Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy.
OBJECTIVE
To determine whether measurement of cardiac troponin T (cTnT) concentration in newly diagnosed peripartum cardiomyopathy (PPCM) can be used to predict persistent left ventricular dysfunction after a 6-month follow-up.


METHODS
This was a prospective, multiple-centre clinical trial that studied 106 patients with newly diagnosed PPCM surviving over 6 months. cTnT concentration was measured within 2 weeks of the onset of PPCM.


RESULTS
Serum cTnT concentration was negatively correlated with left ventricular ejection fraction (LVEF) at follow-up (LVEF, r = -0.518, p = 0.0001). Analysis by receiver operator characteristic curve yielded an area under the curve of 0.764 (95% CI 0.669 to 0.860, p = 0.0001, vs null hypothesis value 0.5) for cTnT, and a cTnT concentration cut off of >0.04 ng/ml, predicting persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%. Among 106 recruited patients, there were 33 patients with cTnT concentrations >0.04 ng/ml and 73 patients with cTnT concentrations < or =0.04 ng/ml. After a 6-month follow-up, there was significantly smaller LVEF (35.42% (13.04% vs 50.16% (10.48%, p = 0.0001) and more persistent left ventricular dysfunction (84.8% vs 31.5%, OR = 12.17 (95% CI 4.17 to 35.57), p = 0.001) in patients with cTnT >0.04 ng/ml than in patients with cTnT < or =0.04 ng/ml.


CONCLUSIONS
Serum cTnT concentration measured within 2 weeks of the onset of PPCM was correlated negatively with LVEF at follow-up. This marker offers a simple, quick, inexpensive, non-invasive method for predicting a persistent LVEF of < or =50%. A cTnT concentration of >0.04 ng/ml predicted persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%.
Hu
C L
CL
Department of Cardiology, Renmin Hospital, Wuhan University School of Medicine, Wuchang District, Wuhan, People's Republic of China. chenglinhu@yahoo.com
Li
Y B
YB
Zou
Y G
YG
Zhang
J M
JM
Chen
J B
JB
Liu
J
J
Tang
Y H
YH
Tang
Q Z
QZ
Huang
C X
CX
D000328:Adult; D015415:Biomarkers / Q000097:blood; D009202:Cardiomyopathies / Q000097:blood*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood*; D011446:Prospective Studies; D011644:Puerperal Disorders / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000378:metabolism*; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
D015415:Biomarkers; D020107:Troponin T