Dynamics of high-sensitivity cardiac troponin T during therapy with balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension

  • 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.

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Author:Steffen D. Kriechbaum, Christoph Bernhard Wiedenroth, Till Keller, Jan Sebastian Wolter, Ruth Ajnwojner, Karina Peters, Moritz Alexander Haas, Fritz Christian Roller, Andreas Breithecker, Andreas Joachim Rieth, Stefan Guth, Andreas Rolf, Dirk Bandorski, Christian Hamm, Eckhard Mayer, Christoph Liebetrau
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/30252896
Parent Title (English):PLoS one
Place of publication:Lawrence, Kan.
Contributor(s):Marc Wilhelm Merx
Document Type:Article
Year of Completion:2018
Date of first Publication:2018/09/25
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2018/11/15
Tag:Angioplasty; Biomarkers; Diagnostic medicine; Hemodynamics; Natriuretic peptide; Pulmonary embolism; Pulmonary hypertension; Troponin
Issue:(9): e0204683
Page Number:12
First Page:1
Last Page:12
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.
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0