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Zubrzycki M, Schramm R, Costard-Jäckle A, Morshuis M, Grohmann J, Gummert JF, Zubrzycka M. Pathogenesis and Surgical Treatment of Congenitally Corrected Transposition of the Great Arteries (ccTGA): Part III. J Clin Med 2024; 13:5461. [PMID: 39336948 PMCID: PMC11432588 DOI: 10.3390/jcm13185461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 09/10/2024] [Accepted: 09/12/2024] [Indexed: 09/30/2024] Open
Abstract
Congenitally corrected transposition of the great arteries (ccTGA) is an infrequent and complex congenital malformation, which accounts for approximately 0.5% of all congenital heart defects. This defect is characterized by both atrioventricular and ventriculoarterial discordance, with the right atrium connected to the morphological left ventricle (LV), ejecting blood into the pulmonary artery, while the left atrium is connected to the morphological right ventricle (RV), ejecting blood into the aorta. Due to this double discordance, the blood flow is physiologically normal. Most patients have coexisting cardiac abnormalities that require further treatment. Untreated natural course is often associated with progressive failure of the systemic right ventricle (RV), tricuspid valve (TV) regurgitation, arrhythmia, and sudden cardiac death, which occurs in approximately 50% of patients below the age of 40. Some patients do not require surgical intervention, but most undergo physiological repair leaving the right ventricle in the systemic position, anatomical surgery which restores the left ventricle as the systemic ventricle, or univentricular palliation. Various types of anatomic repair have been proposed for the correction of double discordance. They combine an atrial switch (Senning or Mustard procedure) with either an arterial switch operation (ASO) as a double-switch operation or, in the cases of relevant left ventricular outflow tract obstruction (LVOTO) and ventricular septal defect (VSD), intra-ventricular rerouting by a Rastelli procedure. More recently implemented procedures, variations of aortic root translocations such as the Nikaidoh or the half-turned truncal switch/en bloc rotation, improve left ventricular outflow tract (LVOT) geometry and supposedly prevent the recurrence of LVOTO. Anatomic repair for congenitally corrected ccTGA has been shown to enable patients to survive into adulthood.
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Affiliation(s)
- Marek Zubrzycki
- Department of Surgery for Congenital Heart Defects, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum Georgstr. 11, 32545 Bad Oeynhausen, Germany;
| | - Rene Schramm
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Angelika Costard-Jäckle
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Michiel Morshuis
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Jochen Grohmann
- Department of Congenital Heart Disease/Pediatric Cardiology, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany;
| | - Jan F. Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Maria Zubrzycka
- Department of Clinical Physiology, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
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Zubrzycki M, Schramm R, Costard-Jäckle A, Morshuis M, Gummert JF, Zubrzycka M. Pathogenesis and Surgical Treatment of Dextro-Transposition of the Great Arteries (D-TGA): Part II. J Clin Med 2024; 13:4823. [PMID: 39200964 PMCID: PMC11355351 DOI: 10.3390/jcm13164823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/04/2024] [Accepted: 08/13/2024] [Indexed: 09/02/2024] Open
Abstract
Dextro-transposition of the great arteries (D-TGA) is the second most common cyanotic heart disease, accounting for 5-7% of all congenital heart defects (CHDs). It is characterized by ventriculoarterial (VA) connection discordance, atrioventricular (AV) concordance, and a parallel relationship with D-TGA. As a result, the pulmonary and systemic circulations are separated [the morphological right ventricle (RV) is connected to the aorta and the morphological left ventricle (LV) is connected to the pulmonary artery]. This anomaly is included in the group of developmental disorders of embryonic heart conotruncal irregularities, and their pathogenesis is multifactorial. The anomaly's development is influenced by genetic, epigenetic, and environmental factors. It can occur either as an isolated anomaly, or in association with other cardiac defects. The typical concomitant cardiac anomalies that may occur in patients with D-TGA include ventriculoseptal defects, patent ductus arteriosus, left ventricular outflow tract obstruction (LVOTO), mitral and tricuspid valve abnormalities, and coronary artery variations. Correction of the defect during infancy is the preferred treatment for D-TGA. Balloon atrial septostomy (BAS) is necessary prior to the operation. The recommended surgical correction methods include arterial switch operation (ASO) and atrial switch operation (AtrSR), as well as the Rastelli and Nikaidoh procedures. The most common postoperative complications include coronary artery stenosis, neoaortic root dilation, neoaortic insufficiency and neopulmonic stenosis, right ventricular (RV) outflow tract obstruction (RVOTO), left ventricular (LV) dysfunction, arrhythmias, and heart failure. Early diagnosis and treatment of D-TGA is paramount to the prognosis of the patient. Improved surgical techniques have made it possible for patients with D-TGA to survive into adulthood.
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Affiliation(s)
- Marek Zubrzycki
- Department of Surgery for Congenital Heart Defects, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany;
| | - Rene Schramm
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Angelika Costard-Jäckle
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Michiel Morshuis
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Jan F. Gummert
- Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, University Hospital, Ruhr-University Bochum, Georgstr. 11, 32545 Bad Oeynhausen, Germany; (R.S.); (A.C.-J.); (M.M.); (J.F.G.)
| | - Maria Zubrzycka
- Department of Clinical Physiology, Faculty of Medicine, Medical University of Lodz, Mazowiecka 6/8, 92-215 Lodz, Poland
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Medhi D, Kamidi SR, Mamatha Sree KP, Shaikh S, Rasheed S, Thengu Murichathil AH, Nazir Z. Artificial Intelligence and Its Role in Diagnosing Heart Failure: A Narrative Review. Cureus 2024; 16:e59661. [PMID: 38836155 PMCID: PMC11148729 DOI: 10.7759/cureus.59661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/06/2024] Open
Abstract
Heart failure (HF) is prevalent globally. It is a dynamic disease with varying definitions and classifications due to multiple pathophysiologies and etiologies. The diagnosis, clinical staging, and treatment of HF become complex and subjective, impacting patient prognosis and mortality. Technological advancements, like artificial intelligence (AI), have been significant roleplays in medicine and are increasingly used in cardiovascular medicine to transform drug discovery, clinical care, risk prediction, diagnosis, and treatment. Medical and surgical interventions specific to HF patients rely significantly on early identification of HF. Hospitalization and treatment costs for HF are high, with readmissions increasing the burden. AI can help improve diagnostic accuracy by recognizing patterns and using them in multiple areas of HF management. AI has shown promise in offering early detection and precise diagnoses with the help of ECG analysis, advanced cardiac imaging, leveraging biomarkers, and cardiopulmonary stress testing. However, its challenges include data access, model interpretability, ethical concerns, and generalizability across diverse populations. Despite these ongoing efforts to refine AI models, it suggests a promising future for HF diagnosis. After applying exclusion and inclusion criteria, we searched for data available on PubMed, Google Scholar, and the Cochrane Library and found 150 relevant papers. This review focuses on AI's significant contribution to HF diagnosis in recent years, drastically altering HF treatment and outcomes.
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Affiliation(s)
- Diptiman Medhi
- Internal Medicine, Gauhati Medical College and Hospital, Guwahati, Guwahati, IND
| | | | | | - Shifa Shaikh
- Cardiology, SMBT Institute of Medical Sciences and Research Centre, Igatpuri, IND
| | - Shanida Rasheed
- Emergency Medicine, East Sussex Healthcare NHS Trust, Eastbourne, GBR
| | | | - Zahra Nazir
- Internal Medicine, Combined Military Hospital, Quetta, Quetta, PAK
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Fernández-Casas A, Leirós-Rodríguez R, Hernandez-Lucas P, González-Represas A. Protective effects of exercise on cardiotoxicity induced by breast cancer treatments: A systematic review and meta-analysis. Maturitas 2024; 183:107932. [PMID: 38325133 DOI: 10.1016/j.maturitas.2024.107932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/18/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVE Currently, one of the main causes of death in women with breast cancer is cardiovascular disease caused by the oncologic therapies. Exercise has demonstrated positive effects on cardiovascular fitness in individuals without cancer. Therefore, the aim of this study was to evaluate the cardioprotective effects of exercise in women with breast cancer, during and after the application of their treatments. METHODS Systematic search was done in PubMed, Scopus, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and PEDro. The articles must have been published in the last ten years; the intervention to be evaluated was to consist of an exercise program; the sample had to comprise women who were undergoing breast cancer treatment or who had completed it at the time of the intervention; and the outcome variables had to include at least one parameter for the assessment of cardiac function and/or structure. RESULTS Of the 28 articles identified, nine reported non-randomized controlled studies, 16 randomized clinical trials and three quasi-experimental studies. The effects of exercise on left ventricular ejection fraction, global longitudinal strain and the E/A waveforms ratio were not significant. However, its effect on VO2max was significant. CONCLUSIONS Exercise does not seem to be effective in avoiding the cardiotoxic effects of oncological treatment for breast cancer. Although exercise seems to mitigate the symptomatology, reflected in improved functional capacity, more long-term studies are needed. PROSPERO REGISTRATION CODE CRD42023391441.
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Affiliation(s)
- Alicia Fernández-Casas
- Functional Biology and Health Sciences Department, University of Vigo, Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, University of Leon, Ponferrada, Spain.
| | - Pablo Hernandez-Lucas
- Functional Biology and Health Sciences Department, University of Vigo, Pontevedra, Spain.
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Montecillo J, Pirker T, Pemberton C, Chew-Harris J. suPAR in cardiovascular disease. Adv Clin Chem 2024; 121:89-131. [PMID: 38797545 DOI: 10.1016/bs.acc.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Soluble urokinase plasminogen activator receptor (suPAR), the soluble counterpart of urokinase plasminogen activator receptor, is found in the circulation at various levels. suPAR and its parent molecule, cell surface uPAR, exhibit similar structure and extracellular functional roles facilitating fibrinolysis, cellular adhesion, and migration. Studies have assessed the correlation between suPAR in cardiovascular disease (CVD). It is postulated that suPAR may serve as an indicator of inflammatory activation and burden during CVD progression. Increased suPAR independently predicts poorer outcomes in acute coronary syndromes, in heart failure, as well as in coronary artery disease and atherosclerosis. To guide translation into clinical utization, suPAR has been assessed in numerous CVD settings for improved risk discrimination independently or in association with established traditional risk factors. Whilst the involvement of suPAR has been explored in other diseases such as kidney diseases and cancer, there is only emerging evidence of suPAR's mechanistic involvement in cardiovascular disease. In this review, we provide a background into suPAR and its potential role as a biomarker in CVD.
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Affiliation(s)
- Jaya Montecillo
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | - Thomas Pirker
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand
| | | | - Janice Chew-Harris
- Christchurch Heart Institute, University of Otago, Christchurch, New Zealand.
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Sleem B, El Rassi C, Zareef R, Bitar F, Arabi M. NT-proBNP cardiac value in COVID-19: a focus on the paediatric population. Cardiol Young 2024:1-10. [PMID: 38528805 DOI: 10.1017/s1047951124000283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
NT-proBNP is a peptide related to brain natriuretic peptide, a cardiac biomarker and a member of the natriuretic family of peptides. NT-proBNP has demonstrated its clinical utility in the assessment of a wide spectrum of cardiac manifestations. It is also considered a more precise diagnostic and prognostic cardiac biomarker than brain natriuretic peptide. With the appearance of the Severe Acute Respiratory Syndrome Coronavirus 2 virus and the subsequent COVID-19 pandemic, diagnosis of heart implications began to pose an increasing struggle for the physician. Echocardiography is considered a central means of evaluating cardiac disorders like heart failure, and it is considered a reliable method. However, other diagnostic methods are currently being explored, one of which involves the assessment of NT-proBNP levels. In the literature that involves the adult population, significant positive correlations were drawn between the levels of NT-proBNP and COVID-19 outcomes such as high severity and fatality. In the paediatric population, however, the literature is scarce, and most of the investigations assess NT-proBNP in the context of Multiple Inflammatory Syndrome in Children, where studies have shown that cohorts with this syndrome had elevated levels of NT-proBNP when compared to non-syndromic cohorts. Thus, more large-scale studies on existing COVID-19 data should be carried out in the paediatric population to further understand the prognostic and diagnostic roles of NT-proBNP.
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Affiliation(s)
- Bshara Sleem
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Christophe El Rassi
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Rana Zareef
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Fadi Bitar
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mariam Arabi
- Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Pediatric Department, Division of Pediatric Cardiology, American University of Beirut Medical Center, Beirut, Lebanon
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Guo W, Xu Y, Liu X, Dou J, Guo Z. Therapeutic effect of adipose-derived stem cells injected into pericardial cavity in rat heart failure. ESC Heart Fail 2024; 11:492-502. [PMID: 38062920 PMCID: PMC10804146 DOI: 10.1002/ehf2.14606] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 10/26/2023] [Accepted: 11/06/2023] [Indexed: 01/24/2024] Open
Abstract
AIMS There are few studies on the treatment of heart failure by injecting stem cells into the pericardial cavity. Can the cells injected into the pericardial cavity migrate through the epicardium to the myocardial tissue? Whether there is therapeutic effect and the mechanism of therapeutic effect are still unclear. This study investigated the therapeutic efficacy and evidence of cell migration of adipose-derived stem cells (ADSCs) injected into the pericardial cavity in rat heart failure. The aim of this study is to demonstrate the effectiveness and mechanism of treating heart failure by injecting stem cells into the pericardial cavity, laying an experimental foundation for a new approach to stem cell therapy for heart disease in clinical practice. METHODS AND RESULTS The inguinal adipose tissue of male SD rats aged 4-6 weeks was taken, ADSCs were isolated and cultured, and their stem cell surface markers were identified. Forty rats aged 6-8 weeks were divided into sham operation group, heart failure group, and treatment group; there were 15 rats in the heart failure group and 15 rats in the treatment group. The heart failure model was established by intraperitoneal injection of adriamycin hydrochloride. The heart function of the three groups was detected by small animal ultrasound. The model was successful if the left ventricular ejection fraction < 50%. The identified ADSCs were injected into the pericardial cavity of rats in the treatment group. The retention of transplanted cells in pericardial cavity was detected by small animal in vivo imaging instrument, and the migration of transplanted cells into myocardial tissue was observed by tissue section and immunofluorescence. Western blotting and immunohistochemical staining were used to detect brain natriuretic peptide (BNP), α-smooth muscle actin (α-SMA), and C-reactive protein (CRP). ADSCs express CD29, CD44, and CD73. On the fourth day after injection of ADSCs into pericardial cavity, they migrated to myocardial tissue through epicardium and gradually diffused to deep myocardium. The cell density in the pericardial cavity remains at a high level for 10 days after injection and gradually decreases after 10 days. Compared with the heart failure group, the expression of BNP and α-SMA decreased (P < 0.05 and P < 0.001, respectively), and the expression of CRP in the treatment group was higher than that in the heart failure group (P < 0.0001). A small amount of BNP, α-SMA, and CRP was expressed in the myocardium of the sham operation group. After injection of ADSCs, interleukin-6 in myocardial tissue was significantly lower than that in heart failure myocardium (P < 0.01). After treatment, vascular endothelial growth factor A was significantly higher than that of heart failure (P < 0.01). CONCLUSIONS Pericardial cavity injected ADSCs can penetrate the epicardium, migrate into the myocardium, and have a therapeutic effect on heart failure. Their mechanism of action is to exert therapeutic effects through anti-inflammatory, anti-fibrosis, and increased angiogenesis.
