title: Differentiation of infiltrative cardiomyopathy from hypertrophic cardiomyopathy using high-sensitivity cardiac troponin T: a case-control study.
abstract: BACKGROUND
  Because infiltrative cardiomyopathy and hypertrophic cardiomyopathy (HCM) share clinical and hemodynamic features of left ventricular (LV) hypertrophy and abnormal diastolic function, it is often difficult to distinguish these entities.
  
  
  METHODS
  We investigated the potential role of high-sensitivity cardiac troponin T (hs-cTnT) for differentiation of infiltrative cardiomyopathy from HCM.
  
  
  RESULTS
  The study group consisted of 46 consecutive patients with infiltrative cardiomyopathies or HCM in whom sarcomere protein gene mutations were identified at Kochi Medical School Hospital; of these, there were 11 patients with infiltrative cardiomyopathy (cardiac amyloidosis in 8 patients and Fabry disease in 3 patients) and 35 HCM patients. Serum hs-cTnT level was significantly higher in patients who had infiltrative cardiomyopathy than in those who had HCM (0.083 ± 0.057 ng/ml versus 0.027 ± 0.034 ng/ml, p < 0.001), whereas brain natriuretic peptide levels did not differ between the two groups. In two age-matched the 2 cohorts (patients evaluated at > 40 years at age), hs-cTnT level, maximum LV wall thickness, posterior wall thickness, peak early (E) transmitral filling velocity, peak early diastolic (Ea) velocity of tissue Doppler imaging at the lateral corner and E/Ea ratios at both the septal and lateral corners were significantly different between the two groups. As for diagnostic accuracy to differentiate the two groups by using receiver operating characteristic analysis, hs-cTnT was the highest value of area under the curve (0.939) and E/Ea (lateral) was second highest value (0.914).
  
  
  CONCLUSIONS
  Serum hs-cTnT is a helpful diagnostic indicator for accurate differentiation between infiltrative cardiomyopathy and HCM.
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. jm-kubotoru@kochi-u.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. ybaba@kochi-u.ac.jp.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Baba
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. t-hirota@kochi-u.ac.jp.
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Hirota
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. jm-tanioka.katsutoshi@kochi-u.ac.jp.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Tanioka
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. yamasakn@kochi-u.ac.jp.
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamasaki
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi, Japan. jm-yamanaks@kochi-u.ac.jp.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamanaka
authors.affiliation: Clinical Trial Center, Kochi Medical School, Kochi, Japan. iiyamat@kochi-u.ac.jp.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Iiyama
authors.affiliation: Clinical Trial Center, Kochi Medical School, Kochi, Japan. kumagain@kochi-u.ac.jp.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kumagai
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. furunot@kochi-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Furuno
authors.affiliation: Department of Laboratory Medicine, Kochi Medical School, Kochi, Japan. sugiurat@kochi-u.ac.jp.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Sugiura
authors.affiliation: Department of Cardiology, Neurology and Aging Science, Kochi Medical School, Oko-cho, Nankoku-shi, 783-8505, Kochi, Japan. kitaokah@kochi-u.ac.jp.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Kitaoka
mesh_terms: D000328:Adult; D000368:Aged; D000686:Amyloidosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D003971:Diastole; D015150:Echocardiography, Doppler; D000795:Fabry Disease / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D020107:Troponin T / Q000097:blood*; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging
chemical_list: C545568:TNNT2 protein, human; D020107:Troponin T