Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.

<h4>Objective</h4>High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1).<h4>Methods</h4>117 patients with DM1 were recruited...

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Main Authors: Mark J Hamilton, Yvonne Robb, Sarah Cumming, Helen Gregory, Alexis Duncan, Monika Rahman, Anne McKeown, Catherine McWilliam, John Dean, Alison Wilcox, Maria E Farrugia, Anneli Cooper, Josephine McGhie, Berit Adam, Richard Petty, Scottish Myotonic Dystrophy Consortium, Cheryl Longman, Iain Findlay, Alan Japp, Darren G Monckton, Martin A Denvir
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2017-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0174166&type=printable
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author Mark J Hamilton
Yvonne Robb
Sarah Cumming
Helen Gregory
Alexis Duncan
Monika Rahman
Anne McKeown
Catherine McWilliam
John Dean
Alison Wilcox
Maria E Farrugia
Anneli Cooper
Josephine McGhie
Berit Adam
Richard Petty
Scottish Myotonic Dystrophy Consortium
Cheryl Longman
Iain Findlay
Alan Japp
Darren G Monckton
Martin A Denvir
author_facet Mark J Hamilton
Yvonne Robb
Sarah Cumming
Helen Gregory
Alexis Duncan
Monika Rahman
Anne McKeown
Catherine McWilliam
John Dean
Alison Wilcox
Maria E Farrugia
Anneli Cooper
Josephine McGhie
Berit Adam
Richard Petty
Scottish Myotonic Dystrophy Consortium
Cheryl Longman
Iain Findlay
Alan Japp
Darren G Monckton
Martin A Denvir
author_sort Mark J Hamilton
collection DOAJ
description <h4>Objective</h4>High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1).<h4>Methods</h4>117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records. Follow up was for a mean of 23 months.<h4>Results</h4>Fifty five females and 62 males (mean age 47.7 years) were included. Complete data were available for ECG in 107, echocardiography in 53. Muscle Impairment Rating Scale score was recorded for all patients. A highly significant excess (p = 0.0007) of DM1 patients presented with cTnI levels greater than the 99th centile of the range usually observed in the general population (9 patients; 7.6%). Three patients with elevated troponin were found to have left ventricular systolic dysfunction (LVSD), compared with four of those with normal range cTnI (33.3% versus 3.7%; p = 0.001). Sixty two patients had a cTnI level < 5ng/L, of whom only one had documented evidence of LVSD. Elevated cTnI was not predictive of severe conduction abnormalities on ECG, or presence of a cardiac device, nor did cTnI level correlate with muscle strength expressed by Muscle Impairment Rating Scale score.<h4>Conclusions</h4>Plasma cTnI is highly elevated in some ambulatory patients with DM1 and shows promise as a tool to aid cardiac risk stratification, possibly by detecting myocardial involvement. Further studies with larger patient numbers are warranted to assess its utility in this setting.
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spelling doaj-art-d5d3a07f0d044a9eaff8ffc4d1e835f12025-08-20T03:26:15ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01123e017416610.1371/journal.pone.0174166Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.Mark J HamiltonYvonne RobbSarah CummingHelen GregoryAlexis DuncanMonika RahmanAnne McKeownCatherine McWilliamJohn DeanAlison WilcoxMaria E FarrugiaAnneli CooperJosephine McGhieBerit AdamRichard PettyScottish Myotonic Dystrophy ConsortiumCheryl LongmanIain FindlayAlan JappDarren G MoncktonMartin A Denvir<h4>Objective</h4>High sensitivity plasma cardiac troponin-I (cTnI) is emerging as a strong predictor of cardiac events in a variety of settings. We have explored its utility in patients with myotonic dystrophy type 1 (DM1).<h4>Methods</h4>117 patients with DM1 were recruited from routine outpatient clinics across three health boards. A single measurement of cTnI was made using the ARCHITECT STAT Troponin I assay. Demographic, ECG, echocardiographic and other clinical data were obtained from electronic medical records. Follow up was for a mean of 23 months.<h4>Results</h4>Fifty five females and 62 males (mean age 47.7 years) were included. Complete data were available for ECG in 107, echocardiography in 53. Muscle Impairment Rating Scale score was recorded for all patients. A highly significant excess (p = 0.0007) of DM1 patients presented with cTnI levels greater than the 99th centile of the range usually observed in the general population (9 patients; 7.6%). Three patients with elevated troponin were found to have left ventricular systolic dysfunction (LVSD), compared with four of those with normal range cTnI (33.3% versus 3.7%; p = 0.001). Sixty two patients had a cTnI level < 5ng/L, of whom only one had documented evidence of LVSD. Elevated cTnI was not predictive of severe conduction abnormalities on ECG, or presence of a cardiac device, nor did cTnI level correlate with muscle strength expressed by Muscle Impairment Rating Scale score.<h4>Conclusions</h4>Plasma cTnI is highly elevated in some ambulatory patients with DM1 and shows promise as a tool to aid cardiac risk stratification, possibly by detecting myocardial involvement. Further studies with larger patient numbers are warranted to assess its utility in this setting.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0174166&type=printable
spellingShingle Mark J Hamilton
Yvonne Robb
Sarah Cumming
Helen Gregory
Alexis Duncan
Monika Rahman
Anne McKeown
Catherine McWilliam
John Dean
Alison Wilcox
Maria E Farrugia
Anneli Cooper
Josephine McGhie
Berit Adam
Richard Petty
Scottish Myotonic Dystrophy Consortium
Cheryl Longman
Iain Findlay
Alan Japp
Darren G Monckton
Martin A Denvir
Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
PLoS ONE
title Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
title_full Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
title_fullStr Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
title_full_unstemmed Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
title_short Elevated plasma levels of cardiac troponin-I predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1: A multicentre cohort follow-up study.
title_sort elevated plasma levels of cardiac troponin i predict left ventricular systolic dysfunction in patients with myotonic dystrophy type 1 a multicentre cohort follow up study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0174166&type=printable
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