背景:心血管和非心脏起源的许多病理状况在其发展过程中都会对收缩性心肌细胞-心肌细胞(CMC)造成损害。检测CMC的最敏感和最具体的标准之一是心肌肌钙蛋白(CT),它们是在CMCs死亡或受损时释放到血清中的调节蛋白分子。检测CT的新(高灵敏度)方法允许在心血管疾病的早期阶段检测微小的CMC损害,因此可以改变对疾病发展机制的理解并开辟新的诊断可能性。心血管系统最常见和危险的早期疾病之一是动脉高血压。本文的目的是总结动脉高血压情况下CMCs损伤和CTs释放到血流中的病理生理机制,并阐述动脉高血压患者CTs水平升高的临床意义。
方法:这是一个描述性综述,它是使用以下数据库准备的:Embase,Pubmed/Medline和WebofScience。在文献检索中使用以下关键词:“心肌损伤”和“动脉高血压”,并结合术语“心肌肌钙蛋白”和“增加机制”。
结论:根据文献分析,在动脉高血压的情况下,CMCs损伤和CTs释放根据以下病理生理机制发生:心肌肥厚,细胞凋亡,破坏CMC细胞膜并增加其对CTs分子的通透性,以及肾小球滤过率的变化。大多数情况下,在动脉高血压的情况下,血清CTs水平升高表明预后不良。在动脉高血压的情况下,关于CT预测意义的数据为使用这些生物标志物选择患者管理计划开辟了前景。
BACKGROUND: Many pathological conditions of both cardiovascular and non-cardiac origin in the course of their development cause damage to contractile cardiac muscle cells-cardiac myocytes (CMCs). One of the most sensitive and specific criteria for detecting CMCs are cardiac troponins (CTs), which are regulatory protein molecules that are released into the blood serum from CMCs upon their death or damage. New (high-sensitive) methods for detecting CTs allow the detection of minor CMCs damages at the earliest stages of cardiovascular diseases and can therefore change the understanding of disease development mechanisms and open up new diagnostic possibilities. One of the most common and dangerous early diseases of the cardiovascular system is arterial hypertension. The purpose of this paper is to summarize the pathophysiological mechanisms underlying CMCs damage and CTs release into the bloodstream in the
case of arterial hypertension and to state the clinical significance of increased CTs levels in patients with arterial hypertension.
METHODS: This is a descriptive review, which was prepared using the following databases: Embase, Pubmed/Medline and Web of Science. The following key words were used in the literature search: \"myocardial injury\" and \"arterial hypertension\" in combination with the terms \"cardiac troponins\" and \"mechanisms of increase\".
CONCLUSIONS: According to a literature analysis, CMCs damage and CTs release in the
case of arterial hypertension occur according to the following pathophysiological mechanisms: myocardial hypertrophy, CMCs apoptosis, damage to the CMC cell membrane and increase in its permeability for CTs molecules, as well as changes in the glomerular filtration rate. Most often, increased CTs serum levels in
case of arterial hypertension indicate an unfavorable prognosis. Data on the CTs predictive significance in
case of arterial hypertension open the prospects for the use of these biomarkers in the choice of patient management plans.