Comparison of plasma microRNA-1 and cardiac troponin T in early diagnosis of patients with acute myocardial infarction

BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.

The Role of Bedside Troponin T Test for Identification of High Risk Patients With Acute Chest Pain

Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.

Prognostic value of high-sensitivity cardiac troponin T in patients with en-domyocardial-biopsy proven cardiac amyloidosis

Objective To investigate prognostic predictors of long-term survival of patients with cardiac amyloidosis （CA）, and to determine predictive value of high-sensitivity cardiac troponin T （hs-cTnT） in CA patients. Methods We recruited 102 consecutive CA cases and followed these patients for 5 years. We described their clinical characteristics at presentation and used a new, high-sensitivity assay to determine the concentration of cTnT in plasma samples from these patients. Results The patients with poor prognosis showed older age （56 ±12 years vs. 50 ±15 years, P=0.022）, higher incidences of heart failure （36.92%vs. 16.22%, P=0.041）, pericardial effusion （60.00%vs. 35.14%, P=0.023）, greater thickness of interventricular septum （IVS） （15 ±4 mm vs. 13 ±4 mm, P=0.034）, higher level of hs-cTnT （0.186 ±0.249 ng/mL vs. 0.044 ±0.055 ng/mL, P=0.001） and higher NT-proBNP （N-terminal pro-B-type natriuretic pep-tide） levels （11,742 ± 10,464 pg/mL vs. 6,031 ± 7,458 pg/mL, P=0.006）. At multivariate Cox regression analysis, heart failure （HR：1.78, 95%CI：1.09-2.92, P=0.021）, greater wall thickness of IVS （HR：1.44, 95%CI：1.04-3.01, P=0.0375） and higher hs-cTnT level （HR：6.16, 95%CI：2.20-17.24, P=0.001） at enrollment emerged as independent predictors of all-cause mortality. Conclusions We showed that hs-cTnT is associated with a very ominous prognosis, and it is also the strongest predictor of all-cause mortality in multivariate analysis. Examination of hs-cTnT concentrations provides valuable prognostic information concerning long-term outcomes.

Correlation of cardiac troponin T levels with inotrope requirement,hypoxic-ischemic encephalopathy,and survival in asphyxiated neonates

BACKGROUND Cardiac involvement in neonates with perinatal asphyxia not only complicates perinatal management but also contributes to increased mortality.AIM To assess cardiac troponin T(cTnT)levels in asphyxiated neonates and their correlation with echocardiography findings,inotrope requirement,hypoxicischemic encephalopathy(HIE)stages,and mortality.METHODS cTnT levels,echocardiographic findings,the requirement of inotropes,HIE stages,and outcome were studied in neonates of gestational age≥34 wk with perinatal asphyxia.RESULTS Among 57 neonates with perinatal asphyxia,male gender,cesarean section,forceps/vacuum-assisted vaginal delivery and late preterm included 33(57.9%),23(40.4%),3(5.3%),and 12(21.1%)respectively.The mean gestational age was 38.4 wk(1.6 wk).HIE stages I,II,and III were observed in 7(12.3%),37(64.9%),and 9(15.8%)neonates respectively.26(45.6%)neonates had echocardiographic changes and 19(33.3%)required inotropes.cTnT levels were elevated in 41(71.9%)neonates[median(IQR);0.285(0.211-0.422)ng/mL].The Median cTnT level showed an increasing trend with increasing changes in echocardiography(P=0.002).Two neonates with mitral regurgitation and global hypokinesia had the highest cTnT levels(1.99 and 0.651 ng/mL).Of 31 neonates with normal echocardiography,18(58.06%)showed elevated cTnT.cTnT levels were significantly higher in those who required inotropic support than those who did not(P=0.007).Neonates with HIE stage III had significantly higher cTnT levels compared to those with HIE stage I/II(P=0.013).Survivors had lower median cTnT levels[0.210(0.122-0.316)ng/mL]than who succumbed[0.597(0.356-1.146)ng/mL].CONCLUSION cTnT levels suggestive of cardiac involvement were observed in 71.9%of asphyxiated neonates.cTnT levels correlated with echocardiography findings,inotrope requirement,HIE stages,and mortality.

