High sensitivity cardiac troponin T and systemic right ventricular function in adults with congenitally corrected transposition of the great arteries

Abstract

BackgroundHigh sensitive troponin T (hsTnT), a marker of myocardial injury, appears to be a promising diagnostic tool in patients with congenital heart disease. However, little is known about its distribution among adults with systemic right ventricle (sRV). We aimed to assess the distribution of hsTnT concentrations in patients with congenitally corrected transposition of the great arteries (ccTGA) and to evaluate its relationship with sRV function and NT-proBNP. MethodsA cross-sectional study of adults with ccTGA was conducted. Patients underwent transthoracic echocardiography, hs-TnT and NTproBNP measurements. In the echocardiographic study, the sRV function was assessed qualitatively and quantitatively using fractional area change (FAC), TAPSE, myocardial performance index (MPI), systolic pulsed Doppler velocity (s′) and global longitudinal strain (GLS. ResultsFifty patients with ccTGA (20F/30M) and a mean age of 34.8±13.6years (range 18-63years) were included, with 27 of them (54%) having detectable hsTnT. Patients with detectable hsTnT were older and more often had NYHA class>I. Detectable hsTnT was associated with lower FAC (0.35 vs. 0.41, p<0.01) and GLS (−14.4% vs. -17.8%, p<0.01)) and higher MPI (0.67 vs. 0.48, p<0.01)). Hs-TnT correlated weekly with NT-proBNP (r=0.38; p<0.001). The area under the curve for the detection of sRV dysfunction (FAC<0.35) was higher for hs-TnT (0.839; CI 0.713-0.952) than for NT-proBNP (0.709; CI 0.545-0.873). ConclusionHsTnT was detectable in over half of the ccTGA population and was related to the sRV function. Compared to NTproBNP, hsTnT level seems to be superior biomarker in discriminating patients with sRV dysfunction.