PMID- 31882822
OWN - NLM
STAT- MEDLINE
DCOM- 20201116
LR  - 20210110
IS  - 2045-2322 (Electronic)
IS  - 2045-2322 (Linking)
VI  - 9
IP  - 1
DP  - 2019 Dec 27
TI  - Relationship of extracellular volume assessed on cardiac magnetic resonance and 
      serum cardiac troponins and natriuretic peptides with heart failure outcomes.
PG  - 20168
LID - 10.1038/s41598-019-56213-4 [doi]
LID - 20168
AB  - Measures of serum cardiac troponins and natriuretic peptides have become 
      established as prognostic heart failure risk markers. In addition to detecting 
      myocardial fibrosis through late gadolinium enhancement (LGE), extracellular 
      volume fraction (ECV) measures by cardiac magnetic resonance (CMR) have emerged 
      as a phenotypic imaging risk marker for incident heart failure outcomes. We 
      sought to examine the relationship between cardiac troponins, natriuretic 
      peptides, ECV and their associations with incident heart failure events in a CMR 
      referral base. Mid short axis T1 maps were divided into 6 cardiac segments, each 
      classified as LGE absent or present. Global ECV was derived from T1 maps using 
      the area-weighted average of only LGE-absent segments. ECV was considered 
      elevated if measured >30%, the upper 95% bounds of a reference healthy group 
      without known cardiac disease (n = 28). Patients were dichotomized by presence of 
      elevated ECV. High-sensitivity cardiac troponin T (hs-cTnT) and N-terminal B-type 
      natriuretic peptide (NT-proBNP) were measured using serum samples acquired and 
      stored at time of CMR scan, and patients were categorized into 3 groups for each 
      blood marker based on recommended cutoff values. Subsequent heart failure 
      admission and any death were ascertained. Relationships with ECV, hs-cTnT, and 
      NT-proBNP were examined separately and as a composite with Cox proportional 
      hazard models. Of 1,604 serial patients referred for a clinical CMR with 
      myocardial T1 maps, 331 were eligible after exclusions and had blood available 
      and were followed over a median 25.0 [interquartile range 21.8, 31.7] months. 
      After adjustments for age (mean 57.3 [standard deviation (SD) 15.1 years), gender 
      (61% male), and ethnicity (12.7% black), elevated ECV remained a predictor of a 
      first composite heart failure outcome for patients with high levels of hs-cTnT 
      (>/=14 ng/L; hazard ratio [HR] 2.42 [95% confidence interval (CI) 1.17, 5.03]; 
      p = 0.02) and NT-proBNP (>/=300 pg/mL; HR 2.28 [95% CI 1.24, 4.29]; p = 0.01). 
      Similar trends were seen for lower category levels of blood markers, but did not 
      persist with minimal covariate adjustments. Elevated measures of ECV by CMR are 
      associated with incident heart failure outcomes in patients with high hs-cTnT and 
      NT-proBNP levels. This imaging marker may have a role for additional heart 
      failure risk stratification.
FAU - Yang, Eric Y
AU  - Yang EY
AUID- ORCID: 0000-0003-2234-3269
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Khan, Mohammad A
AU  - Khan MA
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Graviss, Edward A
AU  - Graviss EA
AUID- ORCID: 0000-0003-1024-5813
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Nguyen, Duc T
AU  - Nguyen DT
AUID- ORCID: 0000-0002-5059-4404
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Bhimaraj, Arvind
AU  - Bhimaraj A
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Nambi, Vijay
AU  - Nambi V
AD  - Houston Methodist Hospital, Houston, TX, USA.
AD  - Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
FAU - Hoogeveen, Ron C
AU  - Hoogeveen RC
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
FAU - Ballantyne, Christie M
AU  - Ballantyne CM
AD  - Houston Methodist Hospital, Houston, TX, USA.
AD  - Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
FAU - Zoghbi, William A
AU  - Zoghbi WA
AD  - Houston Methodist Hospital, Houston, TX, USA.
FAU - Shah, Dipan J
AU  - Shah DJ
AUID- ORCID: 0000-0002-6179-2393
AD  - Houston Methodist Hospital, Houston, TX, USA. djshah@houstonmethodist.org.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20191227
PL  - England
TA  - Sci Rep
JT  - Scientific reports
JID - 101563288
RN  - 0 (Biomarkers)
RN  - 0 (Natriuretic Peptides)
RN  - 0 (Troponin T)
SB  - IM
MH  - Aged
MH  - Biomarkers
MH  - Extracellular Matrix
MH  - Female
MH  - Heart Failure/*diagnostic imaging/*metabolism/mortality
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - *Magnetic Resonance Imaging/methods
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptides/*blood
MH  - Prognosis
MH  - Proportional Hazards Models
MH  - Sensitivity and Specificity
MH  - Troponin T/*blood
PMC - PMC6934524
COIS- The authors declare no competing interests.
EDAT- 2019/12/29 06:00
MHDA- 2020/11/18 06:00
PMCR- 2019/12/27
CRDT- 2019/12/29 06:00
PHST- 2019/04/03 00:00 [received]
PHST- 2019/12/06 00:00 [accepted]
PHST- 2019/12/29 06:00 [entrez]
PHST- 2019/12/29 06:00 [pubmed]
PHST- 2020/11/18 06:00 [medline]
PHST- 2019/12/27 00:00 [pmc-release]
AID - 10.1038/s41598-019-56213-4 [pii]
AID - 56213 [pii]
AID - 10.1038/s41598-019-56213-4 [doi]
PST - epublish
SO  - Sci Rep. 2019 Dec 27;9(1):20168. doi: 10.1038/s41598-019-56213-4.