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High sensitivity troponin might be a marker of subclinical scleroderma heart involvement: a preliminary study

Abstract

Introduction

Although often asymptomatic, cardiac involvement is common in systemic sclerosis (SSc), and is associated with an increased morbidity and mortality. The aim of this study is to investigate whether high-sensitivity troponin (HSTn) might represent a useful tool to detect subclinical scleroderma heart involvement (SHI) in SSc.

Methods

We enrolled 65 consecutive SSc patients who performed HSTn test, electrocardiogram and an echocardiogram within six months of HSTn test. We acquired also data about N-terminal segment of proBNP (NT-proBNP) and cardiac magnetic resonance imaging (cMRI). We excluded patients with overt pulmonary arterial hypertension. We defined as subclinical SHI the presence of the following conditions: diastolic dysfunction, pericardial effusion, conduction abnormalities/arrhythmias, oedema and/or T2 weighted non-ischemic pattern showed by cMRI.

Results

Twelve patients showed SHI, and 23 and 29, respectively, had high levels of HSTn and of NT-proBNP. SHI is correlated with high levels of HSTn (p = 0.02) with a significant difference between HSTn values in patients with or without SHI (59 vs. 13 ng/mL; p = 0.0097). Moreover, among patients with abnormal NT-proBNP, 18 also had out of range HSTn (Spearman rank correlation 0.5; p<0.0001). According to ROC curve analysis, the best HSTn cut-off value in distinguishing between patients with and patients without SHI was 16 ng/mL (sensitivity 66.7%, specificity 83%; area under the curve: 0.77 (95% CI: 0.65-0.87) p<0.001.

Conclusions

Our data show a close relationship between HSTn and NT-proBNP in SSc patients with SHI. HSTn might be a marker of SHI while NT-proBNP seems to be less specific for heart dysfunction.

J scleroderma relat disord 2017; 2(3): 183 - 187

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/jsrd.5000244

Authors

Simone Barsotti, Chiara Stagnaro, Anna d’Ascanio, Alice Parma, Michele Emdin, Umberto Conti, Marta Mosca, Alessandra Della Rossa

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Division of Rheumatology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa - Italy
  • Department of Medical Biotechnologies, University of Siena, Siena - Italy
  • Cardiology and Cardiovascular Medicine Division, Fondazione Toscana Gabriele Monasterio, Pisa - Italy
  • Cardiology Unit 2, Pisa University Hospital, Pisa - Italy

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