SP539HIGH-SENSITIVE CARDIAC TROPONIN I IN ASYMPTOMATIC PATIENTS UNDERGOING CHRONIC HAEMODIALYSIS TREATMENT

A transient form of hypertrophic cardiomyopathy has been previously described in infants of diabetic mothers. When it occurs, it is generally benign. The purpose of our study was to establish the extent of injury to the cardiomyocytes in symptomatic and asymptomatic patients with and without hypertrophic cardiomyopathy.Thus, we compared 35 consecutive patients to 20 healthy controls, establishing the significance, if any, of differences in cardiac troponin-I and creatine kinase, including its MB-fraction, and seeking to establish the value of these parameters in the diagnosis of cardiac injury. We also determined to levels of glucose and insulin in the serum, and took note of electrocardiographic and echocardiographic investigations. Values were determined at the 1st and 7th days after admission in the patients, while parameters were measured in the control group only on the first day.We found that the levels of cardiac troponin-I in the serum, known to be a marker for cardiac injury, were significantly elevated in symptomatic patients with life-threatening respiratory or haemodynamic distress. We speculate that transient ventricular hypertrophy is neither the cause nor the consequence of damage to the cardiomyocytes. It would be interesting, nonetheless, to determine the relationship, if any, between cardiomyocytic damage and clinical outcome.

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MO744HIGH SENSIVITY CARDIAC TROPONIN I, A POSSIBLE BIOMARKER OF DIASTOLIC DYSFUNCTION IN ASYMPTOMATIC PATIENTS IN HEMODIALYSIS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfab097.0024 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

Maria Paz Castro Fernández ◽

Luis Guillermo Piccone Saponara ◽

Esperanza Moral Berrio ◽

Guillermo Ferrer García ◽

Gloria García Conejo ◽

...

Keyword(s):

Logistic Regression ◽

Early Intervention ◽

Diastolic Dysfunction ◽

Cardiac Troponin ◽

Troponin I ◽

Statistical Significance ◽

Left Ventricular ◽

Cardiac Troponin I ◽

Early Assessment ◽

Asymptomatic Patients

Abstract Background and Aims Impairment in the diastolic function is strongly associated with heart failure and cardiovascular disease in patients with end-stage renal disease (ESRD), with a high prevalence of 50-65% and unobvious early symptoms. Hence, it is of great importance to explore serum biomarkers for early assessment of diastolic disfunction in patients with ESRD, providing evidence for performing an early intervention. When myocardial cell membrane integrity becomes damaged, cardiac troponin is released into the circulation, inducing an elevation of serum cardiac troponin in asymptomatic patients on dialysis. We analyzed the relationship between high-sensitivity cardiac troponin I biomarker (hs-cTnI) and left ventricular diastolic dysfunction (LVDD) in a cohort of asymptomatic patients on haemodialysis at our center. Method Cross-sectional study. We include patients on haemodialysis in our center. Demographic variables (age, sex), associated comorbidity, hs-cTnI levels, and echocardiographic parameters were collected. Statistical analysis was performed with SPSS 25.0. Categorical variables are expressed as percentages and compared using Chi2 test. Quantitative variables are expressed as mean ± standard deviation, and T-student, Anova or U-mann Whitney was used to compare them. Logistic regression analysis was performed to determine independent predictors of LVDD. Statistical significance for a value of p <0.05. Results 80 patients, with an average age of 67.44 ± 13 years. 57.5% were men. 86.3% had high blood pressure (HBP), 52.5% were diabetic, 75% dyslipidemic, and 51.2% had overweight/obese body mass index. 32.5% had previous history of ischemic heart disease, 41.3% had moderate/severe left ventricle hypertrophy (LVH), 8.8% left ventricular ejection fraction (LVEF) <55% and 37.5% LVDD. Mean hs-cTnI was 31.27 ± 59.37 ng/L. LVDD was related to age (71 ± 10 years vs 65 ± 14 years p = 0.049), HBP (96.7% vs 3.3% p = 0.036), moderate/severe LVH (63.3% vs 36.7% p = 0.002), heart rate (HR) (66.96 ± 8.6 vs 77.28 ± 43.63 p = 0.036) and hs-cTnI (47.48 ± 81.97 ng/L vs 21.54 ± 38.06 ng/L p = 0.005). We divide the hs-cTnI into quartiles, with mean hs-cTnI levels 4.83 ± 1.92 ng/L in Q1, 9.86 ± 1.68 ng/L in Q2, 20.67 ± 4.26 ng L in Q3 and 89.73 ± 98.49 ng/L in Q4. We observed statistical significance for age (Q3 71 ± 10 ng/L vs 60 ± 17 ng/L p = 0.040), HBP (Q4 141.60 ± 16.68 ng/L vs Q1 123.90 ± 25, 98 ng/L p = 0.025), overweight/obesity (p = 0.001) and LVEF <55% (p = 0.015). The logistic regression showed that HR (OR 0.94 95% CI 0.89-0.99 p = 0.025), LVH severity (OR 5.16 95% CI 1.74-15.25 p = 0.003), and hs-cTnI > 20 (OR 4.11 95% CI 1.38-12.18 p = 0.011) are independent risk factors for LVDD. Conclusion hs-cTnI levels could be a biomarker of LVDD in asymptomatic patients on haemodialysis. New studies with a greater number of patients would increase the evidence for this claim, in order to carry out early intervention and treatment.

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