Is Cardiac Troponin I Valuable to Detect Low-Level Myocardial Damage in Congestive Heart Failure?

Özet

Objectives: Congestive heart failure (CHF) is a heart disease with a growing incidence and prevalence. Creatine kinase-myocardialbase (CK-MB) is generally used to determine myocardial damage; however, it is insufficiently sensitive to measure the relatively lowlevel of myocardial damage that typically occurs in heart failure (HF). The use of cardiac troponins, which are far more sensitive andspecific, has become common to identify myocardial damage and permits the detection of even minute amounts of damage. Theaim of this study was to ascertain whether cardiac troponin I (cTnI) can be used to detect low-level myocardial damage occurringin CHF in real-life conditions.Methods: Fifty patients with CHF symptoms (Group I) and 20 patients who were evaluated as normal (Group II) were included inthis prospective study. The Framingham criteria were used to diagnose HF. Group I was divided into 3 subgroups according to theNew York Heart Association classification of functional capacity: Class II, Group A; Class III, Group B, and Class IV, Group C. On thefirst day of admission, CK-MB and cTnI levels were measured and assessed quantitatively. The cTnI level was compared betweenthese 3 subgroups and between Groups I and II. Linear regression analysis was performed to investigate the relationship betweenejection fraction (EF) and cTnI.Results: The mean cTnI value was 0.084±0.07 ng/mL in Group I and 0.018±0.012 ng/mL in Group II (p=0.0001). The mean cTnI valuewas 0.047±0.016 ng/mL, 0.080±0.048 ng/mL, and 0.175± 0.102 ng/mL in Groups A, B, and C, respectively. The difference betweenthe subgroups of Group I was statistically significant. In addition, it was observed that there was a significant difference in the EF(%) value between Groups I and II and between Groups A, B, and C. Linear regression analysis revealed an inverse relationship between EF and cTnI (r: -0.66) (p=0.0001).Conclusion: As the severity of HF increased, the cTnI serum level also increased. This increase was inversely related to the EF value.These results are consistent with other studies in the literature, suggesting that the cTnI level may be a useful marker in the diagnosis and evaluation of severity of HF.