Chaulin Aleksey
Department of Histology and Embryology, Department of Cardiology and Cardiovascular Surgery, Samara State Medical University, 443099 Samara, Samara Region, Russia.
Research Institute of Cardiology, Samara State Medical University, 443099 Samara, Samara Region, Russia.
Rev Cardiovasc Med. 2023 Jul 6;24(7):194. doi: 10.31083/j.rcm2407194. eCollection 2023 Jul.
Cardiospecific troponins are specifically localized in the troponin-tropomyosin complex and in the cytoplasm of cardiac myocytes. Cardiospecific troponin molecules are released from cardiac myocytes upon their death (irreversible damage in acute coronary syndrome) or reversible damage to cardiac myocytes, for example, during physical exertion or the influence of stress factors. Modern high-sensitive immunochemical methods for detecting cardiospecific troponins T and I are extremely sensitive to minimal reversible damage to cardiac myocytes. This makes it possible to detect damage to cardiac myocytes in the early stages of the pathogenesis of many extra-cardiac and cardiovascular diseases, including acute coronary syndrome. So, in 2021, the European Society of Cardiology approved diagnostic algorithms of acute coronary syndrome, which allow the diagnosis of acute coronary syndrome in the first 1-2 hours from the moment of admission of the patient to the emergency department. However, high-sensitive immunochemical methods for detecting cardiospecific troponins T and I may also be sensitive to physiological and biological factors, which are important to consider in order to establish a diagnostic threshold (99 percentile). One of the important biological factors that affects the 99 percentile levels of cardiospecific troponins T and I are gender characteristics. This article examines the role of gender-specific concentration of cardiospecific troponins in the diagnosis of acute coronary syndrome and the mechanisms of formation of gender-specific serum levels of cardiospecific troponins T and I.
心肌特异性肌钙蛋白特异性定位于肌钙蛋白 - 原肌球蛋白复合物以及心肌细胞的细胞质中。心肌特异性肌钙蛋白分子在心肌细胞死亡（急性冠状动脉综合征中的不可逆损伤）或心肌细胞发生可逆性损伤时释放，例如在体力活动或应激因素影响期间。用于检测心肌特异性肌钙蛋白T和I的现代高敏免疫化学方法对心肌细胞的最小可逆性损伤极其敏感。这使得在许多心外和心血管疾病（包括急性冠状动脉综合征）发病机制的早期阶段检测心肌细胞损伤成为可能。因此，在2021年，欧洲心脏病学会批准了急性冠状动脉综合征的诊断算法，该算法可在患者进入急诊科后的最初1 - 2小时内诊断急性冠状动脉综合征。然而，用于检测心肌特异性肌钙蛋白T和I的高敏免疫化学方法也可能对生理和生物学因素敏感，为了确定诊断阈值（第99百分位数），这些因素需要考虑。影响心肌特异性肌钙蛋白T和I第99百分位数水平的重要生物学因素之一是性别特征。本文探讨了心肌特异性肌钙蛋白性别特异性浓度在急性冠状动脉综合征诊断中的作用以及心肌特异性肌钙蛋白T和I性别特异性血清水平的形成机制。
