High-sensitive troponin T increase after hemodialysis is associated with left ventricular global longitudinal strain and ultrafiltration rate
| Autor: | Serkan Ünlü, Ozlem Gulbahar, Nuri Bülent Boyacı, Selim Turgay Arınsoy, Gökhan Gökalp, Asife Sahinarslan, Burak Sezenöz, Özden Seçkin, Orhan Uludag |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Acute coronary syndrome Longitudinal strain Heart Ventricles medicine.medical_treatment Ultrafiltration macromolecular substances Clinical Cardiology 030204 cardiovascular system & hematology High sensitive Contractility 03 medical and health sciences 0302 clinical medicine Troponin T Renal Dialysis Internal medicine medicine Humans Dialysis biology business.industry General Medicine medicine.disease musculoskeletal system Troponin Ultrafiltration (renal) biology.protein Cardiology Kidney Failure Chronic Female Hemodialysis Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiol J |
| Popis: | Background: Circulating troponin levels are both stable and higher in patients with end-stage renal disease, even in the absence of acute coronary syndrome. These patients commonly have underlying cardiac problems that frequently cause troponin elevation. The effect of hemodialysis (HD) on troponin levels has not been well elucidated. Thus, investigated herein is the relationship between the changes in troponin levels along with left ventricular deformation and volume depletion in patients with end-stage renal disease. Methods: Patients included were between 18 and 85 years of age and were receiving hemodialysis for at least 6 months. High sensitive cardiac troponin T (hs-cTnT) levels were studied in blood samples taken at the beginning and end of HD. Two-dimensional speckle tracking strain imaging was used to evaluate myocardial contractility. Results: Seventy patients (50.7 ± 16.9 years of age, 27 women) were included in study. The mean volume of ultrafiltration was 3260 ± 990 mL. A significant increase in circulating hs-cTnT levels was observed, as well as a prominent decrease in left ventricular global longitudinal strain (GLS) after HD (52.4 ± 40.2 ng/L vs. 66.8 ± 48.5 ng/L, p < 0.001 and 20.1 ± 3.6% vs. 16.8 ± 3.8% p < 0.001, respectively). Moreover, ultrafiltration rate and GLS were found as the strongest independent variables in relation to the relative increase in hs-cTnT. Conclusions: Hemodialysis can cause a significant increase in hsTnT. This can jeopardize the accuracy of clinical diagnoses based on hs-TnT measurements. GLS may be used as a determinant of this hs-TnT increase. The influence of HD on the cardiovascular system should be kept in mind to prevent unnecessary interventions. |
| Databáze: | OpenAIRE |
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