Contreras Alejandro E, Peirone Alejandro R, Juaneda Ernesto, Defagó Víctor, Cuestas Eduardo
Servicio de Cardiología Pediátrica y Cardiopatías Congénitas del Niño y Adulto, Hospital Privado Universitario de Córdoba, Facultad de Medicina, Instituto Universitario de Ciencias Biomédicas de Córdoba, Argentina.
Servicio de Pediatría, Hospital Privado Universitario de Córdoba. Córdoba, Argentina.
Arch Cardiol Mex. 2025 Mar 11;95(2):207-14. doi: 10.24875/ACM.24000076.
The aim was to determine the relationship between the elevation of ultrasensitive troponin T (hs-cTnT) after percutaneous atrial septal defect (ASD) closure with deficient aortic rim and with standard and specific maneuvers of the intervention.
Baseline hs-cTnT was measured and repeated 6 hours after the procedure. To determine the influence of independent variables with the dependent variable (change in hs-cTnT), a generalized linear mixed model was used.
The total cohort consisted in 106 patients. The median age was 8 years, and 22 patients (21%) were older than 18 years. The hs-TnT before the procedure was 3.7 pg/ml and 6 hours after the intervention was finalized was 72.5 pg/ml. The hs-TnT at 6 hours was similar in patients with sufficient vs. deficient aortic rim. A generalized linear mixed model demonstrated a direct relationship between hs-cTnT change and ASD diameter (β: 2.8; CI: 0.8 to 4.9; p < 0.01) and fluoroscopy time (β: 2.7; CI: 0.6 to 4.7; p < 0.01) and an inverse relationship between hs-cTnT change and patient weight (β: -0.7; CI: -1.1 to -0.3; p < 0.01).
The increase in hs-cTnT after percutaneous ASD treatment was directly related to ASD diameter and the fluoroscopy time and inversely to the patient weight. Aortic rim deficit was not associated with elevation of hs-cTnT.
本研究旨在确定经皮房间隔缺损(ASD)封堵术后主动脉边缘不足时超敏肌钙蛋白T(hs-cTnT)升高与干预的标准及特定操作之间的关系。
测量基线hs-cTnT,并在术后6小时重复测量。为确定自变量与因变量(hs-cTnT变化)之间的影响,使用了广义线性混合模型。
总共有106例患者纳入研究。中位年龄为8岁,22例患者(21%)年龄大于18岁。术前hs-TnT为3.7 pg/ml,干预结束后6小时为72.5 pg/ml。主动脉边缘充足与不足的患者在6小时时的hs-TnT相似。广义线性混合模型显示hs-cTnT变化与ASD直径(β:2.8;CI:0.8至4.9;p<0.01)、透视时间(β:2.7;CI:0.6至4.7;p<0.01)呈直接关系,与患者体重呈反比关系(β:-0.7;CI:-1.1至-0.3;p<0.01)。
经皮ASD治疗后hs-cTnT升高与ASD直径和透视时间直接相关,与患者体重呈反比。主动脉边缘不足与hs-cTnT升高无关。