Prognostic Value of Serial High-Sensitivity Troponin T measurements in Adults with Congenital Heart Disease

Publication date: Available online 10 December 2019Source: Canadian Journal of CardiologyAuthor(s): Laurie W. Geenen, Vivan J.M. Baggen, Annemien E. van den Bosch, Jannet A. Eindhoven, Robert M. Kauling, Judith A.A.E. Cuypers, Jolien W. Roos-Hesselink, Eric BoersmaAbstractBackgroundSingle high-sensitivity troponin T (hs-TnT) measurement is predictive of cardiac events in adults with congenital heart disease (ACHD). We aimed to study the prognostic value of serial hs-TnT measurements in stable ACHD patients.MethodsIn total, 602 consecutive ACHD patients were enrolled in this prospective study (2011-2013). Blood sampling was performed at enrollment and thereafter yearly during scheduled visits, up to 4 years. Hs-TnT, NT-proBNP and eGFR were measured. The composite primary endpoint was defined as all-cause mortality, heart failure, arrhythmia, hospitalization, cardiac (re)interventions or thromboembolic events. The relationship between changes in serial hs-TnT and the primary endpoint was studied by joint models with adjustment for repeated NT-proBNP and eGFR.ResultsIn 601 patients (median age 33 [IQR 25-41] years, 42% women, 90% NYHA I) at least one hs-TnT measurement was performed; a mean of 4.3 hs-TnT measurements per patient were collected. After a median follow-up of 5.8 [IQR 5.3-6.3] years, 229 (38.1%) patients reached the primary endpoint. On average, hs-TnT levels increased over time, and more in patients who reached the primary endpoint (P
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research

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Advances in care during the earliest years of life have transformed the epidemiology of congenital heart disease (CHD) with expansion of the adult CHD (ACHD) population becoming larger than the paediatric one [1]. However, these patients are not cured and can develop cardiovascular complications in mid and late adult life, especially in those with complex lesions. Heart failure is one of the most common complications with a life prevalence of at least 30%, continues to increase as patients age, and represents the leading cause of death in ACHD.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
This article presents a review of the current knowledge on HF in rTOF patients, including incidence and prevalence, the most common mechanisms of heart failure, i.e., valvular pathologies, shunt lesions, left atrial hypertension, primary left heart and right heart failure, arrhythmias, and coronary artery disease. In addition, we will review information regarding extracardiac complications, risk factors for the development of heart failure, clinical impact and prognosis, and assessment possibilities, particularly of the right ventricle, as well as management strategies. We explore potential future concepts that may stimula...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
This study aimed to compare outcomes according to arrhythmia management.MethodsAll hospitalisations for IART in ACHD patients were retrospectively identified from medico-administrative database from September 2006 to September 2016. Outcomes of patients with IART managed with direct-current cardioversion (DCCV) were compared with patients referred for catheter ablation (CA). Atrial arrhythmia recurrence, death, stroke and first admission for heart failure (HF) were analyzed during follow-up.ResultsNinety-one ACHD patients with IART (baseline median age 38 years [IQR 29-50], male 64%, 45% moderate CHD and 41% complex CHD) w...
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
Abstract Atrial fibrillation is the most common cardiac arrhythmia in western society affecting more than 35 million individuals worldwide annually. It is a common postoperative complication and may also occur spontaneously during general and local anesthesia administration. Aging, diabetes mellitus, hypertension, and cardiovascular diseases including cardiomyopathies, congenital cardiac anomalies, heart failure, myocardial ischemia, pericarditis, previous cardiac surgery, vascular disease, and valvular heart disease are some correlated factors. Beyond age, increased incidence of atrial fibrillation has been corre...
Source: Annals of Cardiac Anaesthesia - Category: Anesthesiology Authors: Tags: Ann Card Anaesth Source Type: research
AbstractHeart failure with reduced ejection fraction (HFrEF) is common in patients with adult congenital heart disease. Many of the most common congenital defects have a high prevalence of HFrEF, including left-sided obstructive lesions (aortic stenosis, coarctation of the aorta, Shone complex), tetralogy of Fallot, Ebstein anomaly, lesions in which there is a systemic right ventricle, and lesions palliated with a Fontan circulation. However, heart failure with preserved ejection fraction (HFpEF) is also prevalent in all these lesions. Comprehensive evaluation includes physical exam, biomarkers, echocardiography and advanc...
Source: Heart Failure Reviews - Category: Cardiology Source Type: research
Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
In conclusion, T2D impairs vascular function by dysregulated autophagy. Therefore, autophagy could be a potential target for overcoming diabetic microvascular complications. To What Degree Does Loss of Skeletal Muscle with Age Contribute to Immunosenescence? https://www.fightaging.org/archives/2019/11/to-what-degree-does-loss-of-skeletal-muscle-with-age-contribute-to-immunosenescence/ Sarcopenia, the progressive loss of muscle mass and strength, is characteristic of aging. A perhaps surprisingly large fraction of the losses can be averted by strength training, but there are nonetheless inexorable process...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
CONCLUSIONS: The high variability of morphological findings and clinical manifestations of LVNC results in frequent overlooking of this disorder. Therefore, it is important to make the specialists more familiar with this condition and its pathology. Magnetic resonance imaging represents a conducive method to make correct diagnosis of LVNC under several specific conditions, particularly in case of non-conclusive echocardiographic finding. PMID: 31785212 [PubMed - as supplied by publisher]
Source: Neuroendocrinology Letters - Category: Endocrinology Tags: Neuro Endocrinol Lett Source Type: research
In this study, we sought to assess the prevalence of AF in patients with clinically undetected isolated cardiac amyloidosis (ICA) detected at autopsy and identify electrocardiographic (EKG) markers of such amyloid deposits. A total of 1083 patients were included in the study and 3.1% of patients were found to have asymptomatic ICA. Patients with ICA were older and had a higher odds of AF independent of age and CHA2DS2VASc score. Amongst patients with AF, those with ICA were more likely to have persistent forms of AF and had a lower sinus rhythm P-wave amplitude. Further studies are required to further define this entity, i...
Source: Fight Aging! - Category: Research Authors: Tags: Medicine, Biotech, Research Source Type: blogs
Background: Heart diseases and COPD are leading causes for morbidity and mortality. High prevalence of heart diseases in COPD is well described, but the prevalence of COPD among adults with heart disease is not well studied.Aim: To study how common COPD is among adults with heart disease.Method: The study is based on two random population samples from WSAS and OLIN in Western and Northern Sweden (n=1839, ages 21-78y), clinically examined including structured interviews and spirometry in 2009-2012. Included heart diseases were heart failure, ischemic heart disease and arrhythmia, and COPD was defined as chronic airway obstr...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Epidemiology Source Type: research
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