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Frequency and Cause of Cardiac Troponin T Elevation in Chronic Hemodialysis Patients from Study of Cardiovascular Magnetic Resonance

Cardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six... Full description

Journal Title: The American journal of cardiology 2007, Vol.100 (5), p.885-889
Main Author: deFilippi, Christopher R., MD
Other Authors: Thorn, Eric M., MD , Aggarwal, Monica, MD , Joy, Abel, MD , Christenson, Robert H., PhD , Duh, Show-Hong, PhD , Jeudy, Jean, MD , Beache, Garth, MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
NMR
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Frequency and Cause of Cardiac Troponin T Elevation in Chronic Hemodialysis Patients from Study of Cardiovascular Magnetic Resonance
format: Article
creator:
  • deFilippi, Christopher R., MD
  • Thorn, Eric M., MD
  • Aggarwal, Monica, MD
  • Joy, Abel, MD
  • Christenson, Robert H., PhD
  • Duh, Show-Hong, PhD
  • Jeudy, Jean, MD
  • Beache, Garth, MD
subjects:
  • Abridged Index Medicus
  • Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
  • Biological and medical sciences
  • Cardiac patients
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • Contrast Media
  • Cross-Sectional Studies
  • Diabetics
  • Echocardiography
  • Emergency and intensive care: renal failure. Dialysis management
  • Female
  • Gadolinium
  • Gadolinium oxide
  • Heart attack
  • Heart attacks
  • Heart Ventricles - pathology
  • Hemodialysis
  • Humans
  • Hypertrophy, Left Ventricular - blood
  • Hypertrophy, Left Ventricular - diagnosis
  • Image Processing, Computer-Assisted
  • Intensive care medicine
  • Lactate dehydrogenase
  • Magnetic Resonance Imaging
  • Male
  • Medical research
  • Medical sciences
  • Medicine, Experimental
  • Middle Aged
  • Myocardial Infarction - blood
  • Myocardial Infarction - diagnosis
  • Myocardium - pathology
  • NMR
  • Nuclear magnetic resonance
  • Renal Dialysis
  • Risk Factors
  • Stroke Volume - physiology
  • Troponin T - blood
ispartof: The American journal of cardiology, 2007, Vol.100 (5), p.885-889
description: Cardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 ± 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level ≤0.03 ng/ml (median 0.02, interquartile range 0.00 to 0.02, n = 13) and high-risk troponin T level ≥0.07 ng/ml (median 0.15, interquartile range 0.09 to 0.19, n = 13). All underwent CMR imaging for LV mass and for MI by late gadolinium enhancement. Between high- and low-risk patients using hemodialysis, there were no differences in age, gender, ethnicity, or diabetes mellitus. Of the high-risk patients, 3 (23%, 95% confidence interval [CI] 5 to 54) had MI by late gadolinium enhancement versus 0 (0%, 95% CI 0 to 25) low-risk patients (p = 0.22). A diffuse, midwall late gadolinium enhancement pattern was seen in 1 high-risk patient (8%) versus 0 low-risk patient (0%, 95% CI 0 to 25, p = 0.97). Height-adjusted LV mass and LV hypertrophy were not significantly different between high-risk (62 ± 26 g/m2.7 , LV hypertrophy, n = 7, 54%) and low-risk (54 ± 20 g/m2.7 , LV hypertrophy, n = 5, 39%) patients (p = 0.37 for LV mass, p = 0.69 for LV hypertrophy). In conclusion, MI detected by CMR is present in few patients on hemodialysis with high troponin T levels and absent in the setting of very low troponin T levels, suggesting that additional myocardial pathologies cause increased troponin T in patients using hemodialysis.
