Troponin T | Laboratory research

Troponin T Is a protein that is involved Of the heart In the mechanism of regulation of muscle contraction and is produced exclusively in the myocardium.

The calcium-mediated interaction of myosin and actin causes the striated muscle to contract and relax. These processes are regulated by a complex of three proteins - troponins:

• Troponin C - is related to calcium;
• Troponin I Inhibits the interaction between actin and myosin;
• Troponin T - Binds the troponin complex to tropomyosin.

Although there is troponin C in the heart and skeletal muscle with an identical structure, the amino acid sequence of the other two troponin (I, T) in the heart muscle differs from the corresponding skeletal muscle sequence.

Troponins I and T are released into the bloodstream in cases where the integrity of the myocyte cell membrane is disrupted or necrosis occurs, regardless of the cause.

When to take a troponin test T-At?

Troponin T may be useful for the exclusion and confirmation of the diagnostics of acute coronary syndrome, as well as for monitoring the course and prognosis of acute coronary syndrome.

Troponin T Defined in the following cases:

• Myocardial infarction: An increase in the level of troponin indicates myocardial necrosis (regardless of the cause), even in the absence of changes on the ECG;
•  perioperative myocardial infarction;
• Determine the time of reperfusion after initiating thrombolytic therapy (Serial definition is recommended);
• Prognosis in patients with acute coronary syndrome. Long-term clinical observations show higher mortality and more frequent coronary events with early increases in troponin in patients after myocardial infarction, defined as "high-risk patients"; In general, the higher the serum troponin level, the higher the risk;
• Allograft rejection;
• Cardiac risk assessment in patients with chronic renal failure; Recent studies have shown that an increase in troponin levels in this category of patients indicates cardiac pathology associated with an increased risk of mortality.

Myocardial infarction may be suspected and troponin testing may be performed when a person has signs and symptoms such as:

• Chest pain, discomfort and / or cramping pain;
• Rapid heartbeat;
• Shortness of breath and / or difficulty breathing;
• Fatigue;
• Nausea, vomiting;
• Cold sweat;
• Dizziness;
• Fatigue;
• Pain in other areas: back, arm, jaw, neck or abdomen.

In people with stable angina, a troponin test may be prescribed when:

• Symptoms worsen;
• Symptoms appear when a person is resting;
• With treatment the symptoms no longer disappear.

How to prepare for the test?

No special preparation is required for the test.

A blood sample can be taken at any time of the day when acute ischemic coronary syndrome is suspected.

Research material

Venous blood

Possible interpretation of the results

During the first 48 hours of myocardial infarction, troponin levels increase significantly, as well as creatine kinase MB-fraction (CK-MB). Compared to the MB-fraction of creatine kinase, troponin T has a higher specificity – 97,37% (CK-MB – 89,5%)

Troponin titer remains high for 6 days.

An increase in troponin levels without a change in CK-MB indicates the diagnostics of unstable angina pectoris.

A moderate increase in troponin may also be observed in the following non-ischemic conditions:

• Trauma (heart damage), cardioversion, endomyocardial biopsy, cardiac surgery;
• Decompensated heart or kidney failure (acute or chronic);
• Hypotension, cardiac arrhythmia, myocarditis, severe pericarditis;
• Pulmonary embolism, etc.

Resources

https://www.synevo.bg/troponin/