Anti-troponin I antibodies in renal transplant patients.

OBJECTIVE: To characterize the prevalence and clinical correlates of anti-troponin I antibodies in renal transplant patients. METHODS: A group of 48 consecutive renal transplant patients under immunosuppressive therapy were studied. Anti-troponin I antibodies were measured and clinical data were retrieved. RESULTS: An anti-troponin I antibody titer <1:40 was seen in most patients (30). IgG antibody titers ≥1:80 were seen in eight patients, with a single value of 1:160. Regarding IgM antibodies, in six cases titers ≥1:80 were seen, with one value of 1:320. In only one patient were both anti-troponin I antibody IgG and IgM titers 1:80 or higher. Clinical cardiac disease was seen in nine patients. The presence of an anti-troponin I antibody titer ≥1:80 was not associated with the presence of clinical cardiac disease (p=0.232), but was associated with statin therapy status (p=0.008), being less frequent in patients under statin therapy. CONCLUSIONS: Anti-troponin I antibodies are seen in a minority of renal transplant patients, and are not associated with the presence of clinical heart disease, but are associated with lack of statin therapy.

Cardiac metastasis of melanoma as first manifestation of disease.

BACKGROUND: Metastatic tumors of the heart are 20 to 40 times more common than primary tumors. Metastases originate mainly in carcinomas and melanomas, the latter having the greatest propensity for cardiac involvement. On rare occasions this type of tumor may first manifest itself as a cardiac metastasis. METHODS: The authors present clinical, laboratory and imaging data from a patient with a cardiac mass that was the first manifestation of a melanoma. No other tumor location was detected by imaging studies. RESULTS: The patient presented with exertional dyspnea and tachycardia and was found to have a large mass in the right atrium. He underwent surgical removal of the tumor, but curative excision was not possible. A diagnosis of cardiac metastasis from malignant melanoma was made. The patient died soon afterwards from disseminated metastatic disease. CONCLUSIONS: This case represents a rare manifestation of melanoma located in the right atrium, with unknown origin of the primary tumor. Although surgery may be useful to palliate symptoms and improve survival in certain patients, it may also be associated with dissemination of the disease.

Cardiac structure and apnea/hypopnea index in patients with arterial hypertension and excessive weight.

BACKGROUND/AIMS: Arterial hypertension is frequently associated with sleep apnea, excessive weight, and with changes in the echocardiographic characteristics of the left cardiac chambers. The present investigation was conducted in order to search for a possible relation between left cardiac structure and sleep apnea magnitude in patients with arterial hypertension and excessive weight. METHODS: A group of 56 patients with arterial hypertension and mean body mass index of 30.6 +/- 3.8 (weight in kilograms/height in meters squared) was studied by echocardiography, sleep study and electrocardiography. RESULTS: A relatively high mean apnea-hypopnea index (AHI) was found (17.9 +/- 17.2 episodes/h sleep), but this parameter was not found to be correlated with cardiac echocardiographic diameters. Patients with an AHI <5 episodes/h had smaller mean values for left atrial diameter, left ventricular mass index and left ventricular relative wall thickness, when compared to patients with an AHI value of > or =5. The mean corrected QT interval was found to be longer in female patients, whereas left ventricular end-diastolic diameter was smaller than in male patients. CONCLUSION: In patients with arterial hypertension and excessive weight, significant apnea seems to be very common. In such patients, left ventricle wall thickness, left ventricle mass index and the left atrium diameter may act as surrogate markers for significant sleep apnea. Thus, the hypothesis is raised that hypoxia may lead to changes in heart structure.