title: Plasma high sensitivity troponin T levels in adult survivors of childhood leukaemias: determinants and associations with cardiac function.
abstract: BACKGROUND
  We sought to quantify plasma high sensitivity cardiac troponin (hs-cTnT) levels, their determinants, and their associations with left ventricular (LV) myocardial deformation in adult survivors of childhood acute leukaemias.
  
  
  RESULTS
  One hundred adult survivors (57 males) of childhood acute leukaemias, aged 24.1 ± 4.2 years, and 42 age-matched controls (26 males) were studied. Plasma cTnT was determined using a highly sensitive assay. Genotyping of NAD(P)H oxidase and multidrug resistance protein polymorphisms was performed. Left ventricular function was assessed by conventional, three-dimensional, and speckle tracking echocardiography. The medians (interquartile range) of hs-cTnT in male and female survivors were 4.9 (4.2 to 7.2) ng/L and 1.0 (1.0 to 3.5) ng/L, respectively. Nineteen survivors (13 males, 6 females) (19%) had elevated hs-cTnT (>95(th) centile of controls). Compared to those without elevated hs-TnT levels, these subjects had received larger cumulative anthracycline dose and were more likely to have leukaemic relapse, stem cell transplant, and cardiac irradiation. Their LV systolic and early diastolic myocardial velocities, isovolumic acceleration, and systolic longitudinal strain rate were significantly lower. Survivors having CT/TT at CYBA rs4673 had higher hs-cTnT levels than those with CC genotype. Functionally, increased hs-cTnT levels were associated with worse LV longitudinal systolic strain and systolic and diastolic strain rates.
  
  
  CONCLUSIONS
  Increased hs-cTnT levels occur in a significant proportion of adult survivors of childhood acute leukaemias and are associated with larger cumulative anthracycline dose received, history of leukaemic relapse, stem cell transplant, and cardiac irradiation, genetic variants in free radical metabolism, and worse LV myocardial deformation.
authors.affiliation: Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong.
authors.forename: Yiu-fai
authors.initials: YF
authors.lastname: Cheung
authors.forename: Wei
authors.initials: W
authors.lastname: Yu
authors.forename: Daniel Ka-leung
authors.initials: DK
authors.lastname: Cheuk
authors.forename: Frankie Wai-tsoi
authors.initials: FW
authors.lastname: Cheng
authors.forename: Janet Yee-kwan
authors.initials: JY
authors.lastname: Yang
authors.forename: Jeffrey Ping-wa
authors.initials: JP
authors.lastname: Yau
authors.forename: Karin Ka-huen
authors.initials: KK
authors.lastname: Ho
authors.forename: Chi-kong
authors.initials: CK
authors.lastname: Li
authors.forename: Rever Chak-ho
authors.initials: RC
authors.lastname: Li
authors.forename: Hui-Leung
authors.initials: HL
authors.lastname: Yuen
authors.forename: Alvin Siu-cheung
authors.initials: AS
authors.lastname: Ling
authors.forename: Vivian Wing-yi
authors.initials: VW
authors.lastname: Li
authors.forename: Wai-keung
authors.initials: WK
authors.lastname: Wong
authors.forename: Kwong-cheong
authors.initials: KC
authors.lastname: Tsang
authors.forename: Godfrey Chi-fung
authors.initials: GC
authors.lastname: Chan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D018943:Anthracyclines / Q000627:therapeutic use; D059248:Chemoradiotherapy; D002648:Child; D004452:Echocardiography / Q000379:methods; D005787:Gene Frequency; D005838:Genotype; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007938:Leukemia / Q000097:blood* / Q000235:genetics / Q000628:therapy*; D016014:Linear Models; D008297:Male; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins / Q000235:genetics; D009206:Myocardium / Q000378:metabolism; D019255:NADPH Oxidases / Q000235:genetics; D009364:Neoplasm Recurrence, Local; D033581:Stem Cell Transplantation; D017741:Survivors; D020107:Troponin T / Q000097:blood*; D055815:Young Adult
chemical_list: D018943:Anthracyclines; D000089762:Multidrug Resistance-Associated Protein 2; D027425:ATP-Binding Cassette, Sub-Family C Proteins; D019255:NADPH Oxidases; D020107:Troponin T; C086986:CYBA protein, human; C113333:NCF4 protein, human; C421109:multidrug resistance-associated protein 1