Association Between High‐Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW‐CKD Cohort Study

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Soo Wan Kim¹  Su Ah Sung²  Kyu‐Beck Lee³  Dong‐Wan Chae⁴  Hyunjin Ryu⁵  Curie Ahn⁵  Eunjeong Kang⁵  Kook‐Hwan Oh⁵  Joongyub Lee⁶  Jayoun Kim⁷ 

[1] Department of Internal Medicine Chonnam National University Medical School Gwangju South Korea;Department of Internal Medicine Nowon Eulji Medical Center Eulji University Seoul South Korea;Department of Internal Medicine School of Medicine Kangbuk Samsung Hospital Sungkyunkwan University Seoul South Korea;Department of Internal Medicine Seoul National University Bundang Hospital Seoul National University College of Medicine Seongnam South Korea;Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea;Department of Prevention and Management Inha University Hospital Incheon Korea;Medical Research Collaborating Center Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea;

关键词: chronic kidney disease;    diastolic dysfunction;    left ventricular hypertrophy;    troponin T;   

DOI  :  10.1161/JAHA.119.013357

来源: DOAJ

【 摘 要 】

Background It is unclear whether high‐sensitivity troponin T (hs‐TnT) is associated with subclinical cardiac changes in chronic kidney disease (CKD). We evaluated the relationship between hs‐TnT and left ventricular structure and function in a CKD population, according to estimated glomerular filtration rate. Methods and Results We analyzed 2017 patients with CKD stages 1 to 5 (predialysis) in the KNOW‐CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) cohort. The predictor was hs‐TnT level measured at baseline, and the outcomes were left ventricular hypertrophy (LVH) and systolic and diastolic dysfunction shown by echocardiography at baseline and after 4 years. Participants were categorized into quartiles according to hs‐TnT levels. The associations between quartiles of hs‐TnT and outcomes were assessed using multivariable logistic regression analysis with confounders including demographics, medical history, and laboratory findings. A receiver operating characteristic curve was used to assess the diagnostic power of hs‐TnT for the outcomes as a continuous variable. For subgroup analysis, patients were stratified based on an estimated glomerular filtration rate of 60 mL/min per 1.73 m2. Elevated hs‐TnT was associated with LVH and diastolic dysfunction at baseline in an adjusted model but was not associated with systolic dysfunction. These associations remained significant for both estimated glomerular filtration rate subgroups. Receiver operating characteristic curve analysis showed that hs‐TnT as a continuous variable exhibited fair significance for detection of LVH (area under the curve: 0.689) and diastolic dysfunction (area under the curve: 0.744). Multivariable analysis showed that higher hs‐TnT levels at baseline were related to development of LVH but not diastolic dysfunction (n=864). Conclusions In CKD patients, hs‐TnT is strongly associated with alterations of left ventricular structure and diastolic dysfunction for both estimated glomerular filtration rate strata. Baseline hs‐TnT levels are predictive of new LVH on follow‐up.

【 授权许可】

Unknown