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Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy
  1. C L Hu1,
  2. Y B Li2,
  3. Y G Zou3,
  4. J M Zhang4,
  5. J B Chen1,
  6. J Liu1,
  7. Y H Tang1,
  8. Q Z Tang1,
  9. C X Huang1
  1. 1Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
  2. 2Department of Obstetrics and Gynecology, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
  3. 3Department of Cardiology, Xiaogan General Hospital, Xiaogan, People’s Republic of China
  4. 4Department of Cardiology, Wuhan Xiehe Hospital, Wuhan, People’s Republic of China
  1. Correspondence to:
    Dr C L Hu
    Department of Cardiology, Renmin Hospital, Wuhan University School of Medicine, 238 JieFang Road, Wuchang District, Wuhan 430060, People’s Republic of China; chenglinhu{at}yahoo.com

Abstract

Objective: To determine whether measurement of cardiac troponin T (cTnT) concentration in newly diagnosed peripartum cardiomyopathy (PPCM) can be used to predict persistent left ventricular dysfunction after a 6-month follow-up.

Patients and methods: This was a prospective, multiple-centre clinical trial that studied 106 patients with newly diagnosed PPCM surviving over 6 months. cTnT concentration was measured within 2 weeks of the onset of PPCM.

Results: Serum cTnT concentration was negatively correlated with left ventricular ejection fraction (LVEF) at follow-up (LVEF, r = −0.518, p = 0.0001). Analysis by receiver operator characteristic curve yielded an area under the curve of 0.764 (95% CI 0.669 to 0.860, p = 0.0001, vs null hypothesis value 0.5) for cTnT, and a cTnT concentration cut off of >0.04 ng/ml, predicting persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%. Among 106 recruited patients, there were 33 patients with cTnT concentrations >0.04 ng/ml and 73 patients with cTnT concentrations ⩽0.04 ng/ml. After a 6-month follow-up, there was significantly smaller LVEF (35.42% (13.04% vs 50.16% (10.48%, p = 0.0001) and more persistent left ventricular dysfunction (84.8% vs 31.5%, OR = 12.17 (95% CI 4.17 to 35.57), p = 0.001) in patients with cTnT >0.04 ng/ml than in patients with cTnT ⩽0.04 ng/ml.

Conclusion: Serum cTnT concentration measured within 2 weeks of the onset of PPCM was correlated negatively with LVEF at follow-up. This marker offers a simple, quick, inexpensive, non-invasive method for predicting a persistent LVEF of ⩽50%. A cTnT concentration of >0.04 ng/ml predicted persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%.

  • cTnT, cardiac troponin T
  • LVEF, left ventricular ejection fraction PPCM, peripartum cardiomyopathy
  • ROC, receiver-operating characteristic

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Footnotes

  • Published Online First 25 October 2006

  • Competing interests: None.

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