Biological variation of cardiac markers in patients with aortic valve stenosis

Frederique E. C. M. Peeters, Bas L. J. H. Kietselaer, Judith Hilderink, Noreen van der Linden, Marijke Niens, Harry J. G. M. Crijns, Steven J. R. Meex*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Web of Science)

Abstract

Objective Cardiac biomarkers hold promise for followup and management of aortic valve stenosis (AVS). When interpreting serial biomarker measurements of patients with AVS, it can be challenging to distinguish 'real changes' from 'random fluctuation'. Hence, robust estimation of the biological variation of these biomarkers is essential. In the present study we assessed biological variation of B-type natriuretic peptide (BNP), N-terminus pro-brain natriuretic peptide (NT-proBNP), high-sensitivity troponin-T and high-sensitivity troponin-I (hs-TnT and hsTnI), and ST2 in subjects with stable AVS.

Methods Serial blood sampling was performed in 25 subjects with moderate AVS-confirmed by echocardiography-and all free from acute cardiovascular events in the past 6 months. Blood samples were taken on seven standardised occasions during 1 year. Analytical variation (CV A), within-subject biological variation (CV I), between-subject biological variation (CV G), index of individuality (II) and reference change values were calculated for all cardiac biomarkers.

Results CV I was highest for BNP (62.0%, 95% CI 52.5 to 75.4) and lowest for hs-TnI (9.2%, 95% CI 2.8 to 13.8). CV G exceeded the CV I for all biomarkers except BNP, and ranged from 19.8% (95% CI 13.8 to 33.4) for ST2 to 57.2% (95% CI 40.4 to 97.3) for hs-TnT. NT-proBNP, hsTnT and ST2 revealed CV A <5%, while BNP and hs-TnI showed a higher CV A (19.7 and 14.9, respectively). All biomarkers except BNP showed marked individuality, with II ranging from 0.21 to 0.67 (BNP 1.34).

Conclusion This study provides the first biological variation estimates of cardiac biomarkers in patients with stable AVS. These estimates allow a more evidence-based interpretation of biomarker changes in the follow-up and management of patients with AVS.

Original languageEnglish
Article number001040
Number of pages7
JournalOpen Heart
Volume6
Issue number1
DOIs
Publication statusPublished - Jan 2019

Keywords

  • SENSITIVITY TROPONIN-T
  • VALVULAR HEART-DISEASE
  • EUROPEAN ASSOCIATION
  • NATRIURETIC PEPTIDES
  • TASK-FORCE
  • BIOMARKERS
  • FAILURE
  • INDIVIDUALS
  • VARIABILITY
  • PREDICTORS

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