Cardiac Troponin T vs Other Biochemical Markers in Patients With Congestive Heart Failure
スポンサーリンク
概要
- 論文の詳細を見る
Background Several pathologic processes can cause myocardial injury, which is followed by cardiac remodeling and congestive heart failure (CHF). Cardiac troponin T (cTnT), a specific and sensitive marker of myocardial injury, has been related to long-term outcome in patients with CHF, so the relationship between cTnT and other biochemical markers associated with the pathophysiology of CHF was investigated in the present study. Methods and Results Between February 2004 and December 2005,145 consecutive hospitalized patients (mean left ventricular ejection fraction (LVEF) 31.6±0.9%) with CHF were divided into low (<0.01ng/ml) and high (⪈0.01ng/ml) serum cTnT groups. Correlations with other prognostic biochemical markers, including brain natriuretic peptide (BNP), type I collagen C-terminal telopeptide (ICTP), procollagen type HI peptide (PIIIP), renin, norepinephrine (NOREPI), C-reactive protein (CRP), cholesterol, hemoglobin (Hb), uric acid and HbAlc were examined. cTnT was high in 46 (32%) and low in 99 (68%) patients at baseline. Patients with high cTnT had abnormally high blood concentrations of BNP (p<0.0001), ICTP (p<0.0001), PIIIP (p=0.0006), NOREPI (p=0.0119), CRP (p=0.0003), uric acid (p=0.0026) and HbAlc (p=0.0361). In contrast, concentrations of cholesterol and Hb were significantly lower in patients with high cTnT (p-0.0319 and 0.0005, respectively). Death from or rehospitalization for CHF occurred in 41% in the high vs 9% in the low cTnT group (p=0.0002). Univariate analysis showed that high cTnT (p=0.0005), BNP (p=0.0001), renin (p=0.0158), NOREPI (p=0.0094), old age (p=0.0390), low LVEF (p=0.0231) and high New York Heart Association (NYHA) class (p=0.0006) were predictors of death from or rehospitalization for CHF. By multivariate analysis including BNP, NOREPI, age, LVEF and NYHA class, high cTnT and renin remained as significant predictors. Conclusions Patients with ongoing myocardial injury and high cTnT had associated findings consistent with activation of the sympathetic system, synthesis of cardiac fibrosis, inflammation and metabolic abnormalities. By multivariate analysis, high cTnT and renin remained significant predictors of death or rehospitalization.
- 社団法人日本循環器学会の論文
- 2007-04-20
著者
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KITA Toru
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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Kimura Takeshi
Department of Cardiovascular Medicine, Kyoto University Hospital
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Morimoto Takeshi
Center for Medical Education, Kyoto University Graduate School of Medicine
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TANIGUCHI Ryoji
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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Shizuta Satoshi
Department of Cardiovascular Medicine, Kyoto University Hospital
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Sato Sumiko
Ehime Prefectural Central Hospital
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Doi Takahiro
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
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Kobayashi Takashi
Department Of Cardiology Kobe City Medical Center General Hospital
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Doi Takahiro
Department Of Cardiovascular Medicine Kyoto University Hospital
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Kita Toru
Department Of Cardiology Kobe City Medical Center General Hospital
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Sato Yukihito
Department of Cardiovasucular Medicine, Hyogo Prefectural Amagasaki Hospital
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Sato Yukihito
Department Of Cardiology Hyogo Prefectural Amagasaki Hospital
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Nishio Yukiko
Department Of Cardiovascular Medicine Graduate School Of Medicine Kyoto University
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Shizuta Satoshi
Department Of Cardiology Juntendo Shizuoka Hospital
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Saito S
Department Of Cardiology Juntendo Shizuoka Hospital
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Nishio Yukiko
Department Of Cardiovascular Medicine Kyoto University Graduate School Of Medicine
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Sato Yukihito
Department Of Cardiovascular Medicine Hyogo Prefectural Amagasaki Hospital
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Satoh Yukihito
Division Of Cardiology Department Of Internal Medicine Hyogo Prefectural Amagasaki Hospital
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Kimura Takeshi
Department Of Cardiology Kobe City Medical Center General Hospital
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Taniguchi Ryoji
Department Of Cardiovascular Medicine Kyoto University
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Taniguchi Ryoji
Department Of Cardiology Hyogo Prefectural Amagasaki Hospital
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Kawamoto Takahiro
Department Of Geriatric Medicine Graduate School Of Medicine Kyoto University
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Morimoto Takeshi
Center For Medical Education Graduate School Of Medicine Kyoto University
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Nishio Yukiko
Department Of Cardiovascular And Respiratory Medicine Shiga University Of Medical Sciences
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Dohmei Takenori
Department Of Cardiology Kokura Memorila Hospital
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Doi Takahiro
Department Of Cardiology Kokura Memorial Hospital
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MORIMOTO Takeshi
Center for General Internal Medicine and Emergency Care, Kinki University School of Medicine
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KIMURA Takeshi
Department of Applied Chemistry and Molecular Science, Faculty of Engineering, Iwate University
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