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BioMed Research International
Volume 2014, Article ID 217290, 12 pages
Clinical Study

Independent Value of Cardiac Troponin T and Left Ventricular Global Longitudinal Strain in Predicting All-Cause Mortality among Stable Hemodialysis Patients with Preserved Left Ventricular Ejection Fraction

1Division of Nephrology and Cardiology, Department of Internal Medicine, College of Medicine and Hospital, National Cheng Kung University, 138 Sheng-Li Road, Tainan 704, Taiwan
2Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
3Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
4Division of Nephrology, Department of Internal Medicine, Catholic Fu-An Hospital, Yun-Lin, Taiwan

Received 7 February 2014; Accepted 5 April 2014; Published 7 May 2014

Academic Editor: Michael Gotzmann

Copyright © 2014 Junne-Ming Sung et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Using a speckle-tracking echocardiography (STE), we recently demonstrated that a left ventricular (LV) global longitudinal strain (GLS) ≥ −15% and the serum cardiac troponin T (cTnT) concentration are associated with mortality in stable hemodialysis patients with preserved LV ejection fraction (LVEF). In this study, we explored the relationship between cTnT and echocardiographic parameters and evaluated whether the prognostic value provided by cTnT is independent of a GLS ≥ −15% and vice versa. Eighty-eight stable hemodialysis patients with preserved LVEF were followed for 31 months. STE studies and measurements of cTnT were performed at baseline. CTnT concentration had a modest correlation with GLS ( ; ) but had a weak or nonsignificant correlation with other echocardiographic parameters. Adjusting for clinical parameters, hazard ratios for each increase of 0.01 ng/mL in cTnT, and a GLS ≥ −15% on mortality were 1.13 ( ) and 3.09 ( ) without significant interaction between cTnT and GLS ≥ −15%. In addition, an increased cTnT concentration, a GLS ≥ −15%, or their combination showed significant additional predictive value for mortality when included in models consisting of clinical parameters. Therefore, both cTnT and a GLS ≥ −15% are independent predictors of mortality and are useful for risk stratification.