Relationship of cardiac troponin to systolic global longitudinal strain in hypertrophic cardiomyopathy

Agarwal, Anushree; Yousefzai, Rayan; Shetabi, Kambiz; Samad, Fatima; Aggarwal, Saurabh; Cho, Chi; Bush, Michelle; Jan, M. Fuad; Khandheria, Bijoy K.; Paterick, Timothy E.; Tajik, A. Jamil

doi:10.1111/echo.13645

Cited by 11 publications

(7 citation statements)

References 39 publications

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“…Our understanding is that GLS is extremely sensitive in detecting slight reductions in LV systolic function. In cases where there is damage to cardiomyocytes (e.g., hypertrophic cardiomyopathy, cardiotoxicity) accompanied by an increase in troponin levels, there is also typically impairment in GLS [ 48 , 49 ]. In other cases, though, no association has been noted between troponin leak and GLS, even when the mechanism of LV dysfunction is coronary artery disease or inflammation [ 50 , 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Subclinical Left Ventricular Systolic Dysfunction in HIV Patients: Prevalence and Associations with Carotid Atherosclerosis and Increased Adiposity

Athanasiadi

Bonou

Basoulis

et al. 2022

JCM

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Background: Human immunodeficiency virus (HIV) is mainly detected in young, otherwise healthy, individuals. Cardiomyopathy and peripheral artery disease affecting these patients appears to be multifactorial. Prompt and potentially more effective implementation of therapeutic measures could be enabled by pre-symptomatic diagnosis of myocardial dysfunction and peripheral artery damage. However, limited data is available to date on this specific topic. Μethods: We investigated the association between global longitudinal strain (GLS), an established index of subclinical left ventricular systolic dysfunction (LVSD) assessed by two-dimensional speckle-tracking echocardiography, and: (a) patient history; (b) demographic and clinical baseline characteristics; (c) carotid intima-media thickness (IMT) and the presence of carotid atherosclerotic plaque(s), measured by ultrasonography; (d) temperature difference (ΔT) along each carotid artery, measured by microwave radiometry; and (e) basic blood panel measurements, including high-sensitivity troponin-T (hsTnT) and NT-proBNP in people living with HIV (PLWH) and no history of cardiovascular disease. Results: We prospectively enrolled 103 consecutive PLWH (95% male, age 47 ± 11 years, anti-retroviral therapy 100%) and 52 age- and sex-matched controls. PLWH had a significantly higher relative wall thickness (0.38 ± 0.08 vs. 0.36 ± 0.04, p = 0.048), and higher rate of LVSD (34% vs. 15.4%, p = 0.015), and carotid artery atherosclerosis (28% vs. 6%, p = 0.001) compared with controls. Among PLWH, LVSD was independently associated with the presence of carotid atherosclerosis (adj. OR:3.09; 95%CI:1.10–8.67, p = 0.032) and BMI (1.15; 1.03–1.29, p = 0.017), while a trend for association between LVSD and left ventricular hypertrophy was also noted (3.12; 0.73–13.33, p = 0.124). No differences were seen in microwave radiometry parameters, NT-proBNP, hs-TnT and c-reactive protein between PLWH with and without LVSD. Conclusions: Subclinical LVSD and carotid atherosclerosis were significantly more frequent in PLWH compared to a group of healthy individuals, implying a possible link between HIV infection and these two pathological processes. Carotid atherosclerosis and increased adiposity were independently associated with impaired GLS in HIV-infected individuals.

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Section: Discussionmentioning

confidence: 99%

Subclinical Left Ventricular Systolic Dysfunction in HIV Patients: Prevalence and Associations with Carotid Atherosclerosis and Increased Adiposity

Athanasiadi

Bonou

Basoulis

et al. 2022

JCM

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“…Recently, some researchers have investigated whether HCM patients with high T2 show increase in the arrhythmic burden 24–26 and sudden cardiac death rate compared with patients without HighT2 18 . Cardiac troponin, a biomarker of myocardial injury, has been shown to be correlated not only with HighT2 extent 19 but also with GLS in echocardiography studies 27 . In this context, it has been hypothesized that HighT2 might impact LV strain as well as LGE.…”

Section: Discussionmentioning

confidence: 99%

High T2-weighted signal intensity is associated with myocardial deformation in hypertrophic cardiomyopathy

Shi

Chen

et al. 2019

Sci Rep

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The association between global and segmental myocardial strain impairment and fibrosis extent in hypertrophic cardiomyopathy (HCM) is widely verified. The aim of this study was to investigate the contribution of high T2-weighted signal intensity (HighT2) to myocardial deformation in HCM. We prospectively recruited 57 patients with HCM examined by a 3.0 Tesla magnetic resonance scanner with cine, T2-weighted imaging with fat saturation and phase-sensitive inversion recovery. Global and segmental radial, circumferential and longitudinal strains were included for analysis. The extent of HighT2 was negatively correlated with global radial strain (ρ = −0.275, p = 0.038) and positively correlated with global circumferential strain (ρ = 0.308, p = 0.02) and global longitudinal strain (ρ = 0.422, p = 0.001). Radial, circumferential and longitudinal strains were all significantly associated with segment thickness. Regarding circumferential strain, segments at the mid-ventricular level with LGE and HighT2 showed more impairment than segments with only LGE. For longitudinal strain, the influence of HighT2 appeared only at the mid-ventricular level. The HighT2 extent in HCM was observed to contribute to global and segmental strain parameters. At the segmental level, HighT2 indeed affects left ventricular deformation, and follow-up studies are still warranted.

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“…Troponin T and I are both elevated in HCM, and are associated with LGE on CMR, 14 , 18 , 24 , 27 , 32 and global myocardial strain and maximal LV thickness on echocardiography. 28 Elevated troponin T and I levels have also been associated with LV mass on CMR. 29 , 30 , 31 , 33 , 34 , 35 , 37 In one study of subjects with HCM and preserved LV function, elevated hs‐cTnT (high‐sensitivity cardiac troponin T) level was an independent predictor of subsequent LV dysfunction and progression to end‐stage HCM over a mean follow‐up of 6.3±2.8 years.…”

Section: Methodsmentioning

confidence: 99%

Circulating Biomarkers in Hypertrophic Cardiomyopathy

Matthia

Setteducato

Elzeneini

et al. 2022

JAHA

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Hypertrophic cardiomyopathy is the most common genetic heart disease. Biomarkers, molecules measurable in the blood, could inform the clinician by aiding in diagnosis, directing treatment, and predicting outcomes. We present an updated review of circulating biomarkers in hypertrophic cardiomyopathy representing key pathologic processes including wall stretch, myocardial necrosis, fibrosis, inflammation, hypertrophy, and endothelial dysfunction, in addition to their clinical significance.

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Relationship of cardiac troponin to systolic global longitudinal strain in hypertrophic cardiomyopathy

Abstract: In this cohort of HCM patients, the association of reduced GLS and positive troponin was independent of LVT. Further studies are warranted to evaluate whether their combination adds prognostic value in identifying high-risk patients to define effective and early intervention strategies.

Cited by 11 publications

References 39 publications

Subclinical Left Ventricular Systolic Dysfunction in HIV Patients: Prevalence and Associations with Carotid Atherosclerosis and Increased Adiposity

Subclinical Left Ventricular Systolic Dysfunction in HIV Patients: Prevalence and Associations with Carotid Atherosclerosis and Increased Adiposity

High T2-weighted signal intensity is associated with myocardial deformation in hypertrophic cardiomyopathy

Circulating Biomarkers in Hypertrophic Cardiomyopathy

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