title: Independent value of cardiac troponin T and left ventricular global longitudinal strain in predicting all-cause mortality among stable hemodialysis patients with preserved left ventricular ejection fraction.
abstract: Using a speckle-tracking echocardiography (STE), we recently demonstrated that a left ventricular (LV) global longitudinal strain (GLS) ≥ -15% and the serum cardiac troponin T (cTnT) concentration are associated with mortality in stable hemodialysis patients with preserved LV ejection fraction (LVEF). In this study, we explored the relationship between cTnT and echocardiographic parameters and evaluated whether the prognostic value provided by cTnT is independent of a GLS ≥ -15% and vice versa. Eighty-eight stable hemodialysis patients with preserved LVEF were followed for 31 months. STE studies and measurements of cTnT were performed at baseline. CTnT concentration had a modest correlation with GLS (rs = 0.44; P < 0.001) but had a weak or nonsignificant correlation with other echocardiographic parameters. Adjusting for clinical parameters, hazard ratios for each increase of 0.01 ng/mL in cTnT, and a GLS ≥ -15% on mortality were 1.13 (P = 0.009) and 3.09 (P = 0.03) without significant interaction between cTnT and GLS ≥ -15%. In addition, an increased cTnT concentration, a GLS ≥ -15%, or their combination showed significant additional predictive value for mortality when included in models consisting of clinical parameters. Therefore, both cTnT and a GLS ≥ -15% are independent predictors of mortality and are useful for risk stratification.
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Junne-Ming
authors.identifier: 0000-0003-1916-7815
authors.initials: JM
authors.lastname: Sung
authors.affiliation: Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Chi-Ting
authors.initials: CT
authors.lastname: Su
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Yu-Tzu
authors.initials: YT
authors.lastname: Chang
authors.affiliation: Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: Yu-Ru
authors.identifier: 0000-0001-6150-960X
authors.initials: YR
authors.lastname: Su
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Wei-Chuan
authors.identifier: 0000-0001-9328-4863
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Saprina P H
authors.initials: SP
authors.lastname: Wang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Catholic Fu-An Hospital, Yun-Lin, Taiwan.
authors.forename: Chun-Shin
authors.initials: CS
authors.lastname: Yang
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Liang-Miin
authors.initials: LM
authors.lastname: Tsai
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Jyh-Hong
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan.
authors.forename: Yen-Wen
authors.identifier: 0000-0003-4662-628X
authors.initials: YW
authors.lastname: Liu
mesh_terms: D000368:Aged; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000503:physiopathology*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism* / Q000473:pathology; D016016:Proportional Hazards Models; D012372:ROC Curve; D012044:Regression Analysis; D006435:Renal Dialysis / Q000401:mortality*; D018709:Statistics, Nonparametric; D013318:Stroke Volume; D020107:Troponin T / Q000378:metabolism*; D014463:Ultrasonography
chemical_list: D020107:Troponin T