Hypertension as One of the Main Non-Myocardial Infarction-Related Causes of Increased Cardiospecific Troponins: From Mechanisms to Significance in Current Medical Practice

Abstract

It is well known that many pathological conditions of both cardiovascular diseases (CVDs) (coronary heart disease, myocardial infarction, arrhythmias, myocarditis, cardiomyopathy, etc.) and noncardiac (sepsis, anemia, kidney diseases, diabetes mellitus, etc.) origin in the course of their development cause injury to contractile cardiac muscle cells -myocardial cells (MCs). One of the most sensitive and specific criteria for detecting MC injury are cardiospecific troponins (CTs), which are regulatory protein molecules that are released into the blood serum from MC upon their death or injury. Current methods for determining CTs are called high-sensitive ones, and their main advantage is a very low minimum detectable concentration (limit of detection) (average 1 -10 ng/L or less), which allows early detection of minor MC injury at the earliest stages of CVDs, and therefore they can 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 hypertension (HT). The novelty of this article lies in the discussion of a new diagnostic direction -predicting the risk of developing CVDs and their dangerous complications in patients with HT by determining the concentration of CTs. In addition, pathophysiological mechanisms underlying MC injury and the release of CTs into the bloodstream and the elimination of CTs into the urine are proposed. This information will contribute to additional fundamental and clinical research to verify the new diagnostic possibility of using CTs in clinical practice (for the management of patients with HT).

Pleiotropic attenuating effect of Ginkgo biloba against isoprenaline-induced myocardial infarction via improving Bcl-2/mTOR/ERK1/2/Na+, K+-ATPase activities

“…This result was consistent with the information presented by Marchetti et al (2020) . A crucial diagnostic of myocardial injury, particularly in myocardial infarction, was cT-I, a protein with contractile characteristics unique to cardiac muscle ( Chaulin, 2022 ). In our study, GBE considerably reduced the amount of cT-I, showing that it had the potential to reduce cardiac damage.…”

Modern View on the Role of Sex-Specific Levels of High-Sensitive Cardiospecific Troponins T and I in the Diagnosis of Myocardial Infarction

“…Clinically, this is expressed by the presence of a wide range of other troponinpositive non-cardiac and cardiac conditions other than myocardial infarction [29,30]. Although not all mechanisms of elevation of cardiospecific troponin levels are known, in some conditions, this may be due to a decrease in oxygen supply to the myocardium, and it is not clear whether the damage is always irreversible, which inevitably leads to cardiac myocytes necrosis, or whether some diseases can cause reversible damage [31][32][33][34]. The main conditions (physiological and pathological) that cause an increase in the levels of cardiospecific troponins are shown in Table 1 [29][30][31][32][33][34].…”

“…Main Causes of Cardiac Myocytes Damage (Physiological and Pathological) and Increased Concentration of Cardiospecific Troponins[29][30][31][32][33][34] …”