Abstract :
Background: Troponin I is a biological marker specifically derived from the cardiac muscle and is
used to make a diagnosis of myocardial injury in clinical practice. Cirrhotic cardiomyopathy is a new entity
recently reported in patients with advanced cirrhosis. Elevation of troponin I is accepted to be a marker of cirrhotic
cardiomyopathy.
Objective: To determine the relationship between troponin I level and the severity of cirrhosis and other
parameters.
Methods: Seventy-nine cirrhotic patients without established cardiovascular diseases were enrolled
consecutively to the study between 1 January 2011 and 31 December 2011. The demographic and laboratory data
were obtained. Sera were collected for measurement of troponin I levels by chemiluminescent microparticle immunoassay
(CMIA). Univariate analysis was performed. Correlation of troponin I level and the severity of cirrhosis
(Child-Pugh and MELD score) were analyzed by Pearson correlation test. P-value less than 0.05 was defined as
statistical significance.
Result: Forty patients (50.6%) were male. Mean age was 60.8 ± 9.2 years. The etiologies of cirrhosis
were alcohol (39.2%) and non-alcohol (60.8%) related. Mean troponin I level was 0.0064 ± 0.013 ng/mL. Child
class A, B, and C were found in 40 (50.6%), 34 (43%), and 5 (6.3%) patients, respectively. From univariate
analysis, the factors significantly associated with decompensated cirrhosis (defined by Child B or Child C group)
were lower blood pressure, hyponatremia, elevation of troponin I level, prolonged QTc interval, and male gender.
There was a significant correlation between troponin I level and serum potassium (r = 0.24, p = 0.035), and Child-
Pugh score (r = 0.28, p = 0.013). Mean troponin I levels in Child class A, B and, C were 0.0028 ± 0.005, 0.0100 ±
0.018, and 0.0098 ± 0.007 ng/mL (p = 0.004), respectively.
Conclusion: Serum troponin I level increases with more advanced stages in cirrhotic patients. This may
lead to the possibility that cirrhotic cardiomyopathy is more common in end stage liver diseases. The use of serum
troponin I to detect cirrhotic cardiomyopathy in clinical practice requires further study. |
file/Thai-Journal-of-gastroenterology-vol-13-no-2-1874419.pdf