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非致密化型心肌病中肌钙蛋白T阳性与神经肌肉疾病及不良预后相关。

Positive troponin-T in noncompaction is associated with neuromuscular disorders and poor outcome.

作者信息

Finsterer J, Stöllberger C, Krugluger W

机构信息

Krankenanstalt Rudolfstiftung, Vienna, Austria.

出版信息

Clin Res Cardiol. 2007 Feb;96(2):109-13. doi: 10.1007/s00392-006-0467-7. Epub 2006 Dec 8.

Abstract

OBJECTIVES

Though cardiac troponin-T may be positive in hypertrophic and dilated cardiomyopathy, it is not known how often troponin-T is positive in left ventricular hypertrabeculation/ noncompaction (LVHT), an unclassified cardiomyopathy. This retrospective study aimed to assess how often troponin-T is positive in LVHT, is associated with elevated CK, is attributable to cardiac or extra-cardiac causes, in particular neuromuscular disorders (NMDs), or if it is a predictor of poor survival.

RESULTS

Among 100 patients, detected over a period of 11 years, troponin-T was determined at least once in 71 (71%) of them. Troponin-T was determined once in 36 patients, twice in 8 cases, three times in 11 patients, and more than three times in 16 cases. Troponin- T was positive at least once in 12 patients (17%). Forty-five of the 71 patients suffered from a NMD (63%). Troponin-T positivity was associated with elevated CK in 6 cases. Troponin-T-positivity was attributable to acute myocardial ischemia in a single case, to chronic renal failure in 5 cases, to dilated cardiomyopathy in 4 cases, to atrial fibrillation in 3 cases, to heart failure in 4 cases, and to NMD in 10 cases. Troponin-T positivity in LVHT patients with NMD was assumed to be due to cardiac involvement in the disease. Among the 22 patients who died during the observational period troponin was determined in 16 and was positive in 4 (25%).

CONCLUSIONS

Troponin-T is positive in 17% of the patients with LVHT. Most of these patients suffer from a NMD. Troponin-T positivity in LVHT predicts the presence of NMD and poor survival.

摘要

目的

尽管心肌肌钙蛋白T在肥厚型和扩张型心肌病中可能呈阳性,但在左心室致密化不全(LVHT)这一未分类的心肌病中,肌钙蛋白T呈阳性的频率尚不清楚。本回顾性研究旨在评估LVHT患者中肌钙蛋白T呈阳性的频率、与肌酸激酶(CK)升高的相关性、是由心脏还是心脏外原因(特别是神经肌肉疾病[NMDs])所致,或者它是否是生存不良的预测指标。

结果

在11年期间检测的100例患者中,71例(71%)至少检测了一次肌钙蛋白T。36例患者检测了一次肌钙蛋白T,8例检测了两次,11例检测了三次,16例检测了三次以上。12例患者(17%)肌钙蛋白T至少有一次呈阳性。71例患者中有45例患有NMD(63%)。6例患者肌钙蛋白T阳性与CK升高相关。肌钙蛋白T阳性的原因,1例为急性心肌缺血,5例为慢性肾衰竭,4例为扩张型心肌病,3例为心房颤动,4例为心力衰竭,10例为NMD。LVHT合并NMD患者的肌钙蛋白T阳性被认为是由于疾病累及心脏。在观察期内死亡的22例患者中,16例检测了肌钙蛋白,4例呈阳性(25%)。

结论

LVHT患者中17%的肌钙蛋白T呈阳性。这些患者大多患有NMD。LVHT患者肌钙蛋白T阳性预示着NMD的存在和生存不良。

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