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Impact of Left Ventricular Hypertrophy on Troponin Release During Acute Myocardial Infarction: New Insights From a Comprehensive Translational Study

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العنوان: Impact of Left Ventricular Hypertrophy on Troponin Release During Acute Myocardial Infarction: New Insights From a Comprehensive Translational Study
المؤلفون: Fernandez-Jimenez, Rodrigo, Silva, Jacobo, Martinez-Martinez, Sara, Lopez-Maderuelo, Dolores, Nuno-Ayala, Mario, Garcia-Ruiz, Jose M, Garcia-Alvarez, Ana, Fernandez-Friera, Leticia, Pizarro, Gonzalo, Garcia-Prieto, Jaime, Sanz-Rosa, David, Lopez-Martin, Gonzalo J., Fernandez-Ortiz, Antonio, Macaya, Carlos, Fuster, Valentin, Redondo, Juan Miguel, Ibáñez, Borja
المساهمون: Instituto de Salud Carlos III, Ministerio de Sanidad, Servicios Sociales e Igualdad (España), Ministerio de Economía y Competitividad (España), Fundación ProCNIC
بيانات النشر: Wiley
سنة النشر: 2015
المجموعة: REPISALUD (REPositorio Institucional en SALUD del Instituto de Salud Carlos III - ISCIII)
مصطلحات موضوعية: Creatine kinase, Hypertrophy, Magnetic resonance imaging, Myocardial infarction, Troponin, PERCUTANEOUS CORONARY INTERVENTION, CREATINE-KINASE ISOENZYMES, MAGNETIC-RESONANCE, CARDIAC INJURY, LABORATORY-ANIMALS, GENERAL-POPULATION, TRANSMURAL EXTENT, ADVERSE OUTCOMES, PROGNOSTIC VALUE, EARLY METOPROLOL
الوصف: Background-Biomarkers are frequently used to estimate infarct size (IS) as an endpoint in experimental and clinical studies. Here, we prospectively studied the impact of left ventricular (LV) hypertrophy (LVH) on biomarker release in clinical and experimental myocardial infarction (MI). Methods and Results-ST-segment elevation myocardial infarction (STEMI) patients (n=140) were monitored for total creatine kinase (CK) and cardiac troponin I (cTnI) over 72 hours postinfarction and were examined by cardiac magnetic resonance (CMR) at 1 week and 6 months postinfarction. MI was generated in pigs with induced LVH (n=10) and in sham-operated pigs (n=8), and serial total CK and cTnI measurements were performed and CMR scans conducted at 7 days postinfarction. Regression analysis was used to study the influence of LVH on total CK and cTnI release and IS estimated by CMR (gold standard). Receiver operating characteristic (ROC) curve analysis was performed to study the discriminatory capacity of the area under the curve (AUC) of cTnI and total CK in predicting LV dysfunction. Cardiomyocyte cTnI expression was quantified in myocardial sections from LVH and sham-operated pigs. In both the clinical and experimental studies, LVH was associated with significantly higher peak and AUC of cTnI, but not with differences in total CK. ROC curves showed that the discriminatory capacity of AUC of cTnI to predict LV dysfunction was significantly worse for patients with LVH. LVH did not affect the capacity of total CK to estimate IS or LV dysfunction. Immunofluorescence analysis revealed significantly higher cTnI content in hypertrophic cardiomyocytes. Conclusions-Peak and AUC of cTnI both significantly overestimate IS in the presence of LVH, owing to the higher troponin content per cardiomyocyte. In the setting of LVH, cTnI release during STEMI poorly predicts postinfarction LV dysfunction. LV mass should be taken into consideration when IS or LV function are estimated by troponin release. ; This work was supported by an award from the ...
نوع الوثيقة: article in journal/newspaper
اللغة: English
تدمد: 2047-9980
Relation: https://doi.org/10.1161/JAHA.114.001218; ISI:000348597500012; J Am Heart Assoc. 2015; 4(1):e001218; http://hdl.handle.net/20.500.12105/5525; Journal of the American Heart Association
DOI: 10.1161/JAHA.114.001218
الاتاحة: https://hdl.handle.net/20.500.12105/5525
https://doi.org/10.1161/JAHA.114.001218
Rights: http://creativecommons.org/licenses/by/4.0/ ; Atribución 4.0 Internacional ; open access
رقم الانضمام: edsbas.E3074960
قاعدة البيانات: BASE
الوصف
تدمد:20479980
DOI:10.1161/JAHA.114.001218