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高血压患者与非高血压患者血清心肌肌钙蛋白浓度与亚临床心血管功能障碍选定参数之间的相关性:真实世界数据的回顾性横断面分析

Correlation Between Cardiac Troponin Serum Concentration and Selected Parameters of Subclinical Cardiovascular Dysfunction in Patients With and Without Arterial Hypertension: Retrospective Cross-Sectional Analysis of Real-World Data.

作者信息

Jakubiak Grzegorz K, Starzak Monika, Pawlas Natalia, Chwalba Artur, Stanek Agata, Cieślar Grzegorz

机构信息

Department of Pharmacology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Jordana 38 St., 41-808 Zabrze, Poland.

Department of Internal Medicine, Angiology and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.

出版信息

J Clin Med. 2025 Aug 23;14(17):5961. doi: 10.3390/jcm14175961.

Abstract

: High-sensitivity cardiac troponin T serum concentration (hs-cTnT) measurement is a well-established tool in the diagnosis of acute cardiovascular (CV) disease. It remains unclear whether resting hs-cTnT could be useful for screening the status of the CV system. The purpose of this study was to compare the correlation between hs-cTnT, determined in patients without clinical symptoms of acute illness, and selected parameters of subclinical CV dysfunction in relation to the coexistence of arterial hypertension (AH). : In total, 101 patients were included in the analysis. The following methods were used to assess the CV system: transthoracic echocardiography, Doppler ultrasonography of the carotid and lower extremity arteries with intima-media thickness (IMT) measurement, pulse wave velocity (PWV), central blood pressure measurement, ankle-brachial index (ABI), and toe-brachial index (TBI). : In patients with AH, significant correlations were found between hs-cTnT and maximal velocity of tricuspid regurgitation ( = 0.397; = 0.003), left atrium volume index (LAVI) ( = 0.39; = 0.002), and IMT in carotid arteries (cIMT) ( = 0.4; = 0.001), common femoral arteries (cfIMT) ( = 0.384; = 0.004), and superficial femoral arteries (sfIMT) ( = 0.352; = 0.01), as well as PWV ( = 0.63; < 0.001), central systolic blood pressure (cSBP) ( = 0.34; = 0.006), central pulse pressure (cPP) ( = 0.354; = 0.004), and ankle-brachial index (ABI) ( = -0.28; = 0.024). In multivariate analysis, the relationship between subclinical CV dysfunction and hs-cTnT remained significant for LAVI, cSBP, cPP, and ABI, as well as showing borderline significance for sfIMT. In patients without AH, only the relationship between hs-cTnT and ABI was significant. According to interaction analysis, AH significantly influenced the relationship between hs-cTnT and cSBP, cPP, and sfIMT. : Resting hs-cTnT correlates significantly with selected parameters of subclinical CV dysfunction in patients with AH. This relationship is clearly weaker in patients without AH. Further research is needed, especially prospective studies on a larger group of patients.

摘要

高敏心肌肌钙蛋白T血清浓度(hs-cTnT)测定是诊断急性心血管(CV)疾病的一项成熟工具。静息hs-cTnT是否有助于筛查心血管系统状况仍不明确。本研究的目的是比较在无急性疾病临床症状的患者中测定的hs-cTnT与亚临床CV功能障碍的选定参数之间的相关性,并探讨与动脉高血压(AH)并存的关系。

总共101例患者纳入分析。采用以下方法评估心血管系统:经胸超声心动图、颈动脉和下肢动脉多普勒超声检查并测量内膜中层厚度(IMT)、脉搏波速度(PWV)、中心血压测量、踝臂指数(ABI)和趾臂指数(TBI)。

在患有AH的患者中,发现hs-cTnT与三尖瓣反流最大速度(r = 0.397;P = 0.003)、左心房容积指数(LAVI)(r = 0.39;P = 0.002)以及颈动脉内膜中层厚度(cIMT)(r = 0.4;P = 0.001)、股总动脉内膜中层厚度(cfIMT)(r = 0.384;P = 0.004)和股浅动脉内膜中层厚度(sfIMT)(r = 0.352;P = 0.01)以及PWV(r = 0.63;P < 0.001)、中心收缩压(cSBP)(r = 0.34;P = 0.006)、中心脉压(cPP)(r = 0.354;P = 0.004)和踝臂指数(ABI)(r = -0.28;P = 0.024)之间存在显著相关性。在多变量分析中,亚临床CV功能障碍与hs-cTnT之间的关系对于LAVI、cSBP、cPP和ABI仍然显著,对于sfIMT显示出临界显著性。在无AH的患者中,只有hs-cTnT与ABI之间的关系显著。根据交互分析,AH显著影响hs-cTnT与cSBP、cPP和sfIMT之间的关系。

静息hs-cTnT与患有AH患者的亚临床CV功能障碍的选定参数显著相关。在无AH的患者中这种关系明显较弱。需要进一步研究,尤其是对更大患者群体的前瞻性研究。

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