title: Prognostic value of cardiac troponin T in patients with moderate to severe heart failure scheduled for cardiac resynchronization therapy.
abstract: BACKGROUND
  Predicting response to cardiac resynchronization therapy (CRT) is challenging. Highly sensitive cardiac troponin T (hsTnT) might predict response to CRT and identify patients at a high risk of experiencing severe cardiovascular events. We investigated whether baseline levels of hsTnT were associated with response to CRT and with severe cardiovascular events after long-term follow-up.
  
  
  METHODS
  Eighty-one consecutive patients were included according to the current guidelines for CRT. Biochemical, functional, and clinical parameters were assessed at baseline and at 3, 6, and 12 months of follow-up; and mortality/cardiac transplantation after 46 ± 6 months of follow-up was investigated. Cardiac magnetic resonance imaging and echocardiography were used to assess left ventricular function including viability and remodeling.
  
  
  RESULTS
  Seventy-five patients completed 12 months of follow-up; and after a follow-up of 46 ± 6 months, a total of 15 patients died, 13 of these from cardiovascular causes, and 7 underwent heart transplantation. Baseline hsTnT <15 ng/L predicted response to CRT and was associated with a more favorable outcome with regard to severe cardiovascular events. Multivariate analysis found that presence of transmural scar tissue/fibrosis on magnetic resonance imaging and use of statins were independently associated with higher concentrations of hsTnT at baseline. There was a strong correlation between hsTnT and N-terminal pro-B-type natriuretic peptide levels.
  
  
  CONCLUSIONS
  Highly sensitive TnT levels were elevated in the majority of heart failure patients who were scheduled for CRT. The HsTnT levels predicted response to CRT as well as long-time survival.
authors.affiliation: University of Oslo, Faculty of Medicine, Department of Cardiology, Oslo University Hospital, Oslo, Norway. marit.aarones@oslo-universitetssykehus.no
authors.forename: Marit
authors.initials: M
authors.lastname: Aarones
authors.forename: Lars
authors.initials: L
authors.lastname: Gullestad
authors.forename: Svend
authors.initials: S
authors.lastname: Aakhus
authors.forename: Thor
authors.initials: T
authors.lastname: Ueland
authors.forename: Rita
authors.initials: R
authors.lastname: Skaardal
authors.forename: Halfdan
authors.initials: H
authors.lastname: Aass
authors.forename: Ragnhild
authors.initials: R
authors.lastname: Wergeland
authors.forename: Hans-Jørgen
authors.initials: HJ
authors.lastname: Smith
authors.forename: Pål
authors.initials: P
authors.lastname: Aukrust
authors.forename: Erik
authors.initials: E
authors.lastname: Kongsgaard
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy; D003404:Creatinine / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D016019:Survival Analysis; D020107:Troponin T / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine