Which troponins are used as cardiac markers in nonischemic heart disease?

Updated: Jul 30, 2021
  • Author: Kamal (Komo) Gursahani, MD, MBA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Answer

A number of studies have demonstrated that troponin T (TnT) can be used for risk stratification of patients with heart failure without ischemia. Specifically, elevated cardiac troponins (cTn) are associated with decreased left ventricular ejection fraction and poor prognosis in patients with heart failure, and they are related to the severity of heart failure. [69]

Isolated studies have shown evidence of myocardial infarction and elevated troponin I (TnI) levels in patients with subarachnoid hemorrhage. [70] Vasoactive peptides released during acute subarachnoid hemorrhage induce deep T-wave inversions on electrocardiography that indicate myocardial injury. As mentioned previously, TnT has been shown to be an independent predictor of outcome in patients with pulmonary embolism; right ventricular strain or infarction from acute pulmonary hypertension causes the elevated troponin level.

Elevated troponin levels have also been documented in other nonischemic cardiac disease states, such as tachyarrhythmias, hypertension, myocarditis, and myocardial contusion.


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