• Medicine · Apr 2023

    Chronic troponin elevation assessed by myocardial T1 mapping in patients with stable coronary artery disease.

    • Carlos Alexandre W Segre, James A de Lemos, Antonildes Nascimento Assunção Junior, Cesar Higa Nomura, Desiderio Favarato, Celia Maria Cassaro Strunz, Alexandre Volney Villa, Jose Rodrigues Parga Filho, Paulo Cury Rezende, Whady Hueb, RamiresJose Antonio FranchiniJAFHeart Institute (InCor) University of São Paulo Clinics Hospital, Sao Paulo, Brazil., Roberto Kalil Filho, and Carlos Vicente Serrano Junior.
    • Heart Institute (InCor) University of São Paulo Clinics Hospital, Sao Paulo, Brazil.
    • Medicine (Baltimore). 2023 Apr 21; 102 (16): e33548e33548.

    BackgroundCardiac troponin detected with sensitive assays can be chronically elevated, in the absence of unstable coronary syndromes. In patients with chronic coronary artery disease, clinically silent ischemic episodes may cause chronic troponin release. T1 mapping is a cardiovascular magnetic resonance technique useful in quantitative cardiac tissue characterization. We selected patients with anatomically and functionally normal hearts to investigate associations between chronic troponin release and myocardial tissue characteristics assessed by T1 mapping.MethodsWe investigated the relationship between cardiac troponin I concentrations and cardiovascular magnetic resonance T1 mapping parameters in patients with stable coronary artery disease enrolled in MASS V study before elective revascularization. Participants had no previous myocardial infarction, negative late gadolinium enhancement, normal left ventricular function, chamber dimensions and wall thickness.ResultsA total of 56 patients were analyzed in troponin tertiles: nativeT1 and extracellular volume (ECV) values (expressed as means ± standard deviations) increased across tertiles: nativeT1 (1006 ± 27 ms vs 1016 ± 27 ms vs 1034 ± 37 ms, ptrend = 0.006) and ECV (22 ± 3% vs 23 ± 1.9% vs 25 ± 3%, ptrend = 0.007). Cardiac troponin I concentrations correlated with native T1(R = 0.33, P = .012) and ECV (R = 0.3, P = .025), and were independently associated with nativeT1 (P = .049) and ventricular mass index (P = .041) in multivariable analysis.ConclusionIn patients with chronic coronary artery disease and structurally normal hearts, troponin I concentrations correlated with T1 mapping parameters, suggesting that diffuse edema or fibrosis scattered in normal myocardium might be associated with chronic troponin release.Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

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