Response by du Fay de Lavallaz et al to Letter Regarding Article, “Skeletal Muscle Disorders: A Noncardiac Source of Cardiac Troponin T”

Lavallaz, Jeanne du Fay de; Piscuoglio, Salvatore; Müller, Christian

doi:10.1161/circulationaha.122.061976

Cited by 3 publications

(5 citation statements)

References 4 publications

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“…Particularly, in ICI‐related myocarditis hs‐TnT was found to be persistently elevated for up to 60 days 18 . Moreover, there is evidence of ectopic TnT expression in the setting of both non‐inflammatory myopathies and myositis, likely related to an overexpression of the TNNT2 gene 19 . It will be hence important to investigate whether this ectopic de novo expression of TnT can also occur in response to certain therapies including ICIs or cancer metastases, or whether it relates to local expression in peripheral myositis.…”

Section: Discussionmentioning

confidence: 99%

“…18 Moreover, there is evidence of ectopic TnT expression in the setting of both non-inflammatory myopathies and myositis, likely related to an overexpression of the TNNT2 gene. 19 It will be hence important to investigate whether this ectopic de novo expression of TnT can also occur in response to certain therapies including ICIs or cancer metastases, or whether it relates to local expression in peripheral myositis. Of interest, hs-TnI has been associated with early signs of left ventricular dysfunction, as shown by reduced left ventricular longitudinal strain in patients under ICI therapy.…”

Section: Discussionmentioning

confidence: 99%

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Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?

et al. 2023

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A 54-year old patient with metastatic melanoma presented with asymptomatic myositis and myocarditis after combined immune checkpoint inhibitors (ICI) therapy (anti-programmed cell death receptor-1, anti-lymphocyte activating gene-3, and anti-indoleamine 2,3-dioxygenase-1). The diagnosis was based on the typical time window after ICI, recurrence upon rechallenge, elevations of CK, high-sensitive troponin T (hs-TnT) and I (hs-TnI), mild NT-proBNP increase, and positive magnetic resonance imaging criteria. Notably, hsTnI was found to more rapidly increase and fall and to be more heart-specific than TnT in the context of ICI-related myocarditis. This led to ICI therapy withdrawal and switch to a less effective systemic therapy. This case report highlights the differential value of hs-TnT and hs-TnI for diagnosis and monitoring of ICI-related myositis and myocarditis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?

et al. 2023

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“…It is well established that neurofilament levels reflect neuroaxonal damage 31,32 . The published information on the origin of serum cTnT levels in ALS is more circumstantial, but evidence from neuromuscular diseases supports that striated muscle expresses cTnT under pathological conditions 8 .…”

Section: Resultsmentioning

confidence: 99%

“…Serum cardiac Troponin T (cTnT), widely in use as a serum marker of myocardial injury, has recently emerged as a promising candidate serum biomarker for ALS, correlating with disease severity and progression 6,7 . Accumulating evidence suggests that degenerating or regenerating skeletal muscle is an extracardiac source of serum cTnT, and can lead to serum cTnT elevations independent of myocardial damage [8][9][10] .…”

Section: Introductionmentioning

confidence: 99%

Cardiac Troponin T is a Serum Biomarker of Respiratory Dysfunction in Amyotrophic Lateral Sclerosis

Koch,

Fabian,

Weinhold

et al. 2024

Preprint

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ObjectiveInformative biomarkers are an urgent need in management and therapy development of amyotrophic lateral sclerosis. Serum cardiac troponin T is elevated in most amyotrophic lateral sclerosis patients and not correlated with neurofilaments. We sought to delineate the functional implications and the informative value of serum troponin T with regard to respiratory function, a major prognostic factor in amyotrophic lateral sclerosis.MethodsWe analyzed two independent hospital-based amyotrophic lateral sclerosis cohorts (d=discovery cohort; v= validation cohort) with data available on serum cardiac troponin T levels (nd=297; nv=49), serum neurofilament light chain levels (nd=116; nv=17), and routine respiratory test results (nd=86; nv=49).ResultsSerum cardiac troponin T levels, unlike serum neurofilaments, were strongly associated with the respiratory domain of the revised amyotrophic lateral sclerosis functional rating score (rd= - 0.29, pd= 0.001; rv= - 0.48, pv= 0.007) and with relevant pulmonary function parameters (nd), namely SVC% (r = - 0.45; p = 0.001), FVC% (r = - 0.43; p = 0.001), FEV1% (r = −0.37, p = 0.007), and PEF (r = - 0.34, p = 0.027).Serum cardiac Troponin T reliably discriminated benchmarks of SVC% < 80%: (AUC 0.75, p = 0.003), FVC % < 80%: (AUC 0.72, p = 0.011) and PEF% <75%: (AUC 0.72, p = 0.015).InterpretationOur findings confirm cardiac Troponin T as an informative serum biomarker in amyotrophic lateral sclerosis, complementing neurofilaments. Serum Troponin T can flag compromised respiratory function in amyotrophic lateral sclerosis and might prove useful as a proxy of respiratory impairment with prognostic implications.

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“…While data on cardiac troponin I are not available in current study, highsensitivity cTnT has been suggested to have stronger association with non-CV comorbidities in head-to-head comparisons even with high-sensitivity troponin I [20]. The ability of cTnT to reflect abnormalities at the level of diseased skeletal muscle [21] might also contribute to these adverse all-cause and non-CV outcomes, given that skeletal muscle dysfunction is prevalent in patients with dyspnea [22]. Robust evidence exists supporting role of cardiac troponins as prognostic markers of mortality and readmissions in both HFpEF and HFrEF patients [15,23].…”

mentioning

confidence: 92%

Cardiac Biomarkers in Dyspnea Hospitalizations – Still Breathing Not Predictively

Agarwal,

AlMahmeed,

Butler

2023

Cardiology

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Response by du Fay de Lavallaz et al to Letter Regarding Article, “Skeletal Muscle Disorders: A Noncardiac Source of Cardiac Troponin T”

Cited by 3 publications

References 4 publications

Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?

Value of troponin T versus I in the diagnosis of immune checkpoint inhibitor‐related myocarditis and myositis: rechallenge?

Cardiac Troponin T is a Serum Biomarker of Respiratory Dysfunction in Amyotrophic Lateral Sclerosis

Cardiac Biomarkers in Dyspnea Hospitalizations – Still Breathing Not Predictively

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