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Affiliation(s)
- Wenjing Guo
- Henan Key Laboratory of Medical Tissue RegenerationXinxiang Medical University601 Jinsui RoadXinxiangHenanChina
- Henan Provincial Key Laboratory of Heart Reconstruction and TransplantationZhengzhou Cardiovascular HospitalZhengzhouHenanChina
| | - Yaping Xu
- Henan Provincial Key Laboratory of Heart Reconstruction and TransplantationZhengzhou Cardiovascular HospitalZhengzhouHenanChina
| | - Xinyi Liu
- Henan Key Laboratory of Medical Tissue RegenerationXinxiang Medical University601 Jinsui RoadXinxiangHenanChina
- Henan Provincial Key Laboratory of Heart Reconstruction and TransplantationZhengzhou Cardiovascular HospitalZhengzhouHenanChina
| | - Jintao Dou
- Henan Key Laboratory of Medical Tissue RegenerationXinxiang Medical University601 Jinsui RoadXinxiangHenanChina
- Henan Provincial Key Laboratory of Heart Reconstruction and TransplantationZhengzhou Cardiovascular HospitalZhengzhouHenanChina
| | - Zhikun Guo
- Henan Key Laboratory of Medical Tissue RegenerationXinxiang Medical University601 Jinsui RoadXinxiangHenanChina
- Henan Provincial Key Laboratory of Heart Reconstruction and TransplantationZhengzhou Cardiovascular HospitalZhengzhouHenanChina
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Lee YY, Sriram B, Wang SF, Kogularasu S, Chang-Chien GP. Advanced Nanomaterial-Based Biosensors for N-Terminal Pro-Brain Natriuretic Peptide Biomarker Detection: Progress and Future Challenges in Cardiovascular Disease Diagnostics. NANOMATERIALS (BASEL, SWITZERLAND) 2024; 14:153. [PMID: 38251118 PMCID: PMC10820909 DOI: 10.3390/nano14020153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/23/2024]
Abstract
Cardiovascular diseases (CVDs) represent a significant challenge in global health, demanding advancements in diagnostic modalities. This review delineates the progressive and restrictive facets of nanomaterial-based biosensors in the context of detecting N-terminal pro-B-type natriuretic peptide (NT-proBNP), an indispensable biomarker for CVD prognosis. It scrutinizes the escalation in diagnostic sensitivity and specificity attributable to the incorporation of novel nanomaterials such as graphene derivatives, quantum dots, and metallic nanoparticles, and how these enhancements contribute to reducing detection thresholds and augmenting diagnostic fidelity in heart failure (HF). Despite these technological strides, the review articulates pivotal challenges impeding the clinical translation of these biosensors, including the attainment of clinical-grade sensitivity, the substantial costs associated with synthesizing and functionalizing nanomaterials, and their pragmatic deployment across varied healthcare settings. The necessity for intensified research into the synthesis and functionalization of nanomaterials, strategies to economize production, and amelioration of biosensor durability and ease of use is accentuated. Regulatory hurdles in clinical integration are also contemplated. In summation, the review accentuates the transformative potential of nanomaterial-based biosensors in HF diagnostics and emphasizes critical avenues of research requisite to surmount current impediments and harness the full spectrum of these avant-garde diagnostic instruments.
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Affiliation(s)
- Yen-Yi Lee
- Institute of Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833301, Taiwan
- Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung 833301, Taiwan
- Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833301, Taiwan
| | - Balasubramanian Sriram
- Department of Materials and Mineral Resources Engineering, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Sea-Fue Wang
- Department of Materials and Mineral Resources Engineering, National Taipei University of Technology, Taipei 10608, Taiwan
| | - Sakthivel Kogularasu
- Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung 833301, Taiwan
- Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833301, Taiwan
| | - Guo-Ping Chang-Chien
- Institute of Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833301, Taiwan
- Super Micro Mass Research and Technology Center, Cheng Shiu University, Kaohsiung 833301, Taiwan
- Center for Environmental Toxin and Emerging-Contaminant Research, Cheng Shiu University, Kaohsiung 833301, Taiwan
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Zilinskaite N, Shukla RP, Baradoke A. Use of 3D Printing Techniques to Fabricate Implantable Microelectrodes for Electrochemical Detection of Biomarkers in the Early Diagnosis of Cardiovascular and Neurodegenerative Diseases. ACS MEASUREMENT SCIENCE AU 2023; 3:315-336. [PMID: 37868357 PMCID: PMC10588936 DOI: 10.1021/acsmeasuresciau.3c00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 10/24/2023]
Abstract
This Review provides a comprehensive overview of 3D printing techniques to fabricate implantable microelectrodes for the electrochemical detection of biomarkers in the early diagnosis of cardiovascular and neurodegenerative diseases. Early diagnosis of these diseases is crucial to improving patient outcomes and reducing healthcare systems' burden. Biomarkers serve as measurable indicators of these diseases, and implantable microelectrodes offer a promising tool for their electrochemical detection. Here, we discuss various 3D printing techniques, including stereolithography (SLA), digital light processing (DLP), fused deposition modeling (FDM), selective laser sintering (SLS), and two-photon polymerization (2PP), highlighting their advantages and limitations in microelectrode fabrication. We also explore the materials used in constructing implantable microelectrodes, emphasizing their biocompatibility and biodegradation properties. The principles of electrochemical detection and the types of sensors utilized are examined, with a focus on their applications in detecting biomarkers for cardiovascular and neurodegenerative diseases. Finally, we address the current challenges and future perspectives in the field of 3D-printed implantable microelectrodes, emphasizing their potential for improving early diagnosis and personalized treatment strategies.
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Affiliation(s)
- Nemira Zilinskaite
- Wellcome/Cancer
Research UK Gurdon Institute, Henry Wellcome Building of Cancer and
Developmental Biology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QN, U.K.
- Faculty
of Medicine, University of Vilnius, M. K. Čiurlionio g. 21, LT-03101 Vilnius, Lithuania
| | - Rajendra P. Shukla
- BIOS
Lab-on-a-Chip Group, MESA+ Institute for Nanotechnology, Max Planck
Center for Complex Fluid Dynamics, University
of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
| | - Ausra Baradoke
- Wellcome/Cancer
Research UK Gurdon Institute, Henry Wellcome Building of Cancer and
Developmental Biology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QN, U.K.
- Faculty
of Medicine, University of Vilnius, M. K. Čiurlionio g. 21, LT-03101 Vilnius, Lithuania
- BIOS
Lab-on-a-Chip Group, MESA+ Institute for Nanotechnology, Max Planck
Center for Complex Fluid Dynamics, University
of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
- Center for
Physical Sciences and Technology, Savanoriu 231, LT-02300 Vilnius, Lithuania
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Saghir H, Andaleeb H, Azhar A, Babu S, Fatima S, Mumtaz H. Diagnostic accuracy of plasma brain natriuretic peptide for evaluation of dyspnea NYHA-III and NYHA-IV in emergency department of tertiary care hospital. Ann Med Surg (Lond) 2023; 85:4739-4744. [PMID: 37811080 PMCID: PMC10553004 DOI: 10.1097/ms9.0000000000001093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 07/13/2023] [Indexed: 10/10/2023] Open
Abstract
Objective To determine the diagnostic accuracy of breathing not properly (BNP) for evaluation of dyspnea NYHA III and IV due to systolic heart failure in emergency department patients keeping echocardiography as the gold standard. Study design Cross-sectional validation study. Setting: Department of Accident and Emergency Duration of Study: 25 July 2022-25 January 2023. Subjects and methods A total of 115 of both sexes presenting with acute onset of dyspnea and having NYHA Class III and IV were included. Emergency nursing staff had immediately taken a single venous blood sample for BNP and creatinine levels and a 2D echo was performed. Ejection fraction was recorded, and the diagnosis of systolic heart failure on the basis of an ejection fraction, that is less than or equal to 45% was documented. Results The age range in this study was from 18 to 65 years, with a mean age of 49.147±8.73 years. Mean BNP levels were 139.452±84.04 pg/ml. Patients with NYHA class III was 67.8 and 32.2% belongs to NYHA class IV. BNP levels greater than or equal to 100 pg/ml diagnosed 76 (66.1%) and echocardiography has diagnosed 68 (59.1%) patients with heart failure. BNP levels greater than or equal to 100 pg/ml had shown sensitivity 94.1%, specificity 74.5%, and diagnostic accuracy 86%, positive predictive value 84.21%, negative prediction value 89.74%, likelihood positive ratio 3.68 and likelihood negative ratio was 0.08 in diagnosis of heart failure. Conclusion BNP estimation is a sensible and particular procedure for diagnosing CHF in patients who present to the emergency department with acute dyspnea and may add extra advantages to the administration of patients with congestive heart failure (CHF) in our population.
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Affiliation(s)
| | | | - Amina Azhar
- Cardiologist Government City Hospital, Talagang, Pakistan
| | - Sadia Babu
- Department of Wah Medical College, Rawalpindi
| | | | - Hassan Mumtaz
- Maroof International Hospital Public Health Scholar, Health Services Academy, Islamabad
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Sağlam EC, Yadigaroğlu M, Güzel M, Turan H, Hakan Aksu Ş, Ocak M, Gorgun S, Arslan U, Yücel M. Combined Use of Serum N-terminal Pro-B-Type Natriuretic Peptide and Glypican-6 in the Diagnosis of Heart Failure. Cureus 2023; 15:e45766. [PMID: 37872895 PMCID: PMC10590535 DOI: 10.7759/cureus.45766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2023] [Indexed: 10/25/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the efficacy of serum glypican-6 (GPC-6) levels and the combination of N-terminal pro-B-type natriuretic peptide (NT-ProBNP) and GPC-6 in the diagnosis of heart failure (HF). METHODS In this prospective study, patients older than 18 years of age, admitted to the emergency department of our hospital between December 2021 and April 2022, diagnosed with heart failure (patient group), and healthy volunteers with similar sociodemographic characteristics (control group) were included. The disease severity classification of the patient group was made according to the 2021 ESC guidelines, using echocardiographic findings. Serum GPC-6 and NT-ProBNP levels were measured by the enzyme-linked immunosorbent assay (ELISA) method, which determines the antigen-antibody relationship. Optimal GPC-6 and NT-ProBNP levels for the diagnosis of HF were determined by receiver operating characteristic (ROC) analysis. The patients were divided into three groups according to these levels. Group 1 consisted of patients with both markers below the cutoff values, Group 2 consisted of patients with either of these markers above the cutoff values, and Group 3 consisted of patients with both markers above the cutoff values. RESULTS The study included 65 heart failure patients and 20 healthy volunteers. When the patient and control groups were compared in terms of serum GPC-6 and serum NT-ProBNP levels, both parameters were evaluated as significantly higher in the patient group (p=0.038 and p<0.001; respectively). In the ROC analysis, it was determined that GPC-6 indicated HF with 58.46% sensitivity and 75% specificity for an optimal cutoff value of 390 pg/ml. In the ROC analysis, it was determined that serum NT-ProBNP indicated HF with 89.23% sensitivity and 70% specificity for an optimal cutoff value of 122 pg/ml. When the groups were compared according to the rate of HF, it was found to be higher in Group 3 compared to Group 2 (97.1% vs. 70.3%, p<0.002) and Group 1 (97.1% vs. 38.5%, p<0.001). This rate was seen to be significantly higher in Group 2 compared to Group 1 (70.3% vs. 38.5%, p=0.042). CONCLUSION The combination of GPC-6 and NT-ProBNP may help diagnose HF patients admitted to the emergency department.
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Affiliation(s)
- Emre Cem Sağlam
- Emergency Medicine, Sadıka Sabancı State Hospital, Sakarya, TUR
| | - Metin Yadigaroğlu
- Emergency Medicine, Samsun University Faculty of Medicine, Samsun, TUR
| | - Murat Güzel
- Emergency Medicine, Samsun University Faculty of Medicine, Samsun, TUR
| | - Hatice Turan
- Emergency Medicine, Kulu State Hospital, Konya, TUR
| | - Şakir Hakan Aksu
- Emergency Medicine, Samsun Education and Research Hospital, Samsun, TUR
| | - Metin Ocak
- Emergency Medicine, Samsun Education and Research Hospital, Samsun, TUR
| | - Selim Gorgun
- Microbiology, University of Health Sciences, Samsun Education and Research Hospital, Samsun, TUR
| | - Uğur Arslan
- Cardiology, Samsun University Faculty of Medicine, Samsun, TUR
| | - Murat Yücel
- Emergency Medicine, Samsun University Faculty of Medicine, Samsun, TUR
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12
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Ha Manh T, Do Anh D, Le Viet T. Effect of body mass index on N-terminal pro-brain natriuretic peptide values in patients with heart failure. Egypt Heart J 2023; 75:75. [PMID: 37642755 PMCID: PMC10465415 DOI: 10.1186/s43044-023-00401-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 08/12/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a biomarker used for the diagnosis of heart failure. There is a relationship between NT-proBNP levels and body mass index (BMI). The study aimed to explore the impact of BMI on NT-proBNP concentrations and to examine whether other factors independent of or combined with BMI affect NT-proBNP values in patients with heart failure. RESULTS A total of 293 participants were recruited. The mean age was 68.9 ± 13.2 years, males accounted for 46.4% of the total cohort, the mean BMI was 23.1 ± 4.0 kg/m2, and the median NT-proBNP level was 3776 (1672-8806) pg/ml. There was an inverse relationship between BMI and log NT-proBNP (r = - 0.29; p < 0.001, Spearman correlation). Each standard deviation increase in BMI (4 kg/m2) was associated with a 7% decrease in NT-proBNP values in the total cohort. The independent inverse determinants of NT-proBNP other than BMI were male gender and eGFR, while the variables directly correlated to NT-proBNP were LVEF ≤ 40% and NYHA class III-IV heart failure. CONCLUSIONS There is an inverse association between BMI and NT-proBNP levels. However, the correlation is weak, and there are other variables that have a significant impact on the NT-proBNP values as well. The NT-proBNP levels are still valuable in the diagnosis of heart failure regardless of BMI status.
