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Clinical Chemistry and Laboratory Medicine (CCLM)

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In This Section
Volume 47, Issue 10 (Oct 2009)


Measurement of circulating concentrations of cardiac troponin I and T in healthy subjects: a tool for monitoring myocardial tissue renewal?

Alberto Giannoni
  • G. Monasterio Foundation, CNR Regione Toscana, and Scuola Superiore Sant'Anna, Pisa, Italy
/ Stefania Giovannini
  • G. Monasterio Foundation, CNR Regione Toscana, and Scuola Superiore Sant'Anna, Pisa, Italy
/ Aldo Clerico
  • G. Monasterio Foundation, CNR Regione Toscana, and Scuola Superiore Sant'Anna, Pisa, Italy


The increased analytical sensitivity of the new generation of methods for cardiac troponin I (cTnI) and T (cTnT) has demonstrated that measurable troponin is present in the blood of healthy adult subjects. These data are not in accordance with the prevailing opinion that any reliably detected increase in cardiac troponins should be considered abnormal and potentially caused by cardiac necrosis. The goal of the present review is to discuss the hypothesis that cardiac troponins can be released from cardiomyocytes, even in healthy adult subjects as a result of a process related to “physiological renewal” of the human myocardium and possibly enhanced by physical exercise or aging. The latest generation of high-sensitive cTnI and cTnT immunoassays are characterized by detection limits (DLs) as low as a few picograms. This clearly represents a greater increase in discrimination than that obtained by the most sophisticated cardiac imaging techniques that are commercially available at present. However, the critical question is whether high-sensitive troponin assays are clinically useful and in particular, whether some specific laboratory biomarkers (such as cTnI and cTnT) yield better diagnostic (or prognostic) accuracy and cost-effectiveness when compared with echocardiography in patients with cardiovascular disease. Only specific and well-designed clinical trials will answer this important question.

Clin Chem Lab Med 2009;47:1167–77.

Keywords: cardiac markers; cardiac troponin I; cardiac troponin T; healthy subjects; physical exercise

About the article

Corresponding author: Prof. Aldo Clerico, MD, Laboratory of Cardiovascular Endocrinology and Cell Biology, G. Monasterio Foundation, CNR Regione Toscana, Scuola Superiore Sant'Anna, Via Trieste 41, 56126 Pisa, Italy Phone: +39-0585-493569, Fax: +39-0585-493601,

Received: 2009-07-22

Accepted: 2009-08-07

Published in Print: 2009-10-01

Citation Information: Clinical Chemistry and Laboratory Medicine, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2009.320. Export Citation

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