电刺激和延迟冷却对宰后牛肉肌原纤维Troponin-T降解的影响

为了探讨牛肉嫩化的机理,选择24头24月龄,体重约500kg杂交牛(鲁西黄牛×西门塔尔)随机分成4组,在宰前或宰后分别进行以下4种处理:常规预冷组,延迟冷却组,电刺激处理组,电刺激和延迟冷却处理组。用SDS-PAGE和蛋白免疫印迹的方法比较分析了4种处理牛肉成熟1,3,7,10d其肌原纤维骨架蛋白Troponin-T的降解情况。结果表明:与常规冷却组相比,电刺激处理在1、3、7d时显著加快了Troponin-T的降解,而10d时差异不显著;延迟冷却处理在1、3d时显著加快了Troponin-T的降解,而7、10d时差异不显著;1、3d时延迟冷却对Troponin-T的降解影响比电刺激显著,而7、10d时则是电刺激比较显著;电刺激和延迟冷却处理的结合对Troponin-T降解的影响比电刺激处理组、延迟冷却处理组显著。综上可见,延迟冷却、电刺激无论在速度和数量上显著加快了Troponin-T的降解,加快了牛肉成熟,缩短了成熟时间,且二者有协同作用。

Association between high-sensitivity cardiac troponin T and N-terminal pro-brain natriuretic peptide in a community based population

Background N-terminal pro-B-type natriuretic peptide （NT-proBNP） and high-sensitivity cardiac troponin T （hs-cTnT） are excellent biomarkers for detecting heart failure and subclinical myocardial injury.However,it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.Methods In a community based study,levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years.The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml.The association of hs-cTnT levels and NT-proBNP levels was analyzed.Results When the subjects with undetectable （〈0.003 ng/ml）,intermediate （0.003-0.014 ng/ml）,and elevated （≥0.014 ng/ml） levels of hs-cTnT were compared （r=0.175,P 〈0.001）,a strong association between the hs-cTnT levels and NT-proBNP levels was observed （β=-0.206,P 〈0.001; β=-0.118,P 〈0.001,respectively）.In multivariable analyses,older age and hs-cTnT were positively and independently associated with NT-proBNP levels （β=0.341,P 〈0.001; β=0.143,P 〈0.001,respectively）,and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels.When the subjects with normal or elevated NT-proBNP were analyzed separately,the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group,whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group （β=0.399,P 〈0.01）.Conclusions In this community based population,NT-proBNP elevation was common.In addition to female gender and older age,subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

EVALUATION OF SERUM TROPONIN T MEASUREMENTIN ACUTE MYOCARDIAL INFARCTION

The release kinetics of the cardiac specific troponin T (cTnT), measured by an immunosorbent assay, in 32 patients with acute myocardial infarction (AMI) was evaluated. In 8 AMI patients (25%), the release kinetics of serum cTnT showed biphasic serum concentration curves with a large peak at 10 to 18 hours after onset and the serum cTnT concentrations were up to 30 to 120 times of the normal upper limit-detected (0.2 μg / ml), and another samll cTnT peak at 70 to 100 hours after onset of pain. The serum cTnT measurements in the remaining 24 AMI patients (75%) gave only one large peak which was around 32 to 108 hours after onset of pain. cTnT appeared in serum as early as 3 to 4 hours and remained elevated until 240 hours after the infarctions. The results indicated that (1) cTnT was a sensitive and specific marker of AMI; (2) the biphasic curve of cTnT releae in general, the ratio of cTnT at around 14 to 32 (14/32)>1 in particular, may be a useful marker suggesting early reperfusion; (3) the continuous elevation of serum cTnT in AMI course might be a prognostic indicator for unfavorable outcomes.

