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肥厚型心肌病中心脏肌钙蛋白 T 高敏升高的患病率及其决定因素。

Prevalence and determinants of elevated high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy.

机构信息

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Cardiol. 2014 Feb;63(2):140-4. doi: 10.1016/j.jjcc.2013.07.008. Epub 2013 Sep 4.

Abstract

BACKGROUND

This study was designed to evaluate the prevalence and determinants of increased high-sensitivity cardiac troponin T (hs-cTnT) as a marker of cardiac injury in patients with hypertrophic cardiomyopathy (HCM).

METHODS

A total of 98 consecutive patients with HCM (71.4% males; mean age 51.18 ± 15.47 years) between 2012 and 2013 were evaluated by measuring the level of serum hs-cTnT along with other clinical assessments.

RESULTS

There were 42 (42.9%) patients with a minimum serum hs-cTnT level of 14 ng/L. The mean hs-cTnT level was 12.37 ng/L (6.94-24.26 ng/L). There were significant differences in chest pain New York Heart Association functional class, left ventricular hypertrophy in the surface electrocardiogram, non-sustained ventricular tachycardia in 24-h electrocardiogram-Holter monitoring, left atrial (LA) area index, ratio of peak early (E) transmitral filling velocity to peak early diastolic annular velocity (Ea septal) at the level of the septal mitral annulus (E/Ea septal), maximum left ventricular (LV) wall thickness ≥ 30 mm, and peak LV outflow gradient ≥ 30 mmHg in echocardiography between the patients with hs-cTnT<14 ng/L and those with hs-cTnT ≥ 14 ng/L. However, after multivariate analysis, age, maximum LV wall thickness, LA area index, and E/Ea septal remained as the independent determinants of elevated hs-cTnT in HCM.

CONCLUSIONS

The results demonstrated that hs-cTnT was elevated in a significant number of our HCM patients; therefore, hs-cTnT can be introduced as a valuable marker of myocardial injury in HCM patients.

摘要

背景

本研究旨在评估作为心肌损伤标志物的高敏心肌肌钙蛋白 T(hs-cTnT)升高在肥厚型心肌病(HCM)患者中的患病率和决定因素。

方法

2012 年至 2013 年期间,评估了 98 例连续 HCM 患者(71.4%为男性;平均年龄 51.18±15.47 岁),并通过测量血清 hs-cTnT 水平及其他临床评估。

结果

42 例(42.9%)患者的血清 hs-cTnT 最低水平为 14ng/L。hs-cTnT 平均水平为 12.37ng/L(6.94-24.26ng/L)。胸痛纽约心脏协会功能分级、体表心电图左室肥厚、24 小时心电图-动态心电图监测非持续性室性心动过速、左心房(LA)面积指数、二尖瓣瓣环间隔部 E 峰与早期舒张期瓣环速度比(Ea 间隔)、最大左心室(LV)壁厚度≥30mm、超声心动图中 LV 流出道最大压差≥30mmHg 等方面,hs-cTnT<14ng/L 组与 hs-cTnT≥14ng/L 组之间存在显著差异。然而,多变量分析后,年龄、最大 LV 壁厚度、LA 面积指数和 Ea 间隔仍为 HCM 患者 hs-cTnT 升高的独立决定因素。

结论

研究结果表明,我们的 HCM 患者中有相当数量的 hs-cTnT 升高;因此,hs-cTnT 可作为 HCM 患者心肌损伤的有价值标志物。

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