Usefulness of High-Sensitivity Cardiac Troponin T to Predict Long-Term Outcome in Patients with Hypertrophic Cardiomyopathy

Gommans, D.H. Frank; Cramer, G. Etienne; Fouraux, Michael A.; Heijmans, Sanne; Michels, Michelle; Timmermans, Janneke; Verheugt, Freek W.A.; Boer, Rudolf A. de; Kofflard, Marcel; Brouwer, Marc A.

doi:10.1016/j.amjcard.2021.04.040

Cited by 11 publications

(10 citation statements)

References 14 publications

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“… MACE definitions: congestive heart failure, arrhythmia, death (references [ 56 , 78 ]); congestive heart failure‐related death, hospitalization, NYHA progression; arrhythmia‐related sudden cardiac death, ventricular tachycardia, appropriate implantable cardioverter defibrillator discharge (reference [ 36 ]); sudden cardiac death; heart failure‐related death, stroke‐related death; heart failure hospitalization, stroke hospitalization, ventricular tachycardia, appropriate implantable cardioverter defibrillator discharge, worsening NYHA class (reference [ 40 ]). BP indicates blood pressure; LV, left ventricle; MACE, major adverse cardiac events; and NYHA, New York Heart Association.…”

Section: Discussionmentioning

confidence: 99%

“… 2 Elevated hs‐cTnT levels correlate with NYHA class, outflow obstruction, systolic dysfunction, abnormal blood pressure response, presence of LGE on CMR, and disease severity in HCM 37 and are an independent predictor adverse events. 36 , 40 Several studies have investigated the predictive value of using a combination of elevated BNP and hs‐cTnT levels: In one the combination was predictive of myocardial fibrosis on CMR, 14 and in another it was associated with ~12% increased risk of cardiovascular events. 15 Like the natriuretic peptides, troponin T and I levels, especially high‐sensitivity forms, are readily available to measure in most clinical settings.…”

Section: Methodsmentioning

confidence: 99%

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Circulating Biomarkers in Hypertrophic Cardiomyopathy

Matthia

Setteducato

Elzeneini

et al. 2022

JAHA

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Hypertrophic cardiomyopathy is the most common genetic heart disease. Biomarkers, molecules measurable in the blood, could inform the clinician by aiding in diagnosis, directing treatment, and predicting outcomes. We present an updated review of circulating biomarkers in hypertrophic cardiomyopathy representing key pathologic processes including wall stretch, myocardial necrosis, fibrosis, inflammation, hypertrophy, and endothelial dysfunction, in addition to their clinical significance.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Circulating Biomarkers in Hypertrophic Cardiomyopathy

Matthia

Setteducato

Elzeneini

et al. 2022

JAHA

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“…CMR plays a significant role in the diagnosis of hypertrophic cardiomyopathy as well as identifying the extent of myocardial fibrosis [ 35 ]. Increased troponin I and T levels were associated with adverse cardiovascular events and increased fibrosis on CMR [ 36 , 37 ]. In our study, troponin I levels among HCM patients who had MACE were borderline significant ( p = 0.06) in comparison with the group without MACE.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Łuczak-Woźniak

Obsznajczyk²,

Niszczota³

et al. 2022

JCM

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Cardiomyopathies have a low prevalence in children and thus may lead to malignant ventricular arrhythmias or the progression of heart failure, resulting in death. In adults, the QRS-T angle derived from ECG has been associated with adverse outcomes in patients with hypertrophic and dilated cardiomyopathies. We aimed to assess the electrocardiographic parameters, including QRS-T angle, associated with adverse cardiac events in children with cardiomyopathies. Forty-two children with cardiomyopathies were included in this study: 19 with dilated cardiomyopathy, 17 with hypertrophic cardiomyopathy, and 6 with left ventricular non-compaction. Additionally, 19 control subjects were recruited. In terms of ECG parameters, the QRS-T angle was significantly greater among patients with adverse outcomes compared to patients without the end points of the study (133° vs. 65°, p < 0.001). On Kaplan–Meier survival curves, QRS-T angle > 120°, increased serum concentrations of NT-proBNP and troponin I levels as well as greater NYHA or Ross scale were associated with the greatest risk of unfavorable outcome. The QRS-T angle appears to be a valuable component of 12-lead ECG interpretation, and might be helpful in outlining patients with the greatest cardiovascular risk. Additionally, serum biomarkers such as NT-proBNP (p = 0.003) and troponin (p < 0.001) are useful in outlining patients with the worst survival.

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“…Another hallmark of HCM is represented by myocardial oedema, which may be detected in a 20-40% of HCM patients using T2-weighted (T2W) sequences, often matching LGE areas. 51,64,65 Differently from ischemic heart disease, where hyperintense areas on T2W images are larger than LGE areas, T2W hyperintensity areas in hypertrophic cardiomyopathy typically show good matching or smaller size than LGE (Fig. 2).…”

Section: Hypertrophic Cardiomyopathymentioning

confidence: 99%

Acute clinical presentation of nonischemic cardiomyopathies: early detection by cardiovascular magnetic resonance

Todiere

Barison

Baritussio

et al. 2022

Journal of Cardiovascular Medicine

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Nonischemic cardiomyopathies include a wide range of dilated, hypertrophic and arrhythmogenic heart muscle disorders, not explained by coronary artery disease, hypertension, valvular or congenital heart disease. Advances in medical treatments and the availability of implantable cardioverter defibrillators to prevent sudden cardiac death have allowed a substantial increase in the survival of affected individuals, thus making early diagnosis and tailored treatment mandatory. The characterization of cardiomyopathies has received a great boost from the recent advances in cardiovascular magnetic resonance (CMR) imaging, which, to date, represents the gold standard for noninvasive assessment of cardiac morphology, function and myocardial tissue changes.An acute clinical presentation has been reported in a nonnegligible proportion of patients with nonischemic cardiomyopathies, usually complaining of acute chest pain, worsening dyspnoea or palpitations; ‘hot phases’ of cardiomyopathies are characterized by a dynamic rise in high-sensitivity troponin, myocardial oedema on CMR, arrhythmic instability, and by an increased long-term risk of adverse remodelling, progression of myocardial fibrosis, heart failure and malignant ventricular arrhythmias. Prompt recognition of ‘hot phases’ of nonischemic cardiomyopathies is of utmost importance to start an early, individualized treatment in these high-risk patients. On the one hand, CMR represents the gold standard imaging technique to detect early and typical signs of ongoing myocardial remodelling in patients presenting with a ‘hot phase’ nonischemic cardiomyopathy, including myocardial oedema, perfusion abnormalities and pathological mapping values. On the other hand, CMR allows the differential diagnosis of other acute heart conditions, such as acute coronary syndromes, takotsubo syndrome, myocarditis, pericarditis and sarcoidosis. This review provides a deep overview of standard and novel CMR techniques to detect ‘hot phases’ of cardiomyopathies, as well as their clinical and prognostic utility.

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Usefulness of High-Sensitivity Cardiac Troponin T to Predict Long-Term Outcome in Patients with Hypertrophic Cardiomyopathy

Cited by 11 publications

References 14 publications

Circulating Biomarkers in Hypertrophic Cardiomyopathy

Circulating Biomarkers in Hypertrophic Cardiomyopathy

Electrocardiographic Parameters Associated with Adverse Outcomes in Children with Cardiomyopathies

Acute clinical presentation of nonischemic cardiomyopathies: early detection by cardiovascular magnetic resonance

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