Associations of High-Sensitivity Cardiac Troponin T, D-Dimer, and N-Terminal Pro-B-Type Natriuretic Peptide with Subclinical Cardiovascular Dysfunction in the General Population: A Retrospective Cross-Sectional Study

高敏心肌肌钙蛋白T、D-二聚体和N末端B型利钠肽前体与普通人群亚临床心血管功能障碍的相关性:一项回顾性横断面研究

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Abstract

PURPOSE: The purpose of this study was to analyze the relationship between resting high-sensitive serum cardiac troponin T concentration (hs-cTnT), D-dimer, and N-terminal pro-B-type natriuretic peptide (NT-proBNP), measured outside the clinical context of acute illness, and selected parameters related to subclinical cardiovascular (CV) dysfunction in the general population. PATIENTS AND METHODS: This retrospective study included patients hospitalized at the Department of Internal Medicine, Angiology and Physical Medicine, Medical University of Silesia, Katowice, Poland, from January 2023 to May 2024. CV system assessment comprised transthoracic echocardiography, Doppler ultrasound of the carotid and lower extremity arteries, pulse wave velocity (PWV) measurement, ankle-brachial index (ABI) measurement, and toe-brachial index (TBI) measurement. RESULTS: Univariate analysis identified the strongest correlations (R > 0.5) between hs-cTnT and intima-media thickness (IMT) in the common carotid and femoral arteries, PWV, and pulse pressure. In multivariate analysis, hs-cTnT independently accounted for the variability in PWV (β = 0.239; 95% CI: 0.016-0.463; p = 0.036) and central diastolic blood pressure [β = -0.3; 95% CI: (-0.582)-(-0.017); p = 0.038], after adjusting for confounding factors. NT-proBNP independently explained the variability in left atrial volume index (LAVI) (β = 0.257; 95% CI: 0.052-0.462; p = 0.015). D-dimer independently accounted for the variability in log-transformed average E/E' value (β = 0.244; 95% CI: 0.039-0.45; p = 0.02) and log-transformed common femoral IMT value (β = 0.169; 95% CI: 0.0001-0.339; p = 0.05). CONCLUSION: hs-cTnT, D-dimer, and NT-proBNP, determined in the absence of acute illness, correlate with selected parameters of subclinical CV dysfunction independently of confounding factors such as age, gender, body mass index, diabetes, hypertension, and smoking.

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