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  4. Association of Subtle Left Ventricular Systolic Dysfunction with Elevated Cardiac Troponin T in Asymptomatic Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction
 
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Association of Subtle Left Ventricular Systolic Dysfunction with Elevated Cardiac Troponin T in Asymptomatic Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

Resource
Acta Cardiol. Sin., 28(2), 95-102
Journal
Acta Cardiol. Sin.
Journal Volume
28
Journal Issue
2
Pages
95-102
Date Issued
2012
Date
2012
Author(s)
Liu, Yen-Wen
Su, Chi-Ting
Chou, Chih-Chen
Wang, Saprina P. H.
Yang, Chun-Shin
Huang, Yao-Yi
Tsai, Liang-Miin
Chen, Jyh-Hong
Tsai, Wei-Chuan
URI
http://ntur.lib.ntu.edu.tw//handle/246246/258946
Abstract
Background: Increased cardiac troponin T (cTnT) concentrations are associated with a poor prognosis in end-stage renal disease (ESRD) patients. However, the impact of increased cTnT levels on left ventricular (LV) function is not well understood. Therefore, our study focused on LV function in asymptomatic hemodialysis patients with preserved left ventricular ejection fraction (LVEF) and elevated cTnT levels. Methods: Asymptomatic ESRD patients undergoing maintenance hemodialysis, with LVEF 50%, underwent echocardiographic examination and further testing to determine serum cTnT, high-sensitivity C-reactive protein (hsCRP) and albumin levels. Subjects were then stratified into one of two groups based on the cTnT level, with a cutoff value of 0.04 ng/mL. Results: There were no significant differences in gender, age, LVEF, systolic myocardial velocity, and the prevalence of comorbidities (except diabetes mellitus) between these two groups. Patients in the high cTnT group (>= 0.04 ng/mL) presented with higher hsCRP levels than patients in the low cTnT group (1.50 +/- 0.35 mg/dL vs. 0.59 +/- 0.62 mg/dL, p = 0.02). Additionally, reduced global LV peak systolic longitudinal strain (GLS) developed in the high cTnT group compared with the low group (-17.1 +/- 3.7% vs. -19.4 +/- 3.5%, p = 0.004). The deteriorated GLS was an independent factor correlated with higher cTnT levels in asymptomatic hemodialysis patients with preserved LVEF (p = 0.013, 95% CI = 0.71-0.96). Conclusion: Patients in the high cTnT group presented with higher levels of hsCRP and more reduced GLS than those in the low cTnT group, and reduced GLS was the independent factor of elevated cTnT level. Consequently, we concluded that those asymptomatic hemodialysis patients with elevated cTnT concentrations had LV systolic dysfunction.
Subjects
Cardiac troponin T
End-stage renal disease
LV systolic function
Speckle tracking echocardiography
Strain
SDGs

[SDGs]SDG3

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