Cardiovascular events prediction by left ventricular longitudinal strain and serum high-sensitivity troponin I in patients with axial spondyloarthritis

2020 ◽  
Vol 39 (11) ◽  
pp. 3373-3382
Author(s):  
Yan Chen ◽  
Yap-Hang Chan ◽  
Ho-Yin Chung ◽  
Mei-Zhen Wu ◽  
Yu-Juan Yu ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Longitudinal Strain ◽  
Troponin I ◽  
Axial Spondyloarthritis ◽  
High Sensitivity ◽  
Left Ventricular ◽  
High Sensitivity Troponin

Abstract 15561: Incremental Prognostic Value of Biventricular Longitudinal Strain and Hs-tni in Covid-19 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mingxing XIE ◽  
Wei Sun ◽  
yanting zhang ◽  
CHUN WU ◽  
Yuji Xie ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Longitudinal Strain ◽  
Troponin I ◽  
Myocardial Strain ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Characteristic Analysis ◽  
Right Ventricular Free Wall ◽  
Heart Chamber ◽  
Incremental Prognostic Value

Background: Myocardial strain derived from two-dimensional speckle-tracking echocardiography (2D-STE) has been shown to be more sensitive to detect early ventricular dysfunction than conventional echocardiography. However, the study about the prognostic value of biventricular longitudinal strain in coronavirus disease 2019 (COVID-19) is still scarce. Aims: We aimed to evaluate the prognostic value of biventricular longitudinal strain and its combination with high-sensitivity troponin I (hs-TNI) in COVID-19 patients. Methods: We enrolled a total of 160 COVID-19 patients who underwent both echocardiogram and hs-TNI testing. The cardiac structure, function and myocardial strain were compared between patients with and without elevated hs-TNI levels. Left ventricular longitudinal strain (LV LS) and right ventricular free wall longitudinal strain (RVFWLS) were determined by 2D-STE. Results: Compared with patients with normal hs-TNI levels, patients with elevated hs-TNI levels had diminished LV diastolic function, larger right-heart chamber, higher proportion of pulmonary hypertension, lower LV LS and RVFWLS. During a median follow-up of 60 days, 23 patients died. The multivariant analysis revealed LV LS and RVFWLS [Odd ratio (confidence interval): 1.533 (1.131-2.079); P =0.006; 1.267 (1.101-1.794), P =0.021, respectively] both were the independent predictors of higher mortality. Further, receiver-operating characteristic analysis revealed that the accuracy for predicting death was greater for the combination of hs-TNI levels with LV LS than separate LV LS (AUC: 0.93 vs 0.77, P =0.001), and for the combination of hs-TNI levels with RVFWLS than RVFWLS alone (AUC: 0.92 vs 0.83, P =0.041). Conclusion: Our study highlights that the combination of ventricular longitudinal strain with hs-TNI can provide a higher accuracy for predicting mortality in COVID-19 patients, which may enhance risk stratification in COVID-19 patients.

Gender, High-Sensitivity Troponin I, and the Risk of Cardiovascular Events (from the Nord-Trøndelag Health Study)

2016 ◽  
Vol 118 (6) ◽  
pp. 816-821 ◽  
Author(s):  
Magnus Nakrem Lyngbakken ◽  
Helge Røsjø ◽  
Oddgeir L. Holmen ◽  
Ståle Nygård ◽  
Håvard Dalen ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Troponin I ◽  
High Sensitivity ◽  
Health Study ◽  
High Sensitivity Troponin

scholarly journals Is High Sensitive-Troponin I A Reliable Biomarker For Cardiac Injury In Methadone Toxicity? A Prospective Cross-Sectional Study

2021 ◽  
Author(s):  
Hasan Shemirani ◽  
Masoumeh Sadeghi ◽  
Azadeh Davoudian Dehkordi ◽  
Farzad Gheshlaghi
Keyword(s):  
Troponin I ◽  
Cardiac Injury ◽  
High Sensitivity ◽  
Cross Sectional Study ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cross Sectional ◽  
Ventricular Ejection Fraction ◽  
High Sensitivity Troponin ◽  
High Sensitive Troponin

