Strong diurnal rhythm of troponin T, but not troponin I, in a patient with renal dysfunction

Linden, Naomi van der; Cornelis, T.; Klinkenberg, Lieke J.J.; Kimenai, Dorien M; Hilderink, Judith M; Litjens, Elisabeth J R; Kooman, Jeroen P.; Bekers, Otto; Dieijen-Visser, Marja P. van; Meex, Steven J.R.

doi:10.1016/j.ijcard.2016.06.268

Cited by 27 publications

(34 citation statements)

References 6 publications

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“…15 Combining 2 signals of cardiomyocyte damage, hs-cTnT and hs-cTnI, might overcome some individual pathophysiological and analytical limitations and thereby increase diagnostic accuracy for AMI with a single blood draw. 11,16,17 Despite differences in biochemical characteristics and release kinetics, 18,19 a recent direct comparison between hs-cTnI and hs-cTnT showed similar, high diagnostic accuracy for AMI, emphasizing the similarities between both isoforms. 12 Based on the observation of an imperfect correlation between blood concentrations of cTnT and cTnI in chronic and acute disorders, 20,21 and in analogy to the quantification of renal function using creatinine and cystatin C, where the combination of 2 parameters associated with the same pathophysiological process but influenced by distinct factors led to a more precise and accurate indicator, 22 we hypothesize that combining hs-cTnI and hs-cTnT concentrations will overcome independent pathophysiological, preanalytical, and analytical differences of the individual molecules, and might therefore have higher diagnostic accuracy for AMI than either hs-cTnI or hs-cTnT alone.…”

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confidence: 99%

Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Linden

Wildi²,

Twerenbold³

et al. 2018

Circulation

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confidence: 99%

Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Linden

Wildi²,

Twerenbold³

et al. 2018

Circulation

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“…В нескольких исследованиях ЦР СТ были изучены более подробно -измерение уровня СТ у одних и тех же пациентов проводилось каждый час в течение суток, что позволяет значительно точнее установить факт наличия или отсутствия ЦР [24][25][26][27]. Клинические характеристики пациентов, участвующих в данных исследованиях, значительно различались (табл.…”

Section: циркадные ритмы стunclassified

“…Во всех упомянутых выше исследованиях ЦР присутствовали у СТ-Т, но не были статистически значимы для СТ-I [25][26][27]. Wildi K, et al также не обнаружили ЦР СТ-I, характерных для СТ-Т [29].…”

Section: циркадные ритмы стunclassified

“…Весьма примечательно, что в исследовании Klinkenberg L почасовые различия концентрации СТ-I составляли не более 1 нг/л [25], тогда как у пациентки с ХБП в исследовании van der Linden N они достигали 2,6 нг/л [26]. Сравнивая результаты данных исследований Klinkenberg L и van der Linden N [25,26], также отметим, что в последнем случае ЦР СТ-Т были гораздо более значимы и могли бы повлиять на точность диагностики ИМ (при использовании ранних алгоритмов диагностики 0-1 ч, и 0-3 ч). В связи с этим, можно предположить, что циркадные колебания концентраций как СТ-Т, так и СТ-I у пациентов в условиях ХБП гораздо более выражены, чем у здоровых индивидуумов.…”

Section: циркадные ритмы стunclassified

“…Поэтому мы не случайно описывали возможности почечной фильтрации выше. Если сравнить исследования Klinkenberg L, et al [24,25] и van der Linden N, et al [26], можно заметить, что у пациентов с нормальной функцией почек наблюдались менее выраженные циркадные изменения СТ-I, чем у пациентов с угнетенной функцией почек. Для СТ-Т также характерная данная тенденция: у пациентов с адекватной почечной фильтрацией (нормальной СКФ) циркадные колебания значительно более выражены.…”

Section: возможные механизмы формирования цр стunclassified

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Circadian rhythms of cardiac troponins: mechanisms and clinical significance

2020

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Modern laboratory methods for determining biomarkers of cardiovascular diseases are highly sensitive and can detect almost single molecules in human biological fluids, significantly speeding up and improving the diagnosis of cardiovascular diseases. However, in this case, there is a decrease in specificity and it is necessary to take into account a number of additional factors that may affect the result of the study. Recent studies have shown that circadian rhythms (CR) are among these factors. This review article is devoted to the discussion of recently discovered CR of cardiac troponins (CT). A number of articles reported that, both in healthy people and in patients with a number of chronic diseases, CT concentrations change during the day. Given that modern algorithms for diagnosing myocardial infarction (MI) are based on serial studies (0-1 h and 0-3 h) of blood serum, and the values of CT in the blood serum for the diagnosis of myocardial infarction (MI) for this period of time are only a few ng/l, the CT CR can to some extent affect the accuracy of MI diagnosis. Thus, natural physiological changes in the concentration of CT during the day can be mistakenly interpreted as diagnostically significant deviations and lead to an erroneous interpretation of laboratory test results.

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Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients

et al. 2020

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Aim Soluble suppression of tumorigenicity‐2 (sST2) is a strong prognostic biomarker in heart failure. The emerging understanding of circadian biology in cardiovascular disease may lead to novel applications in prognosis and diagnosis and may provide insight into mechanistic aspects of the disease–biomarker interaction. So far, it is unknown whether sST2 exhibits a diurnal rhythm. Repeated measurements of sST2 may aid in clinical decision making. The goal of this study was to investigate whether sST2 exhibits diurnal variation in patients with heart failure with reduced ejection fraction (HFrEF) and in control subjects, thereby enhancing its diagnostic and prognostic values. Methods and results The study comprised 32 subjects: 16 HFrEF patients and 16 controls. Blood was collected at seven subsequent time points during a 24 h time period. sST2, N‐terminal pro‐B‐type natriuretic peptide (NT‐proBNP), melatonin, and cortisol were measured from serum. Peak values of sST2 clustered at daytime (modal value: 5 p.m.) in 87.6% of all subjects (81.3% of patients, P = 0.021; 93.8% of controls, P = 0.001), and minimum concentrations at night‐time (modal value: 5 a.m.) in 84.4% (87.5% of patients, P = 0.004 81.3% of controls, P = 0.021). A cosinor analysis of mean normalized sST2 values revealed significant cosine shaped 24 h oscillations of patients (P = 0.026) and controls (P = 0.037). NT‐proBNP in contrast did not show a diurnal rhythm, while melatonin and cortisol patterns were intact in all subjects. Conclusions sST2 exhibits a diurnal rhythm with lower values in the morning than in the late afternoon. This new insight could lead to refinement of its diagnostic and prognostic values through specified and consistent sampling times with repeated measurements. For example, by measuring sST2 during the afternoon, when levels are at their highest, false negatives on prognosis prediction could be avoided.

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Strong diurnal rhythm of troponin T, but not troponin I, in a patient with renal dysfunction

Cited by 27 publications

References 6 publications

Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Combining High-Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Circadian rhythms of cardiac troponins: mechanisms and clinical significance

Prognostic biomarker soluble ST2 exhibits diurnal variation in chronic heart failure patients

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