Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities
Abstract Background COVID-19 has been associated with cardiac troponin T (cTnT) elevations and changes in cardiac structure and function, but the link between cardiac dysfunction and high-sensitive cardiac troponin T (hs-cTnT) in the acute and convalescent phase is unclear. Objective To assess wheth...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-04-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-024-03854-7 |
| _version_ | 1797209590738190336 |
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| author | Tarjei Øvrebotten Albulena Mecinaj Knut Stavem Waleed Ghanima Eivind Brønstad Michael T Durheim Tøri V. Lerum Tony Josefsen Jostein Grimsmo Siri L. Heck Torbjørn Omland Charlotte B. Ingul Gunnar Einvik Peder L. Myhre |
| author_facet | Tarjei Øvrebotten Albulena Mecinaj Knut Stavem Waleed Ghanima Eivind Brønstad Michael T Durheim Tøri V. Lerum Tony Josefsen Jostein Grimsmo Siri L. Heck Torbjørn Omland Charlotte B. Ingul Gunnar Einvik Peder L. Myhre |
| author_sort | Tarjei Øvrebotten |
| collection | DOAJ |
| description | Abstract Background COVID-19 has been associated with cardiac troponin T (cTnT) elevations and changes in cardiac structure and function, but the link between cardiac dysfunction and high-sensitive cardiac troponin T (hs-cTnT) in the acute and convalescent phase is unclear. Objective To assess whether hs-cTnT concentrations are associated with cardiac dysfunction and structural abnormalities after hospitalization for COVID-19, and to evaluate the performance of hs-cTnT to rule out cardiac pathology. Methods Patients hospitalized with COVID-19 had hs-cTnT measured during the index hospitalization and after 3-and 12 months, when they also underwent an echocardiographic study. A subset also underwent cardiovascular magnetic resonance imaging (CMR) after 6 months. Cardiac abnormalities were defined as left ventricular hypertrophy or dysfunction, right ventricular dysfunction, or CMR late gadolinium. Results We included 189 patients with hs-cTnT concentrations measured during hospitalization for COVID-19, and after 3-and 12 months: Geometric mean (95%CI) 13 (11–15) ng/L, 7 (6–8) ng/L and 7 (6–8) ng/L, respectively. Cardiac abnormalities after 3 months were present in 45 (30%) and 3 (8%) of patients with hs-cTnT ≥ and < 5 ng/L at 3 months, respectively (negative predictive value 92.3% [95%CI 88.5–96.1%]). The performance was similar in patients with and without dyspnea. Hs-cTnT decreased from hospitalization to 3 months (more pronounced in intensive care unit-treated patients) and remained unchanged from 3 to 12 months, regardless of the presence of cardiac abnormalities. Conclusion Higher hs-cTnT concentrations in the convalescent phase of COVID-19 are associated with the presence of cardiac pathology and low concentrations (< 5 ng/L) may support in ruling out cardiac pathology following the infection. |
| first_indexed | 2024-04-24T09:57:07Z |
| format | Article |
| id | doaj.art-eae8ad36f7554eb4b312e8b81989cb21 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-24T09:57:07Z |
| publishDate | 2024-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-eae8ad36f7554eb4b312e8b81989cb212024-04-14T11:07:18ZengBMCBMC Cardiovascular Disorders1471-22612024-04-012411910.1186/s12872-024-03854-7Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalitiesTarjei Øvrebotten0Albulena Mecinaj1Knut Stavem2Waleed Ghanima3Eivind Brønstad4Michael T Durheim5Tøri V. Lerum6Tony Josefsen7Jostein Grimsmo8Siri L. Heck9Torbjørn Omland10Charlotte B. Ingul11Gunnar Einvik12Peder L. Myhre13Department of Cardiology, Division of Medicine, Akershus University HospitalDepartment of Cardiology, Division of Medicine, Akershus University HospitalHealth Services Research Unit, Akershus University HospitalInstitute of Clinical Medicine, Faculty of Medicine, University of OsloDepartment of Circulation and Medical Imaging, Norwegian University of Science and TechnologyInstitute of Clinical Medicine, Faculty of Medicine, University of OsloDepartment of Pulmonary Medicine, Oslo University Hospital UllevålDepartment of Cardiology, Østfold Hospital KalnesDepartment of cardiac and pulmonary rehabilitation, Cathinka Guldberg’s HospitalK.G. Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of OsloDepartment of Cardiology, Division of Medicine, Akershus University HospitalDepartment of Circulation and Medical Imaging, Norwegian University of Science and TechnologyDepartment of Pulmonary Medicine, Akershus University HospitalDepartment of Cardiology, Division of Medicine, Akershus University HospitalAbstract Background COVID-19 has been associated with cardiac troponin T (cTnT) elevations and changes in cardiac structure and function, but the link between cardiac dysfunction and high-sensitive cardiac troponin T (hs-cTnT) in the acute and convalescent phase is unclear. Objective To assess whether hs-cTnT concentrations are associated with cardiac dysfunction and structural abnormalities after hospitalization for COVID-19, and to evaluate the performance of hs-cTnT to rule out cardiac pathology. Methods Patients hospitalized with COVID-19 had hs-cTnT measured during the index hospitalization and after 3-and 12 months, when they also underwent an echocardiographic study. A subset also underwent cardiovascular magnetic resonance imaging (CMR) after 6 months. Cardiac abnormalities were defined as left ventricular hypertrophy or dysfunction, right ventricular dysfunction, or CMR late gadolinium. Results We included 189 patients with hs-cTnT concentrations measured during hospitalization for COVID-19, and after 3-and 12 months: Geometric mean (95%CI) 13 (11–15) ng/L, 7 (6–8) ng/L and 7 (6–8) ng/L, respectively. Cardiac abnormalities after 3 months were present in 45 (30%) and 3 (8%) of patients with hs-cTnT ≥ and < 5 ng/L at 3 months, respectively (negative predictive value 92.3% [95%CI 88.5–96.1%]). The performance was similar in patients with and without dyspnea. Hs-cTnT decreased from hospitalization to 3 months (more pronounced in intensive care unit-treated patients) and remained unchanged from 3 to 12 months, regardless of the presence of cardiac abnormalities. Conclusion Higher hs-cTnT concentrations in the convalescent phase of COVID-19 are associated with the presence of cardiac pathology and low concentrations (< 5 ng/L) may support in ruling out cardiac pathology following the infection.https://doi.org/10.1186/s12872-024-03854-7COVID-19TroponinEchocardiographyCardiac functionBiomarker |
| spellingShingle | Tarjei Øvrebotten Albulena Mecinaj Knut Stavem Waleed Ghanima Eivind Brønstad Michael T Durheim Tøri V. Lerum Tony Josefsen Jostein Grimsmo Siri L. Heck Torbjørn Omland Charlotte B. Ingul Gunnar Einvik Peder L. Myhre Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities BMC Cardiovascular Disorders COVID-19 Troponin Echocardiography Cardiac function Biomarker |
| title | Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities |
| title_full | Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities |
| title_fullStr | Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities |
| title_full_unstemmed | Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities |
| title_short | Trajectory of cardiac troponin T following moderate-to-severe COVID-19 and the association with cardiac abnormalities |
| title_sort | trajectory of cardiac troponin t following moderate to severe covid 19 and the association with cardiac abnormalities |
| topic | COVID-19 Troponin Echocardiography Cardiac function Biomarker |
| url | https://doi.org/10.1186/s12872-024-03854-7 |
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