Abstract Background: Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity.Methods: Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018-November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this findings between two groups based on high-sensitivity troponin I results.Results: Mean age of the patients was 34.5±11.1 years (males: 66%). Twelve (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P=0.013 and 83% vs. 16%, P<0.001, respectively). Patients with elevated troponin had reduced left ventricular ejection fraction in comparison to normal group during admission (43.1±15.4% vs. 55%, P<0.001) and this left ventricular ejection fraction remained abnormal after 30 days (43.7±21.6%). Patients in positive high-sensitivity troponin I group had higher regional wall motion abnormality frequency both at admission and 30 days later compared to the other group (0 day: 42% vs. 0, P<0.001, 30th days: 25% vs. 4%, P=0.020).Conclusion: Patients with simultaneous methadone toxicity and positive high-sensitivity troponin I had worse cardiac outcomes and this biomarker could be probably used for better implementation of therapeutic interventions and prognosis.

scholarly journals High-Sensitivity Troponin I and Creatinine Kinase-Myocardial Band in Screening for Myocardial Injury in Patients with Carbon Monoxide Poisoning

Diagnostics ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 242 ◽  
Author(s):  
June-Sung Kim ◽  
Byuk Sung Ko ◽  
Chang Hwan Sohn ◽  
Youn-Jung Kim ◽  
Won Young Kim
Keyword(s):  
Carbon Monoxide ◽  
Troponin I ◽  
Myocardial Dysfunction ◽  
Carbon Monoxide Poisoning ◽  
Right Ventricular Dysfunction ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Co Poisoning ◽  
High Sensitivity Troponin ◽  
Poor Outcomes

Myocardial dysfunction due to acute carbon monoxide (CO) poisoning is common and associated with poor outcomes. The role of cardiac markers, including creatine kinase-myocardial band (CK-MB), high-sensitivity troponin I (hsTnI), and brain natriuretic peptide (BNP), in identifying patients with CO-induced cardiomyopathy were evaluated. This single-center, retrospective cohort study included 905 consecutive adult patients in the CO poisoning registry from February 2009 to December 2019. Cardiomyopathy was defined as any abnormality on transthoracic echocardiography (TTE), including left ventricular systolic and diastolic dysfunction, right ventricular dysfunction, and wall motion abnormalities. The areas under receiver operating curves (AUCs) for biomarkers were compared. Of the 850 included patients, 101 (11.9%) had CO-induced cardiomyopathy. Initial and peak hsTnI and CK-MB concentrations, and initial BNP concentrations were significantly higher in patients with than without cardiomyopathy (all P-values < 0.01), but the AUCs were higher for hsTnI (0.894) and CK-MB (0.864) than for BNP (0.796). Initial TnI > 0.01 ng/mL and CK-MB > 1.5 ng/mL each had 95% sensitivity and 97% negative predictive value for CO-induced cardiomyopathy. Higher hsTnI or CK-MB levels on admission can identify patients at high-risk of CO-induced cardiomyopathy and can be a screening tool for CO poisoning.

scholarly journals Clinical impact on treatment and prognosis of advanced cardiac imaging with echocardiography in the acute setting of a COVID-19 infection

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M Gonzalez Del Hoyo ◽  
L Servato ◽  
R Fernandez-Galera ◽  
E Rodenas ◽  
M Garcia ◽  
...  
Keyword(s):  
Diastolic Dysfunction ◽  
Troponin I ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Smoking History ◽  
Work Analysis ◽  
Lv Dysfunction ◽  
High Sensitivity Troponin ◽  
Hemodynamic Assessment ◽  
Tertiary Center

