Cardiac Troponin T – From Diagnosis of Myocardial Infarction to Cardiovascular Risk Prediction –

Matthias Mueller; Mehrshad Vafaie; Moritz Biener; Evangelos Giannitsis; Hugo A. Katus

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Cardiac Troponin T – From Diagnosis of Myocardial Infarction to Cardiovascular Risk Prediction –

机译：心肌肌钙蛋白T –从心肌梗死的诊断到心血管风险的预测–

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Cardiac troponins (cTns) T and I are exclusively expressed at high concentrations in cardiac muscle and have emerged as the preferred biomarker in the universal definition of myocardial infarction (MI). With the recent introduction of high-sensitivity (hs) assays, diagnostic sensitivity for earlier detection of MI has substantially improved. However, lowering the diagnostic cut-off has increased the detection of myocardial injuries in various non-acute coronary syndrome (ACS) conditions, which are not related to myocardial ischemia, leading to rising difficulties in diagnosing MI in clinical situations. Several approaches, such as serial sampling and incorporation of relative or absolute δ-changes, have been proposed to overcome the limitation of decreased sensitivity for MI diagnosis with hs-cTn assays. Current consensus for rapid rule-in proposes a 20% increase within 3 or 6h when baseline cTn levels are elevated. In the case of negative baseline values, relative increases ≥50% above the 99th percentile were found to be adequate to improve accuracy of MI diagnosis. Besides improved diagnostic accuracy for myocardial injury, even minor cTn elevations provide important prognostic information, and increased levels of cTn are associated with adverse outcomes in both the ACS and non-ACS condition, irrespective of whether the underlying cause is an acute or chronic illness. Thus, it is highly likely that lowering the diagnostic cut-off with even more sensitive assays might improve risk stratification in both conditions.??(Circ J?2013; 77: 1653–1661)

机译：心肌肌钙蛋白（cTns）T和I仅在心肌中以高浓度表达，并已成为心肌梗塞（MI）通用定义中的首选生物标志物。随着最近引入的高灵敏度（hs）分析，用于MI早期检测的诊断灵敏度已大大提高。但是，降低诊断临界值增加了在各种非急性冠状动脉综合征（ACS）情况下对心肌损伤的检测，这些情况与心肌缺血无关，导致在临床情况下诊断MI的难度不断增加。已经提出了几种方法，例如串行采样以及结合相对或绝对δ变化，以克服使用hs-cTn分析进行MI诊断的灵敏度降低的局限性。当前的快速服药共识是，当基线cTn水平升高时，在3或6小时内增加20％。在基线值为负值的情况下，相对高于第99个百分位数的≥50％的相对增加足以提高MI诊断的准确性。除了提高心肌损伤的诊断准确性外，即使轻微的cTn升高也可提供重要的预后信息，而ACS和非ACS情况下cTn的升高与不良结局相关，而不论根本原因是急性还是慢性疾病。因此，极有可能通过使用更加敏感的分析降低诊断截止值可能会改善两种情况下的风险分层。（Circ J？2013; 77：1653-1661）

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《Circulation journal》 |2013年第7期|共9页
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Matthias Mueller; Mehrshad Vafaie; Moritz Biener; Evangelos Giannitsis; Hugo A. Katus;
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中图分类心脏、血管（循环系）疾病;
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1. Cardiac Troponin T - From diagnosis of myocardial infarction to cardiovascular risk prediction [J] . MuellerM., VafaieM., BienerM., Circulation journal . 2013,第7期

机译：心肌肌钙蛋白T-从诊断心肌梗塞到预测心血管风险
2. Cardiac Troponin T - From diagnosis of myocardial infarction to cardiovascular risk prediction [J] . MuellerM., VafaieM., BienerM., Circulation journal . 2013,第7期

机译：心肌肌钙蛋白T-从诊断心肌梗死到心血管风险预测
3. Role of monitoring changes in sensitive cardiac troponin I assay results for early diagnosis of myocardial infarction and prediction of risk of adverse events. [J] . Apple FS, Pearce LA, Smith SW, Clinical Chemistry: Journal of the American Association for Clinical Chemists . 2009,第5期

