{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:14:35Z","timestamp":1790612075698,"version":"4.1.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T00:00:00Z","timestamp":1727654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Sparse information is available on the correct interpretation of elevated high\u2010sensitivity cardiac troponin (hs\u2010cTn) in confirmed muscular dystrophies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Serum concentrations of hs\u2010cTn T (hs\u2010cTnT) and hs\u2010cTn I (hs\u2010cTnI) were determined in 35 stable outpatients with confirmed skeletal muscle dystrophies. We calculated sensitivities, specificities, and positive and negative predictive values of hs\u2010cTnT and hs\u2010cTnI for identification of cardiac involvement using a comprehensive definition that included diastolic left ventricular and right ventricular function, strain analysis using two\u2010dimensional transthoracic echocardiogram and magnetic resonance imaging, myocardial biopsies, and consideration of a variety of triggers for cardiac injury, including arrhythmias, conduction disorders, and hypoxemia due to respiratory failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cardiac involvement was diagnosed in 34 of 35 cases. Specificities of hs\u2010cTnT increased from 12.5% to 100% (<jats:italic>p<\/jats:italic>\u2009=\u20090.0006) applying the comprehensive definition compared to a definition based on electrocardiography and echocardiography alone. At the recommended 99th percentile upper limit of normal, sensitivities were significantly lower for hs\u2010cTnI than for hs\u2010cTnT (29.4% vs. 100%, <jats:italic>p<\/jats:italic>\u2009=\u20090.0164). Conversely, the specificities of hs\u2010cTnT and hs\u2010cTnI increased to 100% when using the comprehensive definition criteria for diagnosing cardiac involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated hs\u2010cTnT but not hs\u2010cTnI discriminates cardiac involvement in cases with confirmed skeletal muscle dystrophies with very high sensitivity and 100% specificity. Prior reports on worse performance may be explained by the use of less sensitive imaging methods or incomplete assessment of cardiac involvement.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.16498","type":"journal-article","created":{"date-parts":[[2024,9,30]],"date-time":"2024-09-30T08:24:46Z","timestamp":1727684686000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Improved diagnostic performance of high\u2010sensitivity cardiac troponins in muscle dystrophies using comprehensive definition criteria for cardiac involvement: A longitudinal study on 35 patients"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6783-143X","authenticated-orcid":false,"given":"Mustafa","family":"Yildirim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Salbach","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"},{"name":"Institute for Cardiomyopathies and Center for Cardiogenetics, Department of Medicine III University of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Pribe\u2010Wolferts","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara Ruth","family":"Milles","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"T\u00e4ger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Mueller\u2010Hennessen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8942-7662","authenticated-orcid":false,"given":"Markus","family":"Weiler","sequence":"additional","affiliation":[{"name":"Department of Neurology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Meder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"},{"name":"Institute for Cardiomyopathies and Center for Cardiogenetics, Department of Medicine III University of Heidelberg  Heidelberg Germany"},{"name":"German Center for Cardiovascular Research Standort Heidelberg\/Mannheim  Heidelberg Germany"},{"name":"Stanford Genome Technology Center Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norbert","family":"Frey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"},{"name":"German Center for Cardiovascular Research Standort Heidelberg\/Mannheim  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Giannitsis","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Cardiology University Hospital of Heidelberg  Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,9,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2010.04.008"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v7.i7.410"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.wco.0000093100.34793.81"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0960-8966(02)00140-2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92671-n"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1041013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1041012"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.00831"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjqcco\/qcaa059"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.01.070"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.19082\/5732"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2007.01.009"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0174166"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2012.04.159"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/openhrt-2021-001592"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.115.004615"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2012.11.049"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2009.132654"},{"key":"e_1_2_10_20_1","unstructured":"International Federation of Clinical Chemistry and Laboratroy Medicine (IFCC).High\u2010sensitivity* cardiac troponin I and T assay analytical characteristics designated by manufacturer IFCC Committee on Clinical Applications of Cardiac Bio\u2010Markers (C\u2010CB).https:\/\/pub\u2010180a8d00f517477ba49634e6b2b147e3.r2.dev\/2023\/11\/High\u2010Sensitivity\u2010Cardiac\u2010Troponin\u2010I\u2010and\u2010T\u2010Assay\u2010Analytical\u2010Characteristics\u2010Designated\u2010By\u2010Manufacturer\u2010v052022.pdf. Accessed October 22 2023."},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev014"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.01.011"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.121.058489"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/ehf2.14864"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ppul.24484"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/life11090947"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-014-7526-1"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.2307\/2531595"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cca.2014.04.007"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001063"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac223"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-21-00426"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2016.264648"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjacc\/zuac122"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000156328.28485.AD"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.07.058"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcmg.2011.03.011"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1515\/dx-2019-0045"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.114.014129"}],"container-title":["European Journal of Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ene.16498","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T04:46:25Z","timestamp":1757565985000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ene.16498"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,9,30]]},"references-count":38,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/ene.16498"],"URL":"https:\/\/doi.org\/10.1111\/ene.16498","archive":["Portico"],"relation":{},"ISSN":["1351-5101","1468-1331"],"issn-type":[{"value":"1351-5101","type":"print"},{"value":"1468-1331","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,9,30]]},"assertion":[{"value":"2024-06-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-13","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-09-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e16498"}}