Abstract Background and objectives Despite myocardial injury being related to excess mortality in acute COVID-19 infection, its impact on imaging findings remains unclear. This study aimed to characterize transthoracic echocardiographic (TTE) findings in patients admitted with COVID-19 infections and its impact on management and prognosis. Methods A prospective observational cohort study was performed among 66 COVID-19 patients who were admitted to a tertiary center between March 1 and May 25, 2020 and underwent TTE. High-sensitivity troponin I (hs-cTnI) data, echocardiographic assessment of right and left ventricular (LV) functional parameters, strain, and myocardial work analysis were obtained. Results 2025 patients were admitted with COVID-19 and in 200 a complete TTE study was performed. Due to poor image quality, only 66 studies were included in the final analysis. The median age was 62 years (IQR, 55–70) and 59.1% of patients were males. The most common comorbidity was hypertension (47%), followed by smoking history (30.3%), atrial fibrillation (9.1%), and chronic obstructive pulmonary disease (7.9%). More than half of the patients (39, 59%) were admitted to the ICU, and half of them (33, 50%) required invasive mechanical ventilation. TTE was mainly indicated because of concerns for systemic conditions (50%) and evaluation of hemodynamic assessment (30%). Thirty-six patients (54.5%) had an abnormal TTE result and 57% had elevated hs-cTnI levels. The most common cardiac abnormality was LV diastolic dysfunction in 33% of the patients, followed by right ventricular dysfunction (12%) and LV dysfunction (6%) (Figure 1). LV GLS was reduced in 48.5% of the cases. Myocardial work performance indices were all reduced in patients with an abnormal TTE (GWI 30%, GCW 30%, GWW 40%, and GWE 40%), although differences were not significant (P&gt;0.2 for all parameters). Patients with an abnormal TTE were older and presented a higher cardiovascular risk profile. There were no significant differences in the levels of D-dimer, NTproBNP, and hs-cTnI between patients with and without diastolic dysfunction, RV, or LV dysfunction (P&gt;0.3 for all parameters). Using Spearman rank correlation, there was an inverse relationship between hs-cTnI and LV strain and myocardial work analysis. TTE results impacted clinical management in 60 patients, mainly de-escalation of medical treatment (Figure 2). Abnormal TTE results did not impact in-hospital outcomes. Conclusions Severe echocardiographic abnormalities are uncommon in hospitalized patients with COVID-19 infections, presenting mostly with subclinical myocardial changes, such as diastolic dysfunction, reduced LV GLS, and myocardial work indices, both associated with high-sensitivity troponin I elevation. An echocardiographic study should be limited to rule out long-term ICU complications or to evaluate hemodynamic instability. Although TTE was a valuable tool for guiding management, it had no significant impact on prognosis. FUNDunding Acknowledgement Type of funding sources: None. Figure 1. Findings on TTE studies. Figure 2. Changes in management.

The utility of cardiac biomarkers and echocardiography for the early detection of bevacizumab- and sunitinib-mediated cardiotoxicity

2015 ◽  
Vol 309 (4) ◽  
pp. H692-H701 ◽  
Author(s):  
Kimberly-Ann Bordun ◽  
Sheena Premecz ◽  
Megan daSilva ◽  
Soma Mandal ◽  
Vineet Goyal ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Murine Model ◽  
Troponin I ◽  
Systolic Dysfunction ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Cardiac Biomarkers ◽  
Systemic Hypertension ◽  
High Sensitivity Troponin ◽  
Lv Ejection Fraction

The recent introduction of novel anticancer therapies, including bevacizumab (BVZ) and sunitinib (SNT), is associated with an increased risk of cardiotoxicity. However, early identification of left ventricular (LV) systolic dysfunction may facilitate dose modification and avoid the development of advanced heart failure. Using a murine model of BVZ- and SNT-mediated cardiotoxicity, we investigated whether cardiac biomarkers and/or tissue velocity imaging (TVI) using echocardiography can detect early changes in cardiac function, before a decrease in LV ejection fraction is identified. A total of 75 wild-type C57Bl/6 male mice were treated with either 0.9% saline, BVZ, or SNT. Serial monitoring of blood pressure, high-sensitivity troponin I, and echocardiographic indexes were performed over a 14-day study period, after which the mice were euthanized for histological and biochemical analyses. Mice treated with either BVZ or SNT developed systemic hypertension as early as day 7, which increased by day 14. Cardiac biomarkers, specifically high-sensitivity troponin I, were not predictive of early LV systolic dysfunction. Although conventional LV ejection fraction values decreased at day 13 in mice treated with either BVZ or SNT, TVI confirmed early LV systolic dysfunction at day 8. Histological and biochemical analysis demonstrated loss of cellular integrity, increased oxidative stress, and increased cardiac apoptosis in mice treated with BVZ or SNT therapy at day 14. In a murine model of BVZ- or SNT-mediated cardiomyopathy, noninvasive assessment by TVI detected early LV systolic dysfunction before alterations in conventional echocardiographic indexes.

scholarly journals ASSOCIATION BETWEEN HIGH-SENSITIVITY TROPONIN I AND MAJOR CARDIOVASCULAR EVENTS AFTER NON-CARDIAC SURGERY

2020 ◽  
Vol 75 (11) ◽  
pp. 110
Author(s):  
Emmanuelle Duceppe ◽  
Flavia K. Borges ◽  
Maria Tiboni ◽  
Rupert Pearse ◽  
Matthew T.V. Chan ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Cardiovascular Events ◽  
Troponin I ◽  
High Sensitivity ◽  
Major Cardiovascular Events ◽  
High Sensitivity Troponin
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