Cardiac Troponin T: It’s all in the shape of you

Cardiovascular diseases are the leading cause of death worldwide. Most of these deaths are due to heart attacks. Rapid diagnosis and intervention is essential to improve the outcome and prognosis of heart attack patients. Though a small portion of suspected heart attack patients can immediately be diagnosed by an electrocardiogram, most rely on (serial) cardiac troponin assessment in blood. Cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are currently the recommended biochemical markers to diagnose a heart attack. Despite the fact that the current tests are excellent in ruling-out a heart attack, these tests are suboptimal in confirming a heart attack. This is because increased levels of cardiac troponins (either T or I) are also detected in other conditions. Research has suggested that the shape of cTnT might be able to differentiate a heart attack from other conditions that cause increased cTnT levels in blood. However, more knowledge on the origin and formation of these different cTnT shapes remains essential to confirm this thought. The research presented in this PhD thesis describes the origin and formation of cTnT shapes in multiple conditions. Ultimately, this research may provide guidance in the development of a new cTnT test which is better and faster in confirming a heart attack and thereby improving the outcome and prognosis of patients suffering from a heart attack.