title: High T2-weighted signal intensity is associated with elevated troponin T in hypertrophic cardiomyopathy.
abstract: Areas of high signal intensity (HighT2) on T2-weighted cardiovascular magnetic resonance (CMR) imaging have been demonstrated in hypertrophic cardiomyopathy (HCM). It has been hypothesised that HighT2 may indicate active tissue injury in HCM. In this context, we studied HighT2 in relation to cardiac troponin.
  
  
  
  Outpatient HCM patients without a history of coronary artery disease underwent CMR imaging at 1.5 T using T2-weighted, cine and late gadolinium enhancement (LGE) imaging to assess HighT2, left ventricular (LV) function, LV mass and the presence and extent of LGE. Highly sensitive cardiac troponin T (hs-cTnT) was assessed as a marker of injury, with hs-cTnT ≥14 and >3 ng/L defined as an elevated and detectable troponin.
  
  
  
  HighT2 was present in 28% of patients (28/101). An elevated hs-cTnT was present in 54% of patients with HighT2 (15/28) compared with 14% of patients without HighT2 (10/73) (p<0.001). Hs-cTnT was detectable in 96% of patients with HighT2 (27/28) compared with 66% of patients without HighT2 (48/73) (p=0.002). In case of an undetectable hs-cTnT, HighT2 was only seen in 4% (1/26). In addition, the extent of HighT2 was related with increasing hs-cTnT concentrations (Spearman's ρ: 0.42, p<0.001).
  
  
  
  In this CMR study of patients with HCM, we observed HighT2 in a quarter of patients, and demonstrated that HighT2 was associated with an elevated hs-cTnT. This observation, combined with the very high negative predictive value of an undetectable hs-cTnT for HighT2, provides supportive evidence for the hypothesis that HighT2 is indicative of recently sustained myocyte injury.
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Dh Frank
authors: DF
authors: Gommans
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: G Etienne
authors: GE
authors: Cramer
authors: Department of Radiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Jeannette
authors: J
authors: Bakker
authors: Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
authors: Michelle
authors: M
authors: Michels
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Hendrik-Jan
authors: HJ
authors: Dieker
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Janneke
authors: J
authors: Timmermans
authors: Department of Clinical Chemistry, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Michael A
authors: MA
authors: Fouraux
authors: Department of Clinical Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Carlo Lm
authors: CL
authors: Marcelis
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Freek Wa
authors: FW
authors: Verheugt
authors: Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors: Marc A
authors: MA
authors: Brouwer
authors: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
authors: Marcel Jm
authors: MJ
authors: Kofflard
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D015415:Biomarkers / Q000097:blood; D002312:Cardiomyopathy, Hypertrophic / Q000097:blood* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D008536:Meglumine / Q000008:administration & dosage; D008875:Middle Aged; D009426:Netherlands; D009942:Organometallic Compounds / Q000008:administration & dosage; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011379:Prognosis; D020107:Troponin T / Q000097:blood*; D015854:Up-Regulation; D016277:Ventricular Function, Left
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D009942:Organometallic Compounds; D020107:Troponin T; D008536:Meglumine; C072417:gadoterate meglumine