Skip to main content
SpringerLink
Log in

Measurements of baseline and follow-up concentrations of cardiac troponin-T and brain natriuretic peptide in patients with heart failure from various etiologies

  • ORIGINAL ARTICLE
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

Since chronic heart failure (CHF) is a complex clinical syndrome, a single biomarker may not reflect all of its characteristics. In this study, the clinical significance of combination and serial measurement of biochemical markers of myocyte injury and myocardial load in patients with CHF from various etiologies was examined. Serum concentrations of cardiac troponin-T (cTnT) and plasma concentrations of brain natriuretic peptide (BNP) were measured simultaneously in 190 patients with CHF, including dilated cardiomyopathy (DCM) (n = 41), ischemic heart disease (n = 40), valvular or congenital disease (n = 53), hypertensive heart disease (n = 16), and hypertrophic cardiomyopathy (HCM) (n = 22). Serum cTnT concentrations ≥0.01 ng/ml were found in 46/190 patients (24%) at baseline (20% in DCM, 42% in ischemic heart disease, 21% in valvular or congenital disease, 43% in hypertensive heart disease, and 9% in HCM). Follow-up samples were obtained in 137 patients after a mean treatment period of 31.8 days. Although BNP decreased significantly in each disease category (P < 0.0001: DCM; P < 0.005: ischemic heart disease; P < 0.05: valvular or congenital disease; P < 0.005: hypertensive heart disease; P < 0.05: HCM), cTnT remained high in 36/137 patients (26%) (19% in DCM, 39% in ischemic heart disease, 25% in valvular or congenital disease, 38% in hypertensive heart disease, and 19% in HCM). The rate of adverse cardiac events was significantly higher in patients with high cTnT than in patients with low cTnT concentrations (P < 0.0001) (P < 0.05: DCM; P < 0.05: ischemic heart disease; P < 0.01: valvular or congenital disease). Multivariate analysis showed that both cTnT and BNP are independent prognostic factors, and patients with elevations of both cTnT and BNP had the poorest prognosis (P < 0.0001). In patients with CHF, the evolution and prognostic value of cTnT and BNP are different. The combined measurements of these markers should refine our understanding of the state and evolution of CHF.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. SA Hunt DW Baker MH Chin MP Cinquegrani AM Feldman GS Francis TG Ganiats S Goldstein G Gregoratos ML Jessup RJ Noble M Packer MA Silver LW Stevenson RJ Gibbons EM Antman JS Alpert DP Faxon V Fuster G Gregoratos AK Jacobs LF Hiratzka RO Russell SC Smith InstitutionalAuthorNameAmerican College of Cardiology InstitutionalAuthorNameAmerican Heart Association (2002) ArticleTitleACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary J Heart Lung Transplant 21 189–203 Occurrence Handle11834347 Occurrence Handle10.1016/S1053-2498(01)00776-8

    Article  PubMed  Google Scholar 

  2. M Jessup S Brozena (2003) ArticleTitleHeart failure (review) N Engl J Med 348 2007–2018 Occurrence Handle12748317 Occurrence Handle10.1056/NEJMra021498

    Article  PubMed  Google Scholar 

  3. JS Alpert K Thygesen E Antman JP Bassand (2000) ArticleTitleMyocardial infarction redefined – a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction J Am Coll Cardiol 36 959–969 Occurrence Handle10987628 Occurrence Handle1:STN:280:DC%2BD3cvlvV2luw%3D%3D Occurrence Handle10.1016/S0735-1097(00)00804-4

    Article  PubMed  CAS  Google Scholar 

  4. AS Jaffe J Ravkilde R Roberts U Naslund FS Apple M Galvani H Katus (2000) ArticleTitleIt's time for a change to a troponin standard Circulation 102 1216–1220 Occurrence Handle10982533 Occurrence Handle1:CAS:528:DC%2BD3cXntFCgtrs%3D

    PubMed  CAS  Google Scholar 

  5. Y Sato T Yamada R Taniguchi K Nagai T Makiyama H Okada K Kataoka H Ito A Matsumori S Sasayama Y Takatsu (2001) ArticleTitlePersistently increased serum concentrations of cardiac troponin T in patients with idiopathic dilated cardiomyopathy are predictive of adverse outcomes Circulation 103 369–374 Occurrence Handle11157687 Occurrence Handle1:CAS:528:DC%2BD3MXhtF2ksLo%3D

