Abstract
The conventional use of high-sensitivity troponins (hs-troponins) is for diagnosing myocardial infarction however they also have a role in chronic disease management. This pilot study assessed the relationship of hs-troponins with echocardiographic markers of left ventricular hypertrophy (LVH) and structural heart disease (SHD). Patients undergoing computer gomography (CT) coronary angiogram for low-intermediate risk chest pain and healthy volunteers were recruited. Hs-troponins Singulex I, Abbott I and Roche T and N-terminal pro-brain natriuretic peptide (NT-proBNP) were evaluated in relation to SHD parameters including left ventricular hypertrophy (LVHEcho) and left atrial enlargement (LAEEcho) on echocardiography. 78 subjects who underwent echocardiography were included in this study. C-statistics (95% confidence interval) of the four biomarkers for predicting LVHEcho were 0.84 (0.72–0.92), 0.84 (0.73–0.92), 0.75 (0.63–0.85) and 0.62 (0.49–0.74); for LAEEcho 0.74 (0.6–0.85), 0.78 (0.66–0.88), 0.55 (0.42–0.67) and 0.68 (0.62–0.85); and composite SHD 0.79 (0.66–0.88), 0.87 (0.75–0.94), 0.62 (0.49–0.73) and 0.74 (0.62–0.84) respectively. Optimal cut points for SHD were >1.2 ng/L, >1.6 ng/L, >8 ng/L and >18 pmol/L respectively. These results advocate the potential role of hs-troponins as screening tools for structural heart disease with theranostic implications.
Highlights
Troponins assays have revolutionised the diagnosis of myocardial necrosis and infarction [1]. new uses for high sensitivity troponin are emerging, which may have a greater impact in primary care
Cardiac computed tomography (CT) was available for 62 (79%) patients, though left ventricular (LV) mass could not be calculated for two patients due to poor contrast opacification of the LV
We have shown that clinical factors such as age, gender and hypertension are strongly associated with troponin concentration, consistent with other data which has shown an influence of physical activity, genetics and other factors including BMI on troponin [3]
Summary
Troponins assays have revolutionised the diagnosis of myocardial necrosis and infarction [1]. New uses for high sensitivity troponin are emerging, which may have a greater impact in primary care. These new uses have come about partly due to the fact that high-sensitivity troponin (hs-troponin) assays are able to measure troponin precisely, at low concentrations, even within a seemingly normal healthy population [2,3]. More importantly is that troponin has a low index of individuality, meaning that variability within an individual over time is relatively narrow and. 2018, 6, 17 highly personalized [4,5,6]. Elevated troponin I has been associated with various disease states such as aging [3], hypertension [7], left ventricular (LV) hypertrophy [8], LV systolic dysfunction [9,10]
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