机译：监测敏感性心肌肌钙蛋白I测定结果的变化对于早期诊断心肌梗死和预测不良事件风险的作用。
4. Cardiac troponin detection using silicon photonic biosensor for the accurate and timely diagnosis and prognosis of acute myocardial infarction [C] . Siew Joo Beh, Markus Knoerzer, Crispin Szydzik, Biophotonics Australasia Conference . 2019

机译：使用硅光子生物传感器的心肌肌钙蛋白检测，用于准确且及时的急性心肌梗死的诊断和预后
5. Troponin and Left Ventricular Function After Myocardial Infarction. [D] . Olson, Adelaide Maria Martins Arruda. 2011

机译：心肌梗塞后肌钙蛋白和左心室功能。
6. High-Sensitivity Cardiac Troponin T in Prediction and Diagnosis of Myocardial Infarction and Long-Term Mortality after Non-Cardiac Surgery [O] . Peter Nagele, Frank Brown, Brian F. Gage, -1

机译：高敏性心肌肌钙蛋白T在非心脏手术后心肌梗死和长期死亡率的预测和诊断中
7. MODERATED EPOSTERS1385Longitudinal strain assessment in dilated cardiomyopathy patients using a novel accelerated DENSE sequence1407Simultaneous T1 and T2 cardiac quantification with CABIRIA: initial clinical experience1423Head-to-head comparison of acceleration algorithms in 4-dimensional flow CMR1502Left ventricular function and size evaluated by hybrid cardiac positron emission tomography-magnetic resonance: Intraindividual comparison of left ventricular ejection fraction and ventricular volumes derived by two modalities1510Left Atrium assessed by Cardiovascular Magnetic Resonance at 1.5 and 3 Tesla – age and gender effects1514Comparison of Free Breathing Cardiac MRI Radial technique to the Standard Multi breath-hold cine SSFP CMR technique for the assessment of LV Volumes and Function1536Self-navigated free-breathing isotropic 3D whole heart phase sensitive inversion recovery magnetic resonance without navigator for detection of myocardial infarction1547Assessment of Right Ventricular Strain Using Myocardial Deformation Recovery Semi Automated Technique: Initial Experience and Normal Values1586Tissue tracking myocardial deformation analysis and prediction of left ventricular remodeling in acute myocardial infarction1589Investigating strategies for optimal 31P MRS clinical cardiac at 3T: Initial Results1620Quantitative Criteria for the Diagnosis of the Congenital Absence of Pericardium by Cardiac Magnetic Resonance1632Widespread tissue injury during acute myocardial infarction: evidence from advanced CMR relaxometry1322Computed tomography coronary angiography verSus sTRess cArdiac magneTic rEsonance for the manaGement of sYmptomatic revascularized patients: a cost effectiveness study (STRATEGY study)1339Comparison of low- versus high-dose of gadobutrol for late gadolinium enhancement imaging at 1.5 Tesla: a clinical feasibility study1347Multi-parametric Cardiac Magnetic Resonance for Prediction of Cardiac Complications in Thalassemia Intermedia: a Prospective Multicenter Study1461Prognostic value of Cardiovascular Magnetic Resonance derived indexes of myocardial fibrosis in heart transplant recipients1523The role of CMR in the acute phase of hospitalization: changing paradigms1542Preoperative CMR-based score predict ventricular response after surgical left ventricular reconstruction in ischemic heart failure patients1555Excellent response rate to cardiac resynchronization therapy guided with magnetic resonance imaging1626The ECG as a predictor of arrhythmogenic substrate on Cardiac Magnetic Resonance Imaging in patients undergoing ablation for premature ventricular contractions1649Comparison of T1-mapping at 3.0T CMR and angiographic APPROACH score for area at risk assessment in ST-segment elevation myocardial infarction1340Pathological correlates of left bundle branch disease in patients with non-ischemic cardiomyopathy: a cardiovascular magnetic resonance study1342Myocardial remodelling and fibrosis in nonischaemic dilated cardiomyopathy: insights from cardiovascular magnetic resonance1411The association between fibrosis and contractile dysfunction in hypertrophic cardiomyopathy assessed by cardiovascular magnetic resonance1622Persistent myocardial inflammation due to intramyocardial haemorrhage in reperfused STEMI as a precursor to adverse LV remodelling - insights from multi-parametric mapping1566Semiquantitative analysis of low and high b value DWI for detecting myocardial edema in acute myocarditis1567Value of Cardiac MRI In Detecting Coronary Artery Disease In Newly Diagnosed Systolic Dysfunction1570Usefulness of cardiac magnetic resonance in tuberous sclerosis complex1578Papillary muscles offer further insight into hypertrophied hearts: a cardiovascular magnetic resonance study1627Diagnostic and clinical implications of CMR timing (early versus late) in patients with troponin positive acute coronary syndromes and unobstructed coronary arteries: Table 1. [O] . Upasana Tayal, Alexandros Kallifatidis, P. Garg, 2016