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Affiliation(s)
- Tuan Ha Manh
- University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., District 5, Ward 11, Ho Chi Minh City, 700000 Vietnam
| | - Duong Do Anh
- Laboratory Department, Sai Gon - Long Khanh Clinic, 57 Nguyen Thi Minh Khai Str., Quarter 5, Ward Xuan An, Long Khanh City, Dong Nai Province 76000 Vietnam
| | - Tung Le Viet
- University of Medicine and Pharmacy at Ho Chi Minh City, 215 Hong Bang Str., District 5, Ward 11, Ho Chi Minh City, 700000 Vietnam
- University Medical Center Ho Chi Minh City, 201 Nguyen Chi Thanh Str., District 5, Ward 12, Ho Chi Minh City, 700000 Vietnam
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Tri Saputra PB, Kurniawan RB, Trilistyoati D, Al Farabi MJ, Susilo H, Alsagaff MY, Oktaviono YH, Sutanto H, Gusnanto A, Dyah Kencono Wungu C. Myocarditis and coronavirus disease 2019 vaccination: A systematic review and meta-summary of cases. BIOMOLECULES & BIOMEDICINE 2023; 23:546-567. [PMID: 36803547 PMCID: PMC10351100 DOI: 10.17305/bb.2022.8779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
Vaccination is significant to control, mitigate, and recover from the destructive effects of coronavirus disease 2019 (COVID-19). The incidence of myocarditis following COVID-19 vaccination has been increasing and growing public concern; however, little is known about it. This study aimed to systematically review myocarditis following COVID-19 vaccination. We included studies containing individual patient data of myocarditis following COVID-19 vaccination published between January 1, 2020 and September 7, 2022 and excluded review articles. Joanna Briggs Institute critical appraisals were used for risk of bias assessment. Descriptive and analytic statistics were performed. A total of 121 reports and 43 case series from five databases were included. We identified 396 published cases of myocarditis and observed that the majority of cases was male patients, happened following the second dose of mRNA vaccine administration, and experienced chest pain as a symptom. Previous COVID-19 infection was significantly associated (p < 0.01; OR, 5.74; 95% CI, 2.42-13.64) with the risk of myocarditis following the administration of the first dose, indicating that its primary mechanism is immune-mediated. Moreover, 63 histopathology examinations were dominated by non-infective subtypes. Electrocardiography and cardiac marker combination is a sensitive screening modality. However, cardiac magnetic resonance is a significant noninvasive examination to confirm myocarditis. Endomyocardial biopsy may be considered in confusing and severe cases. Myocarditis following COVID-19 vaccination is relatively benign, with a median length of hospitalization of 5 days, intensive care unit admission of <12%, and mortality of <2%. The majority was treated with nonsteroidal anti-inflammatory drugs, colchicine, and steroids. Surprisingly, deceased cases had characteristics of being female, older age, non-chest pain symptoms, first-dose vaccination, left ventricular ejection fraction of <30%, fulminant myocarditis, and eosinophil infiltrate histopathology.
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Affiliation(s)
- Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | | | - Makhyan Jibril Al Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Henry Sutanto
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | | | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
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14
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Zhang S, Wang Y, Song D, Guan S, Zhou D, Gong L, Liang L, Guan X, Wang L. Nanopore discrimination and sensitive plasma detection of multiple natriuretic peptides: The representative biomarker of human heart failure. Biosens Bioelectron 2023; 231:115299. [PMID: 37054600 PMCID: PMC10147535 DOI: 10.1016/j.bios.2023.115299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/02/2023] [Accepted: 04/05/2023] [Indexed: 04/15/2023]
Abstract
Natriuretic peptides can relieve cardiovascular stress and closely related to heart failure. Besides, these peptides also have preferable interactions of binding to cellular protein receptors, and subsequently mediate various physiology actions. Hence, detection of these circulating biomarkers could be evaluated as a predictor ("Gold standard") for rapid, early diagnosis and risk stratification in heart failure. Herein, we proposed a measurement to discriminate multiple natriuretic peptides via the peptide-protein nanopore interaction. The nanopore single-molecular kinetics revealed that the strength of peptide-protein interactions was in the order of ANP > CNP > BNP, which was demonstrated by the simulated peptide structures using SWISS-MODEL. More importantly, the peptide-protein interaction analyzing also allowed us to measure the peptide linear analogs and structure damage in peptide by single-chemical bond breakup. Finally, we presented an ultra-sensitive detection of plasma natriuretic peptide using asymmetric electrolyte assay, obtaining a detection limit of ∼770 fM for BNP. At approximately, it is 1597 times lower than that of using symmetric assay (∼1.23 nM), 8 times lower than normal human level (∼6 pM), and 13 times lower than the diagnostic values (∼10.09 pM) complied in the guideline of European Society of Cardiology. That said, the designed nanopore sensor is benefit for natriuretic peptides measurement at single molecule level and demonstrates its potential for heart failure diagnosis.
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Affiliation(s)
- Shaoxia Zhang
- School of Optoelectronic Engineering, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China; Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Yunjiao Wang
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Dandan Song
- School of Optoelectronic Engineering, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China; Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Sarah Guan
- Hinsdale Central High School, Hinsdale, IL, 60521, USA
| | - Daming Zhou
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Linyu Gong
- School of Optoelectronic Engineering, Chongqing University of Posts and Telecommunications, Chongqing, 400065, China
| | - Liyuan Liang
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China
| | - Xiyun Guan
- Department of Chemistry, Illinois Institute of Technology, Chicago, IL, 60616, USA.
| | - Liang Wang
- Chongqing Institute of Green and Intelligent Technology, Chinese Academy of Sciences & Chongqing School, University of Chinese Academy of Sciences, Chongqing, 400714, China.
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15
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Polonschii C, Potara M, Iancu M, David S, Banciu RM, Vasilescu A, Astilean S. Progress in the Optical Sensing of Cardiac Biomarkers. BIOSENSORS 2023; 13:632. [PMID: 37366997 PMCID: PMC10296523 DOI: 10.3390/bios13060632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 05/30/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023]
Abstract
Biomarkers play key roles in the diagnosis, risk assessment, treatment and supervision of cardiovascular diseases (CVD). Optical biosensors and assays are valuable analytical tools answering the need for fast and reliable measurements of biomarker levels. This review presents a survey of recent literature with a focus on the past 5 years. The data indicate continuing trends towards multiplexed, simpler, cheaper, faster and innovative sensing while newer tendencies concern minimizing the sample volume or using alternative sampling matrices such as saliva for less invasive assays. Utilizing the enzyme-mimicking activity of nanomaterials gained ground in comparison to their more traditional roles as signaling probes, immobilization supports for biomolecules and for signal amplification. The growing use of aptamers as replacements for antibodies prompted emerging applications of DNA amplification and editing techniques. Optical biosensors and assays were tested with larger sets of clinical samples and compared with the current standard methods. The ambitious goals on the horizon for CVD testing include the discovery and determination of relevant biomarkers with the help of artificial intelligence, more stable specific recognition elements for biomarkers and fast, cheap readers and disposable tests to facilitate rapid testing at home. As the field is progressing at an impressive pace, the opportunities for biosensors in the optical sensing of CVD biomarkers remain significant.
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Affiliation(s)
- Cristina Polonschii
- International Centre of Biodynamics, Intrarea Portocalelor 1B, 060101 Bucharest, Romania; (C.P.); (S.D.); (R.M.B.)
| | - Monica Potara
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute in Bio-Nano-Sciences, Babes-Bolyai University, T. Laurian Str. 42, 400271 Cluj-Napoca, Romania; (M.P.); (S.A.)
| | - Madalina Iancu
- “Professor Dr. Agrippa Ionescu” Clinical Emergency Hospital, 7 Architect Ion Mincu Street, 011356 Bucharest, Romania;
| | - Sorin David
- International Centre of Biodynamics, Intrarea Portocalelor 1B, 060101 Bucharest, Romania; (C.P.); (S.D.); (R.M.B.)
| | - Roberta Maria Banciu
- International Centre of Biodynamics, Intrarea Portocalelor 1B, 060101 Bucharest, Romania; (C.P.); (S.D.); (R.M.B.)
- Faculty of Chemistry, University of Bucharest, 4-12 “Regina Elisabeta” Blvd., 030018 Bucharest, Romania
| | - Alina Vasilescu
- International Centre of Biodynamics, Intrarea Portocalelor 1B, 060101 Bucharest, Romania; (C.P.); (S.D.); (R.M.B.)
| | - Simion Astilean
- Nanobiophotonics and Laser Microspectroscopy Center, Interdisciplinary Research Institute in Bio-Nano-Sciences, Babes-Bolyai University, T. Laurian Str. 42, 400271 Cluj-Napoca, Romania; (M.P.); (S.A.)
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16
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Fu C, Wang M, Lu Y, Pan J, Li Y, Li Y, Wang Y, Wang A, Huang Y, Sun J, Liu C. Polygonum orientale L. Alleviates Myocardial Ischemia-Induced Injury via Activation of MAPK/ERK Signaling Pathway. Molecules 2023; 28:molecules28093687. [PMID: 37175097 PMCID: PMC10180121 DOI: 10.3390/molecules28093687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 04/06/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023] Open
Abstract
Although Polygonum orientale L. (PO) has a beneficial effect on treatment of myocardial ischemia (MI), its mechanism remains unclear. This study aimed to explore the pharmacological mechanism of PO against MI through MAPK signaling pathways. Firstly, the therapeutic effect of PO was evaluated for treatment of MI mice. Using Western blot and immunohistochemistry, the influence of PO on MAPK signaling pathways and cell apoptosis was investigated. Subsequently, one key pathway (ERK) of MAPK signaling pathways was screened out, on which PO posed the most obvious impact. Finally, an inhibitor of ERK1/2 was utilized to further verify the regulatory effect of PO on the MAPK/ERK signaling pathway. It was found that PO could reduce the elevation of the ST segment; injury of heart tissue; the activity of LDH, CK, NOS, cNOS and iNOS and the levels of NO, BNP, TNF-α and IL-6. It is notable that PO could significantly modulate the protein content of p-ERK/ERK in mice suffering from MI but hardly had an effect on p-JNK/JNK and p-p38/p38. Additionally, the expressions of bax, caspase3 and caspase9 were inhibited in heart tissue in the PO-treated group. To evaluate whether ERK1/2 inhibitor (PD98059) could block the effect of PO on treatment of MI, both PO and PD98059 were given to mice with MI. It was discovered that the inhibitor indeed could significantly reverse the regulatory effects of PO on the above indicators, indicating that PO could regulate p-ERK/ERK. This study provides experimental evidence that PO extenuates MI injury, cardiomyocyte apoptosis and inflammation by activating the MAPK/ERK signaling pathway.
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Affiliation(s)
- Changli Fu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
- School of Pharmacy, Guizhou Medical University, Guiyang 550004, China
| | - Mingjin Wang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
- School of Pharmacy, Guizhou Medical University, Guiyang 550004, China
| | - Yuan Lu
- Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
| | - Jie Pan
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
| | - Yueting Li
- Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
| | - Yongjun Li
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
| | - Yonglin Wang
- Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
| | - Aimin Wang
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
| | - Yong Huang
- Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
| | - Jia Sun
- Guizhou Provincial Key Laboratory of Pharmaceutics, Guizhou Medical University, Guiyang 550004, China
| | - Chunhua Liu
- State Key Laboratory of Functions and Applications of Medicinal Plants, Engineering Research Center for the Development and Application of Ethnic Medicine and TCM (Ministry of Education), Guizhou Medical University, Guiyang 550004, China
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17
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Takvorian KS, Wang D, Courchesne P, Vasan RS, Benjamin EJ, Cheng S, Larson MG, Levy D, Ho JE. The Association of Protein Biomarkers With Incident Heart Failure With Preserved and Reduced Ejection Fraction. Circ Heart Fail 2023; 16:e009446. [PMID: 36475777 PMCID: PMC9937440 DOI: 10.1161/circheartfailure.121.009446] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 08/25/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF) are distinct clinical entities, yet there is scant evidence for associations of proteomic signatures with future development of HFpEF versus HFrEF. METHODS We evaluated the association of 71 protein biomarkers with incident HFpEF versus HFrEF (left ventricular ejection fraction ≥ versus <50%) among Framingham Heart Study participants using multivariable Cox models. RESULTS Among 7038 participants (mean age 49 years; 54% women), 5 biomarkers were associated with increased risk of incident HFpEF (false discovery rate q<0.05): NT-proBNP (N-terminal pro-B-type natriuretic peptide; hazard ratio [HR], 2.13; 95% CI, 1.52-2.99; P<0.001), growth differentiation factor-15 (HR, 1.67; 95% CI, 1.32-2.12; P<0.001), adrenomedullin (HR, 1.58; 95% CI, 1.23-2.04; P<0.001), uncarboxylated matrix Gla protein (HR, 1.55; 95% CI 1.23-1.95; P<0.001), and C-reactive protein (HR, 1.46; 95% CI, 1.17-1.83; P=0.001). Fourteen biomarkers were associated with incident HFrEF (multivariable P<0.001, q<0.05 for all). Of these, 3 biomarkers were associated with both HF subtypes (NT-proBNP, growth differentiation factor-15, and C-reactive protein). When compared directly, myeloperoxidase, resistin, and paraoxanase-1 were more strongly associated with HFrEF than HFpEF. CONCLUSIONS We identified 5 protein biomarkers of new-onset HFpEF representing pathways of inflammation, cardiac stress, and vascular stiffness, which partly overlapped with HFrEF. We found 14 biomarkers associated with new-onset HFrEF, with some distinct associations including myeloperoxidase, resistin, and paraoxanase-1. Taken together, these findings provide insights into similarities and differences in the development of HF subtypes. REGISTRATION URL: https://clinicaltrials.gov/ct2/show/NCT00005121; Unique identifier: NCT0005121.