    PubMed  CAS  Google Scholar 

  6. M Yazici S Demircan K Durna M Sahin (2005) ArticleTitleThe relation between endothelin-1 levels and myocardial injury in chronic ischemic heart failure Heart Vessels 20 95–99 Occurrence Handle15912304 Occurrence Handle10.1007/s00380-004-0812-6

    Article  PubMed  Google Scholar 

  7. Y Sato R Taniguchi T Makiyama K Nagai H Okada T Yamada A Matsumori Y Takatsu (2002) ArticleTitleSerum cardiac troponin T and plasma brain natriuretic peptide in patients with severe cardiac decompensation Heart 88 647–648 Occurrence Handle12433908 Occurrence Handle1:CAS:528:DC%2BD38Xps1Ort70%3D Occurrence Handle10.1136/heart.88.6.647

    Article  PubMed  CAS  Google Scholar 

  8. Y Sato T Kita Y Takatsu T Kimura (2004) ArticleTitleBiochemical markers of myocyte injury in heart failure Review Heart 90 1110–1113 Occurrence Handle1:CAS:528:DC%2BD2cXovVyksLg%3D Occurrence Handle10.1136/hrt.2003.023895

    Article  CAS  Google Scholar 

  9. K Setsuta Y Seino N Takahashi T Ogawa K Sasaki A Harada T Takano H Kishida H Hayakawa (1999) ArticleTitleClinical significance of elevated levels of cardiac troponin T in patients with chronic heart failure Am J Cardiol 84 608–611 Occurrence Handle10482168 Occurrence Handle1:STN:280:DyaK1MvgvFyqtg%3D%3D Occurrence Handle10.1016/S0002-9149(99)00391-4

    Article  PubMed  CAS  Google Scholar 

  10. E Koh T Nakamura H Takahashi (2004) ArticleTitleTroponin-T and brain natriuretic peptide as predictors for adriamycin-induced cardiomyopathy in rats Circ J 68 163–7 Occurrence Handle14745153 Occurrence Handle1:CAS:528:DC%2BD2cXhsVGhsbg%3D Occurrence Handle10.1253/circj.68.163

    Article  PubMed  CAS  Google Scholar 

  11. T Tsutamoto A Wada K Maeda T Hisanaga Y Maeda D Fukai M Ohnishi Y Sugimoto M Kinoshita (1997) ArticleTitleAttenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction Circulation 96 509–516 Occurrence Handle9244219 Occurrence Handle1:STN:280:ByiA1cnjslQ%3D

    PubMed  CAS  Google Scholar 

  12. RJ Rodeheffer (2004) ArticleTitleMeasuring plasma B-type natriuretic peptide in heart failure J Am Coll Cardiol 44 740–49 Occurrence Handle15312852 Occurrence Handle1:CAS:528:DC%2BD2cXmslegu78%3D

    PubMed  CAS  Google Scholar 

  13. P Richardson W McKenna M Bristow B Maisch B Mauntner J O'Connell E Olsen G Thiene J Goodwin I Gyarfas I Martin P Nordet (1996) ArticleTitleReport of the 1995 World Health Organization/International Society and Federation of Cardiology Task Force on the definition and classification of cardiomyopathies Circulation 93 841–842 Occurrence Handle8598070 Occurrence Handle1:STN:280:BymC2sbgtFQ%3D

    PubMed  CAS  Google Scholar 

  14. R Taniguchi Y Sato T Yamada M Ooba H Higuchi A Matsumori T Kimura T Kita (2004) ArticleTitleCombined measurements of cardiac troponin T and N-terminal pro-brain natriuretic peptide in patients with heart failure Circ J 68 1160–1164 Occurrence Handle15564700 Occurrence Handle1:CAS:528:DC%2BD2MXivVKi Occurrence Handle10.1253/circj.68.1160

    Article  PubMed  CAS  Google Scholar 

  15. Y Sato R Taniguchi K Nagai T Makiyama H Okada T Yamada A Matsumori Y Takatsu (2003) ArticleTitleMeasurements of cardiac troponin T in patients with hypertrophic cardiomyopathy (scientific letter) Heart 89 659–660 Occurrence Handle12748227 Occurrence Handle1:STN:280:DC%2BD3s3is1Krsw%3D%3D Occurrence Handle10.1136/heart.89.6.659

