骨格筋疾患:心臓のトロポニンTの非心臓源
Jeanne du Fay de Lavallaz1,2, Alexandra Prepoudis1,2, Maria Janina Wendebourg3
1Cardiovascular Research Institute Basel (J.d.F.d.L., A.P., P.H., D.M.G., A.A., C.P., J.B., T.N., P.L.-A., N.G., S.S., S.P., J. Gallon, S.W., C.M.), University Hospital of Basel, Switzerland.
Circulation
|April 7, 2022
まとめ
心臓トロポニンT (cTnT) レベルは,骨格筋疾患 (SMD) の患者ではしばしば上昇しますが,心臓トロポニンI (cTnI) は上昇しません. cTnTの上昇は骨格筋の再発によるもので,心臓発作によるものではありません.
科学分野:
- 心臓病科
- 生物化学
- 遺伝学
背景:
- 心臓トロポニンT (cTnT) とI (cTnI) は,急性心筋梗塞の診断における重要なバイオマーカーである.
- 以前の研究では,cTnTの潜在的非心臓の源として,希少な骨格筋病気が示された.
- この研究は,骨格筋疾患 (SMD) の患者におけるcTnTの心臓特異性を検証することを目的とした.
研究 の 目的:
- 様々な骨格筋疾患の患者におけるcTnT検査の信頼性と心的特異性を評価する.
- SMD患者のcTnTとcTnIレベルを対照群と比較する.
- 骨格筋における潜在的cTnT上昇の遺伝的根拠を調査する.
主な方法:
- 2つの国の4つの病院で,筋肉の苦情を持つ患者211人の入学見通し.
- 心臓病の分類と判断
- 高感度cTnT (hs-cTnT) とhs-cTnIを複数の測定法で測定する.
- SMDのない3508人の対照群との比較
- 骨格筋生検におけるTNNT/I遺伝子発現の分析
主要な成果:
- SMD患者の55%でhs- cTnT濃度の上昇が観察され,対照群より有意に高かった (13%).
- hs- cTnI濃度は,SMD患者と対照群の間でほぼ同じでした.
- 骨格筋の生検は,SMD患者におけるTNNT2 (cTnTをコードする) の8倍増加を示し,疾患の活動と循環中のcTnTレベルと相関しています.
- TNNI3 (cTnIをコードする) の有意なアップレギュレーションは見つかりませんでした.
結論:
- cTnTの上昇は,活発な慢性SMDの患者で一般的であり,通常は心臓病の兆候ではありません.
- cTnIレベルは,SMD患者では同様の上昇を示さなかった.
- 骨格筋におけるcTnTの再発は,SMDの循環レベルを高めることを示唆しています.
関連する概念動画
Disorders of the Skeletal Muscle
1.2K
The clinical conditions affecting the skeletal muscle tissue are broadly categorized as musculoskeletal and neuromuscular disorders.
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
Musculoskeletal disorders
Musculoskeletal disorders involve injuries and conditions affecting the skeletal muscles and associated connective tissues. These disorders can arise from acute biomechanical stresses or chronic overuse and can occur across different age groups. Common injuries include sprains, fractures, and muscular strains, often resulting from...
1.2K
Blood Studies for Cardiovascular System I: Cardiac Biomarkers
379
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
379
Myasthenia Gravis: Diagnostic Tests
1.4K
Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...
1.4K
Myocarditis II: Clinical Features and Diagnostic Tests
35
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
35
Structure of Cardiac Muscles
14.4K
Cardiac muscle, or myocardium, is a specialized type of muscle found exclusively in the heart. Its unique structural and functional characteristics enable the heart to perform its vital role of pumping blood throughout the body continuously and rhythmically. The cardiac muscle cells, or cardiomyocytes, possess an endomysium and perimysium but do not have an epimysium.
Compared to skeletal muscles, cardiac muscle cells are small and mostly have a single nucleus. Additionally, they are usually...
Compared to skeletal muscles, cardiac muscle cells are small and mostly have a single nucleus. Additionally, they are usually...
14.4K
Skeletal Muscle Relaxants: Adverse Effects
504
Skeletal muscle relaxants are widely used for muscle paralysis and relieving pain following any muscle injury or stiffness. However, depending on the drug type, they can have adverse effects that range from mild to severe. Usually, nondepolarizing neuromuscular blockers have minimal side effects. For example, drugs like d-tubocurarine, cisatracurium, and rocuronium cause hypotension, whereas drugs like baclofen, when stopped abruptly, can lead to the recurrence of spastic conditions.
Unlike...
Unlike...
504


