title: Plasma Levels of High Sensitivity Cardiac Troponin T in Adults with Repaired Tetralogy of Fallot.
abstract: Detectable low circulating level of cardiac troponin T (cTnT) may reflect subclinical myocardial injury. We tested the hypothesis that circulating levels of hs-cTnT are altered in adults with repaired tetralogy of Fallot (TOF) and associated with ventricular volume load and function. Eighty-eight TOF patients and 48 controls were studied. Plasma hs-cTnT levels were determined using a highly sensitive assay (hs-cTnT). The right (RV) and left ventricular (LV) volumes and ejection fraction (EF) were measured using 3D echocardiography and, in 52 patients, cardiac magnetic resonance (CMR). The median (interquartile range) for male and female patients were 4.87 (3.83-6.62) ng/L and 3.11 (1.00-3.87) ng/L, respectively. Thirty percent of female but none of the male patients had increased hs-cTnT levels. Female patients with elevated hs-cTnT levels, compared to those without, had greater RV end-diastolic and end-systolic volumes and LV systolic dyssynchrony index (all p < 0.05). For patient cohort only, hs-cTnT levels correlated positively with CMR-derived RV end-diastolic volume and negatively with echocardiography-derived LV and RV EF (all p < 0.05). Multiple linear regression identified sex and RV EF as significant correlates of log-transformed hs-cTnT levels. Increased hs-cTnT levels occur in 30% of female patients after TOF repair, and are associated with greater RV volumes and worse RV EF.
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: Clare T M
authors.initials: CT
authors.lastname: Lai
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: Sophia J
authors.initials: SJ
authors.lastname: Wong
authors.affiliation: Department of Radiology, Queen Mary Hospital, Hong Kong, China.
authors.forename: Janice J K
authors.initials: JJ
authors.lastname: Ip
authors.affiliation: Department of Pathology and Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China.
authors.forename: Wai-keung
authors.initials: WK
authors.lastname: Wong
authors.affiliation: Department of Pathology and Clinical Biochemistry, Queen Mary Hospital, Hong Kong, China.
authors.forename: Kwong-cheong
authors.initials: KC
authors.lastname: Tsang
authors.affiliation: Department of Radiology, Queen Mary Hospital, Hong Kong, China.
authors.forename: Wendy W M
authors.initials: WW
authors.lastname: Lam
authors.affiliation: Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China.
authors.forename: Yiu-fai
authors.initials: YF
authors.lastname: Cheung
mesh_terms: D000293:Adolescent; D000328:Adult; D006348:Cardiac Surgical Procedures; D016022:Case-Control Studies; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009206:Myocardium / Q000378:metabolism; D011446:Prospective Studies; D013318:Stroke Volume; D013771:Tetralogy of Fallot / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D020107:Troponin T / Q000097:blood*; D055815:Young Adult
chemical_list: D020107:Troponin T