    Article  PubMed  CAS  Google Scholar 

  16. Y Sato R Taniguchi T Yamada A Matsumori (2003) ArticleTitleMeasurements of serum cardiac troponin T in patients with heart failure (letter) Am Heart J 145 e18 Occurrence Handle12679776 Occurrence Handle10.1067/mhj.2003.10

    Article  PubMed  Google Scholar 

  17. JN Cohn R Ferrari N Sharp (2000) ArticleTitleCardiac remodeling-concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling J Am Coll Cardiol 35 569–582 Occurrence Handle10716457 Occurrence Handle1:STN:280:DC%2BD3c7nvFajsw%3D%3D Occurrence Handle10.1016/S0735-1097(99)00630-0

    Article  PubMed  CAS  Google Scholar 

  18. MG St John Sutton N Sharpe (2000) ArticleTitleLeft ventricular remodeling after myocardial infarction: pathophysiology and therapy Circulation 101 2981–2988

    Google Scholar 

  19. TB Horwich J Patel WR MacLellan GC Fanarow (2003) ArticleTitleCardiac troponin I is associated with impaired hemodynamics, progressive left ventricular dysfunction, and increased mortality rates in advanced heart failure Circulation 108 833–838 Occurrence Handle12912820 Occurrence Handle1:CAS:528:DC%2BD3sXmtFCitr0%3D Occurrence Handle10.1161/01.CIR.0000084543.79097.34

    Article  PubMed  CAS  Google Scholar 

  20. ER Perna SM Macin JP Canella N Augier JL Stival JR Cialzeta AE Pitzus EH Garcia R Obregon M Brizuela A Barbagelata (2004) ArticleTitleOngoing myocardial injury in stable severe heart failure: value of cardiac troponin T monitoring for high-risk patient identification Circulation 110 2376–2382 Occurrence Handle15477403 Occurrence Handle10.1161/01.CIR.0000145158.33801.F3

    Article  PubMed  Google Scholar 

  21. J Ishii M Nomura Y Nakamura H Naruse Y Mori T Ishikawa T Ando H Kurokawa T Kondo Y Nagamura K Ezaki H Hishida (2002) ArticleTitleRisk stratification using a combination of cardiac troponin T and brain natriuretic peptide in patients hospitalized for worsening chronic heart failure Am J Cardiol 89 691–695 Occurrence Handle11897211 Occurrence Handle1:CAS:528:DC%2BD38XhvVWkur4%3D Occurrence Handle10.1016/S0002-9149(01)02341-4

    Article  PubMed  CAS  Google Scholar 

  22. J Ishii W Cui F Kitagawa T Kuno Y Nakamura H Naruse Y Mori T Ishikawa Y Nagamura T Kondo H Oshima M Nomura K Ezaki H Hishida (2003) ArticleTitlePrognostic value of combination of cardiac troponin T and B-type natriuretic peptide after initiation of treatment in patients with chronic heart failure Clin Chem 49 2020–2026 Occurrence Handle14633873 Occurrence Handle1:CAS:528:DC%2BD3sXpt1yntrc%3D Occurrence Handle10.1373/clinchem.2003.021311

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan

    Ryoji Taniguchi, Yukiko Nishio, Takeshi Kimura & Toru Kita

  2. Department of Cardiovascular Medicine, Hyogo Prefectural Amagasaki Hospital, Higashidaimotsu-cho 1-1-1, Amagasaki, Hyogo, 660-0828, Japan

    Yukihito Sato

Authors
  1. Ryoji Taniguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yukihito Sato
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yukiko Nishio
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takeshi Kimura
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Toru Kita
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yukihito Sato.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Taniguchi, R., Sato, Y., Nishio, Y. et al. Measurements of baseline and follow-up concentrations of cardiac troponin-T and brain natriuretic peptide in patients with heart failure from various etiologies. Heart Vessels 21, 344–349 (2006). https://doi.org/10.1007/s00380-006-0909-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-006-0909-1

Key words

Search

Navigation