A novel biochemical approach to congestive heart failure: Cardiac troponin T

Background The major structural characteristic of congestive heart failure is myocardial cell death. The aim of our study was to determine whether the level of cardiac troponin T, a protein specific for cardiac necrosis, was increased in patients with congestive heart failure. Methods and results Plasma samples were obtained from 33 patients and 47 healthy control subjects. Quantitative determination of cardiac troponin T was achieved with a second-generation enzyme immunoassay without cross-reactivity with the skeletal muscle troponin T. The mean circulating level of cardiac troponin T was 0.140 ± 0.439 ng/mL in patients with heart failure and 0.0002 ± 0.001 ng/mL in the healthy controls (P = .0001). To evaluate the relation between structural degradation and functional impairment, patients in heart failure were categorized according to their radionuclide left ventricular ejection fraction (LVEF). In the 23 patients with LVEF ≤45%, cardiac troponin T was 0.163 ± 0.50 ng/mL, a level significantly higher than that in patients with LVEF >45% (P = .04). There was also a negative correlation between cardiac troponin T and LVEF (R = –0.41, P = .01). Conclusions These data show that cardiac troponin T is increased in patients with congestive heart failure and that the level parallels the severity of the disease. We conclude that cardiac troponin T is a suitable candidate-marker molecule to monitor congestive heart failure from a structural perspective. (Am Heart J 1999;138:95-9.)