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| Diagnostic value of troponin T for alterations in left ventricular mass andfunction in dialysis patients. Francesca Mallamaci, Carmine Zoccali, Saverio Parlongo, Giovanni Tripepi, Francesco A Benedetto, Sebastiano Cutrupi, Grazia Bonanno, Pasquale Fatuzzo, Francesco Rapisarda, Giuseppe Seminara, Benedetta Stancanelli, Ignazio Bellanuova, Alessando Cataliotti, Lorenzo S Malatino Kidney International 2003; 62(5):1884-1890 ICID: 451000 |
| Article type: Original article |
| IC™ Value: 14.82 |
| BACKGROUND: Cardiac troponin T (cTnT) is related to left ventricular (LV)mass in patients with end-stage renal disease (ESRD). Furthermore, cTnT reflects the severity of systolicdysfunction in patients with heart diseases. We tested the diagnostic value of cTnT for left ventricularhypertrophy (LVH) and LV systolic dysfunction in a large group of clinically stable hemodialysis patientswithout heart failure. RESULTS: CTnT was significantly (P < 0.001) higher in patients with LVH than inthose with normal LV mass. In a multiple logistic regression model, adjusting for potential confounders(including cardiac ischemia), systolic pressure and cTnT (both P = 0.003) were the strongest correlatesof LVH. Similarly, cTnT was significantly higher (P = 0.005) in patients with systolic dysfunction thanin those with normal LV function and in a multiple logistic regression model cTnT ranked as the secondindependent correlate of this alteration after male sex. Serum cTnT had a high positive prediction valuefor the diagnosis of LVH (87%) but its negative prediction value was relatively low (44%). The positivepredictive value of cTnT for LV dysfunction was low (25%) while its negative predictive value was high(93%). A combined analysis including systolic pressure (for the diagnosis of LVH) and sex (for the diagnosisof LV systolic dysfunction) augmented the diagnostic estimates to an important extent (95% positive predictionvalue for LVH and 98% negative prediction value for LV systolic dysfunction). CONCLUSIONS: CTnT has afairly good diagnostic potential for the identification of LVH and for the exclusion of LV systolic dysfunctionin patients with ESRD without heart failure. This marker may be useful for the screening of alterationsin LV mass and function in clinically stable hemodialysis patients. |
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ICID 451000 PMID 12371993 - click here to show this article in PubMed database |
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