title: Highly sensitive cardiac troponin T in heart failure: comparison with echocardiographic parameters and natriuretic peptides.
abstract: BACKGROUND
  Circulating cardiac troponin T is a marker of cardiomyocyte injury, and predicts adverse outcomes in patients with chronic heart failure. However, the significance of highly sensitive cardiac troponin T (hs-TnT) in cardiac dysfunction remains uncertain. The purpose of this study is to evaluate the correlation between hs-TnT and echocardiographic parameters or natriuretic peptides in patients with heart failure.
  
  
  RESULTS
  We analyzed 283 consecutive out- or in-patients who had B-type natriuretic peptide (BNP) ≥20 pg/mL and were examined by echocardiography (mean age 66.5±13.9 years old; 159 males). Hs-TnT, BNP, N-terminal pro-BNP (NT-proBNP), and creatinine levels were measured simultaneously. LVEDD (left ventricular end-diastolic dimension), LVEF (left ventricular ejection fraction), E', E/E', left ventricular (LV) Tei index, and right ventricular (RV) Tei index were determined with echocardiography. The linear regression analyses demonstrated that loghs-TnT correlated with LVEDD (R=0.242, p<0.0001), LVEF (R=-0.369, p<0.0001), E' (R=-0.447, p<0.0001), E/E' (R=0.364, p<0.0001), LV Tei index (R=0.303, p<0.0001), RV Tei index (R=0.443, p<0.0001), and estimated glomerular filtration rate (eGFR) (R=-0.489, p<0.0001). Using multiple variable regression analysis, loghs-TnT independently correlated with LVEF, E/E', RV Tei index, and eGFR. Furthermore, loghs-TnT significantly correlated with logBNP (R=0.567, p<0.0001) or logNT-proBNP (R=0.647, p<0.0001). Multiple variable regression analysis demonstrated that loghs-TnT independently correlated with logBNP, age, and eGFR, or with logNT-proBNP, age, sex, and eGFR.
  
  
  CONCLUSIONS
  The hs-TnT correlated with cardiac dysfunction evaluated by echocardiography and natriuretic peptides in patients with heart failure. The elevation of hs-TnT levels in heart failure may represent cardiac dysfunction due to minor and ongoing myocardial injury.
authors.affiliation: Department of Cardiovascular, Respiratory and Metabolic Medicine, Graduate School of Medicine, Kagoshima University, Kagoshima, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kusumoto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyata
authors.forename: Takuro
authors.initials: T
authors.lastname: Kubozono
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Takuro
authors.initials: T
authors.lastname: Shinsato
authors.forename: So
authors.initials: S
authors.lastname: Kuwahata
authors.forename: Shoji
authors.initials: S
authors.lastname: Fujita
authors.forename: Kunitsugu
authors.initials: K
authors.lastname: Takasaki
authors.forename: Toshinori
authors.initials: T
authors.lastname: Yuasa
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hamasaki
authors.forename: Chuwa
authors.initials: C
authors.lastname: Tei
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003404:Creatinine / Q000097:blood; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000175:diagnosis*; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D045265:Natriuretic Peptides / Q000097:blood; D012044:Regression Analysis; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D045265:Natriuretic Peptides; D020107:Troponin T; D020097:Natriuretic Peptide, Brain; D003404:Creatinine