In AL amyloidosis cardiac involvement dictates prognosis. It has been demonstrated that cardiac dysfunction is best assessed by measuring serum concentrations of N-terminal B-type natriuretic peptide (NT-proBNP) and cardiac troponins. Recently, a new generation of more sensitive assays for troponin measurement has been developed, aiming at identifying minimal cardiac damage. We report the impact of the introduction of a highly sensitive cardiac troponin T (hs-cTnT) assay (Roche Diagnostics) on the detection of cardiac involvement in 109 consecutive newly diagnosed patients with AL amyloidosis. The hs-cTnT was determined on the Modular E system. Cardiac troponin I (cTnI) (Siemens TnI-Ultra™) and NT-proBNP (Roche Diagnostics) were also measured. Sixty nine (63%) patients had cardiac involvement at presentation, as detected by echocardiography. The diagnostic sensitivity of the biomarkers to detect cardiac involvement at diagnosis was 74% for cTnI, 96% for hs-cTnT, and 100% for NT-proBNP, respectively. In additional 15 patients, echographic evidence of amyloid heart involvement developed during 6 months following diagnosis: cTnI was elevated at presentation in 5 cases (33%), hs-cTnT in 12 (80%, P=0,01 versus cTnI) and NT-proBNP in 11 cases (73%). We conclude that hs-cTnT may improve the sensitivity for detection of cardiac damage caused by AL amyloidosis.
|Titolo:||La determinazione della troponina T con il metodo ad alta sensibilità migliora la sensibilità di rilevazione della cardiomiopatia nell'amiloidosi AL|
BARASSI, ALESSANDRA (Secondo)
|Parole Chiave:||Clinical Biochemistry; Biochemistry (medical); Medical Laboratory Technology|
|Settore Scientifico Disciplinare:||Settore BIO/12 - Biochimica Clinica e Biologia Molecolare Clinica|
|Data di pubblicazione:||2010|
|Appare nelle tipologie:||01 - Articolo su periodico|