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Article Dans Une Revue Clinical Science Année : 2010

High-sensitive Troponin T - a novel biomarker for prognosis and disease severity in patients with pulmonary hypertension

Résumé

Background. Pulmonary hypertension is the leading cause of fatal right ventricular failure. However rarely detectable, conventional troponin T (cTnT) is a significant prognostic marker. Therefore, this study evaluates the usefulness of a novel high-sensitive troponin T (hsTnT) assay as a parameter for functional and prognostic evaluation of PH patients. Methods. In 55 pulmonary hypertension patients (idiopathic n=20, chronic thromboembolic n=30, and interstitial lung disease n=5) with a mean pulmonary artery pressure 45±18 mmHg, troponin T was measured by 4th generation conventional assay and a novel high-sensitive assay with a lower detection limit at 2 pg/mL (total imprecision <10% at 99th percentile value (13.4 pg/mL)). Results. In 90.9% of patients, troponin T was detectable using the hsTnT assay and in 30.9% using the 4th generation assay. Concentrations <99th percentile were seen in 27.3% using hsTnT as compared to 10.9% using 4th generation assay. Five of 6 patients with values <30 pg/ml (4th generation assay), or <29.5 pg/mL (hsTnT assay) died during 12-month follow-up. There was a correlation between hsTnT and six minute walk distance (r=-0.92, p=0.0014), right ventricular systolic strain (r=0.95, p=0.0018) and strain rate (r=0.82, p=0.0021). In AUC analysis, hsTnT predicted death at least as effective as heart-type fatty acid binding protein (hFABP) or NT-pro BNP. Moreover, hsTnT predicted WHO class <2 better than NT-proBNP or hFABP. Conclusions. In pulmonary hypertension patients, the novel biomarker high-sensitive troponin T is associated with death and advanced WHO class, and related to systolic right ventricular dysfunction and impaired six minute walk distance.

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Dates et versions

hal-00597816 , version 1 (02-06-2011)

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Arthur Filusch, Evangelos Giannitsis, Hugo Albert Katus, Franz Joachim Meyer. High-sensitive Troponin T - a novel biomarker for prognosis and disease severity in patients with pulmonary hypertension. Clinical Science, 2010, 119 (5), pp.207-213. ⟨10.1042/CS20100014⟩. ⟨hal-00597816⟩

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