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Affiliation(s)
| | - Dongyu Wang
- Cardiovascular Institute and Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Paul Courchesne
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Ramachandran S. Vasan
- Department of Medicine and Boston University School of Medicine, Boston, MA
- Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Boston, MA
- The Framingham Heart Study, Framingham, MA
- Department of Epidemiology and Boston University School of Public Health, Boston, MA
| | - Emelia J. Benjamin
- Cardiology and Preventive Medicine Sections, Boston University School of Medicine, Boston, MA
- The Framingham Heart Study, Framingham, MA
- Department of Epidemiology and Boston University School of Public Health, Boston, MA
| | - Susan Cheng
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai, Los Angeles, CA
| | - Martin G. Larson
- The Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, MA
- Population Sciences Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda MD
| | - Jennifer E. Ho
- Cardiovascular Institute and Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
- Division of Cardiology, Department of Medicine, Beth Israel Deaconness Medical Center, Boston, MA
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18
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Walter E, Arrigo M, Allerstorfer S, Marty P, Hülsmann M. Cost-effectiveness of NT-proBNP-supported screening of chronic heart failure in patients with or without type 2 diabetes in Austria and Switzerland. J Med Econ 2023; 26:1287-1300. [PMID: 37781889 DOI: 10.1080/13696998.2023.2264722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 09/26/2023] [Indexed: 10/03/2023]
Abstract
BACKGROUND Heart failure (HF) is a clinical syndrome with a global burden. Signs and symptoms of HF are nonspecific and often shared with other conditions. The N-terminal prohormone of brain natriuretic peptide (NT-proBNP) serves as a useful biomarker for the diagnosis of HF not only in patients with acute symptoms but also in outpatients with an ambiguous clinical presentation. The aim of the analysis is to evaluate the cost-effectiveness of implementing NT-proBNP in the diagnostic algorithm in patients with/without type 2 diabetes mellitus (T2DM), compared with a diagnosis based primarily on clinical signs or symptoms from the perspective of the Austrian and Swiss healthcare system. METHODS A time-discrete Markov model was developed to simulate the effect/improvement (lifetime-costs, quality-adjusted life-years [QALYs], and life-years [LYs]) due to an NT-proBNP screening in undetected HF patients. Undetected HF patients are included in the model according to a distribution of New York Heart Association (NYHA) classes. The model considers disease progression by transition of NYHA classes. Undetected patients may remain undetected or be detected with the help of NT-proBNP or symptoms. Patients with known HF exhibit a slower disease progression. The probability of dying is influenced by the respective NYHA class. Direct costs (2021 € or CHF) were derived from published sources. QALYs, LYs, and costs were discounted (3% p.a.). RESULTS In the per-patient analysis (at age 60 over lifetime), the incremental cost-utility ratio (ICUR)/QALY of NT-proBNP vs. no screening was €3,042 for HF patients in Austria. Considering the total cohort of undetected HF patients (n = 9,377) with the corresponding age structure over a lifetime, the ICUR increases to €4,356. In Switzerland, the per-patient results show an ICUR of CHF 897. Considering the total cohort of undetected HF patients (n = 6,826) the ICUR amounts to CHF 4,513. If indirect costs are considered, NT-proBNP screening becomes the dominant strategy in both countries. CONCLUSION Overall, the analysis concludes that screening with NT-proBNP is a highly cost-effective or cost-saving diagnostic option for patients with HF, and a sensitivity analysis confirmed these findings.
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Affiliation(s)
- Evelyn Walter
- IPF Institute for Pharmaeconomic Research, Vienna, Austria
| | - Mattia Arrigo
- Department of Internal Medicine, Stadtspital Zürich Triemli, Zurich, Switzerland
| | | | - Petra Marty
- Roche Diagnostics (Switzerland) AG, Rotkreuz, Switzerland
| | - Martin Hülsmann
- Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
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19
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Horckmans M, Diaz Villamil E, Verdier C, Laurell H, Ruidavets JB, De Roeck L, Combes G, Martinez LO, Communi D. Loss-of-function N178T variant of the human P2Y4 receptor is associated with decreased severity of coronary artery disease and improved glucose homeostasis. Front Pharmacol 2022; 13:1049696. [DOI: 10.3389/fphar.2022.1049696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/22/2022] [Indexed: 12/04/2022] Open
Abstract
Human P2Y4 is a UTP receptor, while in mice it is activated by both ATP and UTP. P2Y4 knockout (KO) in mice protects against myocardial infarction and is characterized by increased adiponectin secretion by adipocytes, and decreased cardiac inflammation and permeability under ischemic conditions. The relevance of these data has, however, not been explored to date in humans. In a population study comprising 50 patients with coronary artery disease (CAD) and 50 age-matched control individuals, we analyzed P2RY4 mutations and their potential association with CAD severity and fasting plasma parameters. Among the mutations identified, we focused our attention on a coding region polymorphism (rs3745601) that results in replacement of the asparagine at residue 178 with threonine (N178T) located in the second extracellular loop of the P2Y4 receptor. The N178T variant is a loss-of-function mutation of the human P2Y4 receptor and is encountered less frequently in coronary patients than in control individuals. In coronary patients, carriers of the N178T variant had significantly reduced jeopardy and Gensini cardiac severity scores, as well as lower resting heart rates and plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP). Regarding fasting plasma parameters, the N178T variant was associated with a lower concentration of glucose. Accordingly, P2Y4 KO mice had significantly improved glucose tolerance and insulin sensitivity compared with their WT littermate controls. The improvement of insulin sensitivity resulting from lack of the P2Y4 receptor was no longer observed in the absence of adiponectin. The present study identifies a frequent loss-of-function P2Y4 variant associated with less severe coronary artery atherosclerosis and lower fasting plasma glucose in coronary patients. The role of the P2Y4 receptor in glucose homeostasis was confirmed in mouse. P2Y4 antagonists could thus have therapeutic applications in the treatment of myocardial infarction and type 2 diabetes.
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Lin HC, Huang SC, Wu MH, Wang JK, Lin MT, Chen CA, Lu CW, Chen YS, Chiu SN. Preoperative N-terminal pro-brain natriuretic peptide is associated with Fontan outcomes. J Thorac Cardiovasc Surg 2022; 164:770-780.e3. [PMID: 35031137 DOI: 10.1016/j.jtcvs.2021.11.082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/20/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The role of preoperative N-terminal pro-brain natriuretic peptide level in patient outcomes after the Fontan operation remains unclear. METHODS The medical records of all patients who underwent their first Fontan operation from June 2011 to October 2019 in our tertiary referral pediatric cardiac center were retrospectively reviewed. Preoperative hemodynamic factors and N-terminal pro-brain natriuretic peptide were analyzed to test the association of mortality and morbidity. RESULTS We enrolled 110 patients (men/women 62/48; median age, 4.1 [3.4, 5.8] years; median follow-up period, 4.28 [2.31, 6.71] years). Almost all operations were extracardiac conduits (98.2%). Primary outcomes of death, Fontan takedown, and heart transplantation were observed in 9 patients (8.2%). Abnormal ventricular contractility, elevated preoperative pulmonary artery pressure, high pulmonary vascular resistance index, and high log10 N-terminal pro-brain natriuretic peptide level were associated with poor outcomes. SECONDARY OUTCOMES atrioventricular valve regurgitation moderate or greater, elevated pulmonary artery pressure, high pulmonary vascular resistance index, and high log10 N-terminal pro-brain natriuretic peptide level were associated with rehospitalization due to heart failure. Multivariable Cox regression analysis revealed that log10 N-terminal pro-brain natriuretic peptide was the only significant predictor of all primary and secondary outcomes. A scoring system including factors of pulmonary artery pressure, pulmonary vascular resistance index, and N-terminal pro-brain natriuretic peptide was established, and the risk stratification is associated with outcomes after the Fontan operation. CONCLUSIONS High preoperative N-terminal pro-brain natriuretic peptide was associated with poor outcomes after the Fontan operation.
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Affiliation(s)
- Hsin-Chia Lin
- Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Pediatrics, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan; Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Shu-Chien Huang
- Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Hwan Wu
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Jou-Kou Wang
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Ming-Tai Lin
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Chun-An Chen
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Chun-Wei Lu
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan
| | - Yih-Sharng Chen
- Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Shuenn-Nan Chiu
- Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan.
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21
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Beyazal OF, Kervan Ü, Karahan M, Kocabeyoğlu SS, Sert DE, Temizhan A, Demirkan B, Akdi M, Konşuk Ünlü H, Çatav Z. Relationship Between Preoperative NT-proBNP and Postoperative Adverse Events in Patients with Left Ventricular Assist Device. Int J Artif Organs 2022; 45:817-825. [DOI: 10.1177/03913988221111406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: The aim of this study is to investigate the relationship of preoperative NT-proBNP values with postoperative adverse events in patient left ventricular assist device (LVAD) implantation. Method: Forty-six patients (35 males; mean age 49.4 ± 12.9 years) who underwent LVAD implantation between 2016 and 2018 were evaluated in this study. The analysis was made on the relationship between preoperative NT-proBNP and mortality, postoperative right ventricular failure (RVF), postoperative drainage, duration of intubation, and intensive care unit stay, was examined. The optimal NT-proBNP cut-off values for predicting mortality were determined using Receiver Operator Characteristic (ROC) curve analysis and the patients were divided into two groups according to the specified cut-off point. Result: Median NT-proBNP was higher in patients who died, had postoperative extracorporeal membrane oxygenation, and early RVF. The median NT-proBNP was 11,103 pg/ml in patients with IABP, and 2943 pg/ml in patients without IABP, and the difference was statistically significant ( p = 0.002). The cut-off point for NT-proBNP was found to be 1725.5 pg/ml (Sensitivity:0.929, Specificity:0.688). Accordingly, when the patients were divided into two groups and analyzed, no statistically significant difference was found between preoperative NT-proBNP below or above 1725.5 and postoperative adverse events. There was no statistically significant correlation between preoperative NT-proBNP and postoperative drainage, duration of intubation time, and duration of ICU stay ( p > 0.05). Conclusion: Routine monitoring of preoperative NT-proBNP and comparison with postoperative values are important in terms of patient selection, the timing of surgery, follow-up of postoperative adverse events, and improving outcomes in VAD patients.
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Affiliation(s)
- Osman Fehmi Beyazal
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | - Ümit Kervan
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | - Mehmet Karahan
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | - Sinan Sabit Kocabeyoğlu
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | - Doğan Emre Sert
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | - Ahmet Temizhan
- University of Health Sciences, Ankara City Hospital, Cardiology, Cankaya, Ankara, Turkey
| | - Burcu Demirkan
- University of Health Sciences, Ankara City Hospital, Cardiology, Cankaya, Ankara, Turkey
| | - Mustafa Akdi
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
| | | | - Zeki Çatav
- University of Health Sciences, Ankara City Hospital, Cardiovascular Surgery, Cankaya, Ankara, Turkey
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22
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Raj N, Crooks RM. Plastic-based lateral flow immunoassay device for electrochemical detection of NT-proBNP. Analyst 2022; 147:2460-2469. [PMID: 35531909 PMCID: PMC9178520 DOI: 10.1039/d2an00685e] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023]
Abstract
Here we report an easily fabricated, plastic-based lateral flow device for carrying out metalloimmunoassays. The device is called ocFlow to emphasize the open-channel design. We have shown that the ocFlow is capable of magnetic microbead (MμB)-based metalloimmunoassays for the detection of two types of immunoconjugates: a model composite (MC) and a sandwich immunoassay for the heart failure marker NT-proBNP. In both assays, Ag nanoparticles (AgNPs) were used as electrochemically detectable labels. NT-proBNP and MC concentrations as low as 750.0 pM and 10.0 pM, respectively, could be detected using the ocFlow device. Four key conclusions can be drawn from the results presented herein. First, immunoconjugates attached to the MμBs can be transported in the flow channel using combined hydrodynamic and capillary pressure passive pumping. Second, the ocFlow device is capable of on-chip storage, resolvation, and conjugate formation of both the MC and NT-proBNP composites. Third, electrochemical detection can be conducted on analytes suspended in serum by rinsing the electrodes with a wash buffer. Finally, and perhaps most significantly, the assay is quantitative and has a detection limit for NT-proBNP in the high picomolar range when the necessary reagents are stored on the device in a dry form.
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Affiliation(s)
- Nikhil Raj
- Department of Chemistry, The University of Texas at Austin, 105 E. 24th Street, Stop A5300, Austin, Texas 78712-1224, USA.
| | - Richard M Crooks
- Department of Chemistry, The University of Texas at Austin, 105 E. 24th Street, Stop A5300, Austin, Texas 78712-1224, USA.
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Mohanty V, Pathania M, Bhasi A. Effect of vitamin supplementation in patients of congestive heart failure deficient in vitamin D: A study at a tertiary care center of North India. Ann Afr Med 2022; 21:107-112. [PMID: 35848640 PMCID: PMC9383016 DOI: 10.4103/aam.aam_70_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction Heart Failure is a leading cause of mortality worldwide including India. Most cross sectional studies have demonstrated heart failure is associated with deficiency of essential micronutrients including Vitamin D which may play a important role in pathogenesis of ventricular remodelling in heart failure. Aim Our study performed aimed to determine the effect of supplementation in patients of Heart Failure presenting with Vitamin D deficiency to our institute on severity of Heart Failure. Design and Method 97 patients of Heart failure coming to our institute were given conventional therapies for Heart Failure along with Vitamin supplementation based on serum Vitamin D levels and followed up for 3 months. Results Patient of Heart failure having Vitamin D deficiency had significant reduction in cardiac biomarkers (NT-pro BNP levels), improvement in Left ventricular ejection fraction (LVEF) and more favourable reverse remodelling determined by Left ventricular end diastolic and systolic diameter (LVEDD & LVESD) though quality of life determined by WHODAS 2.0 score did not changed following 12 weeks supplementation of High Dose Vitamin D. Conclusion Recognising and treatment of Vitamin D deficiency may determine long term prognosis in patients of Heart Failure.
