Document Detail


Frequency and cause of cardiac troponin T elevation in chronic hemodialysis patients from study of cardiovascular magnetic resonance.
MedLine Citation:
PMID:  17719339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-07-02
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Sep 
Date Detail:
Created Date:  2007-08-27     Completed Date:  2007-10-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  885-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. cdefilip@medicine.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
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:
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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