Search

The aim of this study was to examine high-sensitivity troponin T and I (hsTnT and hsTnI) after a treadmill run under laboratory conditions and to find a possible connection with echocardiographic, laboratory and other assessed parameters.Nineteen trained men underwent a standardized 2-hour-long treadmill run. Concentrations of hsTnT and hsTnI were assessed before the run, 60, 120 and 180 minutes after the start and 24 hours after the run. Changes in troponins were tested using non-parametric analysis of variance (ANOVA). The multiple linear regression model was used to find the explanatory variables for hsTnT and hsTnI changes. Values of troponins were evaluated using the 0h/1h algorithm.Changes in hsTnT and hsTnI levels were statistically significant (p0.0001 and p0.0001, respectively). In a multiple regression model (adjusted RRelative LV wall thickness, creatinine changes, training volume and body temperature after the run can predict changes in hsTnT and hsTnI levels. When medical attention is needed after physical exercise, hsTn levels should be tested only when clinical suspicion and the patient's history indicate a high probability of myocardial damage.Cilj ove studije bio je da se ispitaju nivoi visokoosetljivih troponina T i I (hsTnT i hsTnI) posle trčanja na pokretnoj traci u laboratorijskim uslovima i da se utvrdi potencijalna povezanost sa ehokardiografskim, laboratorijskim i ostalim procenjivanim parametrima.Devetnaestorica muškaraca podvrgnuti su standardizovanom dvočasovnom trčanju na pokretnoj traci. Koncentracije hsTnT i hsTnI određene su pre trčanja, zatim 60, 120 i 180 minuta posle početka i 24 časa posle završetka trčanja. Promene u troponinima testirane su pomoću testa ANOVA. Model višestruke linearne regresije upotrebljen je za pronalaženje eksplanatornih varijabli za promene u hsTnT i hsTnI. Vrednosti troponina određene su pomoću algoritma 0h/1h.Promene u nivoima hsTnT i hsTnI bile su statistički značajne (p0,0001 i p0,0001). U modelu višestruke regresije (prilagođeni RRelativna debljina zida LV, promene u nivou kreatinina, obim prethodnih treninga i temperatura tela posle trčanja mogu predvideti promene u nivoima hsTnT i hsTnI.

Background Dialysis patients have a high prevalence of cardiovascular mortality but also elevated cardiac troponins (cTns) even without signs of cardiac ischaemia. The study aims to assess variation and prognostic value of high-sensitivity cTnI and cTnT in prevalent dialysis patients. Methods In 198 prevalent haemodialysis (HD) and 78 peritoneal dialysis (PD) patients, 4-monthly serum troponin I and T measurements were obtained. Reference change values (RCVs) were used for variability assessment and competing-risk regression models for survival analyses; maximal follow-up was 50 months. Results HD and PD patients had similar troponin levels [median (interquartile range) troponin I: 25 ng/L (14–43) versus 21 ng/L (11–37), troponin T: 70 ng/L (44–129) versus 67 ng/L (43–123)]. Of troponin I and T levels, 42% versus 98% were above the decision level of myocardial infarction. RCVs were +68/−41% (troponin I) and +29/−23% (troponin T). Increased variability of troponins related to higher age, male sex, protein-energy wasting and congestive heart failure, but not ischaemic heart disease or dialysis form. Elevated troponin T, but not troponin I, predicted death after adjusting for confounders. Conclusions A large proportion of prevalent dialysis patients without current established or ongoing cardiac events have elevated levels of high-sensitivity cTns. Mortality risk was doubled in patients with persistently high troponin T levels. The large intraindividual variation of cTns suggests that serial measurements and reference change levels may be used to improve diagnostic utility. However, evidence-based recommendations require more data from large studies of dialysis patients with cardiac events.

New highly sensitive (hs) assays have challenged the interpretation of cardiac troponins (cTn) as markers of injury while natriuretic peptides remain the markers of choice for myocardial dysfunction. However, variability extracardiac factors such as age, gender and renal function may alter circulating levels. In chronic kidney disease (CKD), the increase in circulating levels of these biomarkers in the absence of cardiac disease underlines the problem of discriminative value for diagnosis as well as the need to redefine the thresholds. In addition, these biomarkers are of potential interest to stratify cardiovascular risk, the leading cause of death in CKD. The aim of this work is to clarify the effect of age and renal function on circulating levels of high-sensitivity troponins and natriuretic peptides.