| Frequency and cause of cardiac troponin T elevation in chronic hemodialysis patients from study of cardiovascular magnetic resonance. | |
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MedLine Citation:
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PMID: 17719339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 +/- 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level </=0.03 ng/ml (median 0.02, interquartile range 0.00 to 0.02, n = 13) and high-risk troponin T level >/=0.07 ng/ml (median 0.15, interquartile range 0.09 to 0.19, n = 13). All underwent CMR imaging for LV mass and for MI by late gadolinium enhancement. Between high- and low-risk patients using hemodialysis, there were no differences in age, gender, ethnicity, or diabetes mellitus. Of the high-risk patients, 3 (23%, 95% confidence interval [CI] 5 to 54) had MI by late gadolinium enhancement versus 0 (0%, 95% CI 0 to 25) low-risk patients (p = 0.22). A diffuse, midwall late gadolinium enhancement pattern was seen in 1 high-risk patient (8%) versus 0 low-risk patient (0%, 95% CI 0 to 25, p = 0.97). Height-adjusted LV mass and LV hypertrophy were not significantly different between high-risk (62 +/- 26 g/m(2.7), LV hypertrophy, n = 7, 54%) and low-risk (54 +/- 20 g/m(2.7), LV hypertrophy, n = 5, 39%) patients (p = 0.37 for LV mass, p = 0.69 for LV hypertrophy). In conclusion, MI detected by CMR is present in few patients on hemodialysis with high troponin T levels and absent in the setting of very low troponin T levels, suggesting that additional myocardial pathologies cause increased troponin T in patients using hemodialysis. |
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Authors:
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Christopher R deFilippi; Eric M Thorn; Monica Aggarwal; Abel Joy; Robert H Christenson; Show-Hong Duh; Jean Jeudy; Garth Beache |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2007-07-02 |
Journal Detail:
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Title: The American journal of cardiology Volume: 100 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-08-27 Completed Date: 2007-10-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 885-9 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. cdefilip@medicine.umaryland.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Contrast Media Cross-Sectional Studies Echocardiography Female Gadolinium / diagnostic use Heart Ventricles / pathology Humans Hypertrophy, Left Ventricular / blood, diagnosis Image Processing, Computer-Assisted Magnetic Resonance Imaging* Male Middle Aged Myocardial Infarction / blood, diagnosis* Myocardium / pathology* Renal Dialysis* Risk Factors Stroke Volume / physiology Troponin T / blood* |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Troponin T; 7440-54-2/Gadolinium |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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