kpcczКомплексные проблемы сердечно-сосудистых заболеванийComplex Issues of Cardiovascular Diseases2306-12782587-9537Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”10.17802/2306-1278-2019-8-4-103-115kpccz-635Research ArticleАНАЛИТИЧЕСКИЙ ОБЗОР. Патологическая физиологияREVIEWS. Pathological physiologyОсобенности метаболизма сердечных тропонинов (обзор литературы)Metabolism of cardiac troponins (literature review)ЧаулинА. М.ChaulinA. M.

Чаулин Алексей Михайлович - врач клинической лабораторной диагностики клинико-диагностической лаборатории СОККД, ассистент кафедры гистологии и эмбриологии СГМУ.

Ул. Аэродромная, 43, Самара, 443070; ул. Чапаевская, 89, Самара, 443099, тел. +7 (927) 770-25-87

Chaulin Aleksey M. - MD, pathologist at the Clinical and Diagnostic Laboratory SRCD; lecturer assistant at the Department of Histology and Embryology SSMU.

43 Aerodromnaya St., Samara, 443070; 89 Chapayevskaya St., Samara, 443099; +7 (927) 770-25-87

alekseymichailovich22976@gmail.comКарелииЛ. С.KarslyanL. S.

Карслян Лиля Степановна, кандидат медицинских наук, заведующая клинико-диагностической лабораторией ОККД, доцент кафедры фундаментальной и клинической биохимии с лабораторной диагностикой СГМУ.

Ул. Аэродромная, 43, Самара, 443070; ул. Чапаевская, 89, Самара, 443099

Karslyan Lilia S. - PhD, Head of the Clinical and Diagnostic Laboratory SRCD; Associate Professor at the Department of Basic and Clinical Biochemistry SSMU.

43 Aerodromnaya St., Samara, 443070; 89 Chapayevskaya St., Samara, 443099

ГригорьеваЕ. В.GrigorievaE. V.

Григорьева Екатерина Владимировна - врач клинической лабораторной диагностики клинико-диагностической лаборатории.

Ул. Аэродромная, 43, Самара, 443070

Grigorieva Ekaterina V. - MD, pathologist at the Clinical and Diagnostic Laboratory.

43 Aerodromnaya St., Samara, 443070

НурбалтаеваД. А.NurbaltaevaD. A.

Нурбалтаева Дона Адылбековна - врач клинической лабораторной диагностики клинико-диагностической лаборатории.

Ул. Аэродромная, 43, Самара, 443070

Nurbaltaeva Dona A. - MD, pathologist at the Clinical and Diagnostic Laboratory.

43 Aerodromnaya St., Samara, 443070

ДупляковД. В.DuplyakovD. V.

Дупляков Дмитрий Викторович - доктор медицинских наук, заместитель главного врача по медицинской части ОККД, профессор кафедры кардиологии и сердечно-сосудистой хирургии Института профессионального образования СГМУ.

Ул. Аэродромная, 43, Самара, 443070; ул. Чапаевская, 89, Самара, 443099

Duplyakov Dmitrii V. - PhD, Director Deputy for Medical Issues SRCD; Professor at the Department of Cardiology and Cardiovascular Surgery SSMU.

43 Aerodromnaya St., Samara, 443070; 89 Chapayevskaya St., Samara, 443099

Государственной бюджетное учреждение здравоохранения Самарский областной клинический кардиологический диспансер; Федералъное государственное бюджетное образовательное учреждение высшего образования «Самарский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияSamara Regional Cardiology Dispensary; Federal State Educational Institution “Samara State Medical University” of the Ministry of Healthcare of the Russian FederationRussian FederationГосударственной бюджетное учреждение здравоохранения Самарский областной клинический кардиологический диспансерРоссияSamara Regional Cardiology DispensaryRussian Federation20192512201984103115Copyright © Чаулин А.М., Карелии Л.С., Григорьева Е.В., Нурбалтаева Д.А., Дупляков Д.В., 20192019Чаулин А.М., Карелии Л.С., Григорьева Е.В., Нурбалтаева Д.А., Дупляков Д.В.Chaulin A.M., Karslyan L.S., Grigorieva E.V., Nurbaltaeva D.A., Duplyakov D.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nii-kpssz.com/jour/article/view/635

В обзоре литературы суммированы сведения об особенностях метаболизма сердечных изоформ тропонинов. Описаны основные механизмы высвобождения тропонинов из интактного миокарда, которые обеспечивают базовые концентрации (менее 99-го перцентиля) у всех здоровых индивидуумов. Тропонины циркулируют в кровотоке в виде гетерогенного пула, в основном в виде фрагментов, что обеспечивается различными внутри- и внеклеточными протеазами. Уточнение данных механизмов необходимо для улучшения диагностики. В статье также сообщается о возможности исследования сердечных тропонинов в других биологических жидкостях человека: перикардиальной, спинномозговой, амниотической, моче и ротовой жидкости. Определение тропонинов в слюне и моче является перспективным направлением неинвазивной диагностики. Сообщается о недавно обнаруженных циркадных особенностях колебаний концентрации кардиального высокочувствительного тропонина Т, которые, вероятно, должны учитываться в современных быстрых алгоритмах диагностики инфаркта миокарда.

The review summarizes all recent data on the metabolism of cardiac troponin isoforms. The main mechanisms of troponin release from intact myocardium are described. These mechanisms ensure its baseline levels (less than the 99th percentile) in all healthy individuals. There are various fragments of troponin that circulate in the blood flow as a heterogeneous pool. Their circulation is related to various intracellular and extracellular proteases. In-depth understanding ofthese mechanisms is required to improve the diagnostic process. The article provides new insights into the evaluation of cardiac troponins in other human biological fluids: pericardial, cerebrospinal, amniotic, urine, and oral fluid. The measurements of saliva and urine levels of troponins seem to be promising alternative for non-invasive diagnosis. Recent circadian patterns of high-sensitive cardiac troponin T alterations are reported. These patterns should be taken into account while practicing fast diagnostic algorithms.

 

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The authors declare that there are no conflicts of interest present.