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Elevated high-sensitivity troponin T levels are associated with adverse cardiac remodelling and myocardial fibrosis in hypertrophic cardiomyopathy


Hasler, Stefanie. Elevated high-sensitivity troponin T levels are associated with adverse cardiac remodelling and myocardial fibrosis in hypertrophic cardiomyopathy. 2017, University of Zurich, Faculty of Medicine.

Abstract

INTRODUCTION: Clinical manifestations of hypertrophic cardiomyopathy (HCM) range from asymptomatic disease to early-onset heart failure and sudden cardiac death (SCD). Risk stratification for SCD remains imperfect and novel risk markers are needed. The aim of our study was to evaluate the association of elevated high-sensitivity cardiac troponin T levels (hs-cTnT) with the severity of disease expression and adverse events in patients with HCM.
METHODS: All patients followed-up at a dedicated HCM clinic at a tertiary care centre between April 2012 and March 2014 were analysed. The clinical care track for these patients includes 12-lead ECG, blood work-up, echocardiography, Holter ECG, exercise stress testing and cardiovascular magnetic resonance imaging (CMR). Clinical data were obtained from medical records.
RESULTS: Of 91 HCM patients (77% males, mean age at follow up 51 ± 16 years), 46 (51%) had elevated hs-cTnT levels (>0.014 ng/ml). Patients with elevated hs-cTnT levels had greater maximum wall thickness (23 ± 7 mm vs 19 ± 3 mm, p = 0.001), more often had myocardial fibrosis (96% vs 54%, p <0.001), and lower exercise capacity (90% predicted vs 76% predicted, p = 0.002). There was a trend towards lower event-free survival estimates (Kaplan-Meier method, 15% vs 7%, p = 0.16).
CONCLUSIONS: Elevated hs-cTnT levels in HCM patients are associated with disease severity and, potentially, with more adverse cardiac events. Future studies should test whether integration of hs-cTnT in clinical decision algorithms will improve risk stratification

Abstract

INTRODUCTION: Clinical manifestations of hypertrophic cardiomyopathy (HCM) range from asymptomatic disease to early-onset heart failure and sudden cardiac death (SCD). Risk stratification for SCD remains imperfect and novel risk markers are needed. The aim of our study was to evaluate the association of elevated high-sensitivity cardiac troponin T levels (hs-cTnT) with the severity of disease expression and adverse events in patients with HCM.
METHODS: All patients followed-up at a dedicated HCM clinic at a tertiary care centre between April 2012 and March 2014 were analysed. The clinical care track for these patients includes 12-lead ECG, blood work-up, echocardiography, Holter ECG, exercise stress testing and cardiovascular magnetic resonance imaging (CMR). Clinical data were obtained from medical records.
RESULTS: Of 91 HCM patients (77% males, mean age at follow up 51 ± 16 years), 46 (51%) had elevated hs-cTnT levels (>0.014 ng/ml). Patients with elevated hs-cTnT levels had greater maximum wall thickness (23 ± 7 mm vs 19 ± 3 mm, p = 0.001), more often had myocardial fibrosis (96% vs 54%, p <0.001), and lower exercise capacity (90% predicted vs 76% predicted, p = 0.002). There was a trend towards lower event-free survival estimates (Kaplan-Meier method, 15% vs 7%, p = 0.16).
CONCLUSIONS: Elevated hs-cTnT levels in HCM patients are associated with disease severity and, potentially, with more adverse cardiac events. Future studies should test whether integration of hs-cTnT in clinical decision algorithms will improve risk stratification

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Additional indexing

Item Type:Dissertation
Referees:Luescher Thomas F, Gruner Christiane
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:20 September 2017
Deposited On:22 Mar 2018 13:21
Last Modified:13 Apr 2018 11:44
OA Status:Gold
Publisher DOI:https://doi.org/10.4414/smw.2016.14285
Other Identification Number:PMID:26999566

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