CHF患者左心功能及短期预后与hs-TnT的关系

Association of high sensitive cardiac troponin T with left ventricular dysfunction and short-time prognosis in patients with chronic heart failure

关键词:  心力衰竭  超敏肌钙蛋白T  左心功能不全  短期预后

Key words:  chronic heart failure  hs-TnT  left ventricular dysfunction  short-time prognosis

摘要:

目的探讨超敏肌钙蛋白T（high sensitive cardiac troponin T,hs-TnT）对慢性心力衰竭（chronic heart failure,CHF）患者左心功能严重程度和短期预后价值的影响。方法182例CHF患者入院后24 h内测定血浆hsTnT水平,经规范化治疗,随访3个月,观察终点是心血管事件（心源性死亡及心力衰竭恶化再入院）。结果EF〈35%组较EF≥35%组hs-TnT水平明显升高,差异有统计学意义（P〈0.05）。不同病因所致CHF各亚组间hs-TnT水平差异无统计学意义（P〉0.05）。以hs-TnT均数0.014μg/L为界,高hs-TnT亚组3个月内心血管事件发生率明显高于正常hs-TnT亚组（54.5% vs 25.0%,P〈0.01）。结论hs-TnT升高提示左心功能严重受损,主要心血管事件的增加可作为对CHF患者早期危险分层的一个指标并指导临床治疗。

Abstract:

Objective To investigate the association of high sensitive cardiac troponin T （hs-TnT） with left ventricular dysfunction and short-time prognosis in patients with chronic heart failure （CHF）. Methods Plasma hs-TnT levels were measured in 182 CHF patients within 24 h after admission. All patients received standard treatment and were followed-up for 3 months. The primary end points were cardiac events including cardiac death and readmission for worsening heart failure. Results Plasma hs-TnT levels in patients with left ventricular ejection fraction（EF）〈35% were significantly higher than those with EF≥35% （P〈0.05）. There was no significant difference in hs-TnT levels among patients with CHF due to different causes （P〉0.05 ）. The incidence of cardiovascular events within 3 months in patients with high hs-TnT （≥0.014μg/L, n=134） was 54.5%, while that in patients with normal hs-TnT （〈0.014μg/L, n=48） was 25.0% （P〈0.01）. Conclusion Plasma hs-TnT levels can be used as a predictor for left ventricular dysfunction and short-time prognosis in patientswith chronic heart failure.