TY - JOUR
T1 - Biological variation of cardiac markers in patients with aortic valve stenosis
AU - Peeters, Frederique E. C. M.
AU - Kietselaer, Bas L. J. H.
AU - Hilderink, Judith
AU - van der Linden, Noreen
AU - Niens, Marijke
AU - Crijns, Harry J. G. M.
AU - Meex, Steven J. R.
N1 - Funding Information:
Funding This study was supported by a research grant from Stichting De Weijerhorst (Maastricht, the Netherlands) to Professor van Dieijen-Visser.The sponsor had no role in the design and conduct of the study, in the collection, analysis and interpretation of the data, or in the preparation, review or approval of the manuscript and the decision to submit the manuscript for publication.
Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/1
Y1 - 2019/1
N2 - 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.
AB - 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.
KW - SENSITIVITY TROPONIN-T
KW - VALVULAR HEART-DISEASE
KW - EUROPEAN ASSOCIATION
KW - NATRIURETIC PEPTIDES
KW - TASK-FORCE
KW - BIOMARKERS
KW - FAILURE
KW - INDIVIDUALS
KW - VARIABILITY
KW - PREDICTORS
U2 - 10.1136/openhrt-2019-001040
DO - 10.1136/openhrt-2019-001040
M3 - Article
SN - 2053-3624
VL - 6
JO - Open Heart
JF - Open Heart
IS - 1
M1 - 001040
ER -