Harvard Medical School, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA; Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
Clin Chim Acta. 2015 Feb 20;441:92-8. doi: 10.1016/j.cca.2014.12.027. Epub 2014 Dec 26.
Cardiac troponins I and T are established biomarkers of cardiac injury. Testing for either of these two cardiac troponins has long been an essential component of the diagnosis of acute myocardial infarction. In addition, cardiac troponin concentrations after acute myocardial infarction predict future adverse events including development of ischemic heart failure and chronic elevations of cardiac troponin correlate with heart failure severity. These predictions and correlations are particularly obvious when cardiac troponin concentrations are measured using the new high sensitivity cardiac troponin assays. Thus, a growing body of literature suggests that cardiac troponin testing may have important clinical implications for heart failure patients with reduced or preserved ejection fraction. In this review, we explore the prognostic utility of measuring cardiac troponin concentrations in patients with acute or chronic heart failure and in populations at risk of developing heart failure and the relationship between cardiac troponin levels and disease severity. We also summarize the ongoing debates and research on whether serial monitoring of cardiac troponin levels may become a useful tool for guiding therapeutic interventions in patients with heart failure.
心肌肌钙蛋白 I 和 T 是已确立的心脏损伤生物标志物。检测这两种心肌肌钙蛋白中的任何一种一直是急性心肌梗死诊断的重要组成部分。此外，急性心肌梗死后心肌肌钙蛋白浓度可预测未来不良事件，包括缺血性心力衰竭的发展，而慢性心肌肌钙蛋白升高与心力衰竭严重程度相关。当使用新的高敏心肌肌钙蛋白检测方法测量心肌肌钙蛋白浓度时，这些预测和相关性尤其明显。因此，越来越多的文献表明，心肌肌钙蛋白检测可能对射血分数降低或保留的心力衰竭患者具有重要的临床意义。在这篇综述中，我们探讨了测量急性或慢性心力衰竭患者以及心力衰竭高危人群中心肌肌钙蛋白浓度的预后价值，以及心肌肌钙蛋白水平与疾病严重程度之间的关系。我们还总结了目前关于连续监测心肌肌钙蛋白水平是否可能成为心力衰竭患者治疗干预的有用工具的争论和研究。
