TY  - JOUR
A1  - Kriechbaum, Steffen D.
A1  - Wiedenroth, Christoph Bernhard
A1  - Keller, Till
A1  - Wolter, Jan Sebastian
A1  - Ajnwojner, Ruth
A1  - Peters, Karina
A1  - Haas, Moritz Alexander
A1  - Roller, Fritz Christian
A1  - Breithecker, Andreas
A1  - Rieth, Andreas Joachim
A1  - Guth, Stefan
A1  - Rolf, Andreas
A1  - Bandorski, Dirk
A1  - Hamm, Christian
A1  - Mayer, Eckhard
A1  - Liebetrau, Christoph
T1  - Dynamics of high-sensitivity cardiac troponin T during therapy with balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension
T2  - PLoS one
N2  - Aims: Balloon pulmonary angioplasty (BPA) is an interventional treatment modality for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Therapy monitoring, based on non-invasive biomarkers, is a clinical challenge. This post-hoc study aimed to assess dynamics of high-sensitivity cardiac troponin T (hs-cTnT) as a marker for myocardial damage and its relation to N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels as a marker for cardiac wall stress.
Methods and results: This study included 51 consecutive patients who underwent BPA treatment and completed a 6-month follow-up (6-MFU) between 3/2014 and 3/2017. Biomarker measurement was performed consecutively prior to each BPA and at 6-MFU.
In total, the 51 patients underwent an average of 5 BPA procedures. The 6-month survival rate was 96.1%. The baseline (BL) meanPAP (39.5±12.1mmHg) and PVR (515.8±219.2dyn×sec×cm-5) decreased significantly within the 6-MFU (meanPAP: 32.6±12.6mmHg, P<0.001; PVR: 396.9±182.6dyn×sec×cm-5, P<0.001). At BL, the median hs-cTnT level was 11 (IQR 6–16) ng/L and the median NT-proBNP level was 820 (IQR 153–1872) ng/L. The levels of both biomarkers decreased steadily after every BPA, showing the first significant difference after the first procedure. Within the 6-MFU, hs-cTnT levels (7 [IQR 5–12] ng/L; P<0.001) and NT-proBNP levels (159 [IQR 84–464] ng/l; P<0.001) continued to decrease. The hs-cTnT levels correlated with the PVR (rrs = 0.42; p = 0.005), the meanPAP (rrs = 0.32; p = 0.029) and the NT-proBNP (rrs = 0.51; p<0.001) levels at BL.
Conclusion: Non-invasive biomarker measurement provides valuable evidence for the decreasing impairment of myocardial function and structure during BPA therapy. Changes in hs-cTNT levels are suggestive for a reduction in ongoing myocardial damage.
KW  - Troponin
KW  - Hemodynamics
KW  - Biomarkers
KW  - Diagnostic medicine
KW  - Pulmonary hypertension
KW  - Angioplasty
KW  - Pulmonary embolism
KW  - Natriuretic peptide
Y1  - 2018
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/47844
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-478444
SN  - 1932-6203
N1  - Copyright: © 2018 Kriechbaum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
VL  - 13
IS  - (9): e0204683
SP  - 1
EP  - 12
PB  - PLoS
CY  - Lawrence, Kan.
ER  -