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High sensitivity troponins in patients with heart failure and preserved left ventricular ejection fraction of valvular genesis

Authors: Kremneva L.V.1 2, Gapon L.I.2, Shalaev S.V.1

Company: 1 Tyumen State Medical University, Tyumen, Russian Federation
2 Tyumen Cardiology Research Center, Tomsk National Research Medical Center, Tyumen, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-1-79-87

For citation: Kremneva L.V., Gapon L.I., Shalaev S.V. High sensitivity troponins in patients with heart failure and preserved left ventricular ejection fraction of valvular genesis. Creative Cardiology. 2025; 19 (1): 79–87 (in Russ.). DOI: 10.24022/1997-3187-2025-19-1-79-87

Received / Accepted:  09.01.2025 / 23.01.2025

Keywords: heart failure with preserved ejection fraction valvular heart disease high sensitivity troponin I



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Abstract

Aim – to assess the possibility of using high sensitivity troponin I (hs-TnI) todetermine the severity of heart failure (HF) in patients with acquired valvular heartdisease (VHD) and left ventricular (LV) preserved ejection fraction (HFpEF).

Material and methods. The study included patients with VHD and signs of HFpEF (LVEF ± 50%). Functional class (FC) of HF was determined according to NYHA criteria. Blood levels of hs-TnI, a precursor of the N-terminal pro-brain natriuretic peptide (Nt-proBNP), were determined using kits for immunochemiluminescent assay, C-reactive protein (CRP) by high sensitive immunoturbidimetric assay. All patients underwent echocardiography using GE Vivid E90. Spearman rank correlation coefficient twas used to evaluate relationship between indicators.

Results. 57 patients (40,4% males, 59,6% females) with VHD and HFpEF (mean age 65 ± 9,1 years) were examined. HF FC II was in 63,2%, HF FC III registered in 36,8% of individuals. Rheumatism was revealed in 21,1%, degenerative defects had 73,3%, mitral valve defects were in 24,6%, aortic valve defects found in 75,4% of patients, arterial hypertension detected in 94,7%, class I–III of obesityhad 43,9%, type 2 diabetes mellitus was in 15,8% of patients. In patients with HF FC III compared to HF FC II, cardiac dimensions were larger: left atrium (4,9 ± 0,8 and 4,6 ± 0,5 cm, P= 0,035), end- diastolic volume (LVV) (155 ± 33 and 131 ± 35 ml, P= 0,015), LV end-systolic volume (ESV) (62 ± 19 and 48 ± 19 ml, P= 0,009); higher levels of hs-TnI (6,0; 3,3–9,5 and 2,0; 1,0–5,7 ng/l, P= 0,002) and Nt-proBNP (4601; 2066–7061 and 292; 215–1056 pg/ml, P= 0,008). Relationship between the level of hs-TnI and LV EDV (r = 0,310, P= 0,025), LV ESV (r = 0,426, P= 0,002), LV EF (r = –0,350, P= 0,010), Nt-proBNP (r = 0,555, P= 0,017), FC HF (r = 0,417, P= 0,001) was revealed.

Conclusion. In patients with VHD the level of hsTn I reflects the extent of myocardial injury and may be used as additional marker of the severity of HFpEF.

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About Authors

  • Lyudmila V. Kremneva, Dr. Med. Sci., Professor, Senior Researcher; ORCID
  • Lyudmila I. Gapon, Dr. Med. Sci., Professor, Head of the Scientific Division of Clinical Cardiology; ORCID
  • Sergey V. Shalaev, Dr. Med. Sci., Professor, Corresponding Member of the Russian Academy of Sciences, Head of the Chair of cardiology and cardiac surgery with a course of emergency medical care; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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