| Objective: Objiective To assess The value of High-sensitive cardiac troponinT (HS-cTNT) for diagnosing of chronic heart failure as well as the differentialdiagnosis with acute myocardial infarction(AMI). Methods: The level ofHS-cTNT was measured in base line serum samples from200CHFpatients(Diagnostic criteria and the inclusion and exclusion criteria for chronicheart failure patients: diagnostic criteria standards European Society ofCardiology Heart Failure reference:1. symptoms of heart failure (rest orexercise).2objective evidence of cardiac dysfunction (resting).3. response totreatment for heart failure (such as diagnosis skeptics)· must have one and twodiagnostic criteria. Excluding all enrolled acute myocardial infarction,unstable angina. were not received within the30d surgery (including heartsurgery), excluding pulmonary disease, patients with no liver, renal dysfunctionand acute and chronic inflammatory diseases.), male95, female105, Age (66±12),100patients with AMI (According to the standard established by theEuropean Society of Cardiology:(1) the typical chest pain, rapid onset, long duration of pain, in the chest or precordial, to the left neck, left arm radiation,the pain was crushing resistance, often accompanied by sense of impendingdoom, nitroglycerin can not be mitigated.(2) typical ECG changes, sustainedabnormal Q waves or more lead appears QS wave, lasting more than24hours)without heart failure, male74, female26, age (65±12),50medicalstudents were taken as normal control group, male23, female27, age (23±1).Based on the level of serum HS-cTNT reference range0.014μg/L, chronicheart failure patients will be divided into HS-cTNT elevated groups andHS-cTNT normal group. HS-cTNT elevated group127cases, including66males and61females, age (67±12). HS-cTNT normal group73cases,including31males and42females; age (64±11). The same day after they werehospitalized in department of cardiology, affiliated hospital of guilin medicaluniversity between Jan2012and Nov2012.. All the subjects were volunteeredto join the study. The heart chamber diameter (the left ventricle, left atrium andright ventricle) and ejection fraction (EF) were measured by HP500B modeechocardiography. Observed in chronic heart failure patients’ hospitalization rateafter six months. Results: All200CHF patients,100AMI patients and50normal controls were involved in the result analysis without any drop.1.Comparison on the level of HS-cTNT: The mean level in the CHF group was8folds higher than that of the normal control [（0.36±0.10）ng/ml, VS(0.03±0.01)ng/ml（p<0.01）]. The mean level in the AMI group was8foldshigher than that of the CHF group [(3.02±1.83) ng/ml（p<0.01）].The threegroups’differences of gender and age were not statistically significant (p>0.05).When the levels of HS-cTNT at0.08to0.23ng/ml is significance fordiagnosis CHF.2. The values of HS-cTNT were increased in fold associatedwith the NYHA class significantly（p<0.05-0.01）.3. The HS-cTNT level in CHF patients showed a positive correlation with NYHA class, left ventriculardiameter, left atrium diameter, right ventricular diameter（r=0,33，0.15,0.142,0.146，p<0.05-0.01）, negative correlation with EF（r=-1.74，p<0.01）.4.HS-cTNT elevated group and the normal group HS-cTNT readmission rate: theelevated HS-cTNT group readmission rate is higher than the normal HS-cTNTgroup（X2=52.5，P＜0.01). The two groups’differences of gender and age werenot statistically significant (p>0.05). Conclusions: The level of HS-cTNT isslightly increased in patients with CHF. The HS-cTNT level in CHF patientsshowed a positive correlation with NYHA class, heart chamber, and negativecorrelation with EF（r=-1.74，p<0.01）. The mean level of the HS-cTNT is0.08-0.23ng/ml, it can be used as the point differential diagnosis of chronicheart failure from acute myocardial infarction. HS-cTNT serum levels haveimportant significance in chronic heart failure patient’s diagnosis and prognosis,as well as identification of AMI. |
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