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titleFrequency and Cause of Cardiac Troponin T Elevation in Chronic Hemodialysis Patients from Study of Cardiovascular Magnetic Resonance
creatordeFilippi, Christopher R., MD ; Thorn, Eric M., MD ; Aggarwal, Monica, MD ; Joy, Abel, MD ; Christenson, Robert H., PhD ; Duh, Show-Hong, PhD ; Jeudy, Jean, MD ; Beache, Garth, MD
creatorcontribdeFilippi, Christopher R., MD ; Thorn, Eric M., MD ; Aggarwal, Monica, MD ; Joy, Abel, MD ; Christenson, Robert H., PhD ; Duh, Show-Hong, PhD ; Jeudy, Jean, MD ; Beache, Garth, MD
descriptionCardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 ± 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level ≤0.03 ng/ml (median 0.02, interquartile range 0.00 to 0.02, n = 13) and high-risk troponin T level ≥0.07 ng/ml (median 0.15, interquartile range 0.09 to 0.19, n = 13). All underwent CMR imaging for LV mass and for MI by late gadolinium enhancement. Between high- and low-risk patients using hemodialysis, there were no differences in age, gender, ethnicity, or diabetes mellitus. Of the high-risk patients, 3 (23%, 95% confidence interval [CI] 5 to 54) had MI by late gadolinium enhancement versus 0 (0%, 95% CI 0 to 25) low-risk patients (p = 0.22). A diffuse, midwall late gadolinium enhancement pattern was seen in 1 high-risk patient (8%) versus 0 low-risk patient (0%, 95% CI 0 to 25, p = 0.97). Height-adjusted LV mass and LV hypertrophy were not significantly different between high-risk (62 ± 26 g/m2.7 , LV hypertrophy, n = 7, 54%) and low-risk (54 ± 20 g/m2.7 , LV hypertrophy, n = 5, 39%) patients (p = 0.37 for LV mass, p = 0.69 for LV hypertrophy). In conclusion, MI detected by CMR is present in few patients on hemodialysis with high troponin T levels and absent in the setting of very low troponin T levels, suggesting that additional myocardial pathologies cause increased troponin T in patients using hemodialysis.
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languageeng
publisherNew York, NY: Elsevier Inc
subjectAbridged Index Medicus ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Cardiac patients ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; Contrast Media ; Cross-Sectional Studies ; Diabetics ; Echocardiography ; Emergency and intensive care: renal failure. Dialysis management ; Female ; Gadolinium ; Gadolinium oxide ; Heart attack ; Heart attacks ; Heart Ventricles - pathology ; Hemodialysis ; Humans ; Hypertrophy, Left Ventricular - blood ; Hypertrophy, Left Ventricular - diagnosis ; Image Processing, Computer-Assisted ; Intensive care medicine ; Lactate dehydrogenase ; Magnetic Resonance Imaging ; Male ; Medical research ; Medical sciences ; Medicine, Experimental ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - diagnosis ; Myocardium - pathology ; NMR ; Nuclear magnetic resonance ; Renal Dialysis ; Risk Factors ; Stroke Volume - physiology ; Troponin T - blood
ispartofThe American journal of cardiology, 2007, Vol.100 (5), p.885-889
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1Thorn, Eric M., MD
2Aggarwal, Monica, MD
3Joy, Abel, MD
4Christenson, Robert H., PhD
5Duh, Show-Hong, PhD
6Jeudy, Jean, MD
7Beache, Garth, MD
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0Frequency and Cause of Cardiac Troponin T Elevation in Chronic Hemodialysis Patients from Study of Cardiovascular Magnetic Resonance
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descriptionCardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 ± 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level ≤0.03 ng/ml (median 0.02, interquartile range 0.00 to 0.02, n = 13) and high-risk troponin T level ≥0.07 ng/ml (median 0.15, interquartile range 0.09 to 0.19, n = 13). All underwent CMR imaging for LV mass and for MI by late gadolinium enhancement. Between high- and low-risk patients using hemodialysis, there were no differences in age, gender, ethnicity, or diabetes mellitus. Of the high-risk patients, 3 (23%, 95% confidence interval [CI] 5 to 54) had MI by late gadolinium enhancement versus 0 (0%, 95% CI 0 to 25) low-risk patients (p = 0.22). A diffuse, midwall late gadolinium enhancement pattern was seen in 1 high-risk patient (8%) versus 0 low-risk patient (0%, 95% CI 0 to 25, p = 0.97). Height-adjusted LV mass and LV hypertrophy were not significantly different between high-risk (62 ± 26 g/m2.7 , LV hypertrophy, n = 7, 54%) and low-risk (54 ± 20 g/m2.7 , LV hypertrophy, n = 5, 39%) patients (p = 0.37 for LV mass, p = 0.69 for LV hypertrophy). In conclusion, MI detected by CMR is present in few patients on hemodialysis with high troponin T levels and absent in the setting of very low troponin T levels, suggesting that additional myocardial pathologies cause increased troponin T in patients using hemodialysis.
