High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease
Objective Pulmonary arterial hypertension due to congenital heart disease (CHD‐PAH) has a poor prognosis. We sought to determine whether the biomarker high‐sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis. Patients Consecutive adult CHD‐P...
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| Veröffentlicht in: | Congenital heart disease 2013-11, Vol.8 (6), p.520-526 |
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| creator | Schuuring, Mark J. van Riel, Annelieke C.M.J. Vis, Jeroen C. Duffels, Marielle G. van Straalen, Jan P. Boekholdt, S. Matthijs Tijssen, Jan G.P. Mulder, Barbara J.M. Bouma, Berto J. |
| description | Objective
Pulmonary arterial hypertension due to congenital heart disease (CHD‐PAH) has a poor prognosis. We sought to determine whether the biomarker high‐sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.
Patients
Consecutive adult CHD‐PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.
Main Outcome Measure
The primary outcome was mortality.
Results
Of all 31 patients (mean age 45 ± 12 years) with CHD‐PAH, eight patients died during a median follow‐up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT‐pro‐BNP and right ventricular function were determinants of death (P |
| doi_str_mv | 10.1111/chd.12022 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_1465862904</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1465862904</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3572-c813f36989aefa7743e8bf186aa761ed311b365d1327925145160bd3c5aa21453</originalsourceid><addsrcrecordid>eNpdkc1OGzEUha2qFX9l0ReoLHXTzYB_ZmzPMgotQUIhEqmK2FjOzA0xnbFT2wPNK_Sp65DAovbCxzrfubq6F6FPlJzRfM6bVXtGGWHsHTqispQFUYS_f9WyvjtExzE-ElIKLtUBOmSclTTfI_R3Yh9WRQQXbbJPNm3wPPi1d9bhOb6KeBSjb6xJ0OJnm1Z45n3AN0NqfA84Q6N26FLce0PXe2fCBo9CgmBNhyebNWSdq3uH2wFw8njs3QM4m7Y2mJDwhY1gInxEH5ami3C6f0_Qj-_f5uNJcX1zeTUeXRcNryQrGkX5kota1QaWRsqSg1osqRLGSEGh5ZQuuKhaypmsWUXLigqyaHlTGcPyj5-gr7u66-B_DxCT7m1soOuMAz9ETUtRKcFqUmb0y3_oox-Cy91pKkXGVF1uqc97alj00Op1sH2egn6dcgbOd8Cz7WDz5lOit-vTeX36ZX16PLl4ETlR7BI2JvjzljDhlxaSy0r_nF7qW3o_vZ3NlJ7yf1lOm7A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1766588944</pqid></control><display><type>article</type><title>High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Schuuring, Mark J. ; van Riel, Annelieke C.M.J. ; Vis, Jeroen C. ; Duffels, Marielle G. ; van Straalen, Jan P. ; Boekholdt, S. Matthijs ; Tijssen, Jan G.P. ; Mulder, Barbara J.M. ; Bouma, Berto J.</creator><creatorcontrib>Schuuring, Mark J. ; van Riel, Annelieke C.M.J. ; Vis, Jeroen C. ; Duffels, Marielle G. ; van Straalen, Jan P. ; Boekholdt, S. Matthijs ; Tijssen, Jan G.P. ; Mulder, Barbara J.M. ; Bouma, Berto J.</creatorcontrib><description>Objective
Pulmonary arterial hypertension due to congenital heart disease (CHD‐PAH) has a poor prognosis. We sought to determine whether the biomarker high‐sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.
Patients
Consecutive adult CHD‐PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.
Main Outcome Measure
The primary outcome was mortality.
Results
Of all 31 patients (mean age 45 ± 12 years) with CHD‐PAH, eight patients died during a median follow‐up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT‐pro‐BNP and right ventricular function were determinants of death (P < .05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P = .005).