COPD急性加重期患者外周血单个核细胞SOCS-1、TLR4 mRNA及血清cTnT、尿酸水平变化分析

目的探讨慢性阻塞性肺疾病(COPD)急性加重期患者外周血单个核细胞中细胞因子信号抑制蛋白-1(SOCS-1)、Toll样受体4(TLR4)mRNA水平及血清心肌肌钙蛋白T(cTnT)、尿酸水平变化。方法收集COPD急性加重期(组)患者70例,COPD稳定期(组)患者40例,对照组健康志愿者40名。检测外周血单个核细胞SOCS-1、TLR4 mRNA水平及血清cTnT、尿酸浓度;行肺功能检查并记录相关指标(FEV1、FEV1%、FEV1/FVC%)。对COPD急性加重期患者进行1 a随访,分为预后不良组和预后良好组。对外周血单个核细胞SOCS-1、TLR4 mRNA水平、血清cTnT、尿酸浓度行Pearson相关性分析,并对COPD急性加重期患者预后评估价值进行ROC曲线分析。结果COPD急性加重期组SOCS-1 mRNA表达水平明显低于COPD稳定期组、对照组,TLR4 mRNA水平及血清cTnT、尿酸浓度明显高于COPD稳定期组和对照组(均P<0.01)。COPD急性加重期组FEV1、FEV1%、FEV1/FVC%明显低于COPD稳定期组和对照组(P<0.05)。COPD急性加重期患者FEV1/FVC%与外周血单个核细胞SOCS-1 mRNA表达水平呈正相关关系(P<0.01),与外周血单个核细胞TLR4 mRNA水平及血清cTnT、尿酸浓度呈负相关关系(P<0.01)。预后不良组SOCS-1 mRNA水平明显低于预后良好组,TLR4 mRNA水平及血清cTnT、尿酸浓度明显高于预后良好组(P<0.05)。外周血单个核细胞SOCS-1、TLR4 mRNA水平及血清cTnT、尿酸联合检测对COPD急性加重期患者预后具有较高的评估价值。结论COPD急性加重期患者SOCS-1低表达,TLR4、cTnT、尿酸高表达,且与肺功能水平密切相关,联合检测对患者预后具有较高的评估价值。

Prognostic role of high-sensitivity troponin T in elderly patients with sepsis in intensive care unit

Background Paucity of data is available on the in-hospital and 28-day prognostic value of at-admission highsensitivity troponin T(hs-TnT)level in elderly patients with sepsis admitted to intensive care units.Methods Patients aged 65 or older with sepsis or septic shock admitted to geriatric ICU in Guangdong Provincial People’s Hospital between January 2010 and December 2017 were enrolled in the study.Receiver operator characteristic(ROC)curve analysis was performed to evaluate the predictive value of hs-TnT for in-hospital mortality.Multivariate Cox survival regression was used to determine independent risk factor of hs-TnT for 28-day death.Results The in-hospital mortality was 64.4%.According to the receiver operator characteristic(ROC)curve analysis,the cut-off for predicting in-hospital death was 65.2 pg/mL.Patients with elevated hs-TnT had a higher rate of in-hospital mortality(75%vs.53.4%,P<0.001)and 28-day mortality(47.7%vs.27.6%,P<0.001).Multivariate regression showed that lg(hs-TnT)was an independent risk factor for in-hospital death(adjusted HR:1.53,95%CI:1.16-2.01,P=0.03).Kaplan-Meier survival curves showed that elderly patients with at-admission hs-TnT>65.2 pg/mL had a worse outcome than those with hs-TnT<65.2 pg/mL(Log-rank test:17.46,P=0.000).Conclusions In elderly patients with sepsis admitted to intensive care units,elevated hs-TnT level measured upon admission was associated with increased mortality rate.hs-TnT independently contributed to the prediction of 28-day mortality.

