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血清肌钙蛋白 I 与肥厚型心肌病患者的左心室壁厚度增加、左心室功能障碍和男性性别有关。

Serum cardiac troponin I is related to increased left ventricular wall thickness, left ventricular dysfunction, and male gender in hypertrophic cardiomyopathy.

机构信息

Department of Medicine and Geriatrics, Kochi Medical School, Kochi, Japan.

出版信息

Clin Cardiol. 2010 Feb;33(2):E1-7. doi: 10.1002/clc.20622.

Abstract

BACKGROUND

Serum cardiac troponin I (cTnI) is a sensitive and specific marker of myocardial injury. However, a systematic evaluation of cTnI in hypertrophic cardiomyopathy (HCM) patients has not been performed.

HYPOTHESIS

The purpose of this study is to evaluate cTnI and determine its relationship to clinical features in HCM.

METHODS

We studied serum cTnI in 162 consecutive HCM patients.

RESULTS

Serum cTnI ranged from 0.01 to 0.83 ng/mL (mean, 0.068 +/- 0.100 ng/mL) and was higher in male patients (P < .001), those with atrial fibrillation (P = .033), and left ventricular (LV) systolic dysfunction (P = .046). Serum cTnI values were also correlated with maximum LV wall thickness (r = 0.30, P < .001), LV end-systolic diameter (r = 0.20, P = .012), and E/Ea (peak early transmitral filling velocity/early diastolic mitral annulus velocity; r = 0.24, P = .004). Serum cTnI levels were not significantly different among New York Heart Association (NYHA) functional class and there was no difference between patients with or without LV outflow tract obstruction; although B-type natriuretic peptide (BNP) levels showed significant difference in those variables. Serum cTnI had very weak correlation with BNP values (r = 0.18, P = .023). Multivariate analysis revealed an independent relationship between cTnI and maximum LV wall thickness, E/Ea, and male gender.

CONCLUSIONS

In patients with HCM, serum cTnI was associated with important clinical indices such as maximum LV wall thickness, LV dysfunction, and male gender. Serum cTnI seemed to have clinical significance different from that of BNP and may not be reflecting cardiac load but the LV remodeling process in HCM.

摘要

背景

血清心肌肌钙蛋白 I(cTnI)是心肌损伤的敏感和特异标志物。然而,尚未对肥厚型心肌病(HCM)患者的 cTnI 进行系统评估。

假设

本研究旨在评估 cTnI 并确定其与 HCM 患者临床特征的关系。

方法

我们研究了 162 例连续 HCM 患者的血清 cTnI。

结果

血清 cTnI 范围为 0.01 至 0.83ng/mL(平均值 0.068±0.100ng/mL),男性患者(P<0.001)、心房颤动(P=0.033)和左心室(LV)收缩功能障碍(P=0.046)患者的 cTnI 更高。血清 cTnI 值与最大 LV 壁厚度(r=0.30,P<0.001)、LV 收缩末期直径(r=0.20,P=0.012)和 E/Ea(峰值早期二尖瓣口充盈速度/早期舒张期二尖瓣环速度;r=0.24,P=0.004)呈正相关。cTnI 水平在纽约心脏协会(NYHA)功能分级之间无显著差异,且在有无 LV 流出道梗阻的患者之间也无差异;尽管 B 型利钠肽(BNP)水平在这些变量中存在显著差异。血清 cTnI 与 BNP 值的相关性非常弱(r=0.18,P=0.023)。多变量分析显示,cTnI 与最大 LV 壁厚度、E/Ea 和男性性别独立相关。

结论

在 HCM 患者中,血清 cTnI 与重要的临床指标如最大 LV 壁厚度、LV 功能障碍和男性性别相关。血清 cTnI 似乎具有与 BNP 不同的临床意义,可能不反映心脏负荷,而是反映 HCM 中的 LV 重塑过程。

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