PMID- 23141854
OWN - NLM
STAT- MEDLINE
DCOM- 20130823
LR  - 20181202
IS  - 1532-8414 (Electronic)
IS  - 1071-9164 (Linking)
VI  - 18
IP  - 11
DP  - 2012 Nov
TI  - Minor myocardial damage is a prevalent condition in patients with acute heart 
      failure syndromes and preserved systolic function with long-term prognostic 
      implications: a report from the CIAST-HF (Collaborative Italo-Argentinean Study 
      on cardiac Troponin T in Heart Failure) study.
PG  - 822-30
LID - S1071-9164(12)01285-7 [pii]
LID - 10.1016/j.cardfail.2012.10.008 [doi]
AB  - BACKGROUND: Half of patients with acute heart failure syndromes (AHFS) have 
      preserved left ventricular ejection fraction (PLVEF). In this setting, the role 
      of minor myocardial damage (MMD), as identified by cardiac troponin T (cTnT), 
      remains to be established. AIM: To evaluate the prevalence and long-term 
      prognostic significance of cTnT elevations in patients with AHFS and PLVEF. 
      PATIENTS AND METHODS: This retrospective, multicenter, collaborative study 
      included 500 patients hospitalized for AHFS with PLVEF (ejection fraction >/=40%) 
      between October 2000 and December 2006. Blood samples were collected within 12 
      hours after admission and were assayed for cTnT. MMD was defined as a cTnT value 
      of >/=0.020 ng/mL. RESULTS: Mean age was 73 +/- 12 years, 47% were female, 38% had an 
      ischemic etiology, and New York Heart Association (NYHA) class was 2.2 +/- 0.7. 
      Mean cTnT value was 0.149 +/- 0.484 ng/mL, and cTnT was directly correlated with 
      serum creatinine (Spearman's Rho = 0.35, P < .001) and NYHA class (0.25, P < 
      .001). MMD was diagnosed in 220 patients (44%). Patients with MMD showed lower 
      left ventricular ejection fraction (P < .05), higher serum creatinine (P < .001), 
      higher prevalence of ischemic etiology and diabetes mellitus, a worse NYHA class 
      (P < .001), and higher natriuretic peptide levels (P < .001) as compared with 
      patients without MMD. At 6-month follow-up, overall event-free survival was 55% 
      and 75% in patients with and without MMD (P < .001), respectively. On 
      multivariate Cox regression analysis, only NYHA class (HR = 1.50; P = .002) and 
      MMD (HR = 1.81; P = .001) were identified as predictors of events. CONCLUSIONS: 
      Increased cTnT levels were detected in approximately 50% of patients with AHFS 
      with preserved systolic function, and were found to correlate with clinical 
      measures of disease severity. The presence of MMD was associated with a worse 
      long-term outcome, lending support to cTnT-based risk stratification in the 
      setting of AHFS.
CI  - Copyright (c) 2012 Elsevier Inc. All rights reserved.
FAU - Perna, Eduardo R
AU  - Perna ER
AD  - Heart Failure Clinic, Coronary Intensive Care Unit, Instituto de Cardiologia 
      "Juana F. Cabral", Corrientes, Argentina. pernaucic@hotmail.com
FAU - Aspromonte, Nadia
AU  - Aspromonte N
FAU - Cimbaro Canella, Juan P
AU  - Cimbaro Canella JP
FAU - Di Tano, Giuseppe
AU  - Di Tano G
FAU - Macin, Stella M
AU  - Macin SM
FAU - Feola, Mauro
AU  - Feola M
FAU - Coronel, Maria L
AU  - Coronel ML
FAU - Milani, Loredano
AU  - Milani L
FAU - Parras, Jorge I
AU  - Parras JI
FAU - Milli, Massimo
AU  - Milli M
FAU - Garcia, Edgar H
AU  - Garcia EH
FAU - Valle, Roberto
AU  - Valle R
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - J Card Fail
JT  - Journal of cardiac failure
JID - 9442138
RN  - 0 (Troponin T)
SB  - IM
MH  - Acute Coronary Syndrome/epidemiology/metabolism/physiopathology
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Argentina/epidemiology
MH  - Cooperative Behavior
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*epidemiology/metabolism/*physiopathology
MH  - Humans
MH  - Italy/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism/*pathology
MH  - Predictive Value of Tests
MH  - Prevalence
MH  - Prognosis
MH  - Retrospective Studies
MH  - Syndrome
MH  - Systole/*physiology
MH  - Time
MH  - Troponin T/biosynthesis/*metabolism
MH  - Young Adult
EDAT- 2012/11/13 06:00
MHDA- 2013/08/24 06:00
CRDT- 2012/11/13 06:00
PHST- 2012/05/18 00:00 [received]
PHST- 2012/09/30 00:00 [revised]
PHST- 2012/10/02 00:00 [accepted]
PHST- 2012/11/13 06:00 [entrez]
PHST- 2012/11/13 06:00 [pubmed]
PHST- 2013/08/24 06:00 [medline]
AID - S1071-9164(12)01285-7 [pii]
AID - 10.1016/j.cardfail.2012.10.008 [doi]
PST - ppublish
SO  - J Card Fail. 2012 Nov;18(11):822-30. doi: 10.1016/j.cardfail.2012.10.008.