Relevance Of Cardiac Troponin I Level With Cardiac Function And Its Prognostic Use In Patients With Chronic Heart Failure

Objective: This study sought to investigate the relevance of cardiac troponin I ( cTnI ) level with the class of cardiac function and its prognostic use in patients with chronic heart failure (CHF ). Methods: Plasma cTnI levels of 106 patients with CHF were measured by ELISA upon admission and one week later . All the patients had chest roentgenogram and electrocardiogram examined . Colored Doppled Echocardiography was performed to measure the left ventricular structure and its function . The controls were 40 healthy persons. Patients with CHF were followed up in three months. The study aimed to find the difference of the cardiovascular events between the patients with high cTnI level and the patients with normal cTnI level. Results: Patients with CHF presented higher plasma cTnI level than the healthy persons. (112.42 +122.45ng/L VS 1.75±4.46ng/L ). The average plasma cTnI concentration in NYHA functional class Ⅱ , class Ⅲ, class IV were 20.19 ± 26.35ng/L, 121.12 + 60.01 ng/L, 270.32±104.40 ng/L . Plasma cTnI level were significantly relatedwith the class of NYHA heart function (p<0.01 ).The average plasma cTnl level in LVEF^40%> 40%—50%> ^50% were 322.4+119.3 ng/L> 204.5 ±70.1 ng/L > 56.3 + 66.2 ng/L. Plasma cTnl concentration were significantly and negatively related with left ventricular ejection fraction ( LVEF )( p<0.01 ). While cTnl level were significantly related with left ventricular end diastolic diameter(LVEDD) -, left ventricular end systolic diameter(LVESD) > left atrial diameter (LAD) and pulmonary artery pressure(PAP)(p<0.01 ). Patients with different etiology in CHF had no significant difference in plasma cTnl concentration (p<0.05) . By following up in three months , twenty-one patients with high cTnl level upon admission then developed cardiovascular events ,the percent is 48.8% o Three patients with normal cTnl level upon admission then developed cardiovascular events ,the percent is 4.76%. So the percent of cardiovascular events within three months in patients with high cTnl level upon admission were higher than the normal cTnl ones (p<0.01). Conclusion:In Plasma cTnl in patients with chronic heart failure were significantly related with the class of NYHA heart function and LVEF. cTnl increased with the increasement of the class of NYHA heart function .While they increased with the reduction of LVEF.2% Plasma cTnl in patients with chronic heart failure reduced with the improvement of the heart function and also decreased with the raising of LVEF.3 m Plasma cTnl were helpful to predict the prognosis in patients with chronic heart failure.