Prognostic Value of Troponin T in Chronic Heart Failure Patients

Abstract

Heart failure (HF) is a growing public health problem with significant morbidity, mortality, and cost to the health care system. Although some patients have significant improvement in left ventricular function over time in response to HF medical therapy, other patients do not respond or have progressive left ventricular dysfunction. Cardiac troponin represent markers of myocardial injury that are detected in a significant portion of patients with acute and chronic HF. Cardiac troponin levels are associated with an increased risk of morbidity and mortality in both acute and chronic HF. Preliminary studies suggest cTn may help in assessment of response to HF therapy and identify patients for whom more intensive monitoring and management may be needed. • The current study aimed to confirm prognostic value of CtnT levels in chronic heart failure. • The current study evaluated. o 40 patients with compensated heart failure (NYHA functional class II, III). 􀀉 Summary 􀀆 112 o 60 patients with decompensated heart failure (NYHA functional class III, IV). Patients with acute coronary syndrome, malignancy, hypovolemia, pulmonary embolism, myocarditis, renal failure and chest trauma were excluded. The candidates were subjected to the following: • History taking • Clinical examination • ECG • Cheat X ray • Laboratory examination • Echocardiography • Quantitative measurement of troponin T. Patients were then divided into two groups according to cTnT level into: Group 1: They are cardiac troponin T negative included 57 patients Group 2: They are cardiac troponin T positive included 43 patients Patients who were cTnT+ had significantly lower left ventricular ejection fractions compared with the patients cTnT􀀉 Summary 􀀆 113 the correlation between cTnT levels and ejection fraction was r = - 252 and P value was > 0.001 which is significant. In this study patients with ischemic etiology about 32 patients, Troponin T positive in 24 patients (55.8 %), while patients with non ischemic etiology 68 patients, 19 patients (44,2%) with Troponin T positive, so patients with ischemic etiology had higher significant difference in concentration of Troponin T.