Differentiating Cardiac Troponin Levels During Cardiac Myosin Inhibition or Cardiac Myosin Activation Treatments: Drug Effect or the Canary in the Coal Mine?

IF 3.8 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
Current Heart Failure Reports Pub Date : 2023-12-01 Epub Date: 2023-10-25 DOI:10.1007/s11897-023-00620-2
Matthew M Y Lee, Ahmad Masri
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引用次数: 0

Abstract

Purpose of review: Cardiac myosin inhibitors (CMIs) and activators are emerging therapies for hypertrophic cardiomyopathy (HCM) and heart failure with reduced ejection fraction (HFrEF), respectively. However, their effects on cardiac troponin levels, a biomarker of myocardial injury, are incompletely understood.

Recent findings: In patients with HCM, CMIs cause substantial reductions in cardiac troponin levels which are reversible after stopping treatment. In patients with HFrEF, cardiac myosin activator (omecamtiv mecarbil) therapy cause modest increases in cardiac troponin levels which are reversible following treatment cessation and not associated with myocardial ischaemia or infarction. Transient changes in cardiac troponin levels might reflect alterations in cardiac contractility and mechanical stress. Such transient changes might not indicate cardiac injury and do not appear to be associated with adverse outcomes in the short to intermediate term. Longitudinal changes in troponin levels vary depending on the population and treatment. Further research is needed to elucidate mechanisms underlying changes in troponin levels.

在心肌肌凝蛋白抑制或心肌肌凝蛋白激活治疗中区分心肌肌钙蛋白水平:药物效应还是煤矿中的金丝雀?
综述目的:心肌肌球蛋白抑制剂(CMIs)和激活剂分别是治疗肥厚型心肌病(HCM)和射血分数降低的心力衰竭(HFrEF)的新兴疗法。然而,它们对心肌肌钙蛋白水平(心肌损伤的生物标志物)的影响尚不完全清楚。最近的研究结果:在HCM患者中,CMIs导致心肌肌钙蛋白水平显著降低,这在停止治疗后是可逆的。在HFrEF患者中,心肌肌球蛋白激活剂(omecamtiv-mecarbil)治疗会导致心肌肌钙蛋白水平适度升高,这在治疗停止后是可逆的,与心肌缺血或梗死无关。肌钙蛋白水平的短暂变化可能反映了心脏收缩力和机械应力的变化。这种短暂的变化可能不表明心脏损伤,并且在中短期内似乎与不良结果无关。肌钙蛋白水平的纵向变化因人群和治疗而异。需要进一步的研究来阐明肌钙蛋白水平变化的潜在机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Current Heart Failure Reports
Current Heart Failure Reports Medicine-Emergency Medicine
CiteScore
5.30
自引率
0.00%
发文量
44
期刊介绍: This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of heart failure. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as investigative, pharmacologic, and nonpharmacologic therapies, pathophysiology, and prevention. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.
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