Analyses of N‑Terminal Pro‑Brain Natriuretic Peptide,Cardiac Troponin T,and Creatine Kinase MB in Pericardial Fluid in Sudden Cardiac Death Caused by Ischemic Heart Disease

Background:Biochemical analyses of N‑terminal pro‑brain natriuretic peptide(NT‑proBNP),cardiac troponin T(cTnT),and creatine kinase MB(CK‑MB)have been reported to be valuable for the auxiliary diagnosis of sudden cardiac death(SCD)in previous forensic studies.Aims and Objectives:The present study aimed to evaluate the diagnostic efficiency of combined analyses of NT‑proBNP,cTnT and CK‑MB in the pericardial fluid for forensic diagnosis of SCD caused by ischemic heart disease.Materials and Methods:Levels of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid of 132 medicolegal autopsy cases were obtained through electrochemiluminescence method.Results:NT‑proBNP,cTnT,and CK‑MB levels were significantly elevated in SCD cases(P<0.05).Receiver‑operating characteristics(ROC)analysis showed that NT‑proBNP,cTnT,and CK‑MB have diagnostic value for the diagnosis of SCD:NT‑proBNP,cutoff value of 2236 pg/ml;cTnT,cutoff value of 199.51 ng/ml;CK‑MB:cutoff value of 2742.5 ng/ml,and the combined analyses of these three biomarkers have better diagnostic efficiency than each single biomarker alone.Moreover,the causes of SCD were sub‑divided into acute ischemic heart disease,acute myocardial infarction(AMI),and recurrent myocardial infarction subgroups for further analysis,which revealed that the ratio of cTnT/CK‑MB could be used to distinguish AMI with the cutoff value of 0.1085 estimated by ROC analysis.Conclusion:These observations suggested that the postmortem biochemical analyses of NT‑proBNP,cTnT,and CK‑MB in the pericardial fluid may assist to diagnose SCD in forensic practice,and the combined analyses of multiple biomarkers have better diagnostic efficiency than each single biomarker alone.On the basis of the postmortem biochemical analyses of NT‑proBNP,cTnT and CK‑MB,combining the ratio of cTnT/CK‑MB could be used to distinguish AMI.

胸痛发作时床边即时检测心肌钙蛋白T诊断急性心肌梗死的价值

目的确定胸痛症状发作后不同时间间隔内,床边心肌肌钙蛋白T(point of care troponin-T testing,POCT-cTnT)对急性心肌梗死(acute myocardial infarction,AMI)的诊断性能,了解其在快速排除AMI方面的意义。方法这项回顾性研究包括了2019年1月至2022年12月期间出现胸痛症状的6024例患者。在入院时测量了POCT-cTnT和中心实验室cTnI水平。通过按时间窗口划分的受试者工作特征(receiver operating characteristics,ROC)分析,评估POCT-cTnT在诊断AMI时的准确性。结果总体而言,POCT-cTnT诊断AMI的AUC为0.826(95%CI:0.816~0.836),灵敏度和特异度分别为72.81%和86.26%。根据胸痛发作的时间进行区间分组(<3 h、3~6 h、6~12 h、12~24 h、24~72 h和≥72 h),6~12 h以后的分组AUC值分别为0.918、0.928、0.920和0.908,差异无统计学意义(P>0.05),均要高于6 h时以内的组(P<0.001);根据胸痛发作时间点进行分组,≥8 h组的AUC为0.921,阴性预测值(negative predictive value,NPV)98.1%和阴性似然比(negative likelihood ratio,-LR)0.11,其AUC高于≥3 h、≥2 h、≥1 h和overall组(P<0.05),而与≥4 h以后的各时间组相比,差异无统计学意义(P>0.05)。结论胸痛发作时间对单次检测POCT-cTnT诊断AMI的性能存在一定的影响,结合胸痛发作至就诊时间,可能提高其诊断或排除AMI的可靠性。在胸痛发作4 h后,单次POCT-cTnT检测能可靠地诊断或排除AMI;当胸痛发作8 h后,其诊断或排除AMI方面具有更高的可靠性。

Clinical significance of serum cardiac troponin T in patients with congestive heart failure