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Affiliation(s)
- Vivek Mohanty
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Monika Pathania
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ankith Bhasi
- Department of Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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24
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Raj N, Crooks RM. Detection Efficiency of Ag Nanoparticle Labels for a Heart Failure Marker Using Linear and Square-Wave Anodic Stripping Voltammetry. BIOSENSORS 2022; 12:203. [PMID: 35448263 PMCID: PMC9029172 DOI: 10.3390/bios12040203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 03/23/2022] [Accepted: 03/26/2022] [Indexed: 12/11/2022]
Abstract
In this article, we compare linear sweep anodic stripping voltammetry (LASV) and square-wave anodic stripping voltammetry (SWASV) for detection of a nano metalloimmunoassay. Two separate immunoassays were examined: a model assay, based on interactions between antibodies, and a sandwich assay for the heart failure marker NT-proBNP. In both cases, one antibody is linked to a magnetic microbead, and one is linked to a spherical Ag nanoparticle label. Electrochemical detection is carried out on a paper device. The three analytical figures of merit studied were the precision of the measurements, the calibration sensitivity, and the limit of detection (LOD). For the NT-proBNP assay, the results show that after optimization of the pulse amplitude and frequency of the potential input for SWASV, the detection efficiency is substantially higher compared to LASV. Specifically, the calibration sensitivity increased by up to ~40 fold, the average coefficient of variation decreased by ~40%, and the (LOD) decreased to 300.0 pM. Finally, for a model immunoassay, a ~10-fold decrease in the LOD was observed for SWASV compared to LASV.
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Affiliation(s)
| | - Richard M. Crooks
- Department of Chemistry, The University of Texas at Austin, 105 E. 24th Street, Stop A5300, Austin, TX 78712-1224, USA;
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25
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Dogheim GM, Khairat I, Omran GA, El-Haggar SM, Amrawy AME, Werida RH. Clinical comparative study assessing the effect of ivabradine on neopterin and NT-Pro BNP against standard treatment in chronic heart failure patients. Eur J Clin Pharmacol 2022; 78:943-954. [PMID: 35238960 PMCID: PMC9107441 DOI: 10.1007/s00228-022-03290-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/01/2022] [Indexed: 12/11/2022]
Abstract
Purpose Heart rate reduction (HR) is a cornerstone in heart failure therapy as it improves patient outcomes. The aim of this study is to evaluate short-term effect of ivabradine on NT-Pro BNP and neopterin in heart failure patients and assess the association between HR and these biomarkers. Methods Sixty patients on standard heart failure therapy were randomly allocated into ivabradine group (n = 30) and non-ivabradine group (n = 30). Ivabradine 5 mg twice daily was given for 3 months. Lipid profile and kidney functions were performed and blood samples for NT-Pro BNP and neopterin were analysed at baseline and after 3 months of intervention in both groups. Results There was a significant improvement in NYHA class in ivabradine group (p < 0.001). Ejection fraction was improved in ivabradine and non-ivabradine groups after intervention (p < 0.001), with a greater improvement in ivabradine group (p = 0.026). Heart rate was reduced in ivabradine group (p < 0.001) and non-ivabradine group (p < 0.001) yet greater reduction was seen in ivabradine group (p < 0.001). Serum creatinine and blood urea nitrogen were reduced in ivabradine group (Scr: p = 0.001, BUN: p = 0.001). NT-Pro BNP and neopterin levels significantly decreased in ivabradine group (NT-Pro BNP: p < 0.001, neopterin p < 0.001). Significant positive correlation was found between HR and biomarker levels after intervention (NT-Pro BNP: r = 0.475, p < 0.001, neopterin: r = 0.384, p = 0.002). Conclusion Ivabradine therapy reduced levels of both biomarkers which correlated well with HR. Biomarker levels might provide a tool for assessing ivabradine effectiveness in HF. Trial registration Date: June 26, 2020. Identifier: NCT04448899. Link: Ivabradine in Patients with Congestive Heart Failure—Full Text View—ClinicalTrials.gov.
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Affiliation(s)
- Gaidaa M. Dogheim
- Pharmacy Practice Department, Faculty of Pharmacy, Alexandria University, Al Mesallah Sharq, Qism Bab Sharqi, Alexandria, Alexandria Governorate Egypt
| | - Ibtsam Khairat
- Cardiology Department, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Gamal A. Omran
- Biochemistry Department, Faculty of Pharmacy, Damanhour University, Damanhour, 22514 Egypt
| | - Sahar M. El-Haggar
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Ahmed M. El Amrawy
- Cardiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rehab H. Werida
- Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, Damanhour University, Damanhour, 22514 Egypt
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26
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Ebong IA, Wilson MD, Chang P, Appiah D, Polonsky T, Ballantyne C, Bertoni AG. NT-pro B-type natriuretic peptide, early menopause, and incident heart failure in postmenopausal women of the ARIC study. Menopause 2022; 29:309-316. [PMID: 35213518 DOI: 10.1097/gme.0000000000001916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE N-Terminal pro B-type Natriuretic Peptide (NT-proBNP), a biomarker of heart failure (HF) has been associated with early menopause. We evaluated the modifying role of early menopause on the association of NT-proBNP with incident HF, and separately for HF subtypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). METHODS We included 4,352 postmenopausal women including 1,174 with early menopause, ages 63.5 ± 5.5 years, without prevalent HF at the Atherosclerosis Risk in Communities study Visit 4. Binary log-transformation was performed for NT-proBNP. Cox proportional hazards models were used to examine the association of NT-proBNP with incident HF, and separately for incident HFpEF and incident HFrEF, testing for effect modification by early menopause and adjusting for HF risk factors. RESULTS We observed 881 HF events over a mean follow-up of 16.5 years. The interaction terms of NT-proBNP and early menopause were not significant for incident HF (Pinteraction 0.95) and incident HFpEF (Pinteraction 0.17) but were significant for incident HFrEF (Pinteraction 0.03). The adjusted hazard ratios resulting from each doubling of NT-proBNP levels amongst women with and without early menopause were 1.33 (1.20-1.47) and 1.34 (1.24-1.44), respectively, for incident HF; 1.57 (1.34-1.86) and 1.38 (1.24-1.54), respectively, for incident HFpEF; and 1.68 (1.42-1.99) and 1.36 (1.22-1.52), respectively, for incident HFrEF. CONCLUSIONS The association of NT-proBNP with incident HFpEF is similar irrespective of early menopause status. However, the association of NT-proBNP with incident HFrEF is greater among women with early menopause when compared to those without early menopause.
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Affiliation(s)
- Imo A Ebong
- Department of Internal Medicine, Division of Cardiovascular Medicine, Department of Public Health Sciences, Division of Biostatistics
| | - Machelle D Wilson
- University of California Davis, Sacramento, CA, Advanced Heart Failure and Transplant Cardiology, University of North Carolina
| | - Patricia Chang
- Chapel Hill, NC, Department of Public Health, Texas Tech University Health Sciences Center
| | - Duke Appiah
- Lubbock, TX, Division of Cardiovascular Medicine, University of Chicago
| | - Tamar Polonsky
- Chicago, Center for Cardiovascular Disease Prevention, Baylor College of Medicine
| | - Christie Ballantyne
- Houston, TX, Division of Public Health Sciences, Wake Forest University School of Medicine
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27
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OUP accepted manuscript. Eur J Prev Cardiol 2022; 29:1124-1141. [DOI: 10.1093/eurjpc/zwac006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/25/2021] [Accepted: 01/04/2022] [Indexed: 11/12/2022]
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Meimoun P, Abdani S, Stracchi V, Elmkies F, Boulanger J, Botoro T, Zemir H, Clerc J. Usefulness of Noninvasive Myocardial Work to Predict Left Ventricular Recovery and Acute Complications after Acute Anterior Myocardial Infarction Treated by Percutaneous Coronary Intervention. J Am Soc Echocardiogr 2021; 33:1180-1190. [PMID: 33010853 DOI: 10.1016/j.echo.2020.07.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/12/2020] [Accepted: 07/12/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Predicting left ventricular recovery (LVR) after acute ST-elevation myocardial infarction (STEMI) is challenging and of prognostic importance. Our objective was to evaluate the usefulness of noninvasive myocardial work (MW), a new index of global and regional myocardial performance, to predict LVR and in-hospital complications after STEMI. METHODS Ninety-three patients with anterior STEMI (mean age, 59 ± 12 years) treated by percutaneous coronary intervention (PCI) were prospectively enrolled and underwent a transthoracic Doppler echocardiography within 24-48 hours after PCI and a median of 92 days at follow-up. Myocardial work is derived from the strain-pressure relation, integrating in its calculation the noninvasive arterial pressure. Segmental LVR was defined as a normalization of wall motion abnormalities of the affected segments and global recovery as an absolute improvement of left ventricular ejection fraction (LVEF) > 5% in patients with baseline LVEF ≤ 50%. In-hospital complications were defined as a composite of death, reinfarction, heart failure, and LV apical thrombus. RESULTS Segmental MW was impaired in infarct segments, more severely in nonrecovering versus recovering segments (P < .01). Furthermore, global constructive MW was significantly correlated with follow-up LVEF (r = 0.58) and global longitudinal strain (r = -0.67; all P < .01). Constructive MW was the best index to predict segmental (P < .01 vs MW index, MW efficiency, and wasted work) and global recovery (P < .05 vs global longitudinal strain) with an independent association (odds ratio = 1.17, 95% CI, 1.13-1.20, and odds ratio = 1.43, 95% CI, 1.18-1.68, respectively; all P < .001). Moreover, global constructive MW was more severely impaired in patients with in-hospital complications (n = 16; P < .01). CONCLUSIONS In patients with anterior STEMI treated by PCI, constructive MW is an independent predictor of segmental and global LVR and is significantly impaired in patients with in-hospital complications.
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Affiliation(s)
- Patrick Meimoun
- Department of Cardiology, Compiègne Hospital, Compiègne, France.
| | - Souad Abdani
- Department of Cardiology, Compiègne Hospital, Compiègne, France
| | | | | | | | - Thierry Botoro
- Department of Cardiology, Compiègne Hospital, Compiègne, France
| | - Hamdane Zemir
- Department of Cardiology, Compiègne Hospital, Compiègne, France
| | - Jerome Clerc
- Department of Cardiology, Compiègne Hospital, Compiègne, France
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29
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Moriarty ME, Miller MA, Murray MJ, Duignan PJ, Gunther-Harrington CT, Field CL, Adams LM, Schmitt TL, Johnson CK. Exploration of serum cardiac troponin I as a biomarker of cardiomyopathy in southern sea otters (Enhydra lutris nereis). Am J Vet Res 2021; 82:529-537. [PMID: 34166086 DOI: 10.2460/ajvr.82.7.529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare serum cardiac troponin I (cTnI) concentrations between sea otters with and without cardiomyopathy and describe 2 cases of cardiomyopathy with different etiologies. ANIMALS 25 free-ranging southern sea otters (Enhydra lutris nereis) with (n = 14; cases) and without (11; controls) cardiomyopathy and 17 healthy managed southern sea otters from aquariums or rehabilitation centers (controls). PROCEDURES Serum cTnI concentration was measured in live sea otters. Histopathologic and gross necropsy findings were used to classify cardiomyopathy status in free-ranging otters; physical examination and echocardiography were used to assess health status of managed otters. Two otters received extensive medical evaluations under managed care, including diagnostic imaging, serial cTnI concentration measurement, and necropsy. RESULTS A significant difference in cTnI concentrations was observed between cases and both control groups, with median values of 0.279 ng/mL for cases and < 0.006 ng/mL for free-ranging and managed controls. A cutoff value of ≥ 0.037 ng/mL yielded respective sensitivity and specificity estimates for detection of cardiomyopathy of 64.3% and 90.9% for free-ranging cases versus free-ranging controls and 64.3% and 94.1% for free-ranging cases versus managed controls. CONCLUSIONS AND CLINICAL RELEVANCE Cardiomyopathy is a common cause of sea otter death that has been associated with domoic acid exposure and protozoal infection. Antemortem diagnostic tests are needed to identify cardiac damage. Results suggested that serum cTnI concentration has promise as a biomarker for detection of cardiomyopathy in sea otters. Serial cTnI concentration measurements and diagnostic imaging are recommended to improve heart disease diagnosis in managed care settings.
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Affiliation(s)
- Megan E Moriarty
- From the Karen C. Drayer Wildlife Health Center and EpiCenter for Disease Dynamics, One Health Institute, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616
| | - Melissa A Miller
- From the Marine Wildlife Veterinary Care and Research Center, California Department of Fish and Wildlife, Santa Cruz, CA 95060
| | | | | | - Catherine T Gunther-Harrington
- From the Department of Medicine & Epidemiology, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616
| | - Cara L Field
- From the Marine Mammal Center, Sausalito, CA 94965
| | - Lance M Adams
- From the Aquarium of the Pacific, Long Beach, CA 90802
| | - Todd L Schmitt
- From the SeaWorld Animal Health and Rescue Center, San Diego, CA 92109
| | - Christine K Johnson
- From the Karen C. Drayer Wildlife Health Center and EpiCenter for Disease Dynamics, One Health Institute, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616
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30
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Bellagambi FG, Petersen C, Salvo P, Ghimenti S, Franzini M, Biagini D, Hangouët M, Trivella MG, Di Francesco F, Paolicchi A, Errachid A, Fuoco R, Lomonaco T. Determination and stability of N-terminal pro-brain natriuretic peptide in saliva samples for monitoring heart failure. Sci Rep 2021; 11:13088. [PMID: 34158583 PMCID: PMC8219749 DOI: 10.1038/s41598-021-92488-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/01/2021] [Indexed: 02/05/2023] Open
Abstract
Heart failure (HF) is the main cause of mortality worldwide, particularly in the elderly. N-terminal pro-brain natriuretic peptide (NT-proBNP) is the gold standard biomarker for HF diagnosis and therapy monitoring. It is determined in blood samples by the immunochemical methods generally adopted by most laboratories. Saliva analysis is a powerful tool for clinical applications, mainly due to its non-invasive and less risky sampling. This study describes a validated analytical procedure for NT-proBNP determination in saliva samples using a commercial Enzyme-Linked Immuno-Sorbent Assay. Linearity, matrix effect, sensitivity, recovery and assay-precision were evaluated. The analytical approach showed a linear behaviour of the signal throughout the concentrations tested, with a minimum detectable dose of 1 pg/mL, a satisfactory NT-proBNP recovery (95-110%), and acceptable precision (coefficient of variation ≤ 10%). Short-term (3 weeks) and long-term (5 months) stability of NT-proBNP in saliva samples under the storage conditions most frequently used in clinical laboratories (4, - 20, and - 80 °C) was also investigated and showed that the optimal storage conditions were at - 20 °C for up to 2.5 months. Finally, the method was tested for the determination of NT-proBNP in saliva samples collected from ten hospitalized acute HF patients. Preliminary results indicate a decrease in NT-proBNP in saliva from admission to discharge, thus suggesting that this procedure is an effective saliva-based point-of-care device for HF monitoring.
