Key result
Abnormal hs-cTnT linked to ~2 mm greater LV apical thickness in apical HCM.
Why the study?
Expression levels of hs-cTNT and NT-proBNP in apical hypertrophic cardiomyopathy patients and their relationships with echocardiography parameters remained unclear.
Observational (n=267)
No
Absolute Event Rate: 16.9% vs 14.9%
p-value: p=<0.001
In patients with apical hypertrophic cardiomyopathy, left ventricular apical thickness is independently associated with elevated levels of hs-cTNT and NT-proBNP, suggesting a link between structural remodeling and myocardial injury.
Does not warrant practice change in apical HCM; hypothesis-generating for biomarker-remodeling links, needing prospective validation.
Background Apical hypertrophic cardiomyopathy (AHCM) is a subtype of hypertrophic cardiomyopathy (HCM). The expression level of high-sensitive cardiac troponin T (hs-cTNT) and N-terminal pro-BNP (NT-proBNP) in AHCM patients, and these relationships between echocardiography parameters were still unclear. Methods We retrospectively screened AHCM patients between January 2019 and December 2021 in Zhongshan Hospital Fudan University. The relationship between the level of hs-cTNT, NT-proBNP and echocardiography parameters were analyzed. The risk factors for elevated hs-cTNT and NT-proBNP level were investigated with linear regression analysis. Results A total of 267 AHCM patients were enrolled. They were divided into hs-cTNT normal (129, 48.3%) and abnormal (138, 51.7%) group. Compared with hs-cTNT normal group, hs-cTNT abnormal group were elder (68.3 ± 11.6 vs. 63.8 ± 10.6, P = 0.001); with higher rate of atrial fibrillation (AF) (41.3% vs. 17.8%, P < 0.001) and higher level of NT-proBNP concentration (752.0 [343.8–1345.5] vs. 249.0 [104.0–541.0], P < 0.001). For echocardiography parameters, hs-cTNT abnormal patients have thicker interventricular septum (IVS) (11.6 ± 2.0 vs. 11.0 ± 1.7, P = 0.02), thicker left ventricular apical (LVA) (16.9 ± 3.0 vs. 14.9 ± 2.3, P < 0.001) and larger left atrium diameter (LAD) (45.9 ± 6.6 vs. 42.4 ± 5.1, P < 0.001). LVA was independently correlated with both the level of hs-cTNT and NT-proBNP (hs-cTNT r = 0.224, P = 0.143; NT-proBNP r = 0.370, P < 0.001). Linear regression analysis revealed that LVA was independent risk factor of both the elevated hs-cTNT and NT-proBNP level. Conclusions More than half of AHCM patients had abnormal hs-cTNT level. LVA was positively and independently correlated with the level of hs-cTNT and NT-proBNP.
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Zhang et al. (2025) conducted an observational in Apical hypertrophic cardiomyopathy (AHCM) (n=267). Abnormal hs-cTNT vs. Normal hs-cTNT (≤0.014 ng/mL) was evaluated on Left ventricular apical thickness (LVA) in mm (p=<0.001). In patients with apical hypertrophic cardiomyopathy, abnormal hs-cTNT levels were associated with significantly greater left ventricular apical thickness compared to normal levels (16.9 mm vs 14.9 mm).
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