title: High-Sensitivity Troponin: A Clinical Blood Biomarker for Staging Cardiomyopathy in Fabry Disease.
abstract: High-sensitivity troponin (hs-TNT), a biomarker of myocardial damage, might be useful for assessing fibrosis in Fabry cardiomyopathy. We performed a prospective analysis of hs-TNT as a biomarker for myocardial changes in Fabry patients and a retrospective longitudinal follow-up study to assess longitudinal hs-TNT changes relative to fibrosis and cardiomyopathy progression.
  
  
  
  For the prospective analysis, hs-TNT from 75 consecutive patients with genetically confirmed Fabry disease was analyzed relative to typical Fabry-associated echocardiographic findings and total myocardial fibrosis as measured by late gadolinium enhancement (LE) on magnetic resonance imaging. Longitudinal data (3.9±2.0 years), including hs-TNT, LE, and echocardiographic findings from 58 Fabry patients, were retrospectively collected. Hs-TNT level positively correlated with LE (linear correlation coefficient, 0.72; odds ratio, 32.81 [95% CI, 3.56-302.59]; P=0.002); patients with elevated baseline hs-TNT (>14 ng/L) showed significantly increased LE (median: baseline, 1.9 [1.1-3.3] %; follow-up, 3.2 [2.3-4.9] %; P<0.001) and slightly elevated hs-TNT (baseline, 44.7 [30.1-65.3] ng/L; follow-up, 49.1 [27.6-69.5] ng/L; P=0.116) during follow-up. Left ventricular wall thickness and EF of patients with elevated hs-TNT were decreased during follow-up, indicating potential cardiomyopathy progression.
  
  
  
  hs-TNT is an accurate, easily accessible clinical blood biomarker for detecting replacement fibrosis in patients with Fabry disease and a qualified predictor of cardiomyopathy progression. Thus, hs-TNT could be helpful for staging and follow-up of Fabry patients.
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Nora
authors.initials: N
authors.lastname: Seydelmann
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Dan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Krämer
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Christiane
authors.initials: C
authors.lastname: Drechsler
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Hu
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Nordbeck
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Schneider
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Störk
authors.affiliation: ICREA-Universitat Pompeu Fabra, Barcelona, Germany.
authors.forename: Bart
authors.initials: B
authors.lastname: Bijnens
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Ertl
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Wanner
authors.affiliation: Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany Innere Klinik II, Katharinen-Hospital, Unna, Germany f.weidemann@katharinen-hospital.de.
authors.forename: Frank
authors.initials: F
authors.lastname: Weidemann
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D015415:Biomarkers / Q000378:metabolism; D009202:Cardiomyopathies / Q000097:blood / Q000175:diagnosis*; D018450:Disease Progression; D004452:Echocardiography; D000795:Fabry Disease / Q000150:complications*; D005260:Female; D005355:Fibrosis / Q000097:blood / Q000175:diagnosis; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis; D018810:Magnetic Resonance Angiography; D008297:Male; D009206:Myocardium / Q000473:pathology*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D011446:Prospective Studies; D012189:Retrospective Studies; D014336:Troponin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D014336:Troponin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: biomarker; cardiomyopathy; fabry disease; myocardial fibrosis; troponin T