title: Relation of highly sensitive cardiac troponin T in hypertrophic cardiomyopathy to left ventricular mass and cardiovascular risk.
abstract: Elevated cardiac troponin can be seen in patients with left ventricular (LV) hypertrophy and in asymptomatic subjects with a high a priori risk of cardiovascular disease (CVD). In hypertrophic cardiomyopathy (HC) troponin can be detected as well, but little is known about the contribution of LV mass, on the one hand, and the long-term risk of CVD, on the other. In an observational single-center study of 62 patients with HC, without a history of CVD, we assessed the Framingham Heart 10-year risk score (FH10yrs), LV mass index (LVMI) using magnetic resonance imaging, and highly sensitive cardiac troponin T (hs-cTnT). Hs-cTnT (>3 ng/L) was detectable in 74% of patients (46 of 62). Hs-cTnT was elevated in 26% (16 of 62) of patients (ninety-ninth percentile reference limit of 14 ng/L or more). From 3 to 14 ng/L, patients were older, more often had hypertension, and the FH10yrs was higher. Hs-cTnT correlated positively with LVMI (p<0.001) and maximal wall thickness (p<0.001). In addition, LVMI and hypertension were independently associated with increasing hs-cTnT concentrations in linear regression. Using multivariate binary logistic regression, both LVMI and FH10yrs were independently associated with detectable hs-cTnT levels. In contrast, only LVMI was associated with elevated hs-cTnT levels. In conclusion, hs-cTnT was detectable in 3 quarters and elevated in a quarter of our patients with HC. Although detectable hs-cTnT is associated with both LV mass and CVD risk, elevated hs-cTnT relates to LV mass only. This indicates that hypertrophy more than the risk of CVD seems the most important drive for hs-cTnT to occur in these patients.
authors: Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands. Electronic address: crame120@planet.nl.
authors: Gilbert
authors: G
authors: Cramer
authors: Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Jeannette
authors: J
authors: Bakker
authors: Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Frank
authors: F
authors: Gommans
authors: Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Marc
authors: M
authors: Brouwer
authors: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Maurice
authors: M
authors: Kurvers
authors: Department of Clinical Chemistry, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Michael
authors: M
authors: Fouraux
authors: Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors: Freek
authors: F
authors: Verheugt
authors: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Marcel
authors: M
authors: Kofflard
mesh_terms: D015415:Biomarkers / Q000097:blood; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000175:diagnosis; D018450:Disease Progression; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T