cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2021-2639cardiovascular-2639Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEW ARTICLESВысокочувствительные сердечные тропонины: циркадные ритмыHigh-sensitivity cardiac troponins: circadian rhythmshttps://orcid.org/0000-0002-2712-0227ЧаулинА. М.ChaulinA. M.

Чаулин Алексей Михайлович — врач клинической лабораторной диагностики клинико-диагностической лаборатории, аспирант, ассистент кафедры гистологии и эмбриологии

Aleksey Michailovich Chaulin

alekseymichailovich22976@gmail.comhttps://orcid.org/0000-0002-6453-2976ДупляковД. В.DuplyakovD. V.

Дупляков Дмитрий Викторович — доктор медицинских наук, заместитель главного врача по медицинской части, профессор кафедры кардиологии и сердечно-сосудистой хирургии

Dmitry Viktorovich Duplyakov

duplyakov@yahoo.comГБУЗ Самарский областной клинический кардиологический диспансерSamara Regional Clinical Cardiology DispensaryГБУЗ Самарский областной клинический кардиологический диспансер; ФГБОУ ВО Самарский государственный медицинский университет Минздрава РоссииSamara Regional Clinical Cardiology Dispensary; Samara State Medical University20211802202120126392639Copyright © Чаулин А.М., Дупляков Д.В., 20212021Чаулин А.М., Дупляков Д.В.Chaulin A.M., Duplyakov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/2639

Высокочувствительные сердечные тропонины (hs-cTnI и hs-cTnT), безусловно, привнесли ряд положительных моментов в отношении диагностики и лечения сердечно-сосудистых заболеваний: ускорение диагностики острого инфаркта миокарда (ранние алгоритмы диагностики: 0-1 ч, 0-3 ч), и более раннее начало оптимального лечения, расширение диагностических и прогностических возможностей (ранее выявление повреждений миокарда при проведении химиотерапевтического лечения, при эндокардитах, миокардитах и других заболеваниях). Однако повышение чувствительности несколько уменьшило специфичность и создало необходимость более тщательной интерпретации повышенных уровней hs-cTnI и hs-cTnT при целом ряде нозологий, при которых в той или иной степени повреждаются кардиомиоциты. Кроме того, возникла необходимость введения референсных уровней hs-cTnI и hs-cTnT (99 перцентиля) с учетом гендерной принадлежности. В последнее время также появились сведения о циркадных (суточных) колебаниях уровней hs-cTnT и hs-cTnI. В статье подробно анализируются результаты клинических исследований, обнаруживших циркадные ритмы hs-cTnI и hs-cTnT, обсуждаются возможные механизмы, лежащие в основе суточных изменений концентраций hs-cTnT и hs-cTnI.

High-sensitivity cardiac troponins (hs-cTnI and hs-cTnT) contribute to a progression in the diagnosis and treatment of cardiovascular diseases: acceleration of diagnosis of acute myocardial infarction (early diagnostic algorithms: 0-1 h, 0-3 h), and earlier initiation of optimal treatment, expansion of diagnostic and prognostic potential (earlier detection of myocardial damage during chemotherapy, endocarditis, myocarditis and other diseases). However, increased sensitivity slightly reduced the specificity and created the need for a more thorough interpretation of elevated levels of hs-cTnI and hs-cTnT in a number of pathologies that damage cardiomyocytes. In addition, there was a need to introduce reference levels of hs-cTnI and hs-cTnT (99 percentile), taking into account sex. Recently, there has also been information about circadian (diurnal) variations in hs-cTnT and hs-cTnI levels. We analyze in detail the results of clinical studies that found circadian changes in hs-cTnI and hs-cTnT. Possible mechanisms underlying these changes in hs-cTnT and hs-cTnI concentrations are discussed.

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