Russian Clinical Laboratory DiagnosticsRussian Clinical Laboratory DiagnosticsКлиническая лабораторная диагностика0869-20842412-1320Eco-Vector63697510.17816/cld636975ReviewsОбзорыReview ArticleAnalysis of cardiac troponins to determine the drugs cardiotoxicityАнализ сердечных тропонинов крови для определения кардиотоксичности лекарственных препаратовhttps://orcid.org/0000-0003-1221-23963315-4018SheshurinaTatyana A.ШешуринаТатьяна Андреевна
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

mitralis@list.ruhttps://orcid.org/0000-0002-7272-16546462-6448DorofeykovVladimir V.ДорофейковВладимир Владимирович
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук, профессор

vdorofeykov@ya.ruThe Lesgaft National State University of Physical Education, Sports and HealthНациональный государственный Университет физической культуры, спорта и здоровья имени П.Ф. ЛесгафтаCity medical and physical education dispensaryГородской врачебно-физкультурный диспансерAlmazov National Medical Research CentreНациональный медицинский исследовательский центр имени В.А. Алмазова10122024010520246915181310202420112024Copyright ©; 2024, Sheshurina T.A., Dorofeykov V.V.Copyright ©; 2024, Шешурина Т.А., Дорофейков В.В.2024Sheshurina T.A., Dorofeykov V.V.Шешурина Т.А., Дорофейков В.В.https://creativecommons.org/licenses/by-nc-nd/4.0https://kld-journal.fedlab.ru/0869-2084/article/view/636975

In modern medicine, the problem of the toxic effect of drugs on the human body persists. Cardiotoxicity is damage to the heart muscle by drugs and biologically active additives is one of the most common negative consequences. The task of doctors is to identify the presence of cardiotoxicity in the early stages before the appearance of clinical symptoms, timely adjust therapy and add cardioprotectors if necessary. Today, the main methods of diagnosing cardiotoxicity are imaging methods — echocardiography and magnetic resonance imaging. These methods show structural changes in the myocardium that have already occurred and a decrease in the working indicators of the heart. The active implementation and development of an algorithm for the use of troponin tests before and during therapy by drugs with cardiotoxic effects makes it possible to identify high-risk patients, diagnose damage to the heart muscle earlier and reduce the number of studies. The review analyzes trials in which cardiac troponins were used as cardiotoxicity markers of various drugs, shows the technical limitations of laboratory methods for troponin T and I tests, and the prospects for predictive use of determining highly sensitive tests for cardiac troponins.

В современной медицине сохраняется проблема токсического действия лекарственных препаратов на организм человека. Кардиотоксичность — повреждение сердечной мышцы как медицинскими препаратами, так и биологически активными добавками — одно из часто встречающихся негативных последствий. Задача врачей — выявить наличие кардиотоксичности на ранних стадиях до появления клинических симптомов, своевременно скорректировать терапию и добавить при необходимости кардиопротекторы. На сегодняшний день основными методами диагностики кардиотоксичности являются визуализирующие методы — эхокардиография и магнитно-резонансная томография, которые показывают уже произошедшие структурные изменения в миокарде и снижение рабочих показателей сердца. Активное внедрение и разработка алгоритма использования тропониновых тестов до и во время терапии препаратами с кардиотоксичным действием позволяет выявить пациентов высокого риска, диагностировать повреждение сердечной мышцы раньше и сократить количество инструментальных исследований. В обзоре проанализированы исследования, в которых использовали сердечные тропонины в качестве маркеров кардиотоксичности различных лекарственных препаратов, показаны технические ограничения лабораторных методов тестирования тропонина T и I, перспективы прогностического использования определения высокочувствительных тестов на сердечные тропонины.

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