Significance and Determinants of Cardiac Troponin I in Patients With Obstructive Hypertrophic Cardiomyopathy

Zhang, Changlin; Liu, Rong; Yuan, Jiansong; Cui, Jingang; Hu, Fenghuan; Yang, Wei; Zhang, Yan; Yang, Chengzhi; Qiao, Shubin

doi:10.1016/j.amjcard.2015.09.006

Cited by 19 publications

(21 citation statements)

References 24 publications

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“…The imaging protocol and analysis have been described previously [27]. Briefly, a true fast imaging with steady-state precession (TrueFISP) sequence was used to obtain cine images.…”

Section: Methodsmentioning

confidence: 99%

Sex-related differences in the associations between plasma free fatty acid levels and clinical features in patients with hypertrophic cardiomyopathy

et al. 2016

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BackgroundPrevious studies have indicated that inefficient energy utilization may play a pivotal role in hypertrophic cardiomyopathy (HCM). However, whether plasma free fatty acid (FFA), a main energy substrate of heart, has an effect on HCM remains unclear. Besides, several studies have suggested sex-related differences in HCM features and FFA metabolism. Here, we aimed to explore the association between plasma FFA levels and HCM and potential effects of sex on this relation.MethodsA total of 412 patients (age 47.8 ± 12.7 years, 243 males (59.0%)) with HCM were recruited. Complete medical history was collected. Echocardiography and cardiovascular magnetic resonance imaging (CMRI) were performed. Fasting plasma FFA was determined by clinical laboratory. Left ventricular mass (LVM), maximum wall thickness (MWT), and left atrium diameter (LAD) were assessed with CMRI.ResultsThe median FFA levels were 0.38 (interquartile range (IQR) 0.27–0.52) mmol/L in men and 0.40 (IQR 0.30–0.59) mmol/L in women. The FFA levels were significantly lower in men compared with those in women (p = 0.005). Compared with women, men had greater LVM index (LVMI) (96.8 ± 37.6 vs. 78.6 ± 31.5 g/m2, p < 0.001). FFA levels in male patients correlated positively with LVM, LVMI, LAD, cholesterol levels, high-density lipoprotein-cholesterol (HDL-C) levels, heart rate, and systolic blood pressure (SBP). However, none of these variables were significantly associated with sqrt (FFA) in female patients except a borderline correlation of LAD (p = 0.050). Multiple linear regression analysis was performed in male patients and revealed that HDL-C (β = 0.191, p = 0.002), heart rate (β = 0.182, p = 0.004), SBP (β = 0.167, p = 0.007), LVMI (β = 0.132, p = 0.032), and LAD (β = 0.165, p = 0.009) were independently associated with increasing FFA levels.ConclusionsIn patients with HCM, LVMI, LAD, HDL-C, SBP, and heart rate were independently associated with increasing plasma FFA levels in males, whereas not in females. These results suggest that sex may affect the pathogenesis of HCM through influencing FFA metabolism. And these sex-related differences should be taken into account in therapeutic approaches to influence myocardial FFA metabolism in HCM.

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“…The imaging protocol and analysis have been described previously [27]. Briefly, a true fast imaging with steady-state precession (TrueFISP) sequence was used to obtain cine images.…”

Section: Methodsmentioning

confidence: 99%

Sex-related differences in the associations between plasma free fatty acid levels and clinical features in patients with hypertrophic cardiomyopathy

et al. 2016

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“…Individuals with elevated Tn have a higher prevalence of LGE. 43,46,48,49 but data are conflicting on whether Tn measurement is an independent predictor of the extent of LGE. 48,49 A high T2 signal on CMR, a potential marker of active tissue injury, in HCM is also associated with elevated troponin levels.…”

Section: Familial Cardiomyopathy Tnnt2 Tnni3 Tnnc1mentioning

confidence: 99%

“…38 Clinical correlates: troponin elevation in HCM is associated with greater LV wall thickness 37,[39][40][41][42][43] and LV mass. [44][45][46] Two studies found Tn elevation in patients with LV outflow tract obstruction 37,42 but another found no correlation. 40 The natural history of HCM includes progression to heart failure and Tn elevation is present in those with LV systolic dysfunction 37,40,44 although the degree of hs-TnT elevation does not correlate linearly with ejection fraction.…”

Section: Familial Cardiomyopathy Tnnt2 Tnni3 Tnnc1mentioning

confidence: 99%

“…37,40 Diastolic dysfunction, usually an earlier feature in HCM is also associated with Tn release. Several studies report correlations between Tn and left atrial (LA) area or diameter 37,42,46 as well as filling pressure measured by the ratio between early diastolic mitral inflow velocity and early diastolic mitral annular velocity (E/Ea) 40,42 It is uncertain whether Tn can help detect the presence of paroxysmal atrial fibrillation (AF) with studies reporting both a positive 40,47 and negative association. 42,46 More recently Tn levels have been related to the presence and extent of late gadolinium enhancement (LGE) on cardiac magnetic resonance imaging (CMR).…”

Section: Familial Cardiomyopathy Tnnt2 Tnni3 Tnnc1mentioning

confidence: 99%

“…43,52 Combining measurement of cardiac troponins with natriuretic peptides may provide additional value in assessing prognosis of several cardiomyopathies. In HCM, Brain natriuretic peptide (BNP) or N-terminal pro-brain natriuretic peptide (NT-proBNP) correlates with similar clinical parameters to Tn, 44,46,48,51,53 but was superior to hs-TnT at predicting which unaffected gene mutation carriers would go on to develop HCM. 54 To date there are few biomarker studies in pre-phenotypic disease in any cardiomyopathy.…”

Section: Familial Cardiomyopathy Tnnt2 Tnni3 Tnnc1mentioning

confidence: 99%

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Measurement of Troponin in Cardiomyopathies

2016

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Troponins are thin myofilament proteins that regulate the contraction of cardiac and skeletal muscle. The cardio-specific troponin I (TnI) and T (TnT) proteins are sensitive and specific biomarkers of myocardial injury which over the past twenty years have revolutionised the diagnosis and management of myocardial infarction. With the advent of high sensitivity assays the role for cardiac troponins is possibly expanding. Elevated levels are associated with adverse cardiovascular events and mortality in heart failure and the general population. Studies in cardiomyopathies are generally small with <200 patients, but serum troponin levels can be chronically raised and detect subclinical myocyte damage. This review examines all major published studies of cardiac troponin measurement in cardiomyopathies. There is considerable variability among studies regarding assays used and definitions of abnormal results but elevated troponin levels are almost invariably related to poor prognosis and their negative predictive value is important.

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Cardiac troponin I is associated with non-sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy

Zhou¹,

Yuan³

et al. 2020

Heart Vessels

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Significance and Determinants of Cardiac Troponin I in Patients With Obstructive Hypertrophic Cardiomyopathy

Cited by 19 publications

References 24 publications

Sex-related differences in the associations between plasma free fatty acid levels and clinical features in patients with hypertrophic cardiomyopathy

Sex-related differences in the associations between plasma free fatty acid levels and clinical features in patients with hypertrophic cardiomyopathy

Measurement of Troponin in Cardiomyopathies

Cardiac troponin I is associated with non-sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy

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