Objective To determine whether the level of serum cardiac troponin T (cTnT) was increased in patients with congestive heart failure (CHF). Methods This study consisted of 265 patients with CHF and 75 healthy people. Serum cTnT was measured by electrochemiluminescence immunoassay using an Elecsys 1010 automatic analyzer. Results cTnT concentration was 0.181±0.536 ng/mL in CHF patients and 0.003±0.001 ng/mL in controls (P<0.001). Patients were categorized according to the levels of heart function and left ventricular ejection fraction (LVEF). In the first group consisting of 105 patients with LVEF≤35%, cTnT was 0.311±0.221 ng/mL. In the second group of 106 patients with LVEF>35%, cTnT was 0.07±0.0 5ng/mL (P<0.01). In patients with NYHA class Ⅰ, Ⅱ, Ⅲ and Ⅳ, cTnT values were 0.062±0.022 ng/mL, 0.113±0.121 mg/mL, 0.191±0.231 mg/ml and 0.384±0.211 mg/mL, respectively (class Ⅰ vs class Ⅱ P>0.05, class Ⅱ vs class Ⅲ P<0.01, class Ⅲ vs class Ⅳ P<0.01). A negative correlation was observed between serum cTnT concentration and LVEF in 265 patients with CHF (r=-0.493, P<0.001).Conclusions This study shows that the level of serum cTnT is increased in patients with CHF and that the increased level indicates the severity of CHF.

血清脑钠肽、心肌肌钙蛋白T及休克指数与急性心肌梗死患者经皮冠脉介入术后主要不良心血管事件的相关性分析

目的 探讨血清脑钠肽(BNP)、心肌肌钙蛋白T(c Tn T)及休克指数(SI)与急性心肌梗死(AMI)患者经皮冠脉介入术(PCI)后主要不良心血管事件(MACE)的相关性。方法 回顾性分析2017年11月至2022年11月于徐州医科大学附属医院、江苏省滨海县人民医院进行PCI治疗的200例AMI患者的临床资料,将其分为MACE组(60例)与无MACE组(140例)。比较两组基线资料、血管狭窄程度(Gensini)评分、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)及术前白蛋白、BNP、c Tn T、SI。采用logistic逐步回归分析MACE的危险因素,通过受试者工作特征(ROC)曲线分析各指标预测MACE的价值。结果 MACE组糖尿病患者占比及年龄、BNP、c Tn T、SI水平高于无MACE组(P<0.05)。logistic逐步回归分析结果显示,年龄(OR=2.145,95%CI=1.056~4.357)、BNP (OR=1.985,95%CI=1.156~3.408)、c Tn T (OR=1.997,95%CI=1.145~3.483)、SI(OR=1.897,95%CI=1.260~3.196)是AMI患者PCI治疗后MACE发生的危险因素(P<0.05)。ROC曲线分析结果显示,年龄、BNP、c Tn T、SI均可用于预测AMI患者PCI治疗后MACE的发生(P<0.05)。结论 年龄、BNP、c Tn T、SI可影响AMI患者PCI治疗后MACE的发生,可用于预测MACE的发生。

婴儿心脏术后肌钙蛋白T水平对机械通气时间延长的影响

目的探讨肌钙蛋白T对婴儿心脏术后机械通气时间延长的影响。方法回顾性选取2019年1月至4月在南方医科大学附属广东省人民医院心外科行体外循环下心内直视术的192例先天性心脏病婴儿,按术后即刻肌钙蛋白T水平分为肌钙蛋白T高值组(3798.0~10000.0 ng/L)、中值组(1827.0~3709.0 ng/L)和低值组(316.2~1801.0 ng/L),各64例。低值组中,女28例,男36例,日龄203.00(129.75,274.50)d;中值组中,女30例,男34例,日龄118.00(76.50,173.75)d;高值组中,女24例,男40例,日龄168.50(78.00,219.25)d。采用方差分析、秩和检验、χ^(2)检验进行统计分析,通过单因素和多因素logistic回归模型分析术后肌钙蛋白T水平与术后机械通气时间延长的相关性,通过单因素和多因素线性回归模型分析术后肌钙蛋白T水平与重症监护停留时间及术后住院天数的相关性。结果术前日龄越小、手术体外循环时间越长、主动脉阻断时间越长,术后肌钙蛋白T水平越高(均P<0.05)。在校正了性别、日龄、胎龄、术前血红蛋白、术前血清肌酐、体外循环时间、主动脉阻断时间、先天性心脏病手术风险调整评分(RACHS-1)等因素后,多因素回归模型发现,肌钙蛋白T水平升高是机械通气时间延长的独立危险因素[OR=1.2(1.1,1.3),P<0.001]。结论肌钙蛋白T水平升高与婴儿先天性心脏病术后机械通气时间延长有关。

