The Diagnostic Value of Serum Cardiac Troponin Ⅰ in Acute Heart Failure_West China Medical Journal

Authors：

Department of Cardiology1 and Nuclear Medicine2, 416 Hospital of China National Nuclear Corporation, Chengdu 610051,China;

Corresponding author：

Keywords：

急性心衰; 肌钙蛋白Ⅰ; 诊断和鉴别诊断

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目的:明确肌钙蛋白Ⅰ(cTnI)在心源性呼吸困难的鉴别诊断中有无应用价值。方法:比较急性心衰与急性肺源性呼吸困难时cTnI的变化情况,并观察一定的cTnI临界值辅助诊断心衰的敏感性和特异性。结果:总共156例患者,最后确诊为急性心衰的患者69例,而肺源性呼吸困难患者87例。急性心衰组的平均cTnI值为076±085ng/dL,而肺源性呼吸困难组为025±032ng/dL,两组间有显著性差异(P lt;0001)。根据ROC曲线计算肌钙蛋白Ⅰ的临界值(截点值)为042ng/dL,其鉴别心衰的敏感度为7153%,特异度为9036%,准确度为8014%。结论:检测肌钙蛋白Ⅰ水平并与其它临床信息相结合,有助于快速准确地诊断充血性心力衰竭。

Citation： WANG Hua,CHEN Qi,SHI Kai Yi,et al. The Diagnostic Value of Serum Cardiac Troponin Ⅰ in Acute Heart Failure. West China Medical Journal, 2009, 24(5): 1119-1121. doi: Copy

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5.	ADAMS KF J R, FONAROW G C, EMERMAN C L, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States:rationale, design, and preliminary observations from the Acute Decompensated Heart Failure National Registry (ADHERE)[J]. Am Heart J,2005,149:209216.
6.	PEACOCK W F, MARCO T D, FONAROW G C, et al. Cardiac Troponin and outcome in acute heart failure[J]. N Engl J Med,2008,358:21172126.
7.	ANGHELOIU G O, DICKERSON R P, RAVAKHAH K. Etiology of troponin Ⅰ elevation in patients with congestive heart failure and low clinical suspicion of myocardial infarction[J]. Resuscitation,2004,63:195201.
8.	LOWBEER C, GUSTAFSSON S A, SEEBERGER A, et al. Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction[J]. Scand J Clin Lab Invest,2004,64:667６76.
9.	MANN D L. Mechanisms and models in heart failure: a combinatorial approach[J]. Circulation,1999,100:9991008.
10.	PERNA E R, MACIN S M, CIMBARO CANELLA J P, et al. High levels of troponin T are associated with ventricular remodeling and adverse inhospital outcome in heart failure[J]. Med Sci Monit,2004,10:CR9095.
11.	YOU J J, AUSTIN P C, ALTER D A, et al. Relation between cardiac troponin Ⅰ and mortality in acute decompensated heart failure[J]. Am Heart J,2007,153:462470.

1. BALES A C, SORRENTINO M J. Causes of congestive heart failure: prompt diagnosis may affect prognosis[J]. Postgrad Med,1997,101:4449,5456.
2. DAO Q, KRISHNASWAMY P, KAZANEGRA R, et al. Utility of Btype natriuretic peptide in the diagnosis of congestive heart failure in an urgentcare setting[J]. J Am Coll Cardiol,2001,37:379385.
3. MAISEL A S, KRISHNASWAMY P, NOWAK RM, et al. Rapid measurement of Btype natriuretic peptide in the emergency diagnosis of heart failure[J]. N Engl J Med,2002,347(3):161167.
4. SAIKI A, IWASE M, TAKEICHI Y, et al. Diversity of the elevation of serum cardiac troponin Ⅰ levels in patients during their first visit to the emergency room[J]. Circ J,2007,71:14581462.
5. ADAMS KF J R, FONAROW G C, EMERMAN C L, et al. Characteristics and outcomes of patients hospitalized for heart failure in the United States:rationale, design, and preliminary observations from the Acute Decompensated Heart Failure National Registry (ADHERE)[J]. Am Heart J,2005,149:209216.
6. PEACOCK W F, MARCO T D, FONAROW G C, et al. Cardiac Troponin and outcome in acute heart failure[J]. N Engl J Med,2008,358:21172126.
7. ANGHELOIU G O, DICKERSON R P, RAVAKHAH K. Etiology of troponin Ⅰ elevation in patients with congestive heart failure and low clinical suspicion of myocardial infarction[J]. Resuscitation,2004,63:195201.
8. LOWBEER C, GUSTAFSSON S A, SEEBERGER A, et al. Serum cardiac troponin T in patients hospitalized with heart failure is associated with left ventricular hypertrophy and systolic dysfunction[J]. Scand J Clin Lab Invest,2004,64:667６76.
9. MANN D L. Mechanisms and models in heart failure: a combinatorial approach[J]. Circulation,1999,100:9991008.
10. PERNA E R, MACIN S M, CIMBARO CANELLA J P, et al. High levels of troponin T are associated with ventricular remodeling and adverse inhospital outcome in heart failure[J]. Med Sci Monit,2004,10:CR9095.
11. YOU J J, AUSTIN P C, ALTER D A, et al. Relation between cardiac troponin Ⅰ and mortality in acute decompensated heart failure[J]. Am Heart J,2007,153:462470.

West China Medical Journal

The Diagnostic Value of Serum Cardiac Troponin Ⅰ in Acute Heart Failure

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