Conclusion
Levels of hsTnT were abnormal in a substantial proportion of CHD‐PAH patients. A significant inverse relationship was found between hsTnT and survival.</description><identifier>ISSN: 1747-079X</identifier><identifier>EISSN: 1747-0803</identifier><identifier>DOI: 10.1111/chd.12022</identifier><identifier>PMID: 23241414</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Academic Medical Centers ; Adult ; Biomarkers - blood ; Chi-Square Distribution ; Congenital Heart Disease ; Eisenmenger Complex - blood ; Eisenmenger Complex - complications ; Eisenmenger Complex - diagnosis ; Eisenmenger Complex - mortality ; Eisenmenger Complex - physiopathology ; Familial Primary Pulmonary Hypertension ; Female ; Humans ; Hypertension, Pulmonary - blood ; Hypertension, Pulmonary - diagnosis ; Hypertension, Pulmonary - etiology ; Hypertension, Pulmonary - mortality ; Hypertension, Pulmonary - physiopathology ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Natriuretic Peptide, Brain - blood ; Netherlands ; Peptide Fragments - blood ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Pulmonary Arterial Hypertension ; Risk Factors ; Survival ; Time Factors ; Troponin ; Troponin T - blood ; Up-Regulation ; Ventricular Function, Right</subject><ispartof>Congenital heart disease, 2013-11, Vol.8 (6), p.520-526</ispartof><rights>2012 Wiley Periodicals, Inc</rights><rights>2012 Wiley Periodicals, Inc.</rights><rights>Copyright © 2013 Wiley Periodicals, Inc</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3572-c813f36989aefa7743e8bf186aa761ed311b365d1327925145160bd3c5aa21453</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fchd.12022$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fchd.12022$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23241414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schuuring, Mark J.</creatorcontrib><creatorcontrib>van Riel, Annelieke C.M.J.</creatorcontrib><creatorcontrib>Vis, Jeroen C.</creatorcontrib><creatorcontrib>Duffels, Marielle G.</creatorcontrib><creatorcontrib>van Straalen, Jan P.</creatorcontrib><creatorcontrib>Boekholdt, S. Matthijs</creatorcontrib><creatorcontrib>Tijssen, Jan G.P.</creatorcontrib><creatorcontrib>Mulder, Barbara J.M.</creatorcontrib><creatorcontrib>Bouma, Berto J.</creatorcontrib><title>High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease</title><title>Congenital heart disease</title><addtitle>Congenit Heart Dis</addtitle><description>Objective
Pulmonary arterial hypertension due to congenital heart disease (CHD‐PAH) has a poor prognosis. We sought to determine whether the biomarker high‐sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.
Patients
Consecutive adult CHD‐PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.
Main Outcome Measure
The primary outcome was mortality.
Results
Of all 31 patients (mean age 45 ± 12 years) with CHD‐PAH, eight patients died during a median follow‐up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT‐pro‐BNP and right ventricular function were determinants of death (P < .05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P = .005).
Conclusion
Levels of hsTnT were abnormal in a substantial proportion of CHD‐PAH patients. A significant inverse relationship was found between hsTnT and survival.</description><subject>Academic Medical Centers</subject><subject>Adult</subject><subject>Biomarkers - blood</subject><subject>Chi-Square Distribution</subject><subject>Congenital Heart Disease</subject><subject>Eisenmenger Complex - blood</subject><subject>Eisenmenger Complex - complications</subject><subject>Eisenmenger Complex - diagnosis</subject><subject>Eisenmenger Complex - mortality</subject><subject>Eisenmenger Complex - physiopathology</subject><subject>Familial Primary Pulmonary Hypertension</subject><subject>Female</subject><subject>Humans</subject><subject>Hypertension, Pulmonary - blood</subject><subject>Hypertension, Pulmonary - diagnosis</subject><subject>Hypertension, Pulmonary - etiology</subject><subject>Hypertension, Pulmonary - mortality</subject><subject>Hypertension, Pulmonary - physiopathology</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Netherlands</subject><subject>Peptide Fragments - blood</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Pulmonary Arterial Hypertension</subject><subject>Risk Factors</subject><subject>Survival</subject><subject>Time Factors</subject><subject>Troponin</subject><subject>Troponin T - blood</subject><subject>Up-Regulation</subject><subject>Ventricular Function, Right</subject><issn>1747-079X</issn><issn>1747-0803</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkc1OGzEUha2qFX9l0ReoLHXTzYB_ZmzPMgotQUIhEqmK2FjOzA0xnbFT2wPNK_Sp65DAovbCxzrfubq6F6FPlJzRfM6bVXtGGWHsHTqispQFUYS_f9WyvjtExzE-ElIKLtUBOmSclTTfI_R3Yh9WRQQXbbJPNm3wPPi1d9bhOb6KeBSjb6xJ0OJnm1Z45n3AN0NqfA84Q6N26FLce0PXe2fCBo9CgmBNhyebNWSdq3uH2wFw8njs3QM4m7Y2mJDwhY1gInxEH5ami3C6f0_Qj-_f5uNJcX1zeTUeXRcNryQrGkX5kota1QaWRsqSg1osqRLGSEGh5ZQuuKhaypmsWUXLigqyaHlTGcPyj5-gr7u66-B_DxCT7m1soOuMAz9ETUtRKcFqUmb0y3_oox-Cy91pKkXGVF1uqc97alj00Op1sH2egn6dcgbOd8Cz7WDz5lOit-vTeX36ZX16PLl4ETlR7BI2JvjzljDhlxaSy0r_nF7qW3o_vZ3NlJ7yf1lOm7A</recordid><startdate>201311</startdate><enddate>201311</enddate><creator>Schuuring, Mark J.</creator><creator>van Riel, Annelieke C.M.J.</creator><creator>Vis, Jeroen C.</creator><creator>Duffels, Marielle G.</creator><creator>van Straalen, Jan P.</creator><creator>Boekholdt, S. Matthijs</creator><creator>Tijssen, Jan G.P.</creator><creator>Mulder, Barbara J.M.</creator><creator>Bouma, Berto J.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>JQ2</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201311</creationdate><title>High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease</title><author>Schuuring, Mark J. ; van Riel, Annelieke C.M.J. ; Vis, Jeroen C. ; Duffels, Marielle G. ; van Straalen, Jan P. ; Boekholdt, S. Matthijs ; Tijssen, Jan G.P. ; Mulder, Barbara J.M. ; Bouma, Berto J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3572-c813f36989aefa7743e8bf186aa761ed311b365d1327925145160bd3c5aa21453</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Academic Medical Centers</topic><topic>Adult</topic><topic>Biomarkers - blood</topic><topic>Chi-Square Distribution</topic><topic>Congenital Heart Disease</topic><topic>Eisenmenger Complex - blood</topic><topic>Eisenmenger Complex - complications</topic><topic>Eisenmenger Complex - diagnosis</topic><topic>Eisenmenger Complex - mortality</topic><topic>Eisenmenger Complex - physiopathology</topic><topic>Familial Primary Pulmonary Hypertension</topic><topic>Female</topic><topic>Humans</topic><topic>Hypertension, Pulmonary - blood</topic><topic>Hypertension, Pulmonary - diagnosis</topic><topic>Hypertension, Pulmonary - etiology</topic><topic>Hypertension, Pulmonary - mortality</topic><topic>Hypertension, Pulmonary - physiopathology</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Netherlands</topic><topic>Peptide Fragments - blood</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Pulmonary Arterial Hypertension</topic><topic>Risk Factors</topic><topic>Survival</topic><topic>Time Factors</topic><topic>Troponin</topic><topic>Troponin T - blood</topic><topic>Up-Regulation</topic><topic>Ventricular Function, Right</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schuuring, Mark J.