Association of cardiac troponin T with left ventricular structure and function in CKD
Rakesh K Mishra, Yongmei Li, Christopher DeFilippi, Michael J Fischer, Wei Yang, Martin Keane, Jing Chen, Jiang He, Radhakrishna Kallem, Edward J Horwitz, Mohammad Rafey, Dominic S Raj, Alan S Go, Michael G Shlipak, CRIC Study Investigators, Harold I Feldman, J Richard Landis, Amanda Hyre Anderson, Shawn Ballard, Boyang Chai, Laura M Dember, Jennifer Dickson, Marie Durborow, Chuck Girard, Melanie Glenn, Elizabeth S Helker, Peter A Kanetsky, Scott Kasner, Stephen E Kimmel, Carissa Mazurick, Steven R Messe, Lisa Nessel, Qiang Pan, Nancy Robinson, Jason Roy, Kaixiang Kelvin Tao, Valerie L Teal, Krista Whitehead, Dawei Xie, Wei Peter Yang, Xiaoming Zhang, Raymond R Townsend, Debbie Cohen, Magdalena M Cuevas, Mark J Duckworth, Virginia Ford, Yonghong Huan, Radhakrishna R Kallem, Juliet Leshner, Stephanie McDowell, Emile R Mohler 3rd, Wanda M Seamon, Angie Sheridan, Jillian Strelsin, Karen Teff, Lawrence J Appel, Cheryl Anderson, Teresa Chan, Alexander Chang, Jeanne Charleston, Tara Harrison, Bernard Jaar, Carla Martin, Edgar Pete Miller, Patience Ngoh, Steve Sozio, Sharon Turban, Jeffrey Fink, Clarissa Diamantidis, Wanda Fink, Lisa Lucas, Tiffany Page, Afshin Parsa, Beth Scism, Stephen Seliger, Matthew Weir, Mahboob Rahman, Mirela A Dobre, Kathryn Clark, Valori Corrigan, Genya Kisin, Radhika Kanthety, Louise Strauss, Jackson T Wright Jr, Jeffrey Schelling, Edward J Horwitz, Lori Guillon, Alicia O'Brien, Noreen O'Malley, Suma Prakash, John R Sedor, Mary Ann Shella, Anne Slaven, Jacqueline Theurer, J Daryl Thornton, Sankar D Navaneethan, Martin J Schreiber, Jon Taliercio, Martha Coleman, Kim Hopkins, Lara Danziger-Isakov, Teresa Markle, Melanie Ramos, Annette Russo, Stephanie Slattery, Kay Stelmach, Velma Stephens, Akinlolu Ojo, Baskaran Sundaram, Jeff Briesmiester, Denise Cornish-Zirker, Nancy Hill, Kenneth Jamerson, Rajiv Saran, Bonnie Welliver, Jillian Wilson, Eric Young, Julie Wright, Susan P Steigerwalt, Keith Bellovich, Jennifer DeLuca, Gail Makos, Kathleen Walls, John M Flack, James Sondheimer, Jennifer Mahn, Mary Maysura, Stephen Migdal, M Jena Mohanty, Carol Muzyk, Yanni Zhuang, James P Lash, Carolyn Brecklin, Eunice Carmona, Janet Cohan, Michael Fischer, Anne Frydrych, Amada Lopez, Claudia Lora, Monica Martinez, Alejandro Mercado, Brenda Moreno, Patricia Meslar, Ana Ricardo, Jiang He, Brent Alper, Vecihi Batuman, Lydia A Bazzano, Bernadette Borja, Jing Chen, Catherine Cooke, Patrice Delafontaine, Karen B DeSalvo, Jacquelyn Dolan, Lee Hamm, Eva Lustigova, Erin Mahone, Lanie Sansing, Claire Starcke, Alan S Go, Arthur Choi, Pete Dorin, Nancy G Jensvold, Joan C Lo, Liliana Metzger, Elisa Frances Nasol, Juan D Ordonez, Rachel Perloff, Nina Sasso, Daphne Thompson, Jingrong Yang, Chi-yuan Hsu, Glenn M Chertow, John W Kusek, Andrew S Narva, Linda Fried, David T Gilbertson, William McClellan, Peter A McCullough, David Nathan, Ann M O'Hare, Paul M Palevsky, Stephen S Rich, John B Stokes, Gina S Wei, Peter W Wilson, Megan Donovan, Steve Master, Ted Mifflin, Linda Morrell, Phillip Hall, Henry Rolin, Sue Saunders, Mathew Budoff, Chris Dailing, Elsayed Z Soliman, Zhu-Ming Zhang, Martin St John Sutton, Martin G Keane, Rakesh K Mishra, Yongmei Li, Christopher DeFilippi, Michael J Fischer, Wei Yang, Martin Keane, Jing Chen, Jiang He, Radhakrishna Kallem, Edward J Horwitz, Mohammad Rafey, Dominic S Raj, Alan S Go, Michael G Shlipak, CRIC Study Investigators, Harold I Feldman, J Richard Landis, Amanda Hyre Anderson, Shawn Ballard, Boyang Chai, Laura M Dember, Jennifer Dickson, Marie Durborow, Chuck Girard, Melanie Glenn, Elizabeth S Helker, Peter A Kanetsky, Scott Kasner, Stephen E Kimmel, Carissa Mazurick, Steven R Messe, Lisa Nessel, Qiang Pan, Nancy Robinson, Jason Roy, Kaixiang Kelvin Tao, Valerie L Teal, Krista Whitehead, Dawei Xie, Wei Peter Yang, Xiaoming Zhang, Raymond R Townsend, Debbie Cohen, Magdalena M Cuevas, Mark J Duckworth, Virginia Ford, Yonghong Huan, Radhakrishna R Kallem, Juliet Leshner, Stephanie McDowell, Emile R Mohler 3rd, Wanda M Seamon, Angie Sheridan, Jillian Strelsin, Karen Teff, Lawrence J Appel, Cheryl Anderson, Teresa Chan, Alexander Chang, Jeanne Charleston, Tara Harrison, Bernard Jaar, Carla Martin, Edgar Pete Miller, Patience Ngoh, Steve Sozio, Sharon Turban, Jeffrey Fink, Clarissa Diamantidis, Wanda Fink, Lisa Lucas, Tiffany