title: Significance and Determinants of Cardiac Troponin I in Patients With Obstructive Hypertrophic Cardiomyopathy.
abstract: Serum cardiac troponins have been demonstrated to have important clinical implications in patients with hypertrophic cardiomyopathy (HC). However, little is known about their roles in patients with obstructive HC. The aim of this study was to explore the clinical significance and determinants of serum cardiac troponin I (cTnI) in patients with obstructive HC using cardiovascular magnetic resonance imaging. We investigated the relations between serum cTnI levels and clinical, echocardiographic, and cardiovascular magnetic resonance parameters and assessed the determinants of serum cTnI in 149 consecutive patients with obstructive HC. The median level of serum cTnI was 0.019 ng/ml (interquartile range 0.009 to 0.044). CTnI was elevated (≥0.04 ng/ml) in 42 (28%) of the overall cohort. Patients with elevated cTnI had greater maximum wall thickness (p <0.001), larger left ventricular mass index (LVMI, p <0.001), more frequency of left atrium diameter ≥50 mm (p = 0.020), higher plasma values of N-terminal pro-B-type natriuretic peptide (p <0.001), and less hypertension (p = 0.014). Serum cTnI levels were positively correlated with maximum wall thickness (r = 0.444, p <0.001), LVMI (r = 0.556, p <0.001), N-terminal pro-B-type natriuretic peptide (r = 0.305, p <0.001), left ventricular end-diastolic volume index (r = 0.246, p = 0.002), and left ventricular end-systolic volume index (r = 0.272, p = 0.001) but negatively with left ventricular ejection fraction (r = -0.180, p = 0.028). On multivariate analysis, LVMI was independently associated with both elevated cTnI (odds ratio 1.032, p = 0.001) and increasing serum cTnI levels (β = 0.556, p <0.001). In addition, the presence of hypertension was independently related to less likely elevated cTnI (odds ratio 0.307, p = 0.029) and decreasing levels of serum cTnI (β = -0.165, p = 0.015). In conclusion, levels of serum cTnI are elevated in a significant proportion of our patients. Serum cTnI is associated with multiple parameters of disease severity, suggesting its great significance in assessing cardiac remodeling in patients with obstructive HC. Left ventricular hypertrophy, as indicated by LVMI, is the major determinant of serum cTnI levels.
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Changlin
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Liu
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jiansong
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Jingang
authors.initials: J
authors.lastname: Cui
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Fenghuan
authors.initials: F
authors.lastname: Hu
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Weixian
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Radiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors.forename: Chengzhi
authors.initials: C
authors.lastname: Yang
authors.affiliation: Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. Electronic address: qsbfw@sina.com.
authors.forename: Shubin
authors.initials: S
authors.lastname: Qiao
mesh_terms: D000328:Adult; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019210:Troponin I / Q000097:blood*; D016277:Ventricular Function, Left
chemical_list: D019210:Troponin I