title: Circulating cardiac troponin T in potential heart transplant donors.
abstract: BACKGROUND
  Brain death may induce myocardial dysfunction, the mechanisms of which are not yet fully understood. Circulating cardiac troponin T is considered a highly sensitive and specific marker of myocardial cell injury.
  
  
  RESULTS
  We prospectively measured circulating cardiac troponin T in 100 brain-dead patients and measured the left ventricular ejection fraction area (LVEFa), using transesophageal echocardiography. Sixty-one patients had normal LVEFa, 25 had moderate decrease in LVEFa (30% to 50%), and 14 had severe decrease in LVEFa (< or = 30%). Circulating cardiac troponin T concentrations were significantly higher (1.68 +/- 1.03 micrograms/L-1, P < .01) in patients with a severe decrease in LVEFa than in the two other groups (0.42 +/- 0.43 and 0.12 +/- 0.16 microgram/L-1, respectively), and there was a significant correlation between LVEFa and cardiac troponin T concentration (p = -0.59, P < .0001). An elevated circulating cardiac troponin T concentration (> or = 0.5 microgram/L-1) was more accurate (sensitivity, 1.00; specificity, 0.84) in predicting a severe decrease in LVEFa than an elevated CKMB value or an increased CKMB/CK ratio.
  
  
  CONCLUSIONS
  An elevated circulating cardiac troponin T was associated with a severe decrease in LVEFa in brain-dead patients, suggesting that severe and potentially irreversible myocardial cell damage occurred. In contrast, CKMB determination was not useful. Since the quality of the donor's heart is considered an important prognosis factor in heart transplantation, the determination of circulating cardiac troponin T concentration could be useful to the heart transplantation team.
authors.affiliation: Département d'Anesthésie-Réanimation, Group Hospitalier Pitié-Salpêtrière, Paris VI University, France.
authors.forename: B
authors.initials: B
authors.lastname: Riou
authors.forename: S
authors.initials: S
authors.lastname: Dreux
authors.forename: S
authors.initials: S
authors.lastname: Roche
authors.forename: M
authors.initials: M
authors.lastname: Arthaud
authors.forename: J P
authors.initials: JP
authors.lastname: Goarin
authors.forename: P
authors.initials: P
authors.lastname: Léger
authors.forename: M
authors.initials: M
authors.lastname: Saada
authors.forename: P
authors.initials: P
authors.lastname: Viars
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001926:Brain Death / Q000097:blood / Q000503:physiopathology*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D014019:Tissue Donors; D014336:Troponin / Q000097:blood*; D020107:Troponin T
chemical_list: D015415:Biomarkers; D014336:Troponin; D020107:Troponin T