The actively secreted plasma extracellular vesicle troponin (ASPECT) study: circulating troponin in extracellular vesicles across cardiovascular disease cohorts
6 affiliations
- 1Albert Einstein College of Medicine, New York City Health and Hospitals, North Central Bronx, The Bronx, NY, USA
- 2Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Mass General Brigham Heart and Vascular Institute, 185 Cambridge Street, Simches 3, Boston, MA, 02114, USA
- 3Division of Cardiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- 4Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- 5Baim Institute for Clinical Research, Boston, MA, USA
- 6Cardiovascular Research Center, Massachusetts General Hospital and Harvard Medical School, Mass General Brigham Heart and Vascular Institute, 185 Cambridge Street, Simches 3, Boston, MA, 02114, USA. [email protected]
Abstract
Cardiac troponin is essential for diagnosing myocardial infarction, yet high-sensitivity assays frequently detect troponin elevations in non-ischemic contexts, complicating clinical decision-making. We investigated extracellular vesicle-associated (EV) versus non-vesicular (NEV) troponin in plasma samples from 266 participants across acute and chronic heart failure, type 1 and type 2 MI, hypertrophic cardiomyopathy, end-stage kidney disease, healthy individuals, and exercise states. EV troponin was negligible in necrosis-dominant conditions (MI, kidney disease) but constituted up to 40-60% of total troponin in chronic heart failure or hypertrophic cardiomyopathy; in healthy controls and athletes, troponin concentrations were near or below the detection limit, though detectable troponin was predominantly EV-associated. Unlike plasma troponin, EV troponin weakly correlated with natriuretic peptides or renal indices, suggesting a distinct release mechanism linked to chronic stress or physiological processes. These findings highlight the potential for EV troponin to distinguish active, non-necrotic processes from acute injury. Further study may clarify its prognostic utility and refine current diagnostics and risk stratification.
Related
- A Circulating Extracellular Vesicle-Bound Fraction of Cardiac Troponin Discriminates Myocardial Homeostasis and Disease States.
- Enterovirus A71 exploits peripheral circulating extracellular vesicles to facilitate blood-brain barrier permeability
- Long-Term Effects of Isoflurane Anesthesia and Surgery: Sex-Associated Neurological Dysfunction and Alterations in Circulating Extracellular Vesicles
- Longitudinally Monitoring Prostate Cancer Bone Metastasis and Treatment Response via Circulating Extracellular Vesicles
- Editorial: Investigating the role of extracellular vesicles in cardiovascular disease mechanisms
BibTeX
@article{spanos2026actively,
title = {{The actively secreted plasma extracellular vesicle troponin (ASPECT) study: circulating troponin in extracellular vesicles across cardiovascular disease cohorts}},
author = {Michail Spanos and Priyanka Gokulnath and Aarush Singh and Christopher Azzam and Ronak Wakhlu and Claire Lin and Ana-Chrysa Maravelias and Timothy Oasan and Albree F Tower-Rader and Megan Wasfy and Petr Jarolı́m and James L. Januzzi and Saumya Das},
journal = {Biomarker Research},
year = {2026},
month = may,
doi = {10.1186/s40364-026-00947-7},
url = {https://doi.org/10.1186/s40364-026-00947-7},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - The actively secreted plasma extracellular vesicle troponin (ASPECT) study: circulating troponin in extracellular vesicles across cardiovascular disease cohorts
AU - Michail Spanos
AU - Priyanka Gokulnath
AU - Aarush Singh
AU - Christopher Azzam
AU - Ronak Wakhlu
AU - Claire Lin
AU - Ana-Chrysa Maravelias
AU - Timothy Oasan
AU - Albree F Tower-Rader
AU - Megan Wasfy
AU - Petr Jarolı́m
AU - James L. Januzzi
AU - Saumya Das
PY - 2026
DA - 2026/05/29
JO - Biomarker Research
DO - 10.1186/s40364-026-00947-7
UR - https://doi.org/10.1186/s40364-026-00947-7
AB - Cardiac troponin is essential for diagnosing myocardial infarction, yet high-sensitivity assays frequently detect troponin elevations in non-ischemic contexts, complicating clinical decision-making. We investigated extracellular vesicle-associated (EV) versus non-vesicular (NEV) troponin in plasma samples from 266 participants across acute and chronic heart failure, type 1 and type 2 MI, hypertrophic cardiomyopathy, end-stage kidney disease, healthy individuals, and exercise states. EV troponin was negligible in necrosis-dominant conditions (MI, kidney disease) but constituted up to 40-60% of total troponin in chronic heart failure or hypertrophic cardiomyopathy; in healthy controls and athletes, troponin concentrations were near or below the detection limit, though detectable troponin was predominantly EV-associated. Unlike plasma troponin, EV troponin weakly correlated with natriuretic peptides or renal indices, suggesting a distinct release mechanism linked to chronic stress or physiological processes. These findings highlight the potential for EV troponin to distinguish active, non-necrotic processes from acute injury. Further study may clarify its prognostic utility and refine current diagnostics and risk stratification.
SN - 2050-7771
ER -