title: High sensitivity troponin and valvular heart disease.
abstract: Blood-based biomarkers have been extensively studied in a range of cardiovascular diseases and have established utility in routine clinical care, most notably in the diagnosis of acute coronary syndrome (e.g., troponin) and the management of heart failure (e.g., brain-natriuretic peptide). The role of biomarkers is less well established in the management of valvular heart disease (VHD), in which the optimal timing of surgical intervention is often challenging. One promising biomarker that has been the subject of a number of recent VHD research studies is high sensitivity troponin (hs-cTn). Novel high-sensitivity assays can detect subclinical myocardial damage in asymptomatic individuals. Thus, hs-cTn may have utility in the assessment of asymptomatic patients with severe VHD who do not have a clear traditional indication for surgical intervention. In this state-of-the-art review, we examine the current evidence for hs-cTn as a potential biomarker in the most commonly encountered VHD conditions, aortic stenosis and mitral regurgitation. This review provides a synopsis of early evidence indicating that hs-cTn has promise as a biomarker in VHD. However, the impact of its measurement on clinical practice and VHD outcomes needs to be further assessed in prospective studies before routine clinical use becomes a reality.
authors.affiliation: Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Cian P
authors.initials: CP
authors.lastname: McCarthy
authors.affiliation: Department of Medicine, Cleveland Clinic Hospital, Cleveland, OH, USA.
authors.forename: Eoin
authors.initials: E
authors.lastname: Donnellan
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Hospital, Cleveland, OH, USA.
authors.forename: Dermot
authors.initials: D
authors.lastname: Phelan
authors.affiliation: Department of Cardiovascular Medicine, Heart and Vascular Institute, Cleveland Clinic Hospital, Cleveland, OH, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Griffin
authors.affiliation: Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Maurice
authors.initials: M
authors.lastname: Enriquez-Sarano
authors.affiliation: Johns Hopkins Coronary Care Unit and Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: jmcevoy1@jhmi.edu.
authors.forename: John W
authors.initials: JW
authors.lastname: McEvoy
mesh_terms: D001024:Aortic Valve Stenosis / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D006801:Humans; D008944:Mitral Valve Insufficiency / Q000097:blood* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin
keywords: Biomarkers; High sensitiity troponin; Valvular heart disease