title: Left ventricular end-diastolic pressure and ejection fraction correlate independently with high-sensitivity cardiac troponin-T concentrations in stable heart failure.
abstract: BACKGROUND
  Cardiac troponin is widely accepted as a biomarker of myocyte injury in patients with myocardial ischemia. Patients with congestive heart failure are also associated with elevated cardiac troponin and it is a very sensitive prognostic marker. However, the mechanisms of troponin elevation in patients with heart failure are not fully understood. Decompensated state itself is suggested as a factor contributing to elevated cardiac troponin-T. However comparison between invasive hemodynamic parameters and cardiac troponin-T is insufficient.
  
  
  METHODS
  Data were collected from 167 patients in stable, chronic HF, without acute coronary syndrome, recent revascularization, mitral stenoses, hemodialysis, or clinically significant right HF. We evaluated the correlations and 95% confidence intervals (CI) between invasive hemodynamic measurements and serum high-sensitivity (hs) concentrations of cTnT.
  
  
  RESULTS
  The serum cTnT concentration was equal to or more than the detection threshold (0.003ng/ml) in all patients. The serum cTnT concentration was equal to or more than the cut-off value of 0.014ng/ml in 46% of patients. By multiple variable analysis, left ventricular (LV) end-diastolic pressure (EDP; adjusted coefficient=0.014; 95% CI 0.0003-0.029; P=0.046) was positively correlated, while hemoglobin (adjusted coefficient=-0.079; 95% CI -0.140 to -0.018; P=0.012), estimated glomerular filtration rate (adjusted coefficient=-0.008; 95% CI -0.013 to -0.003; P=0.004), and LV ejection fraction (EF; adjusted coefficient=-0.011; 95% CI -0.018 to -0.003; P=0.004) were negatively correlated with hs-cTnT concentrations.
  
  
  CONCLUSIONS
  In patients with stable chronic HF, LVEDP and LVEF correlate with the serum concentrations of hs-cTnT, independently of other correlates of elevated plasma concentrations of hs-cTnT.
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Shionimya
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Koyama
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Tanada
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Takahashi
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Takatsu
authors.affiliation: Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Amagasaki, Hyogo, Japan. Electronic address: cardioys@kuhp.kyoto-u.ac.jp.
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Sato
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure / Q000502:physiology*; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology*; D020107:Troponin T / Q000097:blood*; D016277:Ventricular Function, Left / Q000502:physiology*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: Cardiac troponin; Heart failure; Hemodynamics; Left ventricular ejection fraction; Left ventricular end-diastolic pressure