Correlation of High-sensitive Cardiac Troponin T with Chronic Heart Failure and Its Differential Significance for Acute Myocardial Infarction

Objective To explore the correlation of high-sensitive cardiac troponin T(HS-cTNT) with chronic heart failure(CHF) and its differential significance for acute myocardial infarction(AMI).Methods A total of 200 CHF patients(CHF group) and 100 AMI patients(AMI group) hospitalized in this hospital from January to November 2012,50 healthy subjects(control group) were enrolled in this study.Based on level of serum HS-cTNT(reference value 0.014 ng / ml),CHF group were divided into subgroups elevated HS-cTNT(n = 127),normal HS-cTNT(n = 73).Serum HS-cTNT level was determined in all groups on day 1 on admission;all chambers of the heart 〔left ventricle dimension(LVD),left atrial dimension(LAD),right ventricular dimension(RVD) 〕and ejection fraction(EF) were determined by ultrasonic cardiogram;rehospitalization rate was observed in CHF patients after 6 months.Results The HS-cTNT level of CHF group was 18 times higher than that of control group 〔(0.36 ± 0.10) ng / ml,(0.03 ± 0.01) ng / ml,respectively,P 0.05〕;the HS-cTNT level of AMI group 〔(3.02 ± 1.83) ng / ml〕was 8 times higher than that of CHF group(P 0.05).Serum HS-cTNT at 0.08 ~0.23 ng / ml was of significance for CHF diagnosis.There was significant difference in HS-cTNT level between patients with different cardiac functional grading(P 0.05);HS-cTNT level was higher in patients with grades Ⅲ,Ⅳ than in those with grade Ⅱ,higher in those with grade IV than in those with grade Ⅲ(P 0.05).There was difference in HS-cTNT levels between patients due to different causes(P 0.05),HS-cTNT level higher in patients with diabetic cardiomyopathy,ischemic cardiomyopathy,dilated cardiomyopathy than in those with hypertensive cardiopathy,higher in patients with dilated cardiomyopathy than in those with diabetic cardiomyopathy and ischemic cardiomyopathy(P 0.05).HS-cTNT level was positively correlated with cardiac functional grading,LVD,LAD,RVD(r = 0.330,0.150,0.142,0.146,respectively,P 0.05),negatively with EF(r =-1.740,P 0.01).The rehospitalization rate of elevated HS-cTNT group was 40.9%(52 /127),higher than that of normal HS-cTNT group of 21.9%(16 /73),the difference was significant(χ2= 52.5,P 0.01).Conclusion HS-cTNT level is positively correlated with all chambers of the heart,negatively with EF.HS-cTNT level at 0.08 ~0.23 ng / ml can be used as point of differential diagnosis of CHF,AMI.Detection of HS-cTNT level in CHF patients is of importance to clinical treatment and prevention of CHF.