</creatorcontrib><creatorcontrib>van Riel, Annelieke C.M.J.</creatorcontrib><creatorcontrib>Vis, Jeroen C.</creatorcontrib><creatorcontrib>Duffels, Marielle G.</creatorcontrib><creatorcontrib>van Straalen, Jan P.</creatorcontrib><creatorcontrib>Boekholdt, S. Matthijs</creatorcontrib><creatorcontrib>Tijssen, Jan G.P.</creatorcontrib><creatorcontrib>Mulder, Barbara J.M.</creatorcontrib><creatorcontrib>Bouma, Berto J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Computer Science Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Congenital heart disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schuuring, Mark J.</au><au>van Riel, Annelieke C.M.J.</au><au>Vis, Jeroen C.</au><au>Duffels, Marielle G.</au><au>van Straalen, Jan P.</au><au>Boekholdt, S. Matthijs</au><au>Tijssen, Jan G.P.</au><au>Mulder, Barbara J.M.</au><au>Bouma, Berto J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease</atitle><jtitle>Congenital heart disease</jtitle><addtitle>Congenit Heart Dis</addtitle><date>2013-11</date><risdate>2013</risdate><volume>8</volume><issue>6</issue><spage>520</spage><epage>526</epage><pages>520-526</pages><issn>1747-079X</issn><eissn>1747-0803</eissn><abstract>Objective
Pulmonary arterial hypertension due to congenital heart disease (CHD‐PAH) has a poor prognosis. We sought to determine whether the biomarker high‐sensitivity troponin T (hsTnT) measured on routine visit at the outpatient clinic is associated with prognosis.
Patients
Consecutive adult CHD‐PAH (86% Eisenmenger syndrome) patients referred for advanced medical therapy between January 2005 and March 2007 in the Academic Medical Center in Amsterdam. Patients with severe renal impairment were excluded.
Main Outcome Measure
The primary outcome was mortality.
Results
Of all 31 patients (mean age 45 ± 12 years) with CHD‐PAH, eight patients died during a median follow‐up of 5.6 (range 1.6 to 6.8) years. A hsTnT level >0.014 μg/L was the 99th percentile cutoff of the normal distribution and therefore defined as elevated. At baseline, elevated levels of hsTnT were found in eight patients (26%). In univariate Cox regression, hsTnT elevated at baseline, NT‐pro‐BNP and right ventricular function were determinants of death (P < .05 for all). Patients with elevated levels of hsTnT showed a significantly higher mortality rate as compared to patients with normal hsTnT levels (62% vs. 13%, P = .005).
Conclusion
Levels of hsTnT were abnormal in a substantial proportion of CHD‐PAH patients. A significant inverse relationship was found between hsTnT and survival.</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>23241414</pmid><doi>10.1111/chd.12022</doi><tpages>7</tpages></addata></record> |
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| ispartof | Congenital heart disease, 2013-11, Vol.8 (6), p.520-526 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Academic Medical Centers Adult Biomarkers - blood Chi-Square Distribution Congenital Heart Disease Eisenmenger Complex - blood Eisenmenger Complex - complications Eisenmenger Complex - diagnosis Eisenmenger Complex - mortality Eisenmenger Complex - physiopathology Familial Primary Pulmonary Hypertension Female Humans Hypertension, Pulmonary - blood Hypertension, Pulmonary - diagnosis Hypertension, Pulmonary - etiology Hypertension, Pulmonary - mortality Hypertension, Pulmonary - physiopathology Kaplan-Meier Estimate Male Middle Aged Natriuretic Peptide, Brain - blood Netherlands Peptide Fragments - blood Predictive Value of Tests Prognosis Proportional Hazards Models Pulmonary Arterial Hypertension Risk Factors Survival Time Factors Troponin Troponin T - blood Up-Regulation Ventricular Function, Right |
| title | High-sensitivity Troponin T Is Associated with Poor Outcome in Adults with Pulmonary Arterial Hypertension due to Congenital Heart Disease |
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