Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan.
Eur J Heart Fail. 2009 Jul;11(7):653-8. doi: 10.1093/eurjhf/hfp072. Epub 2009 Jun 5.
Both serum cardiac troponin T (cTnT) and renal function are prognostic predictors in patients with chronic heart failure (CHF). We aimed to evaluate the relationship between renal function and serum cTnT.
We measured serum concentrations of cTnT in the aortic root (AO) and coronary sinus (CS) in 258 CHF patients. Patients were divided into two groups: patients with an estimated glomerular filtration rate (eGFR) >or= 60 mL/min/1.73 m(2) [chronic kidney disease (CKD)(-)], and patients with an eGFR < 60 mL/min/1.73 m(2) [CKD (+)]. In 32 (12%) of the 258 CHF patients, serum levels of cTnT were detectable (>or=0.03 ng/mL) in the AO and in the CS. There was no correlation between eGFR and the transcardiac increase in cTnT and there was a significant negative correlation between eGFR and the serum cTnT concentration (r = - 0.365, P = 0.039). There was no difference in the transcardiac gradient of cTnT between patients without CKD (n = 16) and patients with CKD (n = 16) (0.083 +/- 0.11 vs. 0.108 +/- 0.13 ng/mL, P = 0.55). However, the serum cTnT level in the AO was two-fold higher in CHF patients with CKD than patients without CKD (0.20 +/- 0.177 vs. 0.088 +/- 0.065 ng/mL, P < 0.05).
These findings indicate that decreased clearance via the kidney contributes to the elevated cTnT in CHF patients with CKD.
血清心肌肌钙蛋白 T（cTnT）和肾功能都是慢性心力衰竭（CHF）患者的预后预测指标。本研究旨在评估肾功能与血清 cTnT 之间的关系。
我们在 258 例 CHF 患者中测量了主动脉根部（AO）和冠状窦（CS）的血清 cTnT 浓度。患者分为两组：肾小球滤过率（eGFR）≥60 mL/min/1.73 m²[慢性肾脏病（CKD）（-）]和 eGFR<60 mL/min/1.73 m²[CKD（+）]。在 258 例 CHF 患者中，有 32 例（12%）的 AO 和 CS 中可检测到血清 cTnT 水平（≥0.03 ng/mL）。eGFR 与跨心 cTnT 增加之间无相关性，eGFR 与血清 cTnT 浓度呈显著负相关（r = -0.365，P = 0.039）。无 CKD 患者（n = 16）和 CKD 患者（n = 16）之间的 cTnT 跨心梯度无差异（0.083 ± 0.11 对 0.108 ± 0.13 ng/mL，P = 0.55）。然而，CKD 的 CHF 患者的 AO 中的血清 cTnT 水平是无 CKD 患者的两倍（0.20 ± 0.177 对 0.088 ± 0.065 ng/mL，P<0.05）。
这些发现表明，肾脏清除能力下降导致 CKD 的 CHF 患者 cTnT 升高。