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Affiliation(s)
- Francesca G. Bellagambi
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy ,grid.7849.20000 0001 2150 7757Institute of Analytical Sciences (ISA) – UMR 5280, University Claude Bernard Lyon 1, 69100 Lyon, France
| | - Christina Petersen
- grid.452599.60000 0004 1781 8976Cardiology Division, Fondazione Toscana Gabriele Monasterio, 56124 Pisa, Italy
| | - Pietro Salvo
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Silvia Ghimenti
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy
| | - Maria Franzini
- grid.5395.a0000 0004 1757 3729Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Denise Biagini
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy
| | - Marie Hangouët
- grid.4444.00000 0001 2112 9282Institute of Analytical Sciences (ISA), UMR 5280, French National Center for Scientific Research (CNRS), 69100 Lyon, France
| | - Maria Giovanna Trivella
- grid.5326.20000 0001 1940 4177Institute of Clinical Physiology, National Research Council, 56124 Pisa, Italy
| | - Fabio Di Francesco
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy
| | - Aldo Paolicchi
- grid.5395.a0000 0004 1757 3729Department of Translational Research on New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy
| | - Abdelhamid Errachid
- grid.7849.20000 0001 2150 7757Institute of Analytical Sciences (ISA) – UMR 5280, University Claude Bernard Lyon 1, 69100 Lyon, France
| | - Roger Fuoco
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy
| | - Tommaso Lomonaco
- grid.5395.a0000 0004 1757 3729Department of Chemistry and Industrial Chemistry, University of Pisa, 56124 Pisa, Italy
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Cardiac MRI assessment of the right ventricle pre-and post-kidney transplant. Int J Cardiovasc Imaging 2021; 37:1757-1766. [PMID: 33475872 DOI: 10.1007/s10554-020-02153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/29/2020] [Indexed: 10/22/2022]
Abstract
Worsening renal function in chronic kidney disease correlates with worsening right ventricular (RV) systolic function. We evaluated the association between kidney transplantation (KT) and RV structure and systolic function, and the relationships between RV and left ventricular (LV) changes, blood pressure, and specific cardiac biomarkers, in patients with end-stage kidney disease using cardiac magnetic resonance imaging (CMR). In this prospective, multi-centre, cohort study, 39 adult patients on dialysis receiving KT and 42 patients eligible for, but not yet receiving KT, were recruited. CMR was performed at baseline, and repeated at 12 months. Among 81 patients (mean age 51 years, 30% female), RV end-diastolic volume index (RVEDVi), end-systolic volume index (RVESVi), mass index (RVMi), and ejection fraction (RVEF) did not change significantly within either the dialysis or KT group over 12 months (all p ≥ 0.10). There were no significant differences in the 12-month changes of these parameters between the dialysis and KT groups (all p ≥ 0.10). RVMI demonstrated positive correlations with NT-proBNP and systolic blood pressure, but not GDF-15, at baseline and at 12 months. Changes in RVEDVi, RVESVi, and RVEF were positively correlated with changes in LVEDVi, LVESVi, and LVEF, respectively over 12 months (Spearman r = 0.72, 0.52, and 0.41; all p < 0.001), but not mass index (Spearman r = 0.20, p = 0.078). In conclusion, there were no significant changes in RV mass, volumes, or systolic function 12 months after KT, as compared with continuation of dialysis. The associations between RV and LV remodeling may suggest similar underlying pathophysiologic mechanisms.
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Endpoint prediction of heart failure using electronic health records. J Biomed Inform 2020; 109:103518. [DOI: 10.1016/j.jbi.2020.103518] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/10/2020] [Accepted: 07/19/2020] [Indexed: 11/21/2022]
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Ghanem SE, Abdel-Samiee M, Torky MH, Gaafar A, Mohamed SM, Salah Eldin GMM, Awad SM, Diab KA, ELsabaawy DM, Yehia SA, Abdelaziz Elbasyouni HA, Elshormilisy AA. Role of resistin, IL-6 and NH2-terminal portion proBNP in the pathogenesis of cardiac disease in type 2 diabetes mellitus. BMJ Open Diabetes Res Care 2020; 8:e001206. [PMID: 32988848 PMCID: PMC7523202 DOI: 10.1136/bmjdrc-2020-001206] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/29/2020] [Accepted: 08/04/2020] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Epidemiological and genetic studies have recorded the association between proinflammatory cytokines and the development of insulin resistance, diabetes, and cardiovascular disease. The role of interleukin 6 (IL-6), NH2-terminal portion pro-brain natriuretic peptide (NT-proBNP) and resistin in the pathogenesis of heart disease in type 2 diabetes mellitus (T2DM) is still a matter of controversy. The current study aimed to evaluate the role of these biomarkers in the development of left ventricular systolic dysfunction and the ability to use them as non-invasive test in the prediction of left ventricular hypertrophy and systolic dysfunction in T2DM. RESEARCH DESIGN AND METHODS 150 participants were included in this case-control study. Patients were divided into two subgroups according to echocardiographic findings: group 1a included 46 patients with type 2 diabetes mellitus and echocardiographic evidence of abnormal systolic function; group 1b included 54 patients with type 2 diabetes mellitus and with normal echocardiogenic study; and group 2 included 50 apparently healthy controls. Routine laboratory investigations such as complete blood count, liver and renal function tests, and lipid profile, serum IL-6, NT-proBNP, and resistin were measured in all participants. Conventional echocardiography was done with special concern on the assessment of left ventricular systolic function (ejection fraction). RESULTS There was a significant increase in the level of resistin, NT-proBNP and IL-6 in group 1a patients compared with group 1b and in healthy controls. Echocardiographic parameters showed a significant increase in left ventricular mass index, left ventricle posterior wall thickness, interventricular septum thickness, and left ventricle mass in group 1a compared with group 1b and the control group. The increased left ventricular mass index was associated with higher levels of IL-6, NT-proBNP and resistin. CONCLUSIONS Proinflammatory cytokines had a clear relation with left ventricular systolic dysfunction and hypertrophy and can be used as early non-invasive markers for detection of left ventricular remodeling and systolic dysfunction in patients with T2DM.
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Affiliation(s)
- Samar Ebrahim Ghanem
- Department of Clinical Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Mohamed Abdel-Samiee
- Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | | | - Ahmed Gaafar
- Department of Cardiology, Helwan University, Cairo, Egypt
| | - Somia Mokabel Mohamed
- Department of Physiology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | | | - Samah Mohammed Awad
- Department of Clinical Microbiology and Immunology and Molecular Microbiology in Liver and GIT, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Karema A Diab
- Department of Clinical Pathology, National Liver Institute, Menoufia University, Menoufia, Egypt
| | - Dalia M ELsabaawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Menoufia University, Menoufia, Egypt
| | - Sania Ali Yehia
- Department of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia University, Menoufia, Egypt
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Cruz D, Fontes CM, Semeniak D, Huang J, Hucknall A, Chilkoti A, Mikkelsen MH. Ultrabright Fluorescence Readout of an Inkjet-Printed Immunoassay Using Plasmonic Nanogap Cavities. NANO LETTERS 2020; 20:4330-4336. [PMID: 32375003 PMCID: PMC7737629 DOI: 10.1021/acs.nanolett.0c01051] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
Fluorescence-based microarrays are promising diagnostic tools due to their high throughput, small sample volume requirements, and multiplexing capabilities. However, their low fluorescence output has limited their implementation for in vitro diagnostics applications in point-of-care (POC) settings. Here, by integration of a sandwich immunoassay microarray within a plasmonic nanogap cavity, we demonstrate strongly enhanced fluorescence which is critical for readout by inexpensive POC detectors. The immunoassay consists of inkjet-printed antibodies on a polymer brush which is grown on a gold film. Colloidally synthesized silver nanocubes are placed on top and interact with the underlying gold film creating high local electromagnetic field enhancements. By varying the thickness of the brush from 5 to 20 nm, up to a 151-fold increase in fluorescence and 14-fold improvement in the limit-of-detection is observed for the cardiac biomarker B-type natriuretic peptide (BNP) compared to the unenhanced assay, paving the way for a new generation of POC clinical diagnostics.
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Affiliation(s)
- Daniela
F. Cruz
- Department
of Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Cassio M. Fontes
- Department
of Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Daria Semeniak
- Department
of Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Jiani Huang
- Department
of Physics, Duke University, Durham, North Carolina 27708, United States
| | - Angus Hucknall
- Department
of Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
| | - Ashutosh Chilkoti
- Department
of Biomedical Engineering, Duke University, Durham, North Carolina 27708, United States
- E-mail:
| | - Maiken H. Mikkelsen
- Department
of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708, United States
- E-mail:
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Pollok NE, Rabin C, Walgama CT, Smith L, Richards I, Crooks RM. Electrochemical Detection of NT-proBNP Using a Metalloimmunoassay on a Paper Electrode Platform. ACS Sens 2020; 5:853-860. [PMID: 32154707 DOI: 10.1021/acssensors.0c00167] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In this paper, we demonstrate an electrochemical method for detection of the heart failure biomarker, N-terminal prohormone brain natriuretic peptide (NT-proBNP). The approach is based on a paper electrode assembly and a metalloimmunoassay; it is intended for eventual integration into a home-use sensor. Sensing of NT-proBNP relies on the formation of a sandwich immunoassay and electrochemical quantification of silver nanoparticle (AgNP) labels attached to the detection antibodies (Abs). There are four important outcomes reported in this article. First, compared to physisorption of the detection Abs on the AgNP labels, a 27-fold increase in signal is observed when a heterobifunctional cross-linker is used to facilitate this labeling. Second, the assay is selective in that it does not cross-react with other cardiac natriuretic peptides. Third, the assay forms in undiluted human serum (though the electrochemical analysis is carried out in buffer). Finally, and most important, the assay is able to detect NT-proBNP at concentrations between 0.58 and 2.33 nM. This performance approaches the critical NT-proBNP concentration threshold often used by physicians for risk stratification purposes: ∼0.116 nM.
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Affiliation(s)
- Nicole E. Pollok
- Department of Chemistry, The University of Texas at Austin, 100 E. 24th Street, Stop A1590, Austin, Texas 78712-1224, United States
| | - Charlie Rabin
- Department of Chemistry, The University of Texas at Austin, 100 E. 24th Street, Stop A1590, Austin, Texas 78712-1224, United States
| | - Charuksha T. Walgama
- Department of Chemistry, The University of Texas at Austin, 100 E. 24th Street, Stop A1590, Austin, Texas 78712-1224, United States
| | - Leilani Smith
- Department of Chemistry, The University of Texas at Austin, 100 E. 24th Street, Stop A1590, Austin, Texas 78712-1224, United States
| | - Ian Richards
- Interactives Executive Excellence LLC, Austin, Texas 78733, United States
| | - Richard M. Crooks
- Department of Chemistry, The University of Texas at Austin, 100 E. 24th Street, Stop A1590, Austin, Texas 78712-1224, United States
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Krzesiński P, Piechota W, Piotrowicz K, Gielerak G, Woźniak-Kosek A. Association of Estimated Insulin Resistance with N-Terminal B-Type Natriuretic Peptide Concentration in Men with Metabolic Syndrome. Cardiol Res Pract 2019; 2019:8571795. [PMID: 31929901 PMCID: PMC6942809 DOI: 10.1155/2019/8571795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 10/31/2019] [Accepted: 11/18/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The diagnostic and prognostic role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in heart failure is well established. However, additional factors may influence its concentration. One of them is obesity, which in general is accompanied by reduced NT-proBNP levels. However, specific data concerning metabolic syndrome (MS) are equivocal. The aim of the present study was to evaluate the association of NT-proBNP with estimated insulin resistance (eIR) in men with MS. METHODS In 86 male patients with MS (78 of them hypertensive), blood pressure, anthropometric measures, NT-proBNP, creatinine, glucose, and insulin were assessed and eIR was calculated using homeostatic model assessment (HOMA-IR). RESULTS Both eIR and age were independently associated with NT-proBNP concentrations (b = 0.2248, p=0.019; b = 0.0102, p=0.049, respectively). Blood pressure, anthropometric measures, and eGFR were not correlated with NT-proBNP. Patients without eIR had higher NT-proBNP than those with eIR (32.2 ± 26.4 vs 21.4 ± 25.4 pg/mL, p=0.014). The difference was even higher in the younger subgroup of patients reaching nearly 50%. CONCLUSIONS Insulin resistance and, to a lesser degree, age were associated with NT-proBNP levels in men with MS. In younger subjects with eIR, mean NT-proBNP level was lower than in corresponding healthy age males.