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1Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
2Biological and medical sciences
3Cardiac patients
4Cardiology
5Cardiology. Vascular system
6Cardiovascular
7Contrast Media
8Cross-Sectional Studies
9Diabetics
10Echocardiography
11Emergency and intensive care: renal failure. Dialysis management
12Female
13Gadolinium
14Gadolinium oxide
15Heart attack
16Heart attacks
17Heart Ventricles - pathology
18Hemodialysis
19Humans
20Hypertrophy, Left Ventricular - blood
21Hypertrophy, Left Ventricular - diagnosis
22Image Processing, Computer-Assisted
23Intensive care medicine
24Lactate dehydrogenase
25Magnetic Resonance Imaging
26Male
27Medical research
28Medical sciences
29Medicine, Experimental
30Middle Aged
31Myocardial Infarction - blood
32Myocardial Infarction - diagnosis
33Myocardium - pathology
34NMR
35Nuclear magnetic resonance
36Renal Dialysis
37Risk Factors
38Stroke Volume - physiology
39Troponin T - blood
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titleFrequency and Cause of Cardiac Troponin T Elevation in Chronic Hemodialysis Patients from Study of Cardiovascular Magnetic Resonance
authordeFilippi, Christopher R., MD ; Thorn, Eric M., MD ; Aggarwal, Monica, MD ; Joy, Abel, MD ; Christenson, Robert H., PhD ; Duh, Show-Hong, PhD ; Jeudy, Jean, MD ; Beache, Garth, MD
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1Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
2Biological and medical sciences
3Cardiac patients
4Cardiology
5Cardiology. Vascular system
6Cardiovascular
7Contrast Media
8Cross-Sectional Studies
9Diabetics
10Echocardiography
11Emergency and intensive care: renal failure. Dialysis management
12Female
13Gadolinium
14Gadolinium oxide
15Heart attack
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17Heart Ventricles - pathology
18Hemodialysis
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20Hypertrophy, Left Ventricular - blood
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abstractCardiac troponin T level predicts a gradient risk for death in patients using hemodialysis. We used cardiovascular magnetic resonance (CMR) to determine whether an asymptomatic increase of troponin T in patients using hemodialysis is associated with subclinical myocardial infarction (MI). Twenty-six patients using long-term hemodialysis (49 ± 12 years of age, 19 men, 8 diabetics) with left ventricular (LV) ejection fraction >40% and no known coronary artery disease were selected based on a low-risk troponin T level ≤0.03 ng/ml (median 0.02, interquartile range 0.00 to 0.02, n = 13) and high-risk troponin T level ≥0.07 ng/ml (median 0.15, interquartile range 0.09 to 0.19, n = 13). All underwent CMR imaging for LV mass and for MI by late gadolinium enhancement. Between high- and low-risk patients using hemodialysis, there were no differences in age, gender, ethnicity, or diabetes mellitus. Of the high-risk patients, 3 (23%, 95% confidence interval [CI] 5 to 54) had MI by late gadolinium enhancement versus 0 (0%, 95% CI 0 to 25) low-risk patients (p = 0.22). A diffuse, midwall late gadolinium enhancement pattern was seen in 1 high-risk patient (8%) versus 0 low-risk patient (0%, 95% CI 0 to 25, p = 0.97). Height-adjusted LV mass and LV hypertrophy were not significantly different between high-risk (62 ± 26 g/m2.7 , LV hypertrophy, n = 7, 54%) and low-risk (54 ± 20 g/m2.7 , LV hypertrophy, n = 5, 39%) patients (p = 0.37 for LV mass, p = 0.69 for LV hypertrophy). In conclusion, MI detected by CMR is present in few patients on hemodialysis with high troponin T levels and absent in the setting of very low troponin T levels, suggesting that additional myocardial pathologies cause increased troponin T in patients using hemodialysis.
copNew York, NY
pubElsevier Inc
pmid17719339
doi10.1016/j.amjcard.2007.04.028