Highly sensitive cardiac troponin T in heart failure: Comparison with echocardiographic parameters and natriuretic peptides

SummaryBackgroundCirculating cardiac troponin T is a marker of cardiomyocyte injury, and predicts adverse outcomes in patients with chronic heart failure. However, the significance of highly sensitive cardiac troponin T (hs-TnT) in cardiac dysfunction remains uncertain. The purpose of this study is to evaluate the correlation between hs-TnT and echocardiographic parameters or natriuretic peptides in patients with heart failure.Methods and resultsWe analyzed 283 consecutive out- or in-patients who had B-type natriuretic peptide (BNP) ≥20 pg/mL and were examined by echocardiography (mean age 66.5 ± 13.9 years old; 159 males). Hs-TnT, BNP, N-terminal pro-BNP (NT-proBNP), and creatinine levels were measured simultaneously. LVEDD (left ventricular end-diastolic dimension), LVEF (left ventricular ejection fraction), E′, E/E′, left ventricular (LV) Tei index, and right ventricular (RV) Tei index were determined with echocardiography. The linear regression analyses demonstrated that log hs-TnT correlated with LVEDD (R = 0.242, p < 0.0001), LVEF (R = −0.369, p < 0.0001), E′ (R = −0.447, p < 0.0001), E/E′ (R = 0.364, p < 0.0001), LV Tei index (R = 0.303, p < 0.0001), RV Tei index (R = 0.443, p < 0.0001), and estimated glomerular filtration rate (eGFR) (R = −0.489, p < 0.0001). Using multiple variable regression analysis, log hs-TnT independently correlated with LVEF, E/E′, RV Tei index, and eGFR. Furthermore, log hs-TnT significantly correlated with log BNP (R = 0.567, p < 0.0001) or log NT-proBNP (R = 0.647, p < 0.0001). Multiple variable regression analysis demonstrated that log hs-TnT independently correlated with log BNP, age, and eGFR, or with log NT-proBNP, age, sex, and eGFR.ConclusionsThe hs-TnT correlated with cardiac dysfunction evaluated by echocardiography and natriuretic peptides in patients with heart failure. The elevation of hs-TnT levels in heart failure may represent cardiac dysfunction due to minor and ongoing myocardial injury.