NT-proBNP and hs-cTnT levels did not prove particularly useful in predicting timing of AVR conversion; in some cases, a higher biomarker level was associated with a higher proportion of an acute or severe presentation at AVR conversion, but one-third of CS patients in the lowest biomarker tertiles still had an acute or severe presentation at conversion. This evidence concerns the gene TNNT2 and Cowden syndrome 1.