Improved diagnostic performance of high-sensitivity cardiac troponins in muscle dystrophies using comprehensive definition criteria for cardiac involvement

• Verfasst von: Yildirim, Mustafa [VerfasserIn]
• Verfasst von: Salbach, Christian [VerfasserIn]
• Verfasst von: Reich, Christoph [VerfasserIn]
• Verfasst von: Pribe-Wolferts, Regina [VerfasserIn]
• Verfasst von: Milles, Barbara Ruth [VerfasserIn]
• Verfasst von: Täger, Tobias [VerfasserIn]
• Verfasst von: Müller-Hennessen, Matthias [VerfasserIn]
• Verfasst von: Weiler, Markus [VerfasserIn]
• Verfasst von: Meder, Benjamin [VerfasserIn]
• Verfasst von: Frey, Norbert [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Titel: Improved diagnostic performance of high-sensitivity cardiac troponins in muscle dystrophies using comprehensive definition criteria for cardiac involvement
• Titelzusatz: a longitudinal study on 35 patients
• Verf.angabe: Mustafa Yildirim, Christian Salbach, Christoph Reich, Regina Pribe-Wolferts, Barbara Ruth Milles, Tobias Täger, Matthias Mueller-Hennessen, Markus Weiler, Benjamin Meder, Norbert Frey, Evangelos Giannitsis
• E-Jahr: 2024
• Jahr: December 2024
• Umfang: 11 S.
• Illustrationen: Diatramme
• Fussnoten: Online veröffentlicht: 30. September 2024 ; Gesehen am 19.03.2025
• Titel Quelle: Enthalten in: European journal of neurology
• Ort Quelle: Oxford [u.a.] : Wiley-Blackwell, 1994
• Jahr Quelle: 2024
• Band/Heft Quelle: 31(2024), 12 vom: Dez., Artikel-ID e16498, Seite 1-11
• ISSN Quelle: 1468-1331
• DOI: doi:10.1111/ene.16498
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: cardiac involvement
• Sach-SW: cardiac troponin
• Sach-SW: diagnosis
• Sach-SW: muscular dystrophy
• Sach-SW: skeletal muscle dystrophies
• K10plus-PPN: 1920108971

Abstract

Background and purpose Sparse information is available on the correct interpretation of elevated high-sensitivity cardiac troponin (hs-cTn) in confirmed muscular dystrophies. Methods Serum concentrations of hs-cTn T (hs-cTnT) and hs-cTn I (hs-cTnI) were determined in 35 stable outpatients with confirmed skeletal muscle dystrophies. We calculated sensitivities, specificities, and positive and negative predictive values of hs-cTnT and hs-cTnI for identification of cardiac involvement using a comprehensive definition that included diastolic left ventricular and right ventricular function, strain analysis using two-dimensional transthoracic echocardiogram and magnetic resonance imaging, myocardial biopsies, and consideration of a variety of triggers for cardiac injury, including arrhythmias, conduction disorders, and hypoxemia due to respiratory failure. Results Cardiac involvement was diagnosed in 34 of 35 cases. Specificities of hs-cTnT increased from 12.5% to 100% (p = 0.0006) applying the comprehensive definition compared to a definition based on electrocardiography and echocardiography alone. At the recommended 99th percentile upper limit of normal, sensitivities were significantly lower for hs-cTnI than for hs-cTnT (29.4% vs. 100%, p = 0.0164). Conversely, the specificities of hs-cTnT and hs-cTnI increased to 100% when using the comprehensive definition criteria for diagnosing cardiac involvement. Conclusions Elevated hs-cTnT but not hs-cTnI discriminates cardiac involvement in cases with confirmed skeletal muscle dystrophies with very high sensitivity and 100% specificity. Prior reports on worse performance may be explained by the use of less sensitive imaging methods or incomplete assessment of cardiac involvement.