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接受心脏冠状动脉计算机断层扫描的个体中心腔容积与肌钙蛋白水平之间的关联。

An association between volumes of the cardiac chambers and troponin levels in individuals submitted to cardiac coronary computed tomography.

作者信息

Rozenbaum Zach, Arbel Yaron, Granot Yoav, Cohen Dotan, Shmilovich Haim, Ziv-Baran Tomer, Chorin Ehud, Havakuk Ofer, Cohen Merav, Berliner Shlomo, Topilsky Yan, Aviram Galit

机构信息

Department of Cardiology, Tel Aviv Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

Department of Internal Medicine, Tel Aviv Medical Center, Tel Aviv, Affiliated to the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Clin Cardiol. 2017 Oct;40(10):879-885. doi: 10.1002/clc.22739. Epub 2017 Jun 14.

Abstract

BACKGROUND

Previous echocardiographic studies have revealed an association between enlarged cardiac chamber volumes and elevated troponin concentrations. An automatic 4-chamber volumetric analysis tool was adopted to investigate this association in patients who underwent cardiac-gated computed tomography angiography (CCTA).

HYPOTHESIS

We hypothesized that troponin concentration within the normal range correlates with cardiac chambers' volumes.

METHODS

Serum troponin was obtained from 157 ambulatory patients before undergoing CCTA for nonacute coronary artery evaluation. Volumes of the cardiac chambers and the left ventricular mass were automatically analyzed and indexed to body surface area. Patients with a troponin concentrations within the upper quartile (>0.007 ng/mL, n = 39) were compared to patients with a troponin concentrations within the 3 lower quartiles of troponin concentrations (≤0.007 ng/mL, n = 118).

RESULTS

None of the patients had a troponin concentration >0.05 ng/mL (the 99th percentile of the general population). There were no significant differences in baseline characteristics between the groups. There were significant correlations between troponin and ventricular volumes after adjustments for age and gender. In an analysis that included 107 patients without any known heart diseases, including those pathological findings in the current CCTA, there were significant correlations between troponin and the left and right ventricular volumes after adjustments for age, gender, and baseline characteristics (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.03-1.14, P = 0.002 and OR: 1.11, 95% CI: 1.04-1.19, P = 0.002; respectively).

CONCLUSIONS

Using the technology of automatic volumetric analysis in individuals undergoing CCTA, an association between larger right and left cardiac chambers and higher levels of troponin concentration was shown.

摘要

背景

既往超声心动图研究显示心腔容积增大与肌钙蛋白浓度升高之间存在关联。本研究采用自动四腔容积分析工具,对接受心脏门控计算机断层扫描血管造影(CCTA)的患者进行该关联的研究。

假设

我们假设正常范围内的肌钙蛋白浓度与心腔容积相关。

方法

在157例非急性冠状动脉评估的门诊患者接受CCTA之前采集血清肌钙蛋白。对心腔容积和左心室质量进行自动分析,并根据体表面积进行指数化。将肌钙蛋白浓度处于上四分位数(>0.007 ng/mL,n = 39)的患者与肌钙蛋白浓度处于较低三个四分位数(≤0.007 ng/mL,n = 118)的患者进行比较。

结果

所有患者的肌钙蛋白浓度均未超过0.05 ng/mL(一般人群的第99百分位数)。两组患者的基线特征无显著差异。在对年龄和性别进行校正后,肌钙蛋白与心室容积之间存在显著相关性。在一项纳入107例无任何已知心脏病患者(包括本次CCTA中的病理发现)的分析中,在对年龄、性别和基线特征进行校正后,肌钙蛋白与左、右心室容积之间存在显著相关性(优势比[OR]:1.08,95%置信区间[CI]:1.03 - 1.14,P = 0.002;OR:1.11,95% CI:1.04 - 1.19,P = 0.002)。

结论

在接受CCTA的个体中使用自动容积分析技术,显示出较大的左右心腔与较高水平的肌钙蛋白浓度之间存在关联。

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