This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wang, T. J. Search for Related Content PubMed PubMed Citation Articles by Wang, T. J. Related Collections Congestive

(Circulation. 2007;116:1217-1220.)
© 2007 American Heart Association, Inc.

Editorial

Significance of Circulating Troponins in Heart Failure

If These Walls Could Talk

Thomas J. Wang, MD

From the Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, and Framingham Heart Study, Framingham, Mass.

Correspondence to Thomas J. Wang, MD, Cardiology Division, GRB-800, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. E-mail tjwang@partners.org

Key Words: Editorials • biomarkers • heart failure • troponin

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Biomarkers serve 2 potential roles: They provide insight into the pathophysiology of disease, and they aid clinical decision making by clarifying diagnosis, prognosis, or response to therapy. Fulfillment of one role does not ensure fulfillment of the other. For instance, some biomarkers associated with disease progression turn out to provide little incremental clinical value. Thus, studies like the one by Latini and colleagues¹ in this issue of Circulation are valuable because they couple investigation of a biologically interesting association, in this case the link between circulating troponins and heart failure (HF), with a rigorous assessment of clinical utility. The following commentary focuses on 2 questions raised by the study by Latini et al. First, what is the pathophysiological significance of circulating troponins in HF? Second, should we be measuring cardiac troponins in chronic HF patients?

Article p 1242

	The Significance of Cardiac Troponins in HF

 
The troponins comprise 3 proteins (troponin T, I, and C) that regulate actin and myosin interactions during muscle contraction. Troponins T and I have distinct isoforms that exist in skeletal and cardiac muscle; newer-generation assays permit the detection of the isoforms unique to cardiac tissue. The release of these proteins into the bloodstream from cardiomyocyte necrosis accounts for their utility as biomarkers of acute coronary syndromes.

In the past decade, it has been recognized that elevated concentrations of cardiac troponins also are detectable in patients with HF in the absence of unstable coronary syndromes. In 1997, Missov and colleagues² used a highly sensitive research assay to demonstrate elevated concentrations of troponin I . . . [Full Text of this Article]

This article has been cited by other articles:

				J. Sundstrom, E. Ingelsson, L. Berglund, B. Zethelius, L. Lind, P. Venge, and J. Arnlov Cardiac troponin-I and risk of heart failure: a community-based cohort study Eur. Heart J., April 1, 2009; 30(7): 773 - 781. [Abstract] [Full Text] [PDF]

				M. Emdin, S. Vittorini, C. Passino, and A. Clerico Old and new biomarkers of heart failure Eur J Heart Fail, April 1, 2009; 11(4): 331 - 335. [Abstract] [Full Text] [PDF]