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drlouis
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troponins
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08.27.05 (3 years ago)
#1
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which is or are false regarding cardiac troponins?
a) cardiac troponins is elevated in renal failure even without cad
b)cardiac troponin c estimation is found to be clinically useful.
c)hypotension can cause troponin elevation
d)prinzemetal angina is not associated with troponin elevation
e)pulmonary hypertension is associated with troponin elevation
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08.27.05 (3 years ago)
#2
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In patients suffering from end-stage renal failure, cardiac troponin T (cTnT) and I (cTnI) may be increased in serum without other signs of acute myocardial damage.
In binary cTnI-TnC complex TnC protects cTnI from protease cleavage and therefore TnC can be used as a natural stabilizer of cTnI in water solutions. The antibody for trop C is useful along with antibody to the complex.
Prinzmetal's angina is not associated with troponin increase until MI is associated
Troponins in pulmonary hypertension indicate poor prognosis and are associated with right ventricle damage.
Hypotension is not associated with troponin increase
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drlouis
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08.30.05 (3 years ago)
#3
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the answer is (false) is b and d
hypotension is associated with cardiac troponin elevation because of transient ischemia due to demand -supply imbalance just like watershed stroke.(Myocardial oxygen demand frequently increases in the setting of sepsis or septic shock and the systemic inflammatory response syndrome , hypotension or hypovolemia -reduced perfusion pressure, and decreased oxygen delivery to the heart, ultimately resulting in the release of troponin into the systemic circulation )
trponin c estimation is not useful clinically because it`s shared with striated muscle troponin.(In the absence of acute coronary syndromes with thrombus formation and total vessel occlusion or distal embolization, myocardial ischemia can be caused by vasospasm (Prinzmetal angina). Among 93 patients with suspected myocardial ischemia and a subsequent diagnosis of insignificant coronary artery disease, 25% had elevated troponin levels )
source- annals of internal medicine-may 3 2005
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08.31.05 (3 years ago)
#4
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Yes, it is well known that troponin C is shared by both cardiac and skeletal muscles (and so are other troponins), but there is no cardiac specific troponin C, and that is why it is useful to test for it in association with the complex I mentioned in my previous post.
Thanks for this article in Annals of internal medicine.
For those who have not seen this, only abstract is available, free full text would be available after six months of publication. So till then, contemplate on this abstract:
There are very useful rapid responses at the end of page
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08.31.05 (3 years ago)
#5
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A good source for the list of raised troponins:
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