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: | , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
December 2024
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| 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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| 245 | 1 | 0 | |a Improved diagnostic performance of high-sensitivity cardiac troponins in muscle dystrophies using comprehensive definition criteria for cardiac involvement |b a longitudinal study on 35 patients |c 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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| 520 | |a 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. | ||
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