Role of Cardiac Troponin Levels in Acute Heart Failure

Wettersten, Nicholas; Maisel, Alan S.

doi:10.15420/cfr.2015.1.2.102

Cited by 63 publications

(50 citation statements)

References 50 publications

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“…24 25 In patients affected by both systolic and diastolic CHF, as well as acute decompensation, the increase in high-sensitivity Tn (hs-Tn) has a confirmed negative prognostic value. 26– 28 As confirmed in the report by Zhou et al , 4 nearly 50% of ‘non-survivor’ patients present levels of hs-Tn >28 ng/mL with a maximal increase after 16 days from the onset of symptoms. Data regarding CHF emerged in a study on 416 patients with COVID-19 from the Renmin Hospital of Wuhan 3 and divided at admission according to the presence of myocardial injury, indicated by hs-Tn blood levels above 99th percentile.…”

Section: Markers Of Myocardial Injury In Covid-19mentioning

confidence: 61%

COVID-19 in patients with heart failure: the new and the old epidemic

Sisti

Valente

Mandoli

et al. 2020

Postgraduate Medical Journal

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Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread in nearly 200 countries in less than 4 months since its first identification; accordingly, the coronavirus disease 2019 (COVID 2019) has affirmed itself as a clinical challenge. The prevalence of pre-existing cardiovascular diseases in patients with COVID19 is high and this dreadful combination dictates poor prognosis along with the higher risk of intensive care mortality. In the setting of chronic heart failure, SARS-CoV-2 can be responsible for myocardial injury and acute decompensation through various mechanisms. Given the clinical and epidemiological complexity of COVID-19, patiens with heart failure may require particular care since the viral infection has been identified, considering an adequate re-evaluation of medical therapy and a careful monitoring during ventilation.

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Section: Markers Of Myocardial Injury In Covid-19mentioning

confidence: 61%

COVID-19 in patients with heart failure: the new and the old epidemic

Sisti

Valente

Mandoli

et al. 2020

Postgraduate Medical Journal

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“…This complex of proteins is essential in myocytes being directly involved with cell contraction; cardiac‐specific isoforms of troponins including troponin C and cardiac troponin‐1 are excellent markers of cardiomyocyte damage . Troponin levels can also be mildly elevated in AHF, and a number of mechanisms are postulated: 1) forward failure, resulting in subendocardial ischemia; 2) increased wall stress as a direct cause of myocyte damage; and/or 3) increased wall stress, resulting in demand ischemia . All of these mechanisms are exacerbated by preexisting coronary artery disease limiting oxygen delivery.…”

Section: Resultsmentioning

confidence: 99%

Transfusion‐associated circulatory overload—a systematic review of diagnostic biomarkers

et al. 2018

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BACKGROUND: Transfusion-associated circulatory overload (TACO) is the leading cause of transfusionrelated major morbidity and mortality. Diagnosing TACO is difficult because there are no pathognomonic signs and symptoms. TACO biomarkers may aid in diagnosis, decrease time to treatment, and differentiate from other causes of posttransfusion dyspnea such a transfusionrelated acute lung injury. STUDY DESIGN AND METHODS:A systematic review of literature was performed in EMBASE, PubMed, the TRIP Database, and the Cochrane Library, from inception to June 2018. All articles discussing diagnostic markers for TACO were included. Non-English articles or conference abstracts were excluded. RESULTS: Twenty articles discussing biomarkers forTACO were included. The majority investigated B-type natriuretic peptide (BNP) and the N-terminal prohormone cleavage fragment of BNP (NT-proBNP), markers of hydrostatic pressure that can be determined within 1 hour. The data indicate that a post/pretransfusion NT-proBNP ratio > 1.5 can aid in the diagnosis of TACO. Posttransfusion levels of BNP less than 300 or NT-proBNP less than 2000 pg/mL, drawn within 24 hours of the reaction, make TACO unlikely. Cut-off levels that exclude TACO are currently unclear. In critically ill patients, the specificity of natriuretic peptides for circulatory overload is poor. Other biomarkers, such as cytokine profiles, cannot discriminate between TACO and transfusion-related acute lung injury. CONCLUSION:Currently, BNP and NT-proBNP are the primary diagnostic biomarkers researched for TACO. An NT-proBNP ratio greater than 1.5 is supportive of TACO, and low levels of BNP or NT-proBNP can exclude TACO. However, they are unreliable in critically ill patients. Other biomarkers, including cytokines and pulmonary edema fluid-to-serum protein ratio have not yet been sufficiently investigated for clinical use. T ransfusion-associated circulatory overload (TACO) is characterized by acute respiratory distress and pulmonary edema with signs of volume overload following transfusion. 1 It is the foremost cause of transfusion-related mortality in Europe, 2-4 Canada 5 and the United States. 6 TACO is currently underrecognized, 7,8 as it is challenging to diagnose due to lack of pathognomonic signs ABBREVIATIONS: AHF = acute heart failure; ARDS = acute respiratory distress syndrome; BALF = bronchoalveolar lavage fluid; BNP = B-type natriuretic peptide; ICU = intensive care unit; IL = interleukin; NPs = natriuretic peptides; NT-proBNP = N-terminal prohormone of BNP; TACO = transfusion-associated circulatory overload; TNCs = transfused negative controls; TRALI = transfusion-related acute lung injury. From the

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“…Strong evidence 53,60,70,89 • HR comparable in men and women: including stable HF patients, median cTnT levels were 23 ng/L in men and 18 ng/L in women. 67 Several mechanisms have been proposed to explain raised cTns in HF, 131,132 but the exact pathophysiology of sex-related differences remains to be elucidated. We postulate that a greater prevalence of cardiac comorbidities [133][134][135] (e.g.…”

Section: Cardiac Troponins Bmentioning

confidence: 99%

Sex‐related differences in contemporary biomarkers for heart failure: a review

Suthahar

Meems

et al. 2020

European J of Heart Fail

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The use of circulating biomarkers for heart failure (HF) is engrained in contemporary cardiovascular practice and provides objective information about various pathophysiological pathways associated with HF syndrome. However, biomarker profiles differ considerably among women and men. For instance, in the general population, markers of cardiac stretch (natriuretic peptides) and fibrosis (galectin‐3) are higher in women, whereas markers of cardiac injury (cardiac troponins) and inflammation (sST2) are higher in men. Such differences may reflect sex‐specific pathogenic processes associated with HF risk, but may also arise as a result of differences in sex hormone profiles and fat distribution. From a clinical perspective, sex‐related differences in biomarker levels may affect the objectivity of biomarkers in HF management because what is considered to be ‘normal’ in one sex may not be so in the other. The objectives of this review are, therefore: (i) to examine the sex‐specific dynamics of clinically relevant HF biomarkers in the general population, as well as in HF patients; (ii) to discuss the overlap between sex‐related and obesity‐related effects, and (iii) to identify knowledge gaps to stimulate research on sex‐related differences in HF.

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Role of Cardiac Troponin Levels in Acute Heart Failure

Cited by 63 publications

References 50 publications

COVID-19 in patients with heart failure: the new and the old epidemic

COVID-19 in patients with heart failure: the new and the old epidemic

Transfusion‐associated circulatory overload—a systematic review of diagnostic biomarkers

Sex‐related differences in contemporary biomarkers for heart failure: a review

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