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Affiliation(s)
- Paweł Krzesiński
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
| | - Wiesław Piechota
- Department of Laboratory Diagnostics, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
| | - Katarzyna Piotrowicz
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
| | - Grzegorz Gielerak
- Department of Cardiology and Internal Diseases, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
| | - Agnieszka Woźniak-Kosek
- Department of Laboratory Diagnostics, Military Institute of Medicine, Szaserów Street 128, 04-141 Warsaw, Poland
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Dhir S, Dhir A. Cardiovascular Risk Assessment for Noncardiac Surgery: Are We Ready for Biomarkers? J Cardiothorac Vasc Anesth 2019; 34:1914-1924. [PMID: 31866221 DOI: 10.1053/j.jvca.2019.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 09/07/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
Biomarkers aided perioperative cardiac assessment is a relatively new concept. Cardiac biomarkers with historical significance (aspartate transaminase, dehydrogenase, creatinine kinase and myoglobin) have paved the way for traditional biomarkers (cardiac troponin, C-reactive protein, lipoprotein). Contemporary biomarkers like natriuretic peptides (BNP and ProBNP) are validated risk markers in both acute and chronic cardiac diseases and are showing remarkable promise in predicting serious cardiovascular complications after non-cardiac surgery. This review is intended to provide a critical overview of traditional and contemporary biomarkers for perioperative cardiovascular assessment and management. This review also discusses the potential utility of newer biomarkers like galectin-3, sST-2, GDF-15, TNF-alpha, MiRNAs and many others that can predict inflammation, cardiac remodeling, injury and endogenous stress and need further investigations to establish their clinical utility. Though promising, biomarker led perioperative care is still in infancy and it has not been determined that it can improve clinical outcomes.
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Affiliation(s)
- Shalini Dhir
- Department of Anesthesia and Perioperative Medicine, Western University, London, Ontario, Canada.
| | - Achal Dhir
- Department of Anesthesia and Perioperative Medicine, Western University, London, Ontario, Canada
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V S L, Rauf AA, Kurup GM. Sulfated polysaccharides from the edible marine algae Padina tetrastromatica attenuates isoproterenol-induced oxidative damage via activation of PI3K/Akt/Nrf2 signaling pathway - An in vitro and in vivo approach. Chem Biol Interact 2019; 308:258-268. [PMID: 31150630 DOI: 10.1016/j.cbi.2019.05.044] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/07/2019] [Accepted: 05/27/2019] [Indexed: 11/27/2022]
Abstract
The reactive oxygen species (ROS) induced oxidative stress is an inevitable factor for the pathogenesis of cardiovascular diseases. The edible marine algae-derived sulfated polysaccharides gained special attention as novel bioactive compounds having potential pharmacological activities. The present study evaluated in vitro and in vivo cardioprotective properties of sulfated polysaccharides from the edible brown marine algae Padina tetrastromatica (PSPS) against isoproterenol (ISO) induced cardiac damage. The cardioprotective properties of PSPS were first evaluated in H9c2 cardiac myoblasts and the results were confirmed by in vivo studies conducted in male Sprague-Dawley rats. The biochemical parameters, histopathological analysis, mRNA expressions, and ELISA studies indicated that PSPS significantly decreased (p < 0.05) the cardiac damage induced by ISO by reducing lipid peroxidation and improving antioxidant status, both in vitro and in vivo, via modulating PI3k/Akt/Nrf2 signaling pathway. The histopathological evidence further reinforced our findings and highlighted the promising cardioprotective activities offered by PSPS.
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Affiliation(s)
- Lekshmi V S
- Department of Biochemistry, University of Kerala, Thiruvananthapuram, Kerala, India
| | - Arun A Rauf
- Department of Biochemistry, University of Kerala, Thiruvananthapuram, Kerala, India
| | - G Muraleedhara Kurup
- Department of Biochemistry, University of Kerala, Thiruvananthapuram, Kerala, India.
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Development of heart failure risk prediction models based on a multi-marker approach using random forest algorithms. Chin Med J (Engl) 2019; 132:819-826. [PMID: 30829708 PMCID: PMC6595865 DOI: 10.1097/cm9.0000000000000149] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background: The early identification of heart failure (HF) risk may favorably affect outcomes, and the combination of multiple biomarkers may provide a more comprehensive and valuable means for improving the risk of stratification. This study was conducted to assess the importance of individual cardiac biomarkers creatine kinase MB isoenzyme (CK-MB), B-type natriuretic peptide (BNP), galectin-3 (Gal-3) and soluble suppression of tumorigenicity-2 (sST2) for HF diagnosis, and the predictive performance of the combination of these four biomarkers was analyzed using random forest algorithms. Methods: A total of 193 participants (80 patients with HF and 113 age- and gender-matched healthy controls) were included from June 2017 to December 2017. The correlation and regression analysis were conducted between cardiac biomarkers and echocardiographic parameters. The accuracy and importance of these predictor variables were assessed using random forest algorithms. Results: Patients with HF exhibited significantly higher levels of CK-MB, BNP, Gal-3, and sST2. BNP exhibited a good independent predictive capacity for HF (AUC 0.956). However, CK-MB, sST2, and Gal-3 exhibited a modest diagnostic performance for HF, with an AUC of 0.709, 0.711, and 0.777, respectively. BNP was the most important variable, with a remarkably higher mean decrease accuracy and Gini. Furthermore, there was a general increase in predictive performance using the multi-marker model, and the sensitivity, specificity was 91.5% and 96.7%, respectively. Conclusion: The random forest algorithm provides a robust method to assess the accuracy and importance of predictor variables. The combination of CK-MB, BNP, Gal-3, and sST2 achieves improvement in prediction accuracy for HF.
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Bulska-Będkowska W, Chełmecka E, Owczarek AJ, Mizia-Stec K, Witek A, Szybalska A, Grodzicki T, Olszanecka-Glinianowicz M, Chudek J. CA125 as a Marker of Heart Failure in the Older Women: Population-Based Analysis. J Clin Med 2019; 8:jcm8050607. [PMID: 31058877 PMCID: PMC6572540 DOI: 10.3390/jcm8050607] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/25/2019] [Accepted: 04/30/2019] [Indexed: 12/11/2022] Open
Abstract
(1) Background: Cancer antigen 125 (CA125) is a glycoprotein that is expressed by tissue derived from coelomic epithelium in the pleura, peritoneum, pericardium. It has been shown that CA125 concentrations are correlated with NT-proBNP in older people with congestive heart failure (HF). We conducted a study on the association between concentrations of CA125 and NT-proBNP in a population-based cohort of older Polish women. (2) Methods: The current research is sub-study of a large, cross-sectional research project (PolSenior). The study group consisted of 1565 Caucasian women aged 65–102 years. To assess the relationship between CA125 and other variables a stepwise backward multivariate normal and skew-t regression analyses were performed. (3) Results: The median of CA125 concentration was 13.0 U/mL and values over the upper normal range limit (35 U/mL) were observed in 5.1% (n = 79) of the study cohort. The concentration of CA125 was positively related to age, hospitalization for HF and history of atrial fibrillation and chronic obstructive pulmonary disease, levels of NT-proBNP, IL-6, hs-CRP and triglycerides. We found in the multivariate analyses, that increased CA125 levels were independently associated with log10 (IL-6) (β = 11.022), history of hospitalization for HF (β = 4.619), log10 (NT-proBNP) (β = 4.416) and age (β = 3.93 for 10 years). (4) Conclusions: Despite the association between CA125 and NT-proBNP, the usefulness of CA125 for the detection of HF in older women is limited by factors such as inflammatory status and age.
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Affiliation(s)
- Weronika Bulska-Będkowska
- Department of Internal Diseases and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia, 40-027 Katowice, Poland.
| | - Elżbieta Chełmecka
- Department of Statistics, Department of Instrumental Analysis, School of Pharmacy and Laboratory Medicine in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland.
| | - Aleksander J Owczarek
- Department of Statistics, Department of Instrumental Analysis, School of Pharmacy and Laboratory Medicine in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland.
| | - Katarzyna Mizia-Stec
- First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, 40-635 Katowice, Poland.
| | - Andrzej Witek
- Department of Gynecology and Obstetrics, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | | | - Tomasz Grodzicki
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, 31-531 Cracow, Poland.
| | - Magdalena Olszanecka-Glinianowicz
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
| | - Jerzy Chudek
- Department of Internal Diseases and Oncological Chemotherapy, School of Medicine in Katowice, Medical University of Silesia, 40-027 Katowice, Poland.
- Pathophysiology Unit, Department of Pathophysiology, School of Medicine in Katowice, Medical University of Silesia, 40-752 Katowice, Poland.
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Jansen van Vuren E, Malan L, von Känel R, Magnusson M, Lammertyn L, Malan NT. Prospective associations between cardiac stress, glucose dysregulation and executive cognitive function in Black men: The Sympathetic activity and Ambulatory Blood Pressure in Africans study. Diab Vasc Dis Res 2019; 16:236-243. [PMID: 30557037 DOI: 10.1177/1479164118816221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Glucose dysregulation is an independent risk factor for cardiovascular and neurodegenerative disease development through synaptic dysfunction resulting in cognitive decline. The aim of this study was to study the interplay between impaired glycaemic metabolism (hyperglycaemia and insulin resistance), cardiac stress (cardiac troponin T and N-terminal brain natriuretic peptide) and executive cognitive function prospectively, in a bi-ethnic sex cohort. METHODS Black and White teachers (N = 338, aged 20-63 years) from the Sympathetic activity and Ambulatory Blood Pressure in Africans study were monitored over a 3-year period. Fasting blood samples were obtained for cardiac troponin T, N-terminal brain natriuretic peptide, glycated haemoglobin and the homeostatic model assessment-insulin resistance for insulin resistance. The Stroop colour-word conflict test was applied to assess executive cognitive function at baseline. RESULTS Over the 3-year period, Black men revealed constant high levels of cardiac troponin T (⩾4.2 ng/L), pre-diabetes (glycated haemoglobin > 5.7%) and insulin resistance (homeostatic model assessment-insulin resistance >3). %Δ Glycated haemoglobin was associated with %Δ insulin resistance (p < 0.001) and increases in %ΔN-terminal brain natriuretic peptide (p = 0.02) in Black men only. In the latter, baseline Stroop colour-word conflict test was inversely associated with %Δ cardiac troponin T (p = 0.001) and %Δ insulin resistance levels (p = 0.01). CONCLUSION Progressive myocyte stretch and chronic myocyte injury, coupled with glucose dysregulation, may interfere with processes related to interference control in Black men.
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Affiliation(s)
- Esmé Jansen van Vuren
- 1 Hypertension in Africa Research Team (HART) and School for Physiology, Nutrition and Consumer Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Leoné Malan
- 1 Hypertension in Africa Research Team (HART) and School for Physiology, Nutrition and Consumer Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Roland von Känel
- 1 Hypertension in Africa Research Team (HART) and School for Physiology, Nutrition and Consumer Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- 2 Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital of Zurich, Zurich, Switzerland
| | - Martin Magnusson
- 3 Department of Cardiology, Skåne University Hospital, Malmö, Sweden
- 4 Department of Clinical Sciences, Lund University, Lund, Sweden
- 5 Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden
| | - Leandi Lammertyn
- 1 Hypertension in Africa Research Team (HART) and School for Physiology, Nutrition and Consumer Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
- 6 MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa
| | - Nicolaas T Malan
- 1 Hypertension in Africa Research Team (HART) and School for Physiology, Nutrition and Consumer Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
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Wang Y, Zhang R, Huang Y, Zhai M, Zhou Q, An T, Huang Y, Zhao X, Tian P, Zhang Y, Zhang J. Combining the use of amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide in the prognosis of hospitalized heart failure patients. Clin Chim Acta 2019; 491:8-14. [DOI: 10.1016/j.cca.2018.12.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/20/2018] [Accepted: 12/26/2018] [Indexed: 11/25/2022]
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Szunerits S, Mishyn V, Grabowska I, Boukherroub R. Electrochemical cardiovascular platforms: Current state of the art and beyond. Biosens Bioelectron 2019; 131:287-298. [PMID: 30851492 DOI: 10.1016/j.bios.2019.02.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 01/18/2019] [Accepted: 02/04/2019] [Indexed: 01/12/2023]
Abstract
Cardiovascular diseases (CVD) remain the leading cause of death within industrialized nations as well as an increasing cause of mortality and morbidity in many developing countries. Smoking, alcohol consumption and increased level of blood cholesterol are the main CVD risk factors. Other factors, such as the prevalence of overweight/obesity and diabetes, have increased considerably in recent decades and are indirect causes of CVD. Among CVDs, the acute coronary syndrome (ACS) represents the most common cause of emergency hospital admission. Since the prognosis of ACS is directly associated with timely initiation of revascularization, missed, misdiagnosis or late diagnosis have unfavorable medical implications. Early ACS diagnosis can reduce complications and risk of recurrence, finally decreasing the economic burden posed on the health care system as a whole. To decrease the risk of ACS and related CVDs and to reduce associated costs to healthcare systems, a fast management of patients with chest pain has become crucial and urgent. Despite great efforts, biochemical diagnostic approaches of CVDs remain difficult and controversial medical challenges as cardiac biomarkers should be rapidly released into the blood at the time of ischemia and persistent for a sufficient length of time to allow diagnostics, with tests that should be rapid, easy to perform and relatively inexpensive. Early biomarker assessments have involved testing for the total enzyme activity of aspartate aminotransferase (AST), lactate dehydrogenase (LDH) and creatine kinase (CK), which cardiac troponins being the main accepted biomarkers for diagnosing myocardial injury and acute myocardial infarction (AMI). To allow rapid diagnosis, it is necessary to replace the traditional biochemical assays by cardiac biosensor platforms. Among the numerous of possibilities existing today, electrochemical biosensors are important players as they have many of the required characteristics for point-of-care tests. Electrochemical based cardiac biosensors are highly adapted for monitoring the onset and progress of cardiovascular diseases in a fast and accurate manner, while being cheap and scalable devices. This review outlines the state of the art in the development of cardiac electrochemical sensors for the detection of different cardiac biomarkers ranging from troponin to BNP, N-terminal proBNP, and others.
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Affiliation(s)
- Sabine Szunerits
- Univ. Lille, CNRS, Centrale Lille, ISEN, Univ. Valenciennes, UMR 8520-IEMN, F-59000 Lille, France.
| | - Vladyslav Mishyn
- Univ. Lille, CNRS, Centrale Lille, ISEN, Univ. Valenciennes, UMR 8520-IEMN, F-59000 Lille, France
| | - Iwona Grabowska
- Institute of Animal Reproduction and Food Research, Polish Academy of Sciences, Tuwima 10, 10-748 Olsztyn, Poland
| | - Rabah Boukherroub
- Univ. Lille, CNRS, Centrale Lille, ISEN, Univ. Valenciennes, UMR 8520-IEMN, F-59000 Lille, France.
