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High-sensitive cardiac troponin T: a biomarker of left-ventricular diastolic dysfunction in hemodialysis patients

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Abstract

Objective

To identify the relationship between serum high-sensitive cardiac troponin T (hs-cTnT) and left ventricular diastolic dysfunction (LVDD) among maintenance hemodialysis patients and to further explore the value of hs-cTnT in evaluating and predicting LVDD in this special group of patients.

Methods

In a cross-sectional study, 152 dialysis patients with end-stage renal disease (ESRD) underwent Hs-cTnT measurement using the high sensitivity assay. Echocardiography measurements were carried out according to the American Society of Echocardiography recommendations and E/E′ > 15 or E′ < 7 cm/s was defined as diastolic dysfunction. Demographic, biochemical, and echocardiographic values of left ventricular mass index (LVMI), left ventricular ejection fraction (LVEF), left atrial diameter, early/late peak velocities ratio (E/A), early peak diastolic annular velocity (E′) and E/E′ were compared across quartiles of hs-cTnT. The association of plasma hs-cTnT concentrations with echocardiographic parameters was analyzed by Spearman’s correlation. The relationship between serum hs-cTnT and LVDD parameters of E/E′ and E′ was analyzed using multivariate regression analysis, and the value of hs-cTnT on assessing LVDD was evaluated by receiver-operating characteristic (ROC) curves.

Results

The median value of hs-cTnT was 45 pg/ml (range 28–73). All patients had detectable hs-cTnT, while 88% had greater hs-cTnT than the 99th percentile of the general population (14 pg/ml). Serum hs-cTnT values showed a significantly positive correlation with E/E′ (r = 0.739, p < 0.001) and LVMI (r = 0.608, p < 0.001), but showed a negative correlation with E′ (r = − 0.554, p < 0.001). Serum hs-cTnT was not associated with LV systolic dysfunction. The associations of hs-cTnT with E/E′ and E′ persisted after multivariate adjustment for LVMI and comorbidities. In logistic multiple regression analysis, compared with the lowest quartile of hs-cTnT, the highest two quartiles were approximately 5 and 11 times more likely to have E/E′ > 15 and 7 and 17 times more likely to have E′ < 7 cm/s. The area under the ROC curve for hs-cTnT evaluating E/E′ > 15 was 0.847 and evaluating E′ < 7 cm/s was 0.799, which denoted a moderate accuracy.

Conclusions

Our studies suggest that serum hs-cTnT may serve as a biomarker of LVDD in hemodialysis patients.

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Funding

This work was supported by Shanghai Health and Family Planning Commission Foundation of Changning District (20174Y004), and National Science Foundation of China (81770718).

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Authors and Affiliations

  1. Department of Nephrology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200336, China

    Linlin Sun, Yonglan Wang, Miao Ding, Xinmiao Xie, Dingyu Zhu, Fuhua Chen, Nan Zhang & Xiaoxia Wang

  2. Department of Nephrology, Yuhuangding Hospital, Qingdao University Medical College, Yantai, 264000, China

    Yongqiang Ji

Authors
  1. Linlin Sun
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  2. Yongqiang Ji
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  3. Yonglan Wang
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  4. Miao Ding
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  5. Xinmiao Xie
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  6. Dingyu Zhu
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  7. Fuhua Chen
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  8. Nan Zhang
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  9. Xiaoxia Wang
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Corresponding authors

Correspondence to Linlin Sun or Xiaoxia Wang.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the institutional and international research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all participants included in the study.

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Cite this article

Sun, L., Ji, Y., Wang, Y. et al. High-sensitive cardiac troponin T: a biomarker of left-ventricular diastolic dysfunction in hemodialysis patients. J Nephrol 31, 967–973 (2018). https://doi.org/10.1007/s40620-018-0540-0

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  • DOI: https://doi.org/10.1007/s40620-018-0540-0

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