Associations of High‐Sensitivity Cardiac Troponin and N‐Terminal Pro‐B‐Type Natriuretic Peptide With Echocardiographic Features in Patients With Hypertension

ABSTRACT High‐sensitivity cardiac troponin T (hs‐cTnT) and/or N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP) levels are associated with left ventricular structure and function in general populations, however, evidence regarding their relationship with multidimensional echocardiographic features in patients with hypertension remains limited. Hypertensive adults (aged ≥18 years) from a multicenter prospective cohort who underwent echocardiography from 2017 to 2020 were included in this study. Associations of serum hs‐cTnT and NT‐proBNP, alone and combined, with echocardiographic features were evaluated in multivariable‐adjusted models. Among a total of 1803 hypertensive participants (mean age, 51.0 ± 11.9 years; 29.7% women), the median levels of hs‐cTnT and NT‐proBNP were 5.13 ng/L (IQR 3.68, 7.30) and 32.80 ng/L (IQR 17.85, 59.25), respectively. Participants in the highest hs‐cTnT tertile showed greater left ventricular and atrial remodeling and higher flow velocity than those in the lowest tertile, including mean increases of 0.59 mm in left ventricular end‐diastolic diameter (95% CI 0.02–1.16), 2.78 g/m2 in left ventricular mass index (95% CI 0.32–5.24), 3.61 cm/s in aortic valve velocity (95% CI 0.54–6.67), and 0.61 mm in left atrial diameter (95% CI 0.09–1.13). Elevated NT‐proBNP levels were also associated with these structural changes, along with impaired diastolic function and arterial enlargement. Participants with the highest tertiles for both biomarkers had more pronounced cardiac structural and functional abnormalities, including increased interventricular septum thickness and worse diastolic function. Elevations in hs‐cTnT and/or NT‐proBNP are associated with subclinical changes in cardiac structure and function in hypertensive patients.