificity of 86.5%); the cut‐off value for CP that best predicted AF event in DM1 patients was 9 pmol/L (sensitivity of 89% and specificity of 87%). Conclusion NT‐proBNP and CP represent two independent predictors of AF onset in DM1 population with conduction disturbances underwent PM implantation.

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High-sensitive cardiac troponin T (hs-cTnT) assay as serum biomarker to predict cardiac risk in myotonic dystrophy: A case-control study

Cited by 15 publications

References 27 publications

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

Rare Disease: Cardiac Risk Assessment With MRI in Patients With Myotonic Dystrophy Type 1

Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study

SERUM cardiac‐specific biomarkers and atrial fibrillation in myotonic dystrophy type I

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