Cardiac Troponin T as Early Marker of Subclinical Cardiovascular Deterioration in Black Hypertensive Women

Heart Lung Circ. 2017 Aug;26(8):825-832. doi: 10.1016/j.hlc.2016.11.010. Epub 2016 Dec 19.

Abstract

Background: Hypertensive heart disease is a rising concern, especially among black South African women. As high sensitivity cardiac troponin T (cTnT) is a marker of cardiomyocyte damage, we determined the potential link of (i) systemic endothelial dysfunction (reflected by urinary albumin-to-creatinine ratio), (ii) large artery stiffness, (iii) cardiac volume load (estimated by the N-terminal prohormone B-type natriuretic peptide (Nt-proBNP)), and (iv) ECG left ventricular hypertrophy in post-menopausal black women.

Methods: In 121 (50 normotensive and 71 hypertensive) black women (mean age: 60.6 years), basic cardiovascular assessments including blood pressure and ECG were performed, along with plasma and urinary biomarkers including cTnT.

Results: The cTnT levels (p=0.049) along with Nt-proBNP (p=0.003), pulse pressure (p<0.0001) and the Cornell product (p=0.030) were higher in hypertensive than normotensive women. Only in hypertensive women, was cTnT independently associated with urinary albumin-to-creatinine ratio (β=0.25; p=0.019), pulse pressure (β=0.31; p=0.019), Nt-proBNP (β=0.47; p<0.0001) and Cornell product (β=0.31; p=0.018). An independent association between albumin-to-creatinine ratio and cTnT was also evident in normotensive women (β=0.34; p=0.037).

Conclusion: We found cTnT to be a useful marker in an elderly black population relating to several measures of cardiovascular deterioration - from subclinical endothelial dysfunction to left ventricular hypertrophy.

Keywords: Arterial stiffness; Endothelial dysfunction; Hypertension; Left ventricular hypertrophy; Troponin T.

MeSH terms

  • Albuminuria / blood
  • Albuminuria / etiology
  • Albuminuria / urine
  • Biomarkers / blood
  • Biomarkers / urine
  • Black People*
  • Creatinine / urine
  • Female
  • Humans
  • Hypertension / blood*
  • Hypertension / complications
  • Hypertension / urine
  • Hypertrophy, Left Ventricular / blood*
  • Hypertrophy, Left Ventricular / etiology
  • Hypertrophy, Left Ventricular / urine
  • Middle Aged
  • Prospective Studies
  • Troponin T / blood*

Substances

  • Biomarkers
  • Troponin T
  • Creatinine