Left ventricular end-diastolic pressure and ejection fraction correlate independently with high-sensitivity cardiac troponin-T concentrations in stable heart failure

Background: Cardiac troponin is widely accepted as a biomarker of myocyte injury in patients with myocardial ischemia. Patients with congestive heart failure are also associated with elevated cardiac troponin and it is a very sensitive prognostic marker. However, the mechanisms of troponin elevation in patients with heart failure are not fully understood. Decompensated state itself is suggested as a factor contributing to elevated cardiac troponin-T. However comparison between invasive hemodynamic parameters and cardiac troponin-T is insufficient. Methods: Data were collected from 167 patients in stable, chronic HF, without acute coronary syndrome, recent revascularization, mitral stenoses, hemodialysis, or clinically significant right HF. We evaluated the correlations and 95% confidence intervals (Cl) between invasive hemodynamic measurements and serum high-sensitivity (hs) concentrations of cTnT. Results: The serum cTnT concentration was equal to or more than the detection threshold (0.003 ng/ml) in all patients. The serum cTnT concentration was equal to or more than the cut-off value of 0.014 ng/ml in 46% of patients. By multiple variable analysis, left ventricular (LV) end-diastolic pressure (EDP; adjusted coefficient = 0.014; 95% Cl 0.0003-0.029; P = 0.046) was positively correlated, while hemoglobin (adjusted coefficient = 0.079; 95% CI -0.140 to -0.018; P = 0.012), estimated glomerular filtration rate (adjusted coefficient = -0.008; 95% CI -0.013 to 0.003; P = 0.004), and LV ejection fraction (EF; adjusted coefficient = -0.011; 95% CI -0.018 to 0.003; P = 0.004) were negatively correlated with hs-cTnT concentrations. Conclusion: In patients with stable chronic HF, LVEDP and LVEF correlate with the serum concentrations of hs-cTnT, independently of other correlates of elevated plasma concentrations of hs-cTnT. (C) 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.