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Cardiac troponin I is associated with non-sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy

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Abstract

As highly sensitive and specific markers of myocardial damage, cardiac troponins were demonstrated to correlate with clinical parameters of patients with hypertrophic cardiomyopathy. However, the relationship between cardiac troponins and presence of non-sustained ventricular tachycardia (NSVT) in hypertrophic cardiomyopathy remains unclear. The aim of our study was to explore the association between serum cardiac troponin I (cTNI) and presence of NSVT in patients with hypertrophic obstructive cardiomyopathy (HOCM). A total of 309 HOCM patients were enrolled in our study. All participants underwent clinical evaluations, including collections of medical history, blood tests, 24-h Holter monitoring, echocardiography, and cardiac magnetic resonance imaging. There were 53 (17.2%) patients with NSVT and 256 patients without it. Compared to patients without NSVT, serum cTNI (P < 0.001) and plasma NT-proBNP (P = 0.042) were significantly higher in patients with NSVT. Moreover, cTNI and NT-proBNP were positively correlated with left atrial diameter, maximum wall thickness (MWT), left ventricular volume index and left ventricular mass index. In multivariable logistic analysis, log cTNI [odds ratio (OR) = 2.408, 95% confidence interval (CI) 1.108–5.325, P = 0.027], left ventricular end-diastole diameter (OR = 0.922, 95%CI 0.856–0.994, P = 0.034), MWT (OR = 1.131, 95%CI 1.035–1.235, P = 0.006) and left ventricular end-systole volume index (OR = 1.060, 95%CI 1.025–1.096, P = 0.001) were independent determinants of NSVT occurrence after adjustment for potential cofounders. Serum cTNI level was elevated in patients with NSVT. And it was independently associated with NSVT in patients with HOCM. Our results suggest that it may be more reasonable for HOCM patients with elevated serum cTNI to extend the time of Holter monitoring.

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References

  1. Maron BJ, Ommen SR, Semsarian C, Spirito P, Olivotto I, Maron MS (2014) Hypertrophic cardiomyopathy: present and future, with translation into contemporary cardiovascular medicine. J Am Coll Cardiol 64:83–99

    Article  Google Scholar 

  2. Maron BJ, Maron MS (2013) Hypertrophic cardiomyopathy. Lancet 381:242–255

    Article  Google Scholar 

  3. Guo L, Zhang M, Hu M, Wang B, Wang J, Zuo L, Yang W, Liu B, Liu L (2019) Prevalence of subcutaneous implantable cardioverter-defibrillator based on template ECG screening and ineligible surface ECG predicting factors in patients with hypertrophic cardiomyopathy in China. Heart Vessels 34:851–859

    Article  CAS  Google Scholar 

  4. Veselka J, Anavekar NS, Charron P (2017) Hypertrophic obstructive cardiomyopathy. Lancet 389:1253–1267

    Article  Google Scholar 

  5. Marian AJ, Braunwald E (2017) Hypertrophic cardiomyopathy: genetics, pathogenesis, clinical manifestations, diagnosis, and therapy. Circ Res 121:749–770

    Article  CAS  Google Scholar 

  6. Authors/Task Force m, Elliott PM, Anastasakis A, Borger MA, Borggrefe M, Cecchi F, Charron P, Hagege AA, Lafont A, Limongelli G, Mahrholdt H, McKenna WJ, Mogensen J, Nihoyannopoulos P, Nistri S, Pieper PG, Pieske B, Rapezzi C, Rutten FH, Tillmanns C, Watkins H (2014) 2014 ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 35:2733–2779

    Article  Google Scholar 

  7. Monserrat L, Elliott PM, Gimeno JR, Sharma S, Penas-Lado M, McKenna WJ (2003) Non-sustained ventricular tachycardia in hypertrophic cardiomyopathy. J Am Coll Cardiol 42:873–879

    Article  Google Scholar 

  8. Dimitrow PP, Chojnowska L, Rudzinski T, Piotrowski W, Ziolkowska L, Wojtarowicz A, Wycisk A, Dabrowska-Kugacka A, Nowalany-Kozielska E, Sobkowicz B, Wrobel W, Aleszewicz-Baranowska J, Rynkiewicz A, Loboz-Grudzien K, Marchel M, Wysokinski A (2010) Sudden death in hypertrophic cardiomyopathy: old risk factors re-assessed in a new model of maximalized follow-up. Eur Heart J 31:3084–3093

    Article  Google Scholar 

  9. Hen Y, Tsugu-Yagawa M, Iguchi N, Utanohara Y, Takada K, Machida H, Takara A, Teraoka K, Inoue K, Takamisawa I, Takayama M, Yoshikawa T (2018) Prognostic value of cardiovascular magnetic resonance imaging for life-threatening arrhythmia detected by implantable cardioverter-defibrillator in Japanese patients with hypertrophic cardiomyopathy. Heart Vessels 33:49–57