Troponin T from the Japanese Pearl Oyster <i>Pinctada fucata</i>: Molecular Cloning, Tissue Distribution, Gene Structure, and Interaction Analysis with Tropomyosin

Troponin (Tn) is composed of three subunits (TnI, TnC and TnT) that bind Ca2+ and regulate striated muscle contraction in vertebrates. TnT’s function has been extensively described in vertebrates, but its role has been obscure in molluscan muscles. Our previous work indicated that the TnC and TnI subunits work in adductor phasic muscle, but not in catch muscle. Here, we have characterized TnT from the Japanese bivalve pearl oyster Pinctada fucata to start to explain the function of Tn in molluscan muscle contraction. We determined the primary structure of the full-length TnT protein from the P. fucata adductor muscle (Pifuc-TnT), and found that it is composed of 316 amino acid residues with a predicted molecular mass of 37.4 kDa. Multiple sequence alignment showed that Pifuc-TnT has an extension of >60 residues at the C-terminus that are not present in vertebrate TnTs, including known TnTs from other mollusks. Pifuc-TnT gene structure predictions using Splign alignment of the cDNA generated in this study and genome sequences indicated that Pifuc-TnT consists of 13 exons. Start and stop codons are located in exons 2 and 12, respectively. Quantitative real-time PCR revealed that the Pifuc-TnT gene was predominantly expressed in adductor phasic muscle, weakly in adductor catch muscle, slightly in gill, and not at all in mantle and foot. These findings suggest that TnT plays a regulatory role in adductor phasic muscle contraction, but not in catch contraction. Isothermal titration calorimetry revealed that unlike vertebrate TnTs, Pifuc-TnT does not interact with P. fucata tropomyosin-1 nor with tropomyosin-2. These findings in P. fucata imply that Tn functions differently in molluscan muscle than it does in vertebrates.

血Fib、TNI、TnT及Lp-PLA2与急性心肌梗死预后的相关性分析

目的 探讨血纤维蛋白原(Fib)、肌钙蛋白I(TNI)、肌钙蛋白T(TnT)及脂蛋白相关磷脂酶A2(Lp-PLA2)与急性心肌梗死(AMI)预后的相关性。方法 选取2020至2021年诊治的AMI患者122例作为研究组,入院后第3个月按照发生不良心血管事件(MACE)将AMI患者分为预后不良组(发生MACE)39例和预后良好组(未发生MACE)83例,并选取同期体检的健康志愿者40例作为对照组。比较研究组与对照组、预后不良组和预后良好组的血Fib、TNI、TnT及Lp-PLA2水平,并分析血Fib、TNI、TnT及Lp-PLA2对AMI患者预后不良的预测价值。结果 研究组血Fib、TNI、TnT、Lp-PLA2明显高于对照组(P<0.05)。预后不良组血Fib、TNI、TnT、Lp-PLA2明显高于预后良好组(P<0.05)。受试者工作特征(ROC)曲线分析显示,Fib、TNI、TnT、Lp-PLA2、四者联合预测AMI患者预后不良的曲线下面积(AUC)分别为0.826、0.816、0.878,0.947、0.947,在最佳临界值对应的敏感度、特异度分别为:Fib为56.4%、100%,TNI为51.3%、100%,TnT为51.3%、100%,Lp-PLA2为76.9%、84.3%,四者联合为82.1%、100%。结论 AMI患者血Fib、TNI、TnT及Lp-PLA2水平呈高表达,且预后不良血Fib、TNI、TnT及Lp-PLA2水平越高;血Fib、TNI、TnT及Lp-PLA2四者联合对AMI患者预后不良具有较高的预测价值。

