Özet:

Conjustive heart failure is a heart disease with an increased incidence and prevalence rate. The CK-MB, which is commonly used to detect myocardial damage, is sensitive to the detection of relatively low levels of myocardial damage that occurs in the case of heart failure. The use of heart troponins, which are much more sensitive and specific to identify myocardial damage, has entered the widespread application and has allowed the detection of myocardial damage at very low levels. In our study, we aimed at checking whether heart troponin I (cTnI) is used to detect low-level myocardial damage occurring in real life conditions, congestive heart failure. The work group (Group I) consisted of 50 patients with congestive heart failure symptoms and the control group (Group II) consisted of 20 patients normally assessed in all emergency services and internal diseases clinics. Patients and the control group were taken to work prospectively. In the diagnosis of congestive heart failure, Framingham criteria were used. According to the New York Heart Association, the functional capacity of patients (Group I) was determined. The group I was divided into three subgroups according to the heart failure degree, functional capacity class II, group A; functional capacity class III, group B and functional capacity class IV, group C, respectively. On the first day of the entry, the levels of CK-MB and cTnI were measured and quantitatively determined. The levels of cTnI were compared between these three groups and between the working group and the control group. After the general condition of all the incidents was stabilized, ecocardiographic examinations were carried out. Linear regression analysis was conducted to investigate the relationship between the ejection fraction (EF) and cTnI. Results: A total of 50 patients, including 32 men, 18 women, between 43 and 75 years of age, 12 men, 8 women, and 20 cases of examination were taken. The value of cTnI was 0.084 0.07 ng / mL in Group I and 0.018 ± 0.012 ng / mL in Group II (p = 0.0001). The average cTnI values were measured in Group A, Group B and Group C, respectively, as 0.047±0.016 ng/mL, 0.080±0.048 ng/mL and 0.175±0.102 ng/mL. The difference between the subgroups was statistically significant. The EF (%) values in Group A, Group B and Group C were respectively 38.6 ± 3.5, 30.9 ± 4.6, 22.8 ± 3.3 and in Group I and Group II respectively 32.4 ± 6.9, 60.9 ± 4.3. The difference between Groups I and II and the difference between Groups A and B and C was statistically meaningful. When the vertical regression analysis was performed, there was a reverse relationship between EF and cTnI (r: -0.66) (p = 0.0001). The result: As functional capacity deteriorates, cTnI serum levels increase. This increase suggests that it can be used in the diagnosis of heart failure in the way, it was reverse proportion with the values of the injection fraction (%). Our findings, in line with other studies in literature, show that cTnI levels can be used as a useful indicator for assessing the severity of heart failure.

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