Cardiac troponins in congestive heart failure

Background We sought to assess the release of cardiac troponins in congestive heart failure (CHF). Methods and Results We performed a computer-assisted search of the English language literature (MEDLINE database) followed by a manual search of the reference list of pertinent articles retrieved. Studies evaluating the release of cardiac troponins (T and I) in patients with CHF were screened for review. Studies investigating cardiac troponins in patients with ischemic coronary syndromes that reported the rate of CHF were also selected. Available data on the release of cardiac troponins in ischemic and nonischemic CHF were summarized. Possible mechanisms of cell death in the progression to end-stage CHF were discussed. Conclusions Cardiac troponins were detected in patients with advanced CHF. These markers correlated with the severity of CHF and suggest an association with worse prognosis. Possible mechanisms for the release of cardiac troponins T and I in advanced CHF may include the following: ventricular remodeling, presence of coronary artery disease in CHF, abnormalities of coronary microcirculation, and reduced coronary reserve. Further studies will be necessary to elucidate the actual mechanism and determine the clinical significance of cardiac troponins in CHF. (Am Heart J 1999;138:646-53.)