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Association between high-sensitivity troponin T, left ventricular hypertrophy, and myocardial performance index

Zusammenhang zwischen hochsensitivem Troponin T, linksventrikulärer Hypertrophie und myokardialem Performance-Index

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Abstract

Background

The prognostic importance of high-sensitivity cardiac troponin T (hs-cTnT) has recently been reported in patients with heart failure. The myocardial performance index (MPI), which combines parameters of both systolic and diastolic ventricular function, provides a better marker of left ventricular dysfunction in hypertensive patients with preserved left ventricular ejection fraction (LVEF).

Aim

We aimed to investigate the relationship between hs-cTnT and tissue Doppler-derived MPI in newly diagnosed hypertensive patients with preserved LVEF.

Methods

We studied 306 patients with newly diagnosed hypertension. The patients were divided into two groups according to their median MPI values: MPIlo and MPIhigh groups. The MPI was calculated from the pulsed-wave Doppler recordings. Left ventricular mass index (LVMI) was determined according to the Devereux formula. hs-cTnT, uric acid, and high-sensitivity C-reactive protein (hs-CRP) levels were measured in all patients.

Results

Hs-cTnT, hs-CRP, and uric acid levels were higher in the MPIhigh group compared with the MPIlow group (p < 0.05, for all). The LVMI values in the MPIhigh group were higher than in the MPIlow group (p < 0.05). MPI was independently associated with age, uric acid, hs-cTnT, and LVMI in multivariate analysis. Multivariate logistic regression analysis showed that MPI and LVMI were independent predictors of high hs-cTnT level in newly diagnosed hypertensive patients with preserved LVEF.

Conclusion

Hs-cTnT was independently associated with LV dysfunction and LV hypertrophy assessed with MPI in newly diagnosed hypertensive patients.

Zusammenfassung

Hintergrund

Die prognostische Bedeutung des hochsensitiven kardialen Troponin T (hs-cTnT) ist vor Kurzem bei Herzinsuffizienzpatienten beschrieben worden. Der myokardiale Performance-Index (MPI), bei dem Parameter sowohl der systolischen als auch der diastolischen Ventrikelfunktion kombiniert werden, stellt einen besseren Marker der linksventrikulären Funktionsstörung bei Hypertoniepatienten mit erhaltener linksventrikulärer Ejektionsfraktion (LVEF) dar.

Ziel

Ziel war die Untersuchung des Zusammenhangs zwischen hs-cTnT und per Gewebsdoppler ermitteltem MPI bei Patienten mit Erstdiagnose einer Hypertonie bei erhaltener LVEF.

Methoden

Es wurden 306 Patienten mit Erstdiagnose einer Hypertonie untersucht. Sie wurden ihren mittleren MPI-Werten entsprechend in 2 Gruppen eingeteilt: MPIlow und MPIhigh. Der MPI wurde aus den Daten der Untersuchung mittels gepulstem (PW-)Doppler errechnet. Der linksventrikuläre Massenindex (LVMI) wurde nach der Devereux-Formel ermittelt. Die Werte für Hs-cTnT, Harnsäure und hochsensitives C-reaktives Protein (hs-CRP) wurden bei sämtlichen Patienten bestimmt.

Ergebnisse

Die Hs-cTnT-, hs-CRP- und Harnsäurespiegel waren in der MPIhigh-Gruppe höher als in der MPIlow-Gruppe (p < 0,05, für alle). Die LVMI-Werte der MPIhigh-Gruppe waren höher als in der MPIlow-Gruppe (p < 0,05). Der MPI war unabhängig mit dem Alter, dem Harnsäure- und hs-cTnT-Wert sowie dem LVMI in der multivariaten Analyse assoziiert. Die multivariate logistische Regressionsanalyse zeigte, dass MPI und LVMI unabhängige Prädiktoren eines hohen hs-cTnT-Spiegels bei Patienten mit Erstdiagnose einer Hypertonie bei erhaltener LVEF waren.

Schlussfolgerung

Hs-cTnT war in unabhängiger Weise mit einer per MPI ermittelten LV-Funktionsstörung und LV-Hypertrophie bei Patienten mit Erstdiagnose einer Hypertonie assoziiert.

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Authors and Affiliations

  1. Department of Cardiology, Adana Numune Training and Research Hospital, 01170, Adana, Turkey

    Onur Kaypakli MD, Mustafa Gür MD, Hakan Uçar MD, Ali Kivrak MD, Taner Şeker MD, Durmuş Yildiray Şahin MD, Zafer Elbasan MD, Caner Türkoğlu MD & Murat Çayli MD

  2. Department of Internal Medicine, Mersin State Hospital, Mersin, Turkey

    Mehmet Yavuz Gözükara MD

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  1. Onur Kaypakli MD
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  2. Mustafa Gür MD
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Correspondence to Onur Kaypakli MD.

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Conflict of interest

O. Kaypakli, M. Gür, M.Y. Gözükara, H. Uçar, A. Kivrak, T. Şeker, D.Y. Şahin, Z. Elbasan, C. Türkoğlu, and M. Çayli state that there are no conflicts of interest.

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Kaypakli, O., Gür, M., Gözükara, M. et al. Association between high-sensitivity troponin T, left ventricular hypertrophy, and myocardial performance index. Herz 40, 1004–1010 (2015). https://doi.org/10.1007/s00059-015-4322-3

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