机译：在使用新的扩张型心肌病的患者缓和EPOSTERS1385Longitudinal应变评估加速DENSE sequence1407Simultaneous T1和T2与CABIRIA心脏定量：在4维流动的加速算法初始临床experience1423Head对头比较CMR1502Left心室功能和尺寸由混合心脏正电子发射断层摄影术评价 - 磁性共振：由两个modalities1510Left庭派生左室射血分数和心室体积的个体间的比较，在1.5和3特斯拉评估心血管磁共振 - 免费的年龄和性别effects1514Comparison呼吸心脏MRI径向技术标准的多屏气电影SSFP CMR技术的LV卷和Function1536Self-导航自由呼吸各向同性3D整个心脏相位敏感反转恢复磁共振导航仪没有检测右Ventricu心肌infarction1547Assessment的评估拉尔菌株使用心肌变形恢复半自动技术：初步经验和正常Values1586Tissue跟踪心肌变形分析和预测左室重构急性心肌infarction1589Investigating策略优化31P MRS临床心脏在3T：初始Results1620Quantitative标准的先天缺失的诊断心包心脏磁Resonance1632Widespread组织损伤急性心肌梗死时：证据先进CMR relaxometry1322Computed CT冠状动脉成像与压力心脏磁共振对症的管理吻合血管患者：成本效益研究（战略研究）1339Comparison低与高剂量钆布醇在1.5特斯拉晚钆增强成像的临床可行性，在中间型地贫心脏并发症的预测study1347Multi参数心脏核磁共振的前瞻性德穆尔心血管磁共振的ticenter Study1461Prognostic价值衍生心肌纤维化指标在住院的急性期CMR的心脏移植recipients1523The作用：改变基于CMR-paradigms1542Preoperative比分预测缺血性心脏衰竭patients1555Excellent响应速度外科左心室重建心脏再同步化后心室反应治疗与磁共振imaging1626The ECG导引作为心脏磁共振成像致心律失常性基板的在ST段抬高心肌infarction1340Pathological在风险评估经历在3.0T CMR T1映射的室性早搏contractions1649Comparison和血管造影APPROACH分数区域消融患者的预测左束支传导疾病的患者与非缺血性心肌病相关因素：心血管磁共振study1342Myocardial重塑和纤维化nonischaemic扩张型心肌病：在从在由心血管磁性resonance1622Persistent心肌炎症评估肥厚型心肌病的纤维化和收缩功能障碍之间心血管磁性resonance1411The协会由于心肌内出血景点在再灌注STEMI为先导，以不利的LV重塑 - 从低的多参数mapping1566Semiquantitative分析和高的b值DWI的见解为在心脏MRI检测冠状动脉疾病急性myocarditis1567Value在结节性硬化症complex1578Papillary肌肉初诊收缩期Dysfunction1570Usefulness心脏磁共振检测心肌水肿提供进一步的深入了解肥大心脏：心血管磁共振study1627Diagnostic和CMR定时的临床意义（早期与晚）患者肌钙蛋白阳性的急性冠脉综合征和通畅的冠状动脉：表1。

Cardiac Troponin T – From Diagnosis of Myocardial Infarction to Cardiovascular Risk Prediction –

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