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Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study.
J Am Heart Assoc. 2019 09 17; 8(18):e013357.JA

Abstract

Background It is unclear whether high-sensitivity troponin T (hs-TnT) is associated with subclinical cardiac changes in chronic kidney disease (CKD). We evaluated the relationship between hs-TnT and left ventricular structure and function in a CKD population, according to estimated glomerular filtration rate. Methods and Results We analyzed 2017 patients with CKD stages 1 to 5 (predialysis) in the KNOW-CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) cohort. The predictor was hs-TnT level measured at baseline, and the outcomes were left ventricular hypertrophy (LVH) and systolic and diastolic dysfunction shown by echocardiography at baseline and after 4 years. Participants were categorized into quartiles according to hs-TnT levels. The associations between quartiles of hs-TnT and outcomes were assessed using multivariable logistic regression analysis with confounders including demographics, medical history, and laboratory findings. A receiver operating characteristic curve was used to assess the diagnostic power of hs-TnT for the outcomes as a continuous variable. For subgroup analysis, patients were stratified based on an estimated glomerular filtration rate of 60 mL/min per 1.73 m2. Elevated hs-TnT was associated with LVH and diastolic dysfunction at baseline in an adjusted model but was not associated with systolic dysfunction. These associations remained significant for both estimated glomerular filtration rate subgroups. Receiver operating characteristic curve analysis showed that hs-TnT as a continuous variable exhibited fair significance for detection of LVH (area under the curve: 0.689) and diastolic dysfunction (area under the curve: 0.744). Multivariable analysis showed that higher hs-TnT levels at baseline were related to development of LVH but not diastolic dysfunction (n=864). Conclusions In CKD patients, hs-TnT is strongly associated with alterations of left ventricular structure and diastolic dysfunction for both estimated glomerular filtration rate strata. Baseline hs-TnT levels are predictive of new LVH on follow-up.

Authors+Show Affiliations

Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea.Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea.Medical Research Collaborating Center Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea.Department of Prevention and Management Inha University Hospital Incheon Korea.Department of Internal Medicine School of Medicine Kangbuk Samsung Hospital Sungkyunkwan University Seoul South Korea.Department of Internal Medicine Seoul National University Bundang Hospital Seoul National University College of Medicine Seongnam South Korea.Department of Internal Medicine Nowon Eulji Medical Center Eulji University Seoul South Korea.Department of Internal Medicine Chonnam National University Medical School Gwangju South Korea.Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea.Department of Internal Medicine Seoul National University Hospital Seoul National University College of Medicine Seoul South Korea.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31514574

Citation

Kang, Eunjeong, et al. "Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study." Journal of the American Heart Association, vol. 8, no. 18, 2019, pp. e013357.
Kang E, Ryu H, Kim J, et al. Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study. J Am Heart Assoc. 2019;8(18):e013357.
Kang, E., Ryu, H., Kim, J., Lee, J., Lee, K. B., Chae, D. W., Sung, S. A., Kim, S. W., Ahn, C., & Oh, K. H. (2019). Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study. Journal of the American Heart Association, 8(18), e013357. https://doi.org/10.1161/JAHA.119.013357
Kang E, et al. Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study. J Am Heart Assoc. 2019 09 17;8(18):e013357. PubMed PMID: 31514574.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association Between High-Sensitivity Cardiac Troponin T and Echocardiographic Parameters in Chronic Kidney Disease: Results From the KNOW-CKD Cohort Study. AU - Kang,Eunjeong, AU - Ryu,Hyunjin, AU - Kim,Jayoun, AU - Lee,Joongyub, AU - Lee,Kyu-Beck, AU - Chae,Dong-Wan, AU - Sung,Su Ah, AU - Kim,Soo Wan, AU - Ahn,Curie, AU - Oh,Kook-Hwan, Y1 - 2019/09/13/ PY - 2019/9/14/entrez PY - 2019/9/14/pubmed PY - 2020/9/15/medline KW - chronic kidney disease KW - diastolic dysfunction KW - left ventricular hypertrophy KW - troponin T SP - e013357 EP - e013357 JF - Journal of the American Heart Association JO - J Am Heart Assoc VL - 8 IS - 18 N2 - Background It is unclear whether high-sensitivity troponin T (hs-TnT) is associated with subclinical cardiac changes in chronic kidney disease (CKD). We evaluated the relationship between hs-TnT and left ventricular structure and function in a CKD population, according to estimated glomerular filtration rate. Methods and Results We analyzed 2017 patients with CKD stages 1 to 5 (predialysis) in the KNOW-CKD (Korean Cohort Study for Outcome in Patients With Chronic Kidney Disease) cohort. The predictor was hs-TnT level measured at baseline, and the outcomes were left ventricular hypertrophy (LVH) and systolic and diastolic dysfunction shown by echocardiography at baseline and after 4 years. Participants were categorized into quartiles according to hs-TnT levels. The associations between quartiles of hs-TnT and outcomes were assessed using multivariable logistic regression analysis with confounders including demographics, medical history, and laboratory findings. A receiver operating characteristic curve was used to assess the diagnostic power of hs-TnT for the outcomes as a continuous variable. For subgroup analysis, patients were stratified based on an estimated glomerular filtration rate of 60 mL/min per 1.73 m2. Elevated hs-TnT was associated with LVH and diastolic dysfunction at baseline in an adjusted model but was not associated with systolic dysfunction. These associations remained significant for both estimated glomerular filtration rate subgroups. Receiver operating characteristic curve analysis showed that hs-TnT as a continuous variable exhibited fair significance for detection of LVH (area under the curve: 0.689) and diastolic dysfunction (area under the curve: 0.744). Multivariable analysis showed that higher hs-TnT levels at baseline were related to development of LVH but not diastolic dysfunction (n=864). Conclusions In CKD patients, hs-TnT is strongly associated with alterations of left ventricular structure and diastolic dysfunction for both estimated glomerular filtration rate strata. Baseline hs-TnT levels are predictive of new LVH on follow-up. SN - 2047-9980 UR - https://www.unboundmedicine.com/medline/citation/31514574/Association_Between_High_Sensitivity_Cardiac_Troponin_T_and_Echocardiographic_Parameters_in_Chronic_Kidney_Disease:_Results_From_the_KNOW_CKD_Cohort_Study_ L2 - https://www.ahajournals.org/doi/10.1161/JAHA.119.013357?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -