A novel biochemical approach to congestive heart failure: Cardiac troponinT

Background The major structural characteristic of congestive heart failure is myocardial cell death. The aim of our study was to determine whether the level of cardiac troponin T, a protein specific for cardiac necrosis, was increased in patients with congestive heart failure. Methods and Results plasma samples were obtained from 33 patients and 47 he althy control subjects. Quantitative determination of cardiac troponin T wa s achieved with a second-generation enzyme immunoassay without cross-reacti vity with the skeletal muscle troponin T. The mean circulating level of car diac troponin Twos 0.140 +/- 0.439 ng/ml in patients with heart failure and 0.0002 +/- 0.001 ng/ml in the healthy controls (P = .0001). To evaluate th e relation between structural degradation and functional impairment, patien ts in heart failure were categorized according to their radionuclide left v entricular ejection fraction (LVEF). In the 23 patients with LVEF less than or equal to 45%, cardiac troponin T was 0.163 +/- 0.50 ng/ml, a level sign ificantly higher than that in patients with LVEF >45% (P = .04). There was also a negative correlation between cardiac troponin T and LVEF (R = -0.41, P = .01). Conclusions These data show thai cardiac troponin T is increased in patient s with congestive heart failure and that the level parallels the severity o f the disease. We conclude that cardiac troponin T is a suitable candidate- marker molecule to monitor congestive heart failure from a structural persp ective.