    Article  Google Scholar 

  10. Kubo T, Kitaoka H, Yamanaka S, Hirota T, Baba Y, Hayashi K, Iiyama T, Kumagai N, Tanioka K, Yamasaki N, Matsumura Y, Furuno T, Sugiura T, Doi YL (2013) Significance of high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy. J Am Coll Cardiol 62:1252–1259

    Article  CAS  Google Scholar 

  11. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, Joint ESCAAHAWHFTFfUDoMI, Authors/Task Force Members C, Thygesen K, Alpert JS, White HD, Biomarker S, Jaffe AS, Katus HA, Apple FS, Lindahl B, Morrow DA, Subcommittee ECG, Chaitman BR, Clemmensen PM, Johanson P, Hod H, Imaging S, Underwood R, Bax JJ, Bonow JJ, Pinto F, Gibbons RJ, Classification S, Fox KA, Atar D, Newby LK, Galvani M, Hamm CW, Intervention S, Uretsky BF, Steg PG, Wijns W, Bassand JP, Menasche P, Ravkilde J, Trials, Registries S, Ohman EM, Antman EM, Wallentin LC, Armstrong PW, Simoons ML, Trials, Registries S, Januzzi JL, Nieminen MS, Gheorghiade M, Filippatos G, Trials, Registries S, Luepker RV, Fortmann SP, Rosamond WD, Levy D, Wood D, Trials, Registries S, Smith SC, Hu D, Lopez-Sendon JL, Robertson RM, Weaver D, Tendera M, Bove AA, Parkhomenko AN, Vasilieva EJ, Mendis S, Bax JJ, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Document R, Morais J, Aguiar C, Almahmeed W, Arnar DO, Barili F, Bloch KD, Bolger AF, Botker HE, Bozkurt B, Bugiardini R, Cannon C, de Lemos J, Eberli FR, Escobar E, Hlatky M, James S, Kern KB, Moliterno DJ, Mueller C, Neskovic AN, Pieske BM, Schulman SP, Storey RF, Taubert KA, Vranckx P, Wagner DR (2012) Third universal definition of myocardial infarction. J Am Coll Cardiol 60:1581–1598

    Article  Google Scholar 

  12. Zhang C, Liu R, Yuan J, Cui J, Hu F, Yang W, Zhang Y, Yang C, Qiao S (2015) Significance and determinants of cardiac troponin i in patients with obstructive hypertrophic cardiomyopathy. Am J Cardiol 116:1744–1751

    Article  CAS  Google Scholar 

  13. Moreno V, Hernandez-Romero D, Vilchez JA, Garcia-Honrubia A, Cambronero F, Casas T, Gonzalez J, Martinez P, Climent V, de la Morena G, Valdes M, Marin F (2010) Serum levels of high-sensitivity troponin T: a novel marker for cardiac remodeling in hypertrophic cardiomyopathy. J Card Fail 16:950–956

    Article  CAS  Google Scholar 

  14. Kubo T, Kitaoka H, Okawa M, Yamanaka S, Hirota T, Hoshikawa E, Hayato K, Yamasaki N, Matsumura Y, Yasuda N, Sugiura T (2010) Serum cardiac troponin I is related to increased left ventricular wall thickness, left ventricular dysfunction, and male gender in hypertrophic cardiomyopathy. Clin Cardiol 33:E1–7

    Article  Google Scholar 

  15. Jenab Y, Pourjafari M, Darabi F, Boroumand MA, Zoroufian A, Jalali A (2014) Prevalence and determinants of elevated high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy. J Cardiol 63:140–144

    Article  Google Scholar 

  16. Cramer G, Bakker J, Gommans F, Brouwer M, Kurvers M, Fouraux M, Verheugt F, Kofflard M (2014) Relation of highly sensitive cardiac troponin T in hypertrophic cardiomyopathy to left ventricular mass and cardiovascular risk. Am J Cardiol 113:1240–1245

    Article  CAS  Google Scholar 

  17. Kubo T, Kitaoka H, Okawa M, Yamanaka S, Hirota T, Baba Y, Hayato K, Yamasaki N, Matsumura Y, Yasuda N, Sugiura T, Doi YL (2011) Combined measurements of cardiac troponin I and brain natriuretic peptide are useful for predicting adverse outcomes in hypertrophic cardiomyopathy. Circ J 75:919–926

    Article  Google Scholar 

  18. Gersh BJ, Maron BJ, Bonow RO, Dearani JA, Fifer MA, Link MS, Naidu SS, Nishimura RA, Ommen SR, Rakowski H, Seidman CE, Towbin JA, Udelson JE, Yancy CW, American College of Cardiology Foundation/American Heart Association Task Force on Practice G, American Association for Thoracic S, American Society of E, American Society of Nuclear C, Heart Failure Society of A, Heart Rhythm S, Society for Cardiovascular A, Interventions, Society of Thoracic S (2011) 2011 ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation 124:2761–2796

