TASS-2 (Tyrolean Aortic Stenosis Study-2) aims to characterize the clinical value of minimally elevated troponin T plasma levels both in patients with asymptomatic and symtomatic aortic stenosis.

Population

One patient cohort consists of patients with severe symptomatic aortic stenosis admitted for planned valve operation since 2010, when involved institutions started to routinely analyse hsTnT plasma levels. The other patient cohort consists of asymptomatic patients with aortic stenosis diagnosed treated conservatively.

Brief Title

High-Sensitivity Troponin T Plasma Levels in Patients With Aortic Stenosis (Tyrolean Aortic Stenosis Study-2)

Official Title

High-Sensitivity Troponin T Plasma Levels in Patients With Aortic Stenosis

Brief Summary

TASS-2 (Tyrolean Aortic Stenosis Study-2) aims to characterize the clinical value of <br /> minimally elevated troponin T plasma levels both in patients with asymptomatic and symtomatic <br /> aortic stenosis.

Detailed Description

Development of symptoms such as heart failure, syncope or angina pectoris is the
well-established indication for valve operation in patients with severe aortic stenosis.
However, many patients tend to misinterpretate or even ignore symptom onset, and irreversible
myocardial dysfunction may occur. Measurement of aortic valve area by transthoracic
echocardiography using the continuity equation is prone to methological mistakes, whereas
transvalvular gradients are usually easy to quantify but may underestimate hemodynamic
effects in the presence of low flow (stroke volume index below 35 ml/m2). All these
shortcomings in clinical routine may be overcome by objectively and easily assessable
parameters indicating advanced aortic stenosis. Severe aortic valve calcification is such a
risk factor for worse prognosis. However, assessment of valve calcification by
echocardiography is a subjective measurement and highly operator-dependent. Quantification of
valve calcification by multi detector computed tomography is limited by exposure to
radiation, availibilty and cost.

A laboratory parameter already used in clinical routine would fullfill the requirements for
such a risk stratification much better. Natriuretic peptides may be of interest in this
context, but their plasma levels are strongly influenced by age, sex, concomitant arterial
hypertension and/or renal dysfunction and volume status. Recently, high-sensitivity troponin
plasma levels have been suggested to indicate ongoing myocardial fibrosis in aortic stenosis.
A small study with 60 patients suggested that hs-TnT predicte the operative outcome of AS. We
therefore set out to characterize the clinical value of minimally elevated troponin T plasma
levels both in patients with asymptomatic and symtomatic aortic stenosis.