HEART FAILURE AND CARDIOMYOPATHY Troponin T measurement can predict persistent left ventricular dysfunction in peripartum cardiomyopathy

Objective: To determine whether measurement of cardiac troponin T (cTnT) concentration in newly diagnosed peripartum cardiomyopathy (PPCM) can be used to predict persistent left ventricular dysfunction after a 6-month follow-up. Patients and methods: This was a prospective, multiple-centre clinical trial that studied 106 patients with newly diagnosed PPCM surviving over 6 months. cTnT concentration was measured within 2 weeks of the onset of PPCM. Results: Serum cTnT concentration was negatively correlated with left ventricular ejection fraction (LVEF) at follow-up (LVEF, r = 20.518, p = 0.0001). Analysis by receiver operator characteristic curve yielded an area under the curve of 0.764 (95% CI 0.669 to 0.860, p = 0.0001, vs null hypothesis value 0.5) for cTnT, and a cTnT concentration cut off of .0.04 ng/ml, predicting persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%. Among 106 recruited patients, there were 33 patients with cTnT concentrations .0.04 ng/ml and 73 patients with cTnT concentrations (0.04 ng/ml. After a 6-month follow-up, there was significantly smaller LVEF (35.42% (13.04% vs 50.16% (10.48%, p = 0.0001) and more persistent left ventricular dysfunction (84.8% vs 31.5%, OR = 12.17 (95% CI 4.17 to 35.57), p = 0.001) in patients with cTnT .0.04 ng/ml than in patients with cTnT (0.04 ng/ml. Conclusion: Serum cTnT concentration measured within 2 weeks of the onset of PPCM was correlated negatively with LVEF at follow-up. This marker offers a simple, quick, inexpensive, non-invasive method for predicting a persistent LVEF of (50%. A cTnT concentration of .0.04 ng/ml predicted persistent left ventricular dysfunction with a sensitivity of 54.9% and a specificity of 90.9%. Baseline levels of C reactive protein correlated positively with baseline left ventricular end-diastolic and end-systolic diameters and inversely with left ventricular ejection fraction (LVEF). Fas/Apo-1 predicted mortality. 9 The serum cTnT, a specific and highly sensitive marker of myocardial injury, has not been reported in this population. This study was designed to study the prognostic role of cTnT in patients with newly diagnosed PPCM within 2 weeks of the onset of symptoms.