(Modern ideas about the mechanisms of cardiac troponin release and their diagnostic role)

The main mechanism of cardiac troponin release (cTnT and cTnI) proven to date is ischemic necrosis of myocardial cells, which leads to the release of all intracellular molecules, including cTnT and cTnI into the bloodstream in acute myocardial infarction (AMI). However, in real clinical practice, doctors very often encounter many other (besides AMI) pathological conditions in which cTnT and cTnI concentrations in the bloodstream are elevated, but signs of myocardial ischemia are not observed. This clearly indicates the existence of other (non-ischemic) mechanisms of cardiomyocyte damage and the release of cTnT and cTnI into the bloodstream. Understanding all the mechanisms of cardiac troponin release will improve the diagnosis and differential diagnosis of AMI, expand the scope of cTnT and cTnI (for the diagnosis and stratifi cation of risk in other diseases that have a negative impact on myocardial cells). This review systematizes up-to-date information on the mechanisms of cardiac troponin release, discusses in detail the diagnostic role of individual mechanisms of cTnT and cTnI release. Klíčová slova: Akutní infarkt myokardu