Sensitive cardiac troponins and N-terminal pro-B-type natriuretic peptide in stable coronary artery disease: correlation with left ventricular function as assessed by myocardial strain

Int J Cardiovasc Imaging. 2015 Jun;31(5):967-73. doi: 10.1007/s10554-015-0646-6. Epub 2015 Mar 19.

Abstract

N-terminal pro-B-type natriuretic peptide (NT-proBNP) and cardiac troponins (cTns) measured with sensitive assays provide strong prognostic information in patients with stable coronary artery disease. However, the relationship between these biomarkers and myocardial contractile function, as well as infarct size, in this patient group, remains to be defined. The study population consisted of 160 patients referred to a follow-up echocardiography scheduled 1 year after coronary revascularization. Concentrations of NT-proBNP, high-sensitive cTnT (hs-cTnT) and sensitive cTnI assays were assessed. Left ventricular function was measured as global peak systolic longitudinal strain by speckle tracking echocardiography and infarct size was assessed by late-enhancement MRI. NT-proBNP and sensitive cTnI levels were significantly associated with left ventricular function by peak systolic strain (R-values 0.243 and 0.228, p = 0.002 and 0.004) as well as infarct size (R-values 0.343 and 0.366, p = 0.014 and p = 0.008). In contrast, hs-cTnT did not correlate with left ventricular function (R = 0.095, p = 0.231) and only marginally with infarct size (R = 0.237, p = 0.094). NT-proBNP and sensitive cTnI levels correlate with left ventricular function and infarct size in patients with stable coronary artery disease after revascularization. As opposed to hs-cTnT, NT-proBNP and cTnI seem to be indicators of incipient myocardial dysfunction and the extent of myocardial necrosis.

MeSH terms

  • Aged
  • Biomarkers / blood
  • Biomechanical Phenomena
  • Coronary Angiography
  • Coronary Artery Disease / blood
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / physiopathology
  • Coronary Artery Disease / therapy
  • Echocardiography
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Myocardial Contraction*
  • Myocardial Infarction / blood
  • Myocardial Infarction / diagnosis*
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy
  • Myocardial Revascularization
  • Myocardium / pathology
  • Natriuretic Peptide, Brain / blood*
  • Necrosis
  • Norway
  • Peptide Fragments / blood*
  • Predictive Value of Tests
  • Prospective Studies
  • Stress, Mechanical
  • Time Factors
  • Treatment Outcome
  • Troponin I / blood*
  • Troponin T / blood*
  • Ventricular Function, Left*
  • Ventricular Remodeling

Substances

  • Biomarkers
  • Peptide Fragments
  • TNNT2 protein, human
  • Troponin I
  • Troponin T
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain