HIGH SENSITIVITY CARDIAC TROPONIN T IN CIRRHOTIC PATIENTS DURING TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNTS INSERTION

Purpose: It has been known for more than four decades that liver cirrhosis is associated with cardiovascular abnormalities. The aim of our study was to test high-sensitivity troponin T as cardiac necrosis marker in relation to echocardiographic results, hemodynamic parameters, and prognosis in patients before and 24 h after transjugular intrahepatic portosystemic shunts (TIPS) insertion.
Methods: The study population consisted of 55 patients (38 men and 17 women, aged 55.6±8.9 years) with liver cirrhosis treated with TIPS. Cardiac troponin T was measured by high-sensitivity electrochemiluminiscence immunoassay for Elecsys analyzator (Roche Diagnostics, Germany) before and 24 h after TIPS. Echocardiographic and hemodynamic parameters were measured in the same time.
Results: During baseline measurement in patients before TIPS insertion, hs-cTnT was increased above the 99th percentil of healthy reference population (0.014 μg/L) in 39.2 % patients. We have found no significant changes in hs-cTnT after TIPS in comparison with pre-procedural level. Serum hs-cTnT concentration correlated with peak late atrial filling velocity (A) and left atrium diameter (LA). Spearman's coefficients of rank correlation (r) were as follows: pre-procedural hs-cTnT vs. A: r=0.470 (p=0.001); vs. LA: r=0.313 (p=0.025); post-procedural hs-cTnT vs. A: r=0.380 (p=0.011); vs. LA: r=0.292 (p=0.037). Higher hs-cTnT concentrations were associated with higher 1-year mortality in patients before and after TIPS, log-rank test: p=0.018 and p<0.001, respectively.
Conclusions: A minor significant increase of hs-cTnT before and after TIPS was associated with peak late atrial filling velocity and left atrium diameter. Measurement of hs-cTnT may be useful for mortality prediction in cirrhotic patients.