High‐Sensitivity Troponin: A Clinical Blood Biomarker for Staging Cardiomyopathy in Fabry Disease

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Bart Bijnens¹  Stefan Störk²  Georg Ertl²  Peter Nordbeck²  Dan Liu²  Christiane Drechsler²  Christoph Wanner²  Andreas Schneider²  Nora Seydelmann²  Kai Hu²  Johannes Krämer²  Frank Weidemann² 

[1] ICREA–Universitat Pompeu Fabra, Barcelona, Spain;Medizinische Klinik I, University Hospital Würzburg, and Comprehensive Heart Failure Center, Würzburg, Germany;

关键词: biomarker;    cardiomyopathy;    fabry disease;    myocardial fibrosis;    troponin T;   

DOI  :  10.1161/JAHA.115.002839

来源: DOAJ

【 摘 要 】

BackgroundHigh‐sensitivity troponin (hs‐TNT), a biomarker of myocardial damage, might be useful for assessing fibrosis in Fabry cardiomyopathy. We performed a prospective analysis of hs‐TNT as a biomarker for myocardial changes in Fabry patients and a retrospective longitudinal follow‐up study to assess longitudinal hs‐TNT changes relative to fibrosis and cardiomyopathy progression. Methods and ResultsFor the prospective analysis, hs‐TNT from 75 consecutive patients with genetically confirmed Fabry disease was analyzed relative to typical Fabry‐associated echocardiographic findings and total myocardial fibrosis as measured by late gadolinium enhancement (LE) on magnetic resonance imaging. Longitudinal data (3.9±2.0 years), including hs‐TNT, LE, and echocardiographic findings from 58 Fabry patients, were retrospectively collected. Hs‐TNT level positively correlated with LE (linear correlation coefficient, 0.72; odds ratio, 32.81 [95% CI, 3.56–302.59]; P=0.002); patients with elevated baseline hs‐TNT (>14 ng/L) showed significantly increased LE (median: baseline, 1.9 [1.1–3.3] %; follow‐up, 3.2 [2.3–4.9] %; P<0.001) and slightly elevated hs‐TNT (baseline, 44.7 [30.1–65.3] ng/L; follow‐up, 49.1 [27.6–69.5] ng/L; P=0.116) during follow‐up. Left ventricular wall thickness and EF of patients with elevated hs‐TNT were decreased during follow‐up, indicating potential cardiomyopathy progression. Conclusionshs‐TNT is an accurate, easily accessible clinical blood biomarker for detecting replacement fibrosis in patients with Fabry disease and a qualified predictor of cardiomyopathy progression. Thus, hs‐TNT could be helpful for staging and follow‐up of Fabry patients.

【 授权许可】

Unknown