Relationship of serum high-sensitivity cardiac troponin I with left ventricular structure and function in elderly patients undergoing hemodialysis

Abstract

Objective To investigate the relationship of serum high-sensitivity cardiac troponin I (hs-cTnI) with left ventricular structure and function in elderly hemodialysis patients. Methods 92 elderly patients undergoing maintenance hemodialysis at our hemodialysis center were selected between January, 2015 and June, 2018. Their clinical data were collected. Their cardiac structure and function were measured by echocardiography. Results The serum hs-cTnI increased in 32 patients, and was normal in 60 patients. The proportions of the patients with III- IV grade cardiac function and left ventricular hypertrophy (LVH) were significantly higher in the elevated hs-cTnI group than in the normal hs-cTnI group (78.12% vs. 21.67% and 87.50% vs. 63.33%, both P<0.05). There were statistical differences in hemoglobin, serum albumin, brain natriuretic peptide (BNP) , and high sensitivity C reactive protein (hsCRP) between the two groups. Compared to the normal hs-cTnI group, the elevated hs-cTnI group had significantly larger left ventricular diameter (LVD) , left ventricular mass index (LVMI) and the ratio of mitral early diastolic peak flow and mitral annular early diastolic velocity (E/E’) (all P<0.05). The fractional shortening (FS) and left ventricular ejection fraction (EF) in the elevated hs-cTnI group were significantly lower than those in the normal hs-cTnI group (P<0.05). Hs-cTnI positively correlated with hsCRP, BNP, LVD, LVMI, and E/E', and negatively with serum albumin, EF, and FS. Age, hemoglobin, LVMI, and E/E' were significant indicators of high hs-cTnI level in the multivariate logistic regression. The areas under the ROC curve for the diagnosis of LVH, left ventricular systolic insufficiency, and left ventricular diastolic dysfunction by hs-cTn I were 0.697, 0.884, and 0.917, respectively. Conclusions The serum hs-cTnI level of elderly patients undergoing hemodialysis relates to their left ventricular structure and function. Measurement of serum hs-cTnI is helpful to evaluate LVH and left ventricular systolic and diastolic function in elderly patients undergoing hemodialysis. Key words: High-sensitivity cardiac troponin I; Left ventricle; Hemodialysis; Heart failure