    Article  Google Scholar 

  19. Katritsis DG, Zareba W, Camm AJ (2012) Nonsustained ventricular tachycardia. J Am Coll Cardiol 60:1993–2004

    Article  Google Scholar 

  20. Nagueh SF, Bierig SM, Budoff MJ, Desai M, Dilsizian V, Eidem B, Goldstein SA, Hung J, Maron MS, Ommen SR, Woo A (2011) American Society of Echocardiography clinical recommendations for multimodality cardiovascular imaging of patients with hypertrophic cardiomyopathy: endorsed by the American Society of Nuclear Cardiology, Society for Cardiovascular Magnetic Resonance, and Society of Cardiovascular Computed Tomography. J Am Soc Echocardiogr 24:473–498

    Article  Google Scholar 

  21. Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C, Hagendorff A, Monin JL, Badano L, Zamorano JL, European Association of E (2010) European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr 11:307–332

    Article  Google Scholar 

  22. Einvik G, Bhatnagar R, Holmedahl NH, Neukamm A, Omland T, Soyseth V (2017) Premature ventricular complex is more prevalent during acute exacerbated than stable states of chronic obstructive pulmonary disease, and is related to cardiac troponin T. COPD 14:318–323

    Article  Google Scholar 

  23. Bissell LA, Dumitru RB, Erhayiem B, Abignano G, Fent G, Kidambi A, Donica H, Burska A, Del Galdo F, Biglands J, Buckley DL, Greenwood JP, Plein S, Graham L, Buch MH (2019) Incidental significant arrhythmia in scleroderma associates with cardiac magnetic resonance measure of fibrosis and hs-TnI and NT-proBNP. Rheumatology (Oxford) 58:1221–1226

    Article  Google Scholar 

  24. Bravo PE, Zimmerman SL, Luo HC, Pozios I, Rajaram M, Pinheiro A, Steenbergen C, Kamel IR, Wahl RL, Bluemke DA, Bengel FM, Abraham MR, Abraham TP (2013) Relationship of delayed enhancement by magnetic resonance to myocardial perfusion by positron emission tomography in hypertrophic cardiomyopathy. Circ Cardiovasc Imaging 6:210–217

    Article  Google Scholar 

  25. Frey N, Luedde M, Katus HA (2011) Mechanisms of disease: hypertrophic cardiomyopathy. Nat Rev Cardiol 9:91–100

    Article  Google Scholar 

  26. Di Salvo G, Pacileo G, Limongelli G, Baldini L, Rea A, Verrengia M, D'Andrea A, Russo MG, Calabro R (2010) Non sustained ventricular tachycardia in hypertrophic cardiomyopathy and new ultrasonic derived parameters. J Am Soc Echocardiogr 23:581–590

    Article  Google Scholar 

  27. Maron BJ (2010) Contemporary insights and strategies for risk stratification and prevention of sudden death in hypertrophic cardiomyopathy. Circulation 121:445–456

    Article  Google Scholar 

  28. Maron BJ, Tholakanahalli VN, Zenovich AG, Casey SA, Duprez D, Aeppli DM, Cohn JN (2004) Usefulness of B-type natriuretic peptide assay in the assessment of symptomatic state in hypertrophic cardiomyopathy. Circulation 109:984–989

    Article  CAS  Google Scholar 

  29. Arteaga E, Araujo AQ, Buck P, Ianni BM, Rabello R, Mady C (2005) Plasma amino-terminal pro-B-type natriuretic peptide quantification in hypertrophic cardiomyopathy. Am Heart J 150:1228–1232

    Article  CAS  Google Scholar 

  30. Park JR, Choi JO, Han HJ, Chang SA, Park SJ, Lee SC, Choe YH, Park SW, Oh JK (2012) Degree and distribution of left ventricular hypertrophy as a determining factor for elevated natriuretic peptide levels in patients with hypertrophic cardiomyopathy: insights from cardiac magnetic resonance imaging. Int J Cardiovasc Imaging 28:763–772

    Article  Google Scholar 

  31. Geske JB, McKie PM, Ommen SR, Sorajja P (2013) B-type natriuretic peptide and survival in hypertrophic cardiomyopathy. J Am Coll Cardiol 61:2456–2460

    Article  CAS  Google Scholar 

  32. Kawasaki T, Sakai C, Harimoto K, Yamano M, Miki S, Kamitani T (2013) Usefulness of high-sensitivity cardiac troponin T and brain natriuretic peptide as biomarkers of myocardial fibrosis in patients with hypertrophic cardiomyopathy. Am J Cardiol 112:867–872

    Article  CAS  Google Scholar 

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Correspondence to Jingang Cui or Shubin Qiao.

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Zhou, Y., Yu, M., Yuan, J. et al. Cardiac troponin I is associated with non-sustained ventricular tachycardia in patients with hypertrophic obstructive cardiomyopathy. Heart Vessels 35, 876–885 (2020). https://doi.org/10.1007/s00380-019-01549-0

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