Kidney Week

Abstract: TH-PO492

The Association between Cardiac Troponin T and Left Ventricular Structure in CKD: Result from the Korean Cohort Study for Outcomes in Patients with Chronic Kidney Disease (KNOW-CKD)

Session Information

• CKD: Epidemiology, Outcomes - Cardiovascular - I
  November 02, 2017 | Location: Hall H, Morial Convention Center
  Abstract Time: 10:00 AM - 10:00 AM

Category: Chronic Kidney Disease (Non-Dialysis)

• 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

• Kang, Eunjeong, Seoul National University Hospital, Seoul, Korea (the Republic of)

Eunjeong Kang,

• Kim, Hyo Jin, Dongguk University Gyeongju Hospital, Gyeongju, Korea (the Republic of)

Hyo Jin Kim,

• Ryu, Hyunjin, Seoul National University Hospital, Seoul, Korea (the Republic of)

Hyunjin Ryu,

• Han, Miyeun, Busan National University Hospital, Busan, Korea (the Republic of)

Miyeun Han,

• Kim, Hyun suk, Chuncheon Sacred Heart Hospital, Chuncheon, Korea (the Republic of)

Hyun suk Kim,

• Ahn, Curie, Seoul National University Hospital, Seoul, Korea (the Republic of)

Curie Ahn,

• Oh, Kook-Hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)

Kook-Hwan Oh,

Background

Serum cardiac troponin T (cTnT) is a useful marker for cardiovascular disease risk in several population settings. We investigated the association between cTnT and cardiac structure and function in chronic kidney disease (CKD) patients in Korea.

Methods

Data were collected from the KNOW-CKD cohort. cTnT was measured using the highly sensitive assay and was categorized into 4 groups by quartiles (≤6.0, >6.0-10.0, >10.0-16.0, >16.0 pg/mL). Left ventricular hypertrophy (LVH) was defined as LV mass/height^2.7 ≥47g/m^2.7 in female and ≥50g/ m^2.7 in male. LV geometry was categorized into 4groups using left ventricular (LV) mass index and relative wall thickness. Systolic dysfunction was defined as ejection fraction <50% and diastolic dysfunction as E/E’ >15. Demographic and clinical characteristics including age, sex, CKD stage, history of myocardial infarction, body mass index, hemoglobin, and lipid profile were included as covariates. We carried out subgroup analysis dividing into 2 groups based on estimated glomerular filtration rate (eGFR) 60mL/min/1.73m².

Results

Total 2,061 patients were included and the mean age was 53.5±12.3 years old. The highest 2 quartiles of cTnT were related to more than 2-fold odds ratio(OR) of LVH in the fully adjusted model. The highest quartile of cTnT was significantly associated with concentric remodeling, eccentric and concentric LVH, although such associations were not evident with the 2nd or 3rd quartile groups. Systolic and diastolic dysfunction had independent association with increment of cTnT. After the analysis according to eGFR, LVH, diastolic dysfunction, concentric and eccentric LVH were associated with cTnT independently, but not with systolic dysfunction and concentric remodeling. In ROC analysis, area under the curve for both LVH and diastolic dysfunction are above 0.7, regardless of eGFR subgroups.

Conclusion

cTnT was associated strongly with alterations of LV structure and functional abnormalities including systolic and diastolic dysfunction. These tendencies were still observed in subgroup analysis according to the eGFR, except systolic dysfunction. In ROC analysis, cTnT concentration is a reliable screening test for LVH, diastolic dysfunction, regardless of renal function.

Funding

• Government Support - Non-U.S.