Page, Afshin Parsa, Beth Scism, Stephen Seliger, Matthew Weir, Mahboob Rahman, Mirela A Dobre, Kathryn Clark, Valori Corrigan, Genya Kisin, Radhika Kanthety, Louise Strauss, Jackson T Wright Jr, Jeffrey Schelling, Edward J Horwitz, Lori Guillon, Alicia O'Brien, Noreen O'Malley, Suma Prakash, John R Sedor, Mary Ann Shella, Anne Slaven, Jacqueline Theurer, J Daryl Thornton, Sankar D Navaneethan, Martin J Schreiber, Jon Taliercio, Martha Coleman, Kim Hopkins, Lara Danziger-Isakov, Teresa Markle, Melanie Ramos, Annette Russo, Stephanie Slattery, Kay Stelmach, Velma Stephens, Akinlolu Ojo, Baskaran Sundaram, Jeff Briesmiester, Denise Cornish-Zirker, Nancy Hill, Kenneth Jamerson, Rajiv Saran, Bonnie Welliver, Jillian Wilson, Eric Young, Julie Wright, Susan P Steigerwalt, Keith Bellovich, Jennifer DeLuca, Gail Makos, Kathleen Walls, John M Flack, James Sondheimer, Jennifer Mahn, Mary Maysura, Stephen Migdal, M Jena Mohanty, Carol Muzyk, Yanni Zhuang, James P Lash, Carolyn Brecklin, Eunice Carmona, Janet Cohan, Michael Fischer, Anne Frydrych, Amada Lopez, Claudia Lora, Monica Martinez, Alejandro Mercado, Brenda Moreno, Patricia Meslar, Ana Ricardo, Jiang He, Brent Alper, Vecihi Batuman, Lydia A Bazzano, Bernadette Borja, Jing Chen, Catherine Cooke, Patrice Delafontaine, Karen B DeSalvo, Jacquelyn Dolan, Lee Hamm, Eva Lustigova, Erin Mahone, Lanie Sansing, Claire Starcke, Alan S Go, Arthur Choi, Pete Dorin, Nancy G Jensvold, Joan C Lo, Liliana Metzger, Elisa Frances Nasol, Juan D Ordonez, Rachel Perloff, Nina Sasso, Daphne Thompson, Jingrong Yang, Chi-yuan Hsu, Glenn M Chertow, John W Kusek, Andrew S Narva, Linda Fried, David T Gilbertson, William McClellan, Peter A McCullough, David Nathan, Ann M O'Hare, Paul M Palevsky, Stephen S Rich, John B Stokes, Gina S Wei, Peter W Wilson, Megan Donovan, Steve Master, Ted Mifflin, Linda Morrell, Phillip Hall, Henry Rolin, Sue Saunders, Mathew Budoff, Chris Dailing, Elsayed Z Soliman, Zhu-Ming Zhang, Martin St John Sutton, Martin G Keane
Abstract
Background: Serum cardiac troponin T (cTnT) is associated with increased risk of heart failure and cardiovascular death in several population settings. We evaluated associations of cTnT levels with cardiac structural and functional abnormalities in a cohort of patients with chronic kidney disease (CKD) without heart failure.
Study design: Cross-sectional.
Setting & participants: Chronic Renal Insufficiency Cohort (CRIC; N=3,243).
Predictor: The primary predictor was cTnT level. Secondary predictors included demographic and clinical characteristics, hemoglobin level, high-sensitivity C-reactive protein level, and estimated glomerular filtration rate using cystatin C.
Outcomes: Echocardiography was used to determine left ventricular (LV) mass and LV systolic and diastolic function.
Measurements: Circulating cTnT was measured in stored sera using the highly sensitive assay. Logistic and linear regression models were used to examine associations of cTnT level with each echocardiographic outcome.
Results: cTnT was detectable in 2,735 (84%) persons; median level was 13.3 (IQR, 7.7-23.8) pg/mL. Compared with undetectable cTnT (<3.0 pg/mL), the highest quartile (23.9-738.7 pg/mL) was approximately 2 times as likely to have LV hypertrophy (OR, 2.43; 95% CI, 1.44-4.09) in the fully adjusted model. cTnT level had a more modest association with LV systolic dysfunction; as a log-linear variable, a significant association was present in the fully adjusted model (OR of 1.4 [95% CI, 1.2-1.7] per 1-log unit; P < 0.001). There was no significant independent association between cTnT level and LV diastolic dysfunction. When evaluated as a screening test, cTnT level functioned only modestly for LV hypertrophy and concentric hypertrophy detection (area under the curve, 0.64 for both), with weaker areas under the curve for the other outcomes.
Limitations: The presence of coronary artery disease was not formally assessed using either noninvasive or angiographic techniques in this study.
Conclusions: In this large CKD cohort without heart failure, detectable cTnT had a strong association with LV hypertrophy, a more modest association with LV systolic dysfunction, and no association with diastolic dysfunction. These findings indicate that circulating cTnT levels in patients with CKD are predominantly an indicator of pathologic LV hypertrophy.
Published by Elsevier Inc.
Source: PubMed