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首页> 外文期刊>Circulation journal >Cardiac troponin T vs other biochemical markers in patients with congestive heart failure.
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Cardiac troponin T vs other biochemical markers in patients with congestive heart failure.

机译：充血性心力衰竭患者的心肌肌钙蛋白T与其他生化指标的关系。

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BACKGROUND: Several pathologic processes can cause myocardial injury, which is followed by cardiac remodeling and congestive heart failure (CHF). Cardiac troponin T (cTnT), a specific and sensitive marker of myocardial injury, has been related to long-term outcome in patients with CHF, so the relationship between cTnT and other biochemical markers associated with the pathophysiology of CHF was investigated in the present study. METHODS AND RESULTS: Between February 2004 and December 2005, 145 consecutive hospitalized patients (mean left ventricular ejection fraction (LVEF) 31.6+/-0.9%) with CHF were divided into low (<0.01 ng/ml) and high (> or =0.01 ng/ml) serum cTnT groups. Correlations with other prognostic biochemical markers, including brain natriuretic peptide (BNP), type I collagen C-terminal telopeptide (ICTP), procollagen type III peptide (PIIIP), renin, norepinephrine (NOREPI), C-reactive protein (CRP), cholesterol, hemoglobin (Hb), uric acid and HbA1c were examined. cTnT was high in 46 (32%)and low in 99 (68%) patients at baseline. Patients with high cTnT had abnormally high blood concentrations of BNP (p<0.0001), ICTP (p<0.0001), PIIIP (p=0.0006), NOREPI (p=0.0119), CRP (p=0.0003), uric acid (p=0.0026) and HbA1c (p=0.0361). In contrast, concentrations of cholesterol and Hb were significantly lower in patients with high cTnT (p=0.0319 and 0.0005, respectively). Death from or rehospitalization for CHF occurred in 41% in the high vs 9% in the low cTnT group (p=0.0002). Univariate analysis showed that high cTnT (p=0.0005), BNP (p=0.0001), renin (p=0.0158), NOREPI (p=0.0094), old age (p=0.0390), low LVEF (p=0.0231) and high New York Heart Association (NYHA) class (p=0.0006) were predictors of death from or rehospitalization for CHF. By multivariate analysis including BNP, NOREPI, age, LVEF and NYHA class, high cTnT and renin remained as significant predictors. CONCLUSIONS: Patients with ongoing myocardial injury and high cTnT had associated findings consistent with activation of the sympathetic system, synthesis of cardiac fibrosis, inflammation and metabolic abnormalities. By multivariate analysis, high cTnT and renin remained significant predictors of death or rehospitalization.
机译：背景：几种病理过程可能导致心肌损伤，随后发生心脏重塑和充血性心力衰竭（CHF）。心肌肌钙蛋白T（cTnT）是一种特殊且敏感的心肌损伤标志物，已与CHF患者的长期预后相关，因此本研究探讨了cTnT与其他与CHF病理生理学相关的生化标志物之间的关系。方法与结果：2004年2月至2005年12月，将145例连续的CHF住院患者（平均左心室射血分数（LVEF）为31.6 +/- 0.9％）分为低（<0.01 ng / ml）和高（>或= 0.01 ng / ml）血清cTnT组。与其他预后生化指标的相关性，包括脑钠肽（BNP），I型胶原C末端端肽（ICTP），前胶原III型肽（PIIIP），肾素，去甲肾上腺素（NOREPI），C反应蛋白（CRP），胆固醇检查血红蛋白（Hb），尿酸和HbA1c。基线时，cTnT高的有46位（32％），低的99位（68％）患者。 cTnT高的患者的BNP（p <0.0001），ICTP（p <0.0001），PIIIP（p = 0.0006），NOREPI（p = 0.0119），CRP（p = 0.0003），尿酸（p = 0.0026）和HbA1c（p = 0.0361）。相反，高cTnT患者的胆固醇和Hb浓度显着降低（分别为p = 0.0319和0.0005）。 cTnT高组的CHF死亡或再次住院的发生率为41％，低cTnT组为9％（p = 0.0002）。单因素分析显示高cTnT（p = 0.0005），BNP（p = 0.0001），肾素（p = 0.0158），NOREPI（p = 0.0094），老年（p = 0.0390），LVEF低（p = 0.0231）和高纽约心脏协会（NYHA）类（p = 0.0006）是CHF死亡或再次住院的预测指标。通过多变量分析，包括BNP，NOREPI，年龄，LVEF和NYHA类，高cTnT和肾素仍然是重要的预测指标。结论：进行性心肌损伤和高cTnT的患者具有与交感神经系统激活，心脏纤维化合成，炎症和代谢异常相一致的相关发现。通过多变量分析，高cTnT和肾素仍然是死亡或再次住院的重要预测指标。

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