TNNI3 and heart failure: Concentrations of cTnI in the first morning urine (which is known to be more concentrated) in patients with severe AS in our study were significantly lower than 4.1 pg/mL, as suggested in Chen et al. Therefore, when considering our results and the Chen et al. paradigm, patients with severe AS who have an increased risk of acute cardiac events such as a heart failure would be misevaluated if urine cTnI was used as a prognostic biomarker of future cardiac events, as we are proposing in this research study.