Journal article

Publication year: 2018

Journal: PLoS ONE

Volume number: 13

Issue number: 9

ISSN: 1932-6203

Open access status: Gold

DOI Link: https://doi.org/10.1371/journal.pone.0204683

Publisher: Public Library of Science

Abstract: 

Aims

Balloon pulmonary angioplasty (BPA) is an interventional treatment modality for inoperable chronic thromboembolic pulmonary hypertension (CTEPH). Therapy monitoring, based on non-invasive biomarkers, is a clinical challenge. This post-hoc study aimed to assess dynamics of high-sensitivity cardiac troponin T (hs-cTnT) as a marker for myocardial damage and its relation to N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels as a marker for cardiac wall stress.

Methods and results

This study included 51 consecutive patients who underwent BPA treatment and completed a 6-month follow-up (6-MFU) between 3/2014 and 3/2017. Biomarker measurement was performed consecutively prior to each BPA and at 6-MFU.

In total, the 51 patients underwent an average of 5 BPA procedures. The 6-month survival rate was 96.1%. The baseline (BL) meanPAP (39.5 +/- 12.1mmHg) and PVR (515.8 +/- 219.2dynxsecxcm(-5)) decreased significantly within the 6-MFU (meanPAP: 32.6 +/- 12.6mmHg, P<0.001; PVR: 396.9 +/- 182.6dynxsecxcm(-5), P<0.001). At BL, the median hs-cTnT level was 11 (IQR 6-16) ng/L and the median NT-proBNP level was 820 (IQR 153-1872) ng/L. The levels of both biomarkers decreased steadily after every BPA, showing the first significant difference after the first procedure. Within the 6-MFU, hs-cTnT levels (7 [IQR 5-12] ng/L; P<0.001) and NT-proBNP levels (159 [IQR 84-464] ng/l; P<0.001) continued to decrease. The hs-cTnT levels correlated with the PVR (r(rs) = 0.42; p = 0.005), the meanPAP (r(rs) = 0.32; p = 0.029) and the NT-proBNP (r(rs) = 0.51; p<0.001) levels at BL.

Conclusion

Non-invasive biomarker measurement provides valuable evidence for the decreasing impairment of myocardial function and structure during BPA therapy. Changes in hs-cTNT levels are suggestive for a reduction in ongoing myocardial damage.

Harvard Citation style: Kriechbaum, S., Wiedenroth, C., Keller, T., Wolter, J., Ajnwojner, R., Peters, K., et al. (2018) Dynamics of high-sensitivity cardiac troponin T during therapy with balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension, PLoS ONE, 13(9), Article e0204683. https://doi.org/10.1371/journal.pone.0204683

APA Citation style: Kriechbaum, S., Wiedenroth, C., Keller, T., Wolter, J., Ajnwojner, R., Peters, K., Haas, M., Roller, F., Breithecker, A., Rieth, A., Guth, S., Rolf, A., Bandorski, D., Hamm, C., Mayer, E., & Liebetrau, C. (2018). Dynamics of high-sensitivity cardiac troponin T during therapy with balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. PLoS ONE. 13(9), Article e0204683. https://doi.org/10.1371/journal.pone.0204683