Clinical InvestigationCongestive Heart FailurePrognostic value of cardiac troponin T in patients with moderate to severe heart failure scheduled for cardiac resynchronization therapy
Section snippets
Patients and study protocol
The study was an open-label, prospective, longitudinal, and observational study and comprised 81 consecutively recruited patients with stable HF referred to our hospital for evaluation for elective CRT. The selection criteria for inclusion were chosen according to the European Society of Cardiology/American Heart Association/American College of Cardiology/European Heart Rhythm Association guidelines for CRT in moderate to severe chronic HF.10 All patients had a coronary angiogram <3 months
Results
Eighty-one patients were included in the study, 15 (19%) were female, mean age was 64 ± 10 years, and 52% had dilated and 48% had ischemic cardiomyopathy. Mean QRS duration was 175 ± 22 milliseconds. At baseline, echocardiography showed enlarged LV end-diastolic volume (LVEDV) (265 ± 111 mL) and LVESV (210 ± 99 mL) with severely reduced contractions (LVEF 22% ± 8%). In all, 75 patients completed the study period of 12 months. Three patients died (2 because of worsening of HF and 1 because of
Discussion
Our findings demonstrate, first, how elevated hsTnT levels are present in the majority of HF patients scheduled for CRT and, notably, detectable hsTnT levels predicted response to CRT as well as severe cardiovascular events. However, these data must be interpreted with caution. Although our data suggest that hsTnT may predict survival and response to CRT in these patients, larger studies are needed to define a particular cutoff that can be used in clinical practice.
Detectable hsTnT levels in
Conclusion
Our findings suggest that elevated TnT levels have prognostic importance in HF patients, with nonischemic and, in particular, ischemic etiology, who are scheduled for CRT. Reduction in levels of TnT during CRT may be associated with attenuated cardiomyocyte destruction and reverse remodeling of the LV, resulting in a more favorable long-term outcome. Measurement of hsTnT before device implantation may help to identity responders to CRT, and measurement during CRT may help to monitor the effect
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2016, Analytica Chimica ActaCitation Excerpt :For example, in the case of cardiac biomarker detection, Zhang et al. [63] have designed a FET-based device with a functionalized SiNW using monoclonal antibodies (MAbs). Different MAbs against biomolecules such as creatine kinase MB (CK-MB) [64], creatine kinase MM (CK-MM) [65] and cTnT [66,67] have been used as probes to detect the respective antigens. A microfluidic channel was fabricated to allow blood flow through an SiNW array with a filtration chip that specifically filters the cell-related components using a pillar-gap microstructure [68].
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2015, American Journal of MedicineCitation Excerpt :Our analysis suggest that the yield of cTn to identify patients with cardiac syncope or acute myocardial infarction is limited.11,37 Elevation of cTn levels is predictive for adverse outcome during long-term follow-up in various patient populations.31,38-41 This could not be shown in our cohort for patients presenting with syncope.
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