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研究顯示，高敏感肌鈣蛋白T（hs-cTnT）在慢性心衰患者中顯著升高，並且與症狀嚴重程度、左心室功能失調和預後密切相關。hs-cTnT不僅是急性心肌缺血的標誌物，還在慢性心衰的預後中具有重要獨立價值，補充了NT-proBNP的預測能力。
High-sensitive troponin T in chronic heart failure correlates with severity of symptoms, left ventricular dysfunction and prognosis independently from N-terminal pro-b-type natriuretic peptide
高敏感性肌鈣蛋白 T 在慢性心衰竭中與症狀嚴重程度、左心室功能障礙和預後相關，並且這些關聯性獨立於N端腦利鈉肽前體。
Jungbauer CG, Riedlinger J, Buchner S, et al. High-sensitive troponin T in chronic heart failure correlates with severity of symptoms, left ventricular dysfunction and prognosis independently from N-terminal pro-b-type natriuretic peptide. Clin Chem Lab Med. 2011;49(11):1899-1906. doi:10.1515/CCLM.2011.251
https://pubmed.ncbi.nlm.nih.gov/21892905/
Abstract
Background
Troponin T is an established marker of myocardial ischemia. We speculated that the role of the new high-sensitive troponin T (hs-cTnT) might expand towards non-ischemic myocardial disease, indicate disease severity and allow for prognostication in chronic heart failure.
Methods
Hs-cTnT (Roche Diagnostics, Mannheim, Germany) was assessed in 233 individuals with chronic heart failure (n=149) or healthy controls (n=84).
Results
Hs-cTnT was significantly elevated in patients with chronic heart failure [0.018 ng/mL, interquartile range (IQR) 0.009-0.036 ng/mL, vs. controls 0.003 ng/mL, 0.003-0.003 ng/mL, p<0.001] and positively correlated with N-terminal pro-b-type natriuretic peptide (NT-proBNP) (r=0.79, p<0.001). Hs-cTnT increased stepwise and signitificantly according to clinical (NYHA stage) as well as functional (LV ejection fraction, fluid retention) severity (each p<0.001). At a binary cutpoint of 0.014 ng/mL, hs-TropT was a significant predictor of all-cause mortality and all-cause mortality or rehospitalization for congestive heart failure (each p≤0.01). Of note, the prognostic value of hs-TropT was independent and additive to that of NT-proBNP.
Conclusions
Hs-cTnT increases stepwise with the severity of symptoms and LV dysfunction and offers important prognostic information in chronic heart failure, independently from and additive to NT-proBNP. The utility of hs-cTnT expands beyond acute myocardial ischemia and towards chronic heart failure.
摘要
背景
肌鈣蛋白 T 是心肌缺血的確立標誌物。我們推測新型高敏感性肌鈣蛋白 T（hs-cTnT）的作用可能擴展到非缺血性心肌疾病，指示疾病嚴重程度並預測慢性心衰竭的預後。
方法
評估了 233 名慢性心衰竭患者（n=149）或健康對照組（n=84）的 hs-cTnT 濃度。
結果
慢性心衰竭患者的 hs-cTnT 顯著升高，並與 NT-proBNP 呈正相關（r=0.79, p<0.001）。hs-cTnT 隨症狀和左心室功能障礙的嚴重程度逐步增加（每項 p<0.001）。hs-TropT 是全因死亡率和充血性心衰再住院的顯著預測指標，且其預後價值獨立於 NT-proBNP。
結論
hs-cTnT 隨症狀和左心室功能障礙的嚴重程度逐步增加，在慢性心衰竭中提供了重要的預後信息，且其效用超越急性心肌缺血。