title: Diagnostic value of troponin T for alterations in left ventricular mass and function in dialysis patients.
abstract: BACKGROUND
  Cardiac troponin T (cTnT) is related to left ventricular (LV) mass in patients with end-stage renal disease (ESRD). Furthermore, cTnT reflects the severity of systolic dysfunction in patients with heart diseases. We tested the diagnostic value of cTnT for left ventricular hypertrophy (LVH) and LV systolic dysfunction in a large group of clinically stable hemodialysis patients without heart failure.
  
  
  RESULTS
  CTnT was significantly (P < 0.001) higher in patients with LVH than in those with normal LV mass. In a multiple logistic regression model, adjusting for potential confounders (including cardiac ischemia), systolic pressure and cTnT (both P = 0.003) were the strongest correlates of LVH. Similarly, cTnT was significantly higher (P = 0.005) in patients with systolic dysfunction than in those with normal LV function and in a multiple logistic regression model cTnT ranked as the second independent correlate of this alteration after male sex. Serum cTnT had a high positive prediction value for the diagnosis of LVH (87%) but its negative prediction value was relatively low (44%). The positive predictive value of cTnT for LV dysfunction was low (25%) while its negative predictive value was high (93%). A combined analysis including systolic pressure (for the diagnosis of LVH) and sex (for the diagnosis of LV systolic dysfunction) augmented the diagnostic estimates to an important extent (95% positive prediction value for LVH and 98% negative prediction value for LV systolic dysfunction).
  
  
  CONCLUSIONS
  CTnT has a fairly good diagnostic potential for the identification of LVH and for the exclusion of LV systolic dysfunction in patients with ESRD without heart failure. This marker may be useful for the screening of alterations in LV mass and function in clinically stable hemodialysis patients.
authors.affiliation: CNR Centre of Clinical Physiology and Division of Nephrology, Reggio Calabria, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.forename: Saverio
authors.initials: S
authors.lastname: Parlongo
authors.forename: Giovanni
authors.initials: G
authors.lastname: Tripepi
authors.forename: Francesco A
authors.initials: FA
authors.lastname: Benedetto
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Cutrupi
authors.forename: Grazia
authors.initials: G
authors.lastname: Bonanno
authors.forename: Pasquale
authors.initials: P
authors.lastname: Fatuzzo
authors.forename: Francesco
authors.initials: F
authors.lastname: Rapisarda
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Seminara
authors.forename: Benedetta
authors.initials: B
authors.lastname: Stancanelli
authors.forename: Ignazio
authors.initials: I
authors.lastname: Bellanuova
authors.forename: Alessando
authors.initials: A
authors.lastname: Cataliotti
authors.forename: Lorenzo S
authors.initials: LS
authors.lastname: Malatino
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D013599:Systole; D020107:Troponin T / Q000097:blood; D014511:Uremia / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology
chemical_list: D020107:Troponin T