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Jansen van Vuren E, Malan L, von Känel R, Lammertyn L, Cockeran M, Malan NT. Longitudinal changes of cardiac troponin and inflammation reflect progressive myocyte stretch and likelihood for hypertension in a Black male cohort: The SABPA study. Hypertens Res 2019; 42:708-716. [PMID: 30626934 DOI: 10.1038/s41440-018-0183-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 10/12/2018] [Accepted: 10/17/2018] [Indexed: 11/09/2022]
Abstract
Inflammation was cross-sectionally associated with subclinical wall remodeling and hypertension. Whether longitudinal changes (∆) in inflammation, myocyte injury (troponin T), and stretch (N-terminal-pro-B-type natriuretic peptide) are associated with hypertension and ECG left ventricular hypertrophy (ECG-LVH) is unclear. The first prospective analysis in Africa assessing these associations included a cohort of Black and White teachers (N = 338; aged 20-63 years). Fasting blood samples were obtained to measure tumor necrosis factor-alpha (TNF-α), cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Ambulatory blood pressure, 2-lead ECG and resting 10-lead ECG values were obtained. A higher mean hypertensive status (62%) was evident in Blacks compared to Whites (44%, p < 0.001). Over 3-years, NT-proBNP increased in both ethnic groups. No associations were evident in women or in White men. In Black men, ECG-LVH at follow-up was positively associated with baseline cTnT (Adj R2 0.43; β = 0.48; 95% CI 0.28-0.68, p < 0.001) and baseline SBP (Adj R2 0.43; β = 0.29; 95% CI 0.09-0.49, p = 0.006). In Black men, baseline TNF-α (OR = 1.49, 95% CI 1.05-2.14, p = 0.03) and decreased ΔTNF-α (OR = 2.07, 95% CI 1.26-3.40, p = 0.004) increased the likelihood for cTnT levels ≥ 4.2 ng/L. Here, baseline NT-proBNP (OR = 1.12, 95% CI 1.01-1.23, p = 0.03) and ΔNT-proBNP progression (OR = 1.09, 95% CI 1.00-1.81, p = 0.04) increased the likelihood for 24-h hypertension. In conclusion, chronically increased levels of markers of myocyte injury accompanied by progressive myocardial stretch, reflective of cardiac metabolic overdemand, may ultimately increase hypertension and ischemic heart disease risk in a cohort of Black males.
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Affiliation(s)
- Esmé Jansen van Vuren
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa
| | - Leoné Malan
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa.
| | - Roland von Känel
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa.,University Hospital Zurich, Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, Zurich, Switzerland
| | - Leandi Lammertyn
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa.,North-West University, MRC Research Unit for Hypertension and Cardiovascular Disease, Potchefstroom, South Africa
| | - Marike Cockeran
- North-West University, Medicine Usage in South Africa (MUSA), Potchefstroom, South Africa
| | - Nicolaas T Malan
- North-West University, Hypertension in Africa Research Team (HART), Potchefstroom, South Africa
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45
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Grabowska I, Sharma N, Vasilescu A, Iancu M, Badea G, Boukherroub R, Ogale S, Szunerits S. Electrochemical Aptamer-Based Biosensors for the Detection of Cardiac Biomarkers. ACS OMEGA 2018; 3:12010-12018. [PMID: 30320285 PMCID: PMC6173562 DOI: 10.1021/acsomega.8b01558] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 09/07/2018] [Indexed: 05/22/2023]
Abstract
Rapid and accurate diagnostic technologies for early-state identification of cardiovascular abnormalities have become of high importance to prevent and attenuate their progression. The capability of biosensors to determine an increase in the concentration of cardiovascular protein biomarkers in circulating blood immediately after a myocardial infarction makes them ideal point-of-care platforms and alternative approaches to electrocardiograms, chest X-rays, and different laboratory-based immunoassays. We report here a generic approach toward multianalyte sensing platforms for cardiac biomarkers by developing aptamer-based electrochemical sensors for brain natriuretic peptide (BNP-32) and cardiac troponin I (cTnI). For this, commercial gold-based screen-printed electrodes were modified electrophoretically with polyethyleneimine/reduced graphene oxide films. Covalent grafting of propargylacetic acid integrates propargyl groups onto the electrode to which azide-terminated aptamers can be immobilized using Cu(I)-based "click" chemistry. To ensure low biofouling and high specificity, cardiac sensors were modified with pyrene anchors carrying poly(ethylene glycol) units. In the case of BNP-32, the sensor developed has a linear response from 1 pg mL-1 to 1 μg mL-1 in serum; for cTnI, linearity is observed from 1 pg mL-1 to 10 ng mL-1 as demanded for early-stage diagnosis of heart failure. These electrochemical aptasensors represent a step further toward multianalyte sensing of cardiac biomarkers.
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Affiliation(s)
- Iwona Grabowska
- Institute
of Animal Reproduction and Food Research, Polish Academy of Sciences, Tuwima 10, 10-748, Olsztyn, Poland
| | - Neha Sharma
- Indian
Institute of Science Education and Research (IISER), 411008, Pune, India
| | - Alina Vasilescu
- International
Centre of Biodynamics, 1B Intrarea Portocalelor, Sector 6, 060101, Bucharest, Romania
| | - Madalina Iancu
- Agrippa
Ionescu” Emergency Clinical Hospital, 7 Ion Mincu, 011356, Bucharest, Romania
| | - Gabriela Badea
- Agrippa
Ionescu” Emergency Clinical Hospital, 7 Ion Mincu, 011356, Bucharest, Romania
| | - Rabah Boukherroub
- Univ.
Lille, CNRS, Centrale Lille, ISEN, Univ. Valenciennes, UMR 8520-IEMN, 59000, Lille, France
| | - Satishchandra Ogale
- Indian
Institute of Science Education and Research (IISER), 411008, Pune, India
| | - Sabine Szunerits
- Univ.
Lille, CNRS, Centrale Lille, ISEN, Univ. Valenciennes, UMR 8520-IEMN, 59000, Lille, France
- E-mail:
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Wu M, Yang Y, Wang M, Zeng F, Li Q, Liu W, Guo S, He M, Wang Y, Huang J, Zhou L, Li Y, Hu J, Gong W, Zhang Z. Exogenous Pancreatic Kallikrein Improves Diabetic Cardiomyopathy in Streptozotocin-Induced Diabetes. Front Pharmacol 2018; 9:855. [PMID: 30131697 PMCID: PMC6091235 DOI: 10.3389/fphar.2018.00855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 07/16/2018] [Indexed: 12/29/2022] Open
Abstract
Aims: To evaluate the protective effects of exogenous pancreatic kallikrein (PKK) treatment on diabetic cardiomyopathy (DCM) and explore the underlying mechanisms. Methods and Results: Streptozotocin (STZ)-induced diabetic rats, a type 1 diabetic model, were treated with either PKK or saline for 12 weeks. Non-diabetic rats were used as controls. PKK administration attenuated the mitochondria swelling, Z line misalignments, myofibrosis and interstitial collagen accumulation in diabetic myocardial tissue. The oxidative stress imbalance including increased nitrotyrosine, decreased anti-oxidative components such as nuclear receptor nuclear factor like 2 (Nrf2), glutathione peroxidase 1(GPx-1), catalase (CAT) and superoxide dismutase (SOD), were recovered in the heart of PKK-treated diabetic rats. In diabetic rats, protein expression of TGF-β1 and accumulation of collagen I in the heart tissues was decreased after PKK administration. Markers for inflammation were decreased in diabetic rats by PKK treatment. Compared to diabetic rats, PKK reversed the degradation of IκB-α, an inhibitive element of heterotrimer nuclear factor kappa B (NF-κB). The endothelial nitric oxide synthase (eNOS) protein and myocardial nitrate/nitrite were impaired in the heart of diabetic rats, which, however, were restored after PKK treatment. The sarcoplasmic reticulum Ca2+-ATPase 2 (SERCA2) and phospholamban (PLN) were mishandled in diabetic rats, while were rectified in PKK-treated diabetic rats. The plasma NT-proBNP level was increased in diabetic rats while was reduced with PKK treatment. Conclusion: PKK protects against DCM via reducing fibrosis, inflammation, and oxidative stress, promoting nitric oxide production, as well as restoring the function of the calcium channel.
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Affiliation(s)
- Meng Wu
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.,Department of Endocrinology, The Second Affiliated Hospital, Soochow University, Suzhou, China
| | - Yeping Yang
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Meng Wang
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Fangfang Zeng
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Qin Li
- Division of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wenjuan Liu
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Shizhe Guo
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Min He
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Endocrinology and Diabetology, Fudan University, Shanghai, China
| | - Yi Wang
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Jie Huang
- Changzhou Qianhong Biopharma Co., Ltd., Changzhou, China
| | - Linuo Zhou
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Yiming Li
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Endocrinology and Diabetology, Fudan University, Shanghai, China
| | - Ji Hu
- Department of Endocrinology, The Second Affiliated Hospital, Soochow University, Suzhou, China
| | - Wei Gong
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhaoyun Zhang
- Division of Endocrinology and Metabolism, Huashan Hospital, Fudan University, Shanghai, China.,Institute of Endocrinology and Diabetology, Fudan University, Shanghai, China
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47
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Qiu H, Li WP, Shen XH, Guo XY, Hua B, Li HW. Dynamic fluctuations of advanced glycation end products and its C-terminal truncated receptor level in patients with acute ST-segment elevation myocardial infarction and undergoing diabetes or not: A retrospective study. Medicine (Baltimore) 2018; 97:e11278. [PMID: 30045252 PMCID: PMC6078646 DOI: 10.1097/md.0000000000011278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The role of advanced glycation end products (AGEs) and its C-terminal truncated receptor (soluble receptor for advanced glycation end products, sRAGE) in ST-segment elevation myocardial infarction (STEMI) patients with or without diabetes is unknown. We compared their levels in patients with and without STEMI, as well as with and without diabetes. A prospective observational study was performed between December 2014 and December 2015. Study group included STEMI patients with coronary artery disease; control group included patients without coronary artery disease. Levels of AGEs and sRAGE were tested on Days 0, 2, and 5 after STEMI. Levels of creatine kinase-MB (CK-MB), cardiac troponin I, and N-terminal pro-brain natriuretic peptide (NT-proBNP) were tested on Days 0, 1, 2, and 3. Patient's diabetic status was determined by medical history or oral glucose tolerance test. Compared to patients in the control group, STEMI patients showed elevated levels of AGEs and sRAGE. In the STEMI group, diabetic patients had higher levels of AGEs and sRAGE compared to nondiabetic patients. The level of AGEs correlated with peak level of CK-MB in the overall population of patients with STEMI and with peak level of NT-proBNP in diabetic patients with STEMI. Levels of AGEs and sRAGE were elevated after STEMI, especially among patients with diabetes. These markers could serve to indicate the severity of myocardial injury and cardiac insufficiency, and play a potential role in predicting the prognosis of patients with STEMI.
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Affiliation(s)
- Hui Qiu
- Department of Cardiology, Beijing Friendship Hospital
| | - Wei-Ping Li
- Department of Cardiology, Beijing Friendship Hospital
| | - Xu-Hua Shen
- Department of Cardiology, Beijing Friendship Hospital
| | | | - Bing Hua
- Department of Cardiology, Beijing Friendship Hospital
| | - Hong-Wei Li
- Department of Cardiology, Beijing Friendship Hospital
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48
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Fu S, Ping P, Zhu Q, Ye P, Luo L. Brain Natriuretic Peptide and Its Biochemical, Analytical, and Clinical Issues in Heart Failure: A Narrative Review. Front Physiol 2018; 9:692. [PMID: 29922182 PMCID: PMC5996066 DOI: 10.3389/fphys.2018.00692] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 05/17/2018] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) is a primary cause of morbidity and mortality worldwide. As the most widely studied and commonly applied natriuretic peptide (NP), B-type natriuretic peptide (BNP) has the effects of diuresis, natriuresis, vasodilation, anti-hypertrophy, and anti-fibrosis and it inhibits the renin-angiotensin-aldosterone and sympathetic nervous systems to maintain cardiorenal homeostasis and counteract the effects of HF. Both BNP and N-terminal pro B-type natriuretic peptide (NT-proBNP) are applied as diagnostic, managing, and prognostic tools for HF. However, due to the complexity of BNP system, the diversity of BNP forms and the heterogeneity of HF status, there are biochemical, analytical, and clinical issues on BNP not fully understood. Current immunoassays cross-react to varying degrees with pro B-type natriuretic peptide (proBNP), NT-proBNP and various BNP forms and cannot effectively differentiate between these forms. Moreover, current immunoassays have different results and may not accurately reflect cardiac function. It is essential to design assays that can recognize specific forms of BNP, NT-proBNP, and proBNP to obtain more clinical information. Not only the processing of proBNP (corin/furin) and BNP (neprilysin), but also the effects of glycosylation on proBNP processing and BNP assays, should be targeted in future studies to enhance their diagnostic, therapeutic, and prognostic values.
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Affiliation(s)
- Shihui Fu
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China.,Department of Cardiology and Hainan Branch, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ping Ping
- Department of Pharmaceutical Care, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Qiwei Zhu
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Ping Ye
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
| | - Leiming Luo
- Department of Geriatric Cardiology, Chinese People's Liberation Army General Hospital, Beijing, China
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49
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Resolution of ST deviation after myocardial infarction in patients with and without sleep-disordered breathing. SOMNOLOGIE 2018. [DOI: 10.1007/s11818-018-0154-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Biomarkers in Cardiorenal Syndromes. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9617363. [PMID: 29693019 PMCID: PMC5859843 DOI: 10.1155/2018/9617363] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 01/10/2018] [Accepted: 02/01/2018] [Indexed: 12/12/2022]
Abstract
There is a consensus that cardiorenal syndromes (CRS) are defined as the disorders of heart and kidney where acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in another. Patients with CRS have increased hospitalization and mortality rates, and thus their identification is of great implication. Biomarkers are not only predictive in heart failure or renal diseases, but also useful in identifying cardiac dysfunction in renal diseases and renal injury in heart failure. Thus, they may be applied in order to identify patients with CRS and even assess prognosis and guide therapy in these patients. However, studies on biomarkers have just begun in CRS. Future studies are essential to observe current biomarkers and find novel biomarkers in CRS so as to improve diagnosis, therapy, and prognosis of CRS.
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