1,721,199 research outputs found
Will high-sensitive troponin immunoassays lead to more clarity or confusion in clinical practice?
No full textAlthough increases in cTnI (cardiac troponin I) and cTnT (cardiac troponin T) always indicate myocardial damage, the test is not able to identify the mechanisms responsible for this damage, which may not be due to ischaemia, but rather to other clinical conditions. In the present issue of Clinical Science, Filusch and co-workers have assessed cTnT using a high-sensitive assay in patients with pulmonary arterial hypertension. Their study suggests that, even in patients with extracardiac diseases, high-sensitive troponin assays could lead to better risk stratification of patients in whom conventional cTnT assays show values within the 'normal' range. These findings support the hypothesis that increased levels of cTnI and cTnT are an index of cardiac tissue damage, even in patients with extracardiac diseases, thus enabling appropriate diagnosis and, when necessary and available, specific treatment. © The Authors Journal compilation
Cardiac biomarkers for outcome prediction in infant bronchiolitis: Too soon to discard troponin?
Full text linkBackground: Acute bronchiolitis, usually caused by the respiratory syncytial virus, is the most common cause of severe respiratory distress in infants. The clinical relevance of cardiac biomarkers for diagnosis and prognosis of bronchiolitis in infants is still controversial. Aim: This Editorial discuss the results of a recent on the clinical relevance of cardiac specific biomarkers, NT-proBNP and cardiac troponin I (cTnI) in 40 infants with bronchiolitis, 37% requiring admission in the ICU. Results: NT-proBNP levels were significantly associated with prolonged hospitalization and duration of oxygen therapy, while cTnI levels, measured with high-sensitivity (hs) methods, did not. Furthermore NT-proBNP was significantly correlated with left and right ventricular functional echocardiographic parameters, while hs-cTnI was not associated with any echocardiographic parameter. Discussion: Recent results confirm that NT-proBNP assay has a crucial role in the diagnosis, prognosis and follow-up of patients with cardiac disease not only in adult, but even in pediatric age). On the other hand, the clinical usefulness of assay of hs-cTnI and hs-cTnT in pediatric cardiology, at present time, may be greatly limited by the lack of reliable reference intervals. Conclusions: Further well-designed multi-center studies are needed to more accurately evaluate the clinical relevance of cardio-specific biomarkers, and in particular of hs-cTnI and hs-cTnT assay, on prognosis of infants with bronchiolitis
Pathophysiologic relevance of measuring the plasma levels of cardiac natriuretic peptides in humans
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The paradox of low B-type natriuretic peptide levels in obesity revisited: does sex matter?
No full textMeasurement of circulating concentrations of cardiac troponin i and T in healthy subjects: A tool for monitoring myocardial tissue renewal?
No full textThe increased analytical sensitivity of the new generation of methods for cardiac troponin I (cTnI) and T (cTnT) has demonstrated that measurable troponin is present in the blood of healthy adult subjects. These data are not in accordance with the prevailing opinion that any reliably detected increase in cardiac troponins should be considered abnormal and potentially caused by cardiac necrosis. The goal of the present review is to discuss the hypothesis that cardiac troponins can be released from cardiomyocytes, even in healthy adult subjects as a result of a process related to "physiological renewal" of the human myocardium and possibly enhanced by physical exercise or aging. The latest generation of high-sensitive cTnI and cTnT immunoassays are characterized by detection limits (DLs) as low as a few picograms. This clearly represents a greater increase in discrimination than that obtained by the most sophisticated cardiac imaging techniques that are commercially available at present. However, the critical question is whether high-sensitive troponin assays are clinically useful and in particular, whether some specific laboratory biomarkers (such as cTnI and cTnT) yield better diagnostic (or prognostic) accuracy and cost-effectiveness when compared with echocardiography in patients with cardiovascular disease. Only specific and well-designed clinical trials will answer this important question. © 2009 by Walter de Gruyter Berlin New York
Point-of-Care High-Sensitivity Troponin Testing in the Emergency Department: The Way of the Future?
No full textHigh-sensitivity cardiac troponins in pediatric population
No full textApparently healthy children often complain of chest pain, especially after physical exercise. Cardiac biomarker levels are often measured, but the clinical relevance of these assays in children is still debated, even when a cardiac disease is present. Coronary artery disease is exceedingly rare in children, but elevated circulating levels of cardiac troponin I (cTnI) and T (cTnT) in an acute setting may help detect heart failure due to an unknown cardiac disorder, or worsening heart failure, particularly in combination with other biomarkers such as B-type natriuretic peptides. However, the interpretation of biomarkers is often challenging, especially when institutions transition from conventional cTn assays to high-sensitivity (hs-cTn) methods, as well demonstrated in the emergency setting for adult patients. From a clinical perspective, the lack of established reference values in the pediatric age is the main problem limiting the use of hs-cTn methods for the diagnosis and managements of cardiac diseases in infants, children and adolescents. This review aims to discuss the possibility to use hs-cTnI and hs-cTnT to detect cardiac disease and to explore age-related differences in biomarker levels in the pediatric age. We start from some analytical and pathophysiological considerations related to hs-cTn assays. Then, after a systematic literature search, we discuss the current evidence and possible limitations of hs-cTn assay as indicators of cardiac disease in the most frequently cardiac disease in pediatric setting
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