Paz Castro Fernández*, Carmen Vozmediano Poyatos, Martin Negreira Caamaño, Daniel Campos Valverde, Luis Piccone Saponara, Guillermo Ferrer García, Gloria García Conejo, Roger Cox Conforme, Marcos Santos-Olmo Montoya and Agustín Carreño Parrilla
Objective: There are clinical conditions with histological evidence of non-ischemic myocardial necrosis that are associated with elevated troponin levels, such as the structural and functional alterations of the Left Ventricle (LV) that occur in Left Ventricular Diastolic Dysfunction (LVDD). We analyzed the relationship between the ultrasensitive Troponin I biomarker (TnI-US) and LVDD in a cohort of asymptomatic Hemodialysis (HD) patients.
Methods: Descriptive cross-sectional study including 80 patients. Categorical variables were compared using Chi2 test, and quantitative variables were compared with Student's t-test or Mann-Whitney U-test. ROC curve to determine the predictive value of TnI-US levels for LVDD. Logistic regression analysis to determine the factors independently associated with LVDD.
Results: The mean TnI-US was 31.2 ± 59.3 pg/ml, and 40% of patients had TnI-US >20 pg/ml. These patients had higher frequency of LVDD (56.3% vs. 25%, p=0.005). 37.5% of patients had LVDD and higher proportion of moderate/severe Left Ventricular Hypertrophy (LVH) (63.3% vs. 36.7%, p=0.02), lower heart rate at the start of HD (66.9 ± 8.6 bpm vs. 77.2 ± 43.6 bpm, p=0.03), and higher TnI-US (47.4 ± 81.9 pg/ml vs. 21.5 ± 38.1 pg/ml, p=0.005). Logistic regression analysis showed that TnI-US >20 pg/ml [OR: 4.1 (95% CI 1.3-12.1), p=0.01] and moderate/severe LVH [OR: 5.1 (95% CI 1.7-15.2), p=0.003] were independently associated with LVDD, while an increase in heart rate [OR: 0.9 (95% CI 0.8-0.9); p=0.02] was independently associated with a lower risk of LVDD.
Conclusion: TnI-US can be used as a biomarker for LVDD in asymptomatic patients on HD.
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