Elevated serum concentrations of cardiac troponin T in acute allograft rejection after human heart transplantation

Dengler, Thomas J.; Zimmermann, Rainer; Braun, Klaus; Müller-Bardorff, Margit; Zehelein, Joerg; Sack, Falk–Udo; Schnabel, Philipp A.; Kübler, W.; Katus, Hugo A.

doi:10.1016/s0735-1097(98)00257-5

Cited by 94 publications

(63 citation statements)

References 13 publications

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“…In a study of 57 HTx patients evaluated between 1 and 12 months after surgery, cTnT concentrations were significantly higher (P ϭ 0.008) in patients with CAV demonstrated by endomyocardial biopsy (90 ). In the setting of acute allograft rejection following HTx, the sensitivity and specificity of cTn for the detection of significant graft rejection were 80.4% and 61.8%, respectively, and the negative predictive value was 96.2% (91 ). In a pediatric HTx population (n ϭ 9), the predictive power of a single cTnT measurement was not sufficient to replace biopsy (92 ).…”

Section: Iatrogenic Conditions Invasive Proceduresmentioning

confidence: 98%

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

2009

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Background: Although cardiac troponin (cTn) is a cornerstone marker in the assessment and management of patients with acute coronary syndrome (ACS) and heart failure (HF), cTn is not diagnostically specific for any single myocardial disease process. This narrative review discusses increases in cTn that result from acute and chronic diseases, iatrogenic causes, and myocardial injury other than ACS and HF.Content: Increased cTn concentrations have been reported in cardiac, vascular, and respiratory disease and in association with infectious processes. In cases involving acute aortic dissection, cerebrovascular accident, treatment in an intensive care unit, and upper gastrointestinal bleeding, increased cTn predicts a longer time to diagnosis and treatment, increased length of hospital stay, and increased mortality. cTn increases are diagnostically and prognostically useful in patients with cardiac inflammatory diseases and in patients with respiratory disease; in respiratory disease cTn can help identify patients who would benefit from aggressive management. In chronic renal failure patients the diagnostic sensitivity of cTn for ACS is decreased, but cTn is prognostic for the development of cardiovascular disease. cTn also provides useful information when increases are attributable to various iatrogenic causes and blunt chest trauma.Summary: Information on the diagnostic and prognostic uses of cTn in conditions other than ACS and heart failure is accumulating. Although increased cTn in settings other than ACS or heart failure is frequently considered a clinical confounder, the astute physician must be able to interpret cTn as a dynamic marker of myocardial damage, using clinical acumen to determine the source and significance of any reported cTn increase.

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Section: Iatrogenic Conditions Invasive Proceduresmentioning

confidence: 98%

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

2009

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“…In addition, children might have distress related to serial invasive procedures. 3 Therefore, many attempts have been made to develop noninvasive approaches for detecting transplant rejection, eg, an analysis of heart rate variability, 4 pulsed Doppler tissue imaging, 5 monitoring of peak filling rate with acoustic quantification echocardiography, 6 highresolution intramyocardial electrograms, 7 serum protein analysis, 8,9 and detection with 111 In-labeled lymphocytes. 10 None of these approaches, however, have yet gained widespread clinical use.…”

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confidence: 99%

Macrophage Accumulation Associated With Rat Cardiac Allograft Rejection Detected by Magnetic Resonance Imaging With Ultrasmall Superparamagnetic Iron Oxide Particles

et al. 2001

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Background-Acute cardiac allograft rejection continues to be the cause of graft loss and contributes to the morbidity and mortality after cardiac transplantation. In this study, we report a new method for detecting organ rejection in transplantation with an MR-based technique using dextran-coated ultrasmall superparamagnetic iron oxide (USPIO) particles. These particles (Ϸ27 nm in diameter) are known to shorten relaxation times in MRI experiments. Methods and Results-A new rat model of heterotopic heart and lung transplantation has been developed for MRI experiments. Allotransplantations (DA3 BN) were performed (nϭ8), with syngeneic transplantations (BN3 BN) serving as controls (nϭ8). MR images were obtained with a gradient echo method. At postoperative day 7, allotransplants developed moderate rejection as determined histopathologically. A significant reduction in MR signal intensity was observed after USPIO injection into rats with allotransplanted hearts. Syngeneic transplants showed no differences in MR signal intensity before and after USPIO injections. After injection of USPIO particles at postoperative day 6, a group of allotransplanted rats was treated with cyclosporin A (3 mg/kg). Animals treated with cyclosporin A for 7 days showed no reduction in MR signal intensity after USPIO reinjection at day 14, whereas animals treated for 4 days showed a significant decrease in MR signal intensity in the transplanted hearts indicative of acute graft rejection. Pathological analysis of these animals revealed that dextran-coated USPIO particles were taken up by the infiltrating macrophages that accumulated within the rejecting cardiac graft. Conclusions-This

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“…Viral miyokardit akut kardiyomiyositer hasar yaptıysa bunu gösterebilir (9). Yine pediyatrik grupta konjenital kalp hastalığı için operasyon zamanını belirlemede, transplant hastaların-da rejeksiyonun saptanmasında ve antrasiklin zehirlenmesinde izlem amaçlı başka nedenlerle de troponinlerden yararlanılabilir (10).…”

Section: Kardiyak Hasar Biyo-belirteçleriunclassified

Biomarkers in cardiovascular surgery biomarkers as early predictors for organ damage after cardiac surgery

Bozkaya¹

2015

MUSBED

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Elevated serum concentrations of cardiac troponin T in acute allograft rejection after human heart transplantation

Cited by 94 publications

References 13 publications

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

Increases of Cardiac Troponin in Conditions other than Acute Coronary Syndrome and Heart Failure

Macrophage Accumulation Associated With Rat Cardiac Allograft Rejection Detected by Magnetic Resonance Imaging With Ultrasmall Superparamagnetic Iron Oxide Particles

Biomarkers in cardiovascular surgery biomarkers as early predictors for organ damage after cardiac surgery

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