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Improved diagnostic performance of high-sensitivity cardiac troponins in muscle dystrophies using comprehensive definition criteria for cardiac involvement: a longitudinal study on 35 patients

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 confi...

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Main Authors: Yildirim, Mustafa (Author) , Salbach, Christian (Author) , Reich, Christoph (Author) , Pribe-Wolferts, Regina (Author) , Milles, Barbara Ruth (Author) , Täger, Tobias (Author) , Müller-Hennessen, Matthias (Author) , Weiler, Markus (Author) , Meder, Benjamin (Author) , Frey, Norbert (Author) , Giannitsis, Evangelos (Author)
Format: Article (Journal)
Language:English
Published: December 2024
In: European journal of neurology
Year: 2024, Volume: 31, Issue: 12, Pages: 1-11
ISSN:1468-1331
DOI:10.1111/ene.16498
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1111/ene.16498
Verlag, kostenfrei, Volltext: https://onlinelibrary.wiley.com/doi/abs/10.1111/ene.16498
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Author Notes: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
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Summary: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.
Item Description:Online veröffentlicht: 30. September 2024
Gesehen am 19.03.2025
Physical Description:Online Resource
ISSN:1468-1331
DOI:10.1111/ene.16498

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