The association of high-sensitivity cardiac troponin I and T with echocardiographic stages of heart failure with preserved ejection fraction

Abstract

Background This study evaluates the associations between high-sensitivity troponin I and T (hs-TnI/hs-TnT) and the stages of heart failure with preserved ejection fraction (HFpEF)/diastolic dysfunction. Methods Blood samples for biomarker measurements (hs-TnI/hs-TnT/NT-proBNP) were collected within 24 h of routine echocardiographic examination. Patients with left ventricular ejection fraction <50%, right ventricular dysfunction and moderate-to-severe valvular heart disease were excluded. Graduation of diastolic dysfunction was determined according to current guidelines. Results A total of 70 patients were included. Hs-TnT concentrations increased significantly according to the progression of diastolic dysfunction (P\u2009=\u20090.024). Hs-TnT was able to discriminate patients with diastolic dysfunction grade III (AUC\u2009=\u20090.737; P\u2009=\u20090.013), while NT-proBNP revealed a greater AUC (AUC 0.798; P\u2009=\u20090.002). Concentrations of hs-TnI increased only numerically according to the increasing stages of diastolic dysfunction (P\u2009=\u20090.353). In multivariable logistic regression models, hs-TnT concentrations\u2009>\u200928 ng/L were associated with diastolic dysfunction grade III (OR\u2009=\u20094.7, P\u2009=\u20090.024), even after adjusting for NT-proBNP. Conclusion Increasing concentrations of hs-TnT may reflect the stages of diastolic dysfunction being assessed by echocardiography, whereas hs-TnI does not show any association with diastolic dysfunction.