Clinical Value of Troponin Levels to Cardiac Function and Prognosis in Patients with Fulminant Myocarditis.

IF 1.2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

International heart journal Pub Date : 2024-01-01 DOI:10.1536/ihj.23-589

Naoki Shibata, Toru Kondo, Takahiro Okumura, Takahiro Imaizumi, Kaoru Dohi, Hideo Izawa, Nobuyuki Ohte, Tetsuya Amano, Toyoaki Murohara

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引用次数: 0

Abstract

Troponin (Tn) is a biomarker related to myocardial necrosis and is elevated in patients with myocarditis. This study aimed to investigate the association between cardiac Tn levels and the course of cardiac function, and prognosis in patients with fulminant myocarditis (FM) receiving percutaneous mechanical circulatory support (MCS).We used data from a multicenter retrospective registry, CHANGE PUMP 2, which included 216 patients with FM who required MCS. Among them, 141 patients whose Tn levels were available were analyzed. The patients were divided into low and high Tn groups according to the median values of TnT and TnI.The median age was 54 years, and 59.6% were male. The TnT and TnI on day 1 (at MCS initiation) were 3.8 (1.4-10.0) and 21.4 (8.4-68.8) ng/mL. While the left ventricular ejection fraction (LVEF) was similar on day 1 (25.0% versus 24.5%), the low Tn group showed better LVEF improvement on day 7 than the high Tn group (45.0% versus 25.3%, P < 0.001). LVEF at 1 year after admission was higher in the low Tn group (65.0% versus 59.7%, P = 0.039). The low Tn group had a better 90-day composite endpoint in death, durable left ventricular assist device implantation, and heart transplantation compared to the high Tn group (hazard ratio 0.47, 95% CI 0.23-0.95).Tn levels were associated with short- and long-term cardiac recovery and adverse outcomes in patients with FM receiving MCS due to cardiogenic shock.

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肌钙蛋白水平对暴发性心肌炎患者心功能和预后的临床价值

肌钙蛋白（Tn）是一种与心肌坏死相关的生物标志物，在心肌炎患者中会升高。本研究旨在探讨接受经皮机械循环支持（MCS）的暴发性心肌炎（FM）患者的心脏 Tn 水平与心功能病程和预后之间的关系。我们对其中 141 名 Tn 水平可用的患者进行了分析。根据 TnT 和 TnI 的中位值将患者分为低 Tn 组和高 Tn 组。第 1 天（开始使用 MCS 时）的 TnT 和 TnI 分别为 3.8（1.4-10.0）纳克/毫升和 21.4（8.4-68.8）纳克/毫升。虽然第 1 天的左心室射血分数（LVEF）相似（25.0% 对 24.5%），但低 Tn 组在第 7 天的 LVEF 改善情况优于高 Tn 组（45.0% 对 25.3%，P < 0.001）。入院 1 年后，低 Tn 组的 LVEF 更高（65.0% 对 59.7%，P = 0.039）。与高Tn组相比，低Tn组在死亡、持久左心室辅助装置植入和心脏移植方面的90天综合终点更好（危险比为0.47，95% CI为0.23-0.95）。Tn水平与因心源性休克而接受MCS的FM患者的短期和长期心脏恢复及不良预后有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International heart journal 医学-心血管系统

CiteScore

2.50

自引率

6.70%

发文量

148

审稿时长

6-12 weeks

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