入院时血清高敏肌钙蛋白T水平对老年轻中度脑梗死患者长期认知功能的影响

目的 探讨入院时血清高敏肌钙蛋白T(high sensitive cardiac troponin T,hs-cTnT)与老年轻中度脑梗死患者长期认知功能的关系。方法 前瞻性纳入2020年2月至11月濮阳市人民医院住院治疗的轻、中度脑梗死患者207例,根据入院时血清hs-cTnT在脑梗死患者中的分布水平,将患者分为高水平组102例(hs-cTnT>12 ng/L),低水平组105例(hs-cTnT≤12 ng/L)。随访3年,190例脑梗死患者成功随访,高水平组94例,低水平组96例。分析2组患者一般资料、简易智能状态检查量表(mini-mental status examination, MMSE)评分,应用logisitic回归分析影响患者出院时和出院3年后的认知功能影响因素,ROC曲线分析入院时hs-cTnT水平预测脑梗死患者出院3年后发生认知功能障碍的价值。结果 2组出院3年后MMSE评分均高于出院时,发生认知功能障碍比例均低于出院时(P<0.01)。高水平组出院时、出院3年后MMSE评分均显著低于低水平组,发生认知功能障碍比例均显著高于低水平组(P<0.01)。logisitic回归分析显示,女性、入院时hs-cTnT高水平、谵妄持续时间>1 d是脑梗死患者出院时发生认知功能障碍的危险因素(P<0.05,P<0.01),文化程度大专及以上是脑梗死患者出院时发生认知功能障碍的保护因素(P<0.05);年龄、女性、出院时存在认知功能障碍、入院时hs-cTnT高水平是脑梗死患者出院3年后发生认知功能障碍的危险因素(P<0.05,P<0.01)。ROC曲线分析显示,入院时hs-cTnT水平预测脑梗死患者出院3年后发生认知功能障碍的曲线下面积为0.732(95%CI:0.531~0.927)。结论 入院时高水平hs-cTnT是老年轻中度脑梗死患者出院时和出院3年后发生认知功能障碍的危险因素,可帮助预测患者长期认知功能。

血清cTnT、NT-proBNP峰值评估急性心肌梗死后梗死面积及1年不良预后的临床价值

目的探讨肌钙蛋白T(cTnT)峰值联合氨基末端B型利钠肽前体(NT-proBNP)峰值评估急性心肌梗死(AMI)后梗死面积(IS)及1年不良事件的临床价值。方法回顾性分析2016年1月至2021年7月于上海市静安区中心医院就诊的AMI患者150例。每日检测cTnT及NT-proBNP至峰值出现,心脏磁共振评估IS,随访1年不良事件。logistic回归分析IS及不良事件发生的风险因素,ROC曲线分析cTnT、NTproBNP峰值的预后价值。结果共纳入49例患者,根据不良事件发生分为事件组(n=19)和无事件组(n=30),根据中位IS值分为IS≥18.26%组(n=25)和<18.26%组(n=24)。事件组IS、cTnT、NT-proBNP明显高于无事件组,差异有统计学意义(P<0.05)。IS≥18.26%组cTnT、NT-proBNP显著高于IS<18.26%组,不良事件发生有统计学意义(P<0.05)。ROC曲线显示cTnT峰值联合NT-proBNP峰值预测AMI预后效果最好,AUC为0.935,两指标联合预测IS的AUC为0.883。结论血清cTnT、NT-proBNP峰值能反映AMI心肌IS大小,具预后价值,两者联合效果更优。