title: High-sensitive Troponin T increase after exercise in patients with pulmonary arterial hypertension.
abstract: BACKGROUND
  The current study aimed to investigate the release of myocardial high-sensitive Troponin T (hsTnT) in patients with pulmonary arterial hypertension (PAH) in response to maximal physical exercise.
  
  
  METHODS
  In 24 patients with PAH, symptom-limited cardiopulmonary exercise testing was performed. hsTnT was measured by the novel hsTnT assay with a lower limit of detection of 2 ng/L and a total imprecision of less than 10% at the 99th percentile value. hsTnT was related to NT-proBNP, WHO functional class and right ventricular (RV) function. Serial measurement was performed before and 30 min, 180 min, and 300 min after exercise. Healthy volunteers served as a control group.
  
  
  RESULTS
  In 21 PAH patients, hsTnT levels were detectable before exercise with a close correlation between hsTnT and NT-proBNP. hsTnT was detectable in all PAH patients after exercise and significantly increased from 7.5 ng/L at baseline to 14.62 ng/L after 300 min, whereas levels of NT-proBNP remained constant with time.
  
  
  CONCLUSIONS
  Using the novel hsTnT assay, the current study provides first evidence that hsTnT levels increase in PAH patients after maximal physical exercise, while levels of other biomarkers remain constant after exercise testing. This might provide new insights into pathophysiology and individual risk assessment in patients with PAH.
authors.affiliation: Department of Cardiology, Angiology and Respiratory Medicine, University Medical Center, Heidelberg D-69120, Germany. mirko.voelkers@med.uni-heidelberg.de
authors.forename: Mirko
authors.initials: M
authors.lastname: Völkers
authors.forename: David
authors.initials: D
authors.lastname: Rohde
authors.forename: Thomas
authors.initials: T
authors.lastname: Zelniker
authors.forename: Celine S
authors.initials: CS
authors.lastname: Weiss
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.forename: F Joachim
authors.initials: FJ
authors.lastname: Meyer
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000097:blood* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D013923:Thromboembolism / Q000097:blood / Q000503:physiopathology; D020107:Troponin T / Q000097:blood*; D016278:Ventricular Function, Right / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain