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Indian Journal of Thoracic and Cardiovascular Surgery

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25-10-2023 | Aortic Valve Replacement | Original Article

Prognostic value of high-sensitive troponin T in patients with severe aortic stenosis undergoing valve replacement surgery

Authors: Alaa Salama, Ghada Ibrahim, Mohammad Fikry, Moataz Hassan Elsannan, Mohammad Eltahlawi

Published in: Indian Journal of Thoracic and Cardiovascular Surgery | Issue 2/2024

Abstract

Background

Aortic stenosis (AS) is a well-known cause of mortality. We aimed to assess the prognostic value of high-sensitive troponin T (hs-TnT) in symptomatic patients with severe AS and preserved left ventricular ejection fraction (LVEF) after surgical aortic valve replacement (AVR).

Patients and methods

The study recruited patients with severe symptomatic AS fulfilling the inclusion criteria in the period between April 2020 and February 2022. Comprehensive echocardiography was done. The following parameters were assessed: AS severity, LV mass index (LVMI), left atrium volume index (LAVI), and LVEF. E/e′ and LVEF were calculated using the biplane method of Simpsons. Global longitudinal strain (GLS) was assessed by speckle tracking echocardiography. Peripheral blood samples were collected for hs-TnT measurement. All patients underwent surgical AVR. The patients were followed for the following 6 months for major adverse cardiovascular events (MACE). MACE was defined as cardiac death, re-admission for congestive heart failure (CHF) and fatal arrhythmia.

Results

One hundred and eight patients (mean age = 58.7 ± 7.68 years) with severe AS were recruited. Seventeen patients presented with MACE including 8 cardiac deaths. We divided the patients into two groups based on the normal hs-TnT values. The Kaplan–Meier curve revealed a statistically significant difference in MACE rate among troponin groups (log-rank test = 5.06, p = 0.025). There was significant difference between both groups regarding GLS with smaller GLS in negative hs-TnT group. In multivariate analysis, GLS and hs-TnT were significantly associated with MACE (p = 0.022 and < 0.01 respectively). The cutoff value of hs-TnT of 238.25 had a sensitivity of 70% and a specificity of 81% for predicting future MACE. There was a significant correlation between GLS and troponin (p < 0.001).

Conclusions

hs-TnT is associated with bad short-term prognosis after AVR. hs-TnT and GLS could be significant predictors for future MACE in patients with severe symptomatic AS and preserved LVEF who underwent AVR. Elevated hs-TnT and impaired GLS could set an indication of early intervention in asymptomatic severe AS.

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Title: Prognostic value of high-sensitive troponin T in patients with severe aortic stenosis undergoing valve replacement surgery
Authors: Alaa Salama
Ghada Ibrahim
Mohammad Fikry
Moataz Hassan Elsannan
Mohammad Eltahlawi
Publication date: 25-10-2023
Publisher: Springer Nature Singapore
Keywords: Aortic Valve Replacement
Aortic Valve Replacement
Aortic Valve Replacement
Published in: Indian Journal of Thoracic and Cardiovascular Surgery / Issue 2/2024
Print ISSN: 0970-9134
Electronic ISSN: 0973-7723
DOI: https://doi.org/10.1007/s12055-023-01594-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Prognostic value of high-sensitive troponin T in patients with severe aortic stenosis undergoing valve replacement surgery

Abstract

Background

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

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