An association between volumes of the cardiac chambers and troponin levels in individuals submitted to cardiac coronary computed tomography

Abstract

Background: Previous echocardiographic studies have revealed an association between enlarged cardiac chamber volumes and elevated troponin concentrations. An automatic 4-chamber volumetric analysis tool was adopted to investigate this association in patients who underwent cardiac-gated computed tomography angiography (CCTA). Hypothesis:We hypothesized that troponin concentration within the normal range correlates with cardiac chambers' volumes.Methods: Serum troponin was obtained from 157 ambulatory patients before undergoing CCTA for nonacute coronary artery evaluation. Volumes of the cardiac chambers and the left ventricular mass were automatically analyzed and indexed to body surface area. Patients with a troponin concentrations within the upper quartile (>0.007 ng/mL, n = 39) were compared to patients with a troponin concentrations within the 3 lower quartiles of troponin concentrations (≤0.007 ng/mL, n = 118).Results: None of the patients had a troponin concentration >0.05 ng/mL (the 99th percentile of the general population). There were no significant differences in baseline characteristics between the groups. There were significant correlations between troponin and ventricular volumes after adjustments for age and gender. In an analysis that included 107 patients without any known heart diseases, including those pathological findings in the current CCTA, there were significant correlations between troponin and the left and right ventricular volumes after adjustments for age, gender, and baseline characteristics (odds ratio [OR]: 1.08, 95% confidence interval [CI]:1.03-1.14, P = 0.002 and OR: 1.11, 95% CI: 1.04-1.19, P = 0.002; respectively). Conclusions: Using the technology of automatic volumetric analysis in individuals undergoingCCTA, an association between larger right and left cardiac chambers and higher levels of troponin concentration was shown.Computed Tomography, Troponin, Volumetric Analysis | INTRODUCTIONCardiac troponin concentration in the serum is a widely used assay, and the preferred marker of myocardial necrosis. 1 Not uncommonly, elevated troponin concentrations are documented in patients without coronary artery disease. 2,3 There is a graded correlation between troponin levels in the normal range and cardiovascular outcomes. [4][5][6] An association between troponin concentration and left cardiac chamber enlargement, as assessed by various imaging methods, was previously reported. [7][8][9] During the last few years, a computed tomography (CT)-based 4-chamber volumetric analysis software (4CVA) was applied to automatically assess the cardiac chambers' volumes in † Zach Rozenbaum, MD, and Yaron Arbel, MD, contributed equally to the study. patients who underwent a nongated CT pulmonary angiography 10,11 as well as cardiac-gated coronary computed tomography angiography (CCTA). 12 Part of the advantage of the 4CVA technology is its capability to provide the volumes of both the right and left atria and ventricles automatically and simultaneously. The application of 4CVA on patients w...