The article is devoted to problems of clinical-diagnostic value of determination of cardio-specific troponins in human biological fluids. Improvement of laboratory instrumentation and emergence of high sensitivity methods of analysis have allowed to identify troponins in urine, dialysate, and oral fluid. In the review we present actual information related to measurement of troponins in blood serum, data on testing of cardio-specific troponins in urine, dialysate, and oral fluid. Special attention is paid to determination of some cardiomarkers in oral fluid with thorough analysis of diagnostic value and effectiveness of the conducted studies.
Самарский областной клинический кардиологический диспансер, Самара 443070, Российская Федерация 2 Самарский государственный медицинский университет, Самара 443099, Российская Федерация Резюме. В обзорной статье представлены современные представления об особенностях метаболизма тропониновых белков, которые оказывают влияние на результаты анализов. Большое внимание уделено механизмам высвобождения тропонинов из здоровых и поврежденных по различным причинам кардиомиоцитов. Приводятся актуальные сведения, касающиеся протеолитической деградации тропонинов внутри клетки и кровотоке, которые определяют различия между результатами тропониновых диагностикумов. Сообщается о недавно проведенных исследованиях, посвященных неинвазивному определению тропонинов в моче и ротовой жидкости. Обсуждается значение и возможные причины циркадных колебаний концентрации кардиального тропонина Т по данным высокочувствительного определения. Ключевые слова: обзор литературы, лабораторная диагностика, сердечные тропонины, инфаркт миокарда, высвобождение и элиминация тропонинов, апоптоз кардиомиоцитов, циркадные колебания, метаболизм. Конфликт интересов. Авторы декларируют отсутствие явных и потенциальных конфликтов интересов, связанных с публикацией настоящей статьи.
Cardiospecific isoforms of troponins are the most sensitive and specific biomarkers for the diagnosis of myocardial infarction. However, though elevated troponin levels indicate myocardial damage, they do not determine the cause and mechanism of the damage. With the new highly sensitive methods, very minor damages of the heart muscle can be detected. Myocardial damage can occur in many non-coronarogenic diseases. In this review, we discuss the mechanisms of elevation, the diagnostic value of cardiac troponins in the renal failure, tachyarrhythmias, endocarditis, myocarditis, pericarditis, sepsis, neurogenic pathologies (stroke), pulmonary embolism. In addition, we pay attention to the main reasons for a false-positive increase of the concentration of cardiac troponins: heterophilic antibodies, rheumatoid factor, alkaline phosphatase, cross-reactions with skeletal muscle troponins.
Elevated plasma low-density lipoprotein cholesterol (LDL-C) is an important risk factor for cardiovascular diseases. Statins are the most widely used therapy for patients with hyperlipidemia. However, a significant residual cardiovascular risk remains in some patients even after maximally tolerated statin therapy. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a new promising therapeutic target for decreasing LDL-C. PCSK9 reduces LDL intake from circulation by enhancing low-density lipoprotein receptors (LDLR) degradation and preventing LDLR recirculation to the cell surface. In addition to examining the functional role of PCSK9, this review also discusses new drugs for the treatment of hyperlipidemia — PCSK9 inhibitors.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.