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European Journal of Heart Failure Advance Access originally published online on June 5, 2009
European Journal of Heart Failure 2009 11(7):653-658; doi:10.1093/eurjhf/hfp072
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Relationship between renal function and serum cardiac troponin T in patients with chronic heart failure

Takayoshi Tsutamoto*, Chiho Kawahara, Masayuki Yamaji, Keizo Nishiyama, Masanori Fujii, Takashi Yamamoto and Minoru Horie

Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Tsukinowa, Seta, Otsu 520-2192, Japan

* Corresponding author. Tel: +81 77 548 2213, Fax: +81 77 543 5839, Email: tutamoto{at}belle.shiga-med.ac.jp


  Abstract

Aims: Both serum cardiac troponin T (cTnT) and renal function are prognostic predictors in patients with chronic heart failure (CHF). We aimed to evaluate the relationship between renal function and serum cTnT.

Methods and results: We measured serum concentrations of cTnT in the aortic root (AO) and coronary sinus (CS) in 258 CHF patients. Patients were divided into two groups: patients with an estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 [chronic kidney disease (CKD)(–)], and patients with an eGFR < 60 mL/min/1.73 m2 [CKD (+)]. In 32 (12%) of the 258 CHF patients, serum levels of cTnT were detectable (≥0.03 ng/mL) in the AO and in the CS. There was no correlation between eGFR and the transcardiac increase in cTnT and there was a significant negative correlation between eGFR and the serum cTnT concentration (r = – 0.365, P = 0.039). There was no difference in the transcardiac gradient of cTnT between patients without CKD (n = 16) and patients with CKD (n = 16) (0.083 ± 0.11 vs. 0.108 ± 0.13 ng/mL, P = 0.55). However, the serum cTnT level in the AO was two-fold higher in CHF patients with CKD than patients without CKD (0.20 ± 0.177 vs. 0.088 ± 0.065 ng/mL, P < 0.05).

Conclusion: These findings indicate that decreased clearance via the kidney contributes to the elevated cTnT in CHF patients with CKD.

Key Words: Brain natriuretic peptide • Cardiac troponin T • Heart failure • Coronary sinus • Chronic kidney disease

Received January 8, 2008; Revised March 8, 2009; Accepted April 6, 2009


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