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心臓トロポニンIの上昇は,心筋炎と関連しています. 実験的および臨床的相関関係

S C Smith1, J H Ladenson, J W Mason

  • 1Washington University School of Medicine, Department of Medicine, St Louis, Mo, USA.

Circulation
|January 7, 1997
PubMed

Insights

心臓トロポニンI (cTnI) は,心筋炎の診断に有望であり,生検のより侵襲的な代替案を提供している. 特に心不全の初期に cTnI のレベルが上昇すると,この状態の早期診断と治療に役立ちます.

科学分野:

  • 心臓病学 心臓病学
  • 免疫学 免疫学とは
  • バイオマーカーの発見

背景:

  • エンドミオカルディアン生検は,心筋炎の診断の標準ですが,侵襲的であり,収量も低いです.
  • ヒストロジカル診断は,筋細胞の損傷を特定することに依存しています.
  • 心臓トロポニンI (cTnI) は,心筋細胞損傷に対する敏感で特異的な血清マーカーです.

研究 の 目的:

  • 血清心臓トロポニンI (cTnI) 測定の有用性を評価し,心筋炎を診断する.
  • cTnIの診断性能をクレアチンキナーゼ-MB (CK-MB) と比較する.

主な方法:

  • cTnIレベルは,自己免疫性心筋炎のマウスで測定されました.
  • cTnIとCK-MBのレベルは,生検で証明された心筋炎を患った患者およびそれのない患者で測定されました.
  • cTnIレベルと心不全症状の持続時間との相関性が評価されました.

主要な成果:

  • cTnIは,心筋炎を患ったマウスの24/26で上昇した.
  • 患者では,cTnIは34%の心筋炎患者で上昇し,11%の心筋炎患者では上昇した (P=.01).
  • CK-MBは,心筋炎で上昇したのはわずか5.7%で,心筋炎なしでは0%でした (P=.27).
  • cTnIの上昇は,心筋炎患者においてCK-MBよりも頻繁であった (P=.001).
  • cTnIの上昇は,心不全の症状と相関し,持続期間 ≤1ヶ月 (P=.02) であった.

結論:

  • 血清のcTnIは,心筋炎における筋細胞損傷の検出においてCK-MBよりも優れている.
  • cTnI濃度の上昇は,心不全症状の最初の1ヶ月でより一般的であり,早期診断ウィンドウを示唆しています.
要旨

No abstract available in PubMed .

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