title: High-sensitive troponin T in chronic heart failure correlates with severity of symptoms, left ventricular dysfunction and prognosis independently from N-terminal pro-b-type natriuretic peptide.
abstract: BACKGROUND
  Troponin T is an established marker of myocardial ischemia. We speculated that the role of the new high-sensitive troponin T (hs-cTnT) might expand towards non-ischemic myocardial disease, indicate disease severity and allow for prognostication in chronic heart failure.
  
  
  METHODS
  Hs-cTnT (Roche Diagnostics, Mannheim, Germany) was assessed in 233 individuals with chronic heart failure (n=149) or healthy controls (n=84).
  
  
  RESULTS
  Hs-cTnT was significantly elevated in patients with chronic heart failure [0.018 ng/mL, interquartile range (IQR) 0.009-0.036 ng/mL, vs. controls 0.003 ng/mL, 0.003-0.003 ng/mL, p<0.001] and positively correlated with N-terminal pro-b-type natriuretic peptide (NT-proBNP) (r=0.79, p<0.001). Hs-cTnT increased stepwise and signitificantly according to clinical (NYHA stage) as well as functional (LV ejection fraction, fluid retention) severity (each p<0.001). At a binary cutpoint of 0.014 ng/mL, hs-TropT was a significant predictor of all-cause mortality and all-cause mortality or rehospitalization for congestive heart failure (each p≤0.01). Of note, the prognostic value of hs-TropT was independent and additive to that of NT-proBNP.
  
  
  CONCLUSIONS
  Hs-cTnT increases stepwise with the severity of symptoms and LV dysfunction and offers important prognostic information in chronic heart failure, independently from and additive to NT-proBNP. The utility of hs-cTnT expands beyond acute myocardial ischemia and towards chronic heart failure.
authors: Department of Cardiology, Klinik und Poliklinik fuer Innere Medizin II, Universitätsklinikum Regensburg, Regensburg, Germany. carsten.jungbauer@klinik.uni-regensburg.de
authors: Carsten G
authors: CG
authors: Jungbauer
authors: Julia
authors: J
authors: Riedlinger
authors: Stefan
authors: S
authors: Buchner
authors: Christoph
authors: C
authors: Birner
authors: Markus
authors: M
authors: Resch
authors: Matthias
authors: M
authors: Lubnow
authors: Kurt
authors: K
authors: Debl
authors: Monika
authors: M
authors: Buesing
authors: Hendrik
authors: H
authors: Huedig
authors: Günter
authors: G
authors: Riegger
authors: Andreas
authors: A
authors: Luchner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005858:Germany; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000401:mortality
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain