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Rao L, Xu P, Zhang G, Zu R, Luo Y, Zhang K, Yang Y, Wang D, He S, Luo H, Ye B. Prognostic value of creatine kinase (CK)-MB to total-CK ratio in colorectal cancer patients after curative resection. BMC Cancer 2024; 24:543. [PMID: 38684978 PMCID: PMC11059638 DOI: 10.1186/s12885-024-12307-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/23/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate the prognostic significance of postoperative Creatine Kinase type M and B (CK-MB) to total Creatine Kinase (CK) ratio (CK-MB/CK) in colorectal cancer (CRC) patients after radical resection. METHODS This was a single-center retrospective cohort analysis. Subjects were stage I-III CRC patients hospitalized in Sichuan Cancer Hospital from January 2017 to May 2021. Patients were divided into abnormal group and normal group according to whether the CK-MB/CK ratio was abnormal after surgery. Through a comparative analysis of clinical data, laboratory test results, and prognosis differences between the two groups, we aimed to uncover the potential relationship between abnormal CK-MB > CK results and CRC patients. To gauge the impact of CK-MB/CK on overall survival (OS) and disease-free survival (DFS), we employed the multivariable COX regression and LASSO regression analysis. Additionally, Spearman correlation analysis, logistic regression, and receiver-operating characteristic (ROC) curve analysis were conducted to assess the predictive value of the CK-MB/CK ratio for postoperative liver metastasis. RESULTS Cox regression analysis revealed that the CK-MB/CK ratio was a stable risk factors for OS (HR = 3.82, p < 0.001) and DFS (HR = 2.31, p < 0.001). To distinguish hepatic metastases after surgery, the ROC area under the curve of CK-MB/CK was 0.697 (p < 0.001), and the optimal cut-off value determined by the Youden index was 0.347. CONCLUSIONS Postoperative abnormal CK-MB/CK ratio predicts worse prognosis in CRC patients after radical resection and serves as a useful biomarker for detecting postoperative liver metastasis.
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Affiliation(s)
- Lubei Rao
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China.
| | - Pingyao Xu
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Guiji Zhang
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Ruiling Zu
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Yajun Luo
- Department of Gastrointestinal Surgery, Sichuan Cancer Hospital and Institute, Chengdu, Sichuan, China
| | - Kaijiong Zhang
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Ying Yang
- Department of Information, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Dongsheng Wang
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Shuya He
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Huaichao Luo
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China
| | - Bo Ye
- Department of Clinical Laboratory, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, No. 55, Section 4, Renmin South Road, Wuhou District, Chengdu City, Sichuan Province, China.
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Sano M, Toyota T, Morimoto T, Noguchi Y, Shigeno R, Murai R, Okada T, Sasaki Y, Taniguchi T, Kim K, Kobori A, Ehara N, Kinoshita M, Doi A, Tomii K, Kihara Y, Furukawa Y. Risk stratification and prognosis prediction using cardiac biomarkers in COVID-19: a single-centre retrospective cohort study. BMJ Open 2024; 14:e082220. [PMID: 38658000 PMCID: PMC11043716 DOI: 10.1136/bmjopen-2023-082220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/22/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE There is a need for a robust tool to stratify the patient's risk with COVID-19. We assessed the prognostic values of cardiac biomarkers for COVID-19 patients. METHODS This is a single-centre retrospective cohort study. Consecutive laboratory-confirmed COVID-19 patients admitted to the Kobe City Medical Center General Hospital from July 2020 to September 2021 were included. We obtained cardiac biomarker values from electronic health records and institutional blood banks. We stratified patients with cardiac biomarkers as high-sensitive troponin I (hsTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK) and CK myocardial band (CK-MB), using the clinically relevant thresholds. Prespecified primary outcome measure was all-cause death. RESULTS A total of 917 patients were included. hsTnI, NT-proBNP, CK and CK-MB were associated with the significantly higher cumulative 30-day incidence of all-cause death (hsTnI: <5.0 ng/L group; 4.3%, 5.0 ng/L-99%ile upper reference limit (URL) group; 8.8% and ≥99% ile URL group; 25.2%, p<0.001. NT-proBNP: <125 pg/mL group; 5.3%, 125-900 pg/mL group; 10.5% and ≥900 pg/mL group; 31.9%, p<0.001. CK: CONCLUSIONS Elevation of cardiac biomarkers was associated with poor prognosis of COVID-19 patients.
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Affiliation(s)
- Madoka Sano
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshiaki Toyota
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takeshi Morimoto
- Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yu Noguchi
- Department of Cardiovascular Medicine, Tenri Hospital, Tenri, Japan
| | - Ryo Shigeno
- Department of Cardiovascular Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Ryosuke Murai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Taiji Okada
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuhiro Sasaki
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomohiko Taniguchi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kitae Kim
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Atsushi Kobori
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Natsuhiko Ehara
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Makoto Kinoshita
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asako Doi
- Department of Infectious disease, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Yuan B, Huang X, Wen J, Peng M. Dexmedetomidine Pretreatment Confers Myocardial Protection and Reduces Mechanical Ventilation Duration for Patients Undergoing Cardiac Valve Replacement under Cardiopulmonary Bypass. Ann Thorac Cardiovasc Surg 2024; 30:n/a. [PMID: 38684422 DOI: 10.5761/atcs.oa.23-00210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
PURPOSE The study aims to assess the effects of dexmedetomidine (Dex) pretreatment on patients during cardiac valve replacement under cardiopulmonary bypass. METHODS For patients in the Dex group (n = 52), 0.5 μg/kg Dex was given before anesthesia induction, followed by 0.5 μg/kg/h pumping injection before aortic occlusion. For patients in the control group (n = 52), 0.125 ml/kg normal saline was given instead of Dex. RESULTS The patients in the Dex group had longer time to first dose of rescue propofol than the control group (P = 0.003). The Dex group required less total dosage of propofol than the control group (P = 0.0001). The levels of cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), malondialdehyde (MDA), and tumor necrosis factor-α (TNF-α) were lower in the Dex group than the control group at T4, 8 h after the operation (T5), and 24 h after the operation (T6) (P <0.01). The Dex group required less time for mechanical ventilation than the control group (P = 0.003). CONCLUSION The study suggests that 0.50 µg/kg Dex pretreatment could reduce propofol use and the duration of mechanical ventilation, and confer myocardial protection without increased adverse events during cardiac valve replacement.
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Affiliation(s)
- Binglin Yuan
- Department of Anesthesiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
| | - Xiqiang Huang
- Department of Anesthesiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
| | - Junlin Wen
- Department of Anesthesiology, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
| | - Mengzhe Peng
- Pharmacy Intravenous Admixture Services, Zhongshan City People's Hospital, Zhongshan, Guangdong, China
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Liu Y, Gao X, Xiao Q, Wang W, Zhu B. Correlation Between QTc Dispersion and Soluble Growth-stimulating Gene 2 Protein on the Early Prognosis of Acute Carbon Monoxide Poisoning Heart Disease. J Cardiovasc Pharmacol 2021; 78:572-580. [PMID: 34166304 DOI: 10.1097/fjc.0000000000001090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 06/05/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT This study aimed to explore the correlation between QTc dispersion (QTcd) and soluble growth-stimulating gene 2 protein (sST2) after heart rate correction in patients with acute carbon monoxide poisoning heart disease. Among the 150 patients, 35 cases had severe toxic heart disease. The concentrations of sST2, cardiac troponin I, and creatine kinase-MB in the severe group began to increase from admission, 24 hours, and 2 days, respectively, and their detected values were all higher than those in the nonsevere group and the normal control group. There were statistically significant differences in sST2 and QTcd between the poisoning, nonsevere, and normal control groups before the treatment. There was a statistically significant difference between the indexes of the poisoning groups at different degrees 2 and 3 days after poisoning. Receiver operating characteristic curve analysis confirmed the sensitivity and specificity of sST2 and QTcd. The correlation analysis showed that sST2 and QTcd levels were positively correlated with the incidence of severe heart disease at admission. Generally, the combined observation of sST2 and QTcd improved the prediction sensitivity and were early predictor indexes of toxic heart disease.
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Affiliation(s)
- Yongjian Liu
- Department of Emergency, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hebei, China
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Gao C, Liang C, Zhang J, Ma Y, Mu X, Xie M. The correlation between myocardial resilience after high-intensity exercise and markers of myocardial injury in swimmers. Medicine (Baltimore) 2021; 100:e27046. [PMID: 34516494 PMCID: PMC8428701 DOI: 10.1097/md.0000000000027046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/01/2021] [Accepted: 08/03/2021] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT To investigate how high-intensity exercise influences an athlete's myocardial resilience and the correlation between myocardial resilience and markers of myocardial ischemic injury.Fifteen swimmers participated in high-intensity exercises. Cardiac ultrasound was performed before and after exercise on each subject. Left ventricular general strain, systolic general strain rate, and the differences (▴general strain and ▴ general strain rate, respectively), before and after exercise were analyzed. Blood was collected at the morning of the exercise day and 6 hours after exercise to measure cardiac enzyme indicators.The correlation between myocardial resilience and markers of myocardial injury were evaluated. Most cardiac enzymes concentrations increased after exercise (P < .05). Cardiac troponin I, creatine kinase MB, and cardiac troponin T were all correlated with the degree of ▴ peak strain (differential value of posterior wall basal segment before and after exercise) and ▴ peak strain rate (differential value before and after exercise) (P < .05).After high-intensity exercise, the concentrations of creatine kinase MB and cardiac troponin T in the blood are positively correlated with two-dimensional ultrasound deformation indices, proving the fact that the seindices can be used as a diagnostic basis for myocardial injury, and are more sensitive than general strain. The two-dimensional strain echocardiogram is non-invasive and easily accepted by the patient. It can make up for the shortage of myocardial enzymes in the injury areas, including weak timeliness and the inability to locate injury.
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Affiliation(s)
- Can Gao
- Medical Supervision Center, Internist of Sport Medicine Research Institute, General Administration of Sport of China, Beijing, China
| | - Chen Liang
- Medical Supervision Center, Internist of Sport Medicine Research Institute, General Administration of Sport of China, Beijing, China
| | - Jianhong Zhang
- Medical Supervision Center, Internist of Sport Medicine Research Institute, General Administration of Sport of China, Beijing, China
| | - Yun Ma
- Medical Supervision Center, Internist of Sport Medicine Research Institute, General Administration of Sport of China, Beijing, China
| | - Xiuxia Mu
- Department of Ultrasound, Guang’anmen Hospital Chian Academy of Chinese Medical Sciences, Beijing, China
| | - Minhao Xie
- Medical Supervision Center, Internist of Sport Medicine Research Institute, General Administration of Sport of China, Beijing, China
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Lai M, Ai T, Yang S, Wei Y, Deng Y, Yu X, Zhang L. The Value of High-Sensitivity C-reactive Protein in Evaluating Myocardial Damage and the Prognosis in Children with Mycoplasmal Pneumonia. Ann Clin Lab Sci 2021; 51:721-725. [PMID: 34686516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the value of high-sensitivity C-reactive protein (hs-CRP) in evaluating the myocardial damage and prognosis in children with mycoplasmal pneumonia. MATERIALS A total of 150 children with mycoplasmal pneumonia were selected. According to their serum creatine kinase isoenzyme (CK-MB) level, they were divided into 72 cases of the myocardial damage group and 78 cases of the non-myocardial damage group. Eighty healthy children undergoing physical examination were selected as the control group. The electrocardiography results and serum CK-MB and hs-CRP levels were compared among the subjects. The correlations among the above indexes were analyzed. RESULTS The levels of hs-CRP and CK-MB in the myocardial damage group were significantly higher than those in the nonmyocardial damage group and control group, respectively (P<0.05). The rates of abnormal hs-CRP and abnormal electrocardiogram in the myocardial damage group were significantly higher than those in the non-myocardial damage group, respectively (P<0.05). In the 150 children with mycoplasmal pneumonia, the serum hs-CRP and CK-MB levels were positively correlated (P<0.001), and the abnormal hs-CRP rate was positively correlated with the abnormal electrocardiogram rate (P<0.001). In the myocardial damage group, the serum levels of hs-CRP and CK-MB after treatment were significantly lower than those before treatment, respectively (P<0.05). After treatment, each index in the myocardial damage group had no significant difference with those in the control group (P>0.05). CONCLUSION hs-CRP may be an important index for evaluating the myocardial damage and prognosis in children with mycoplasmal pneumonia. The combination of hs-CRP and CK-MB detection has obvious guiding significance for the monitoring and treatment of mycoplasmal pneumonia complicated by myocardial damage.
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Affiliation(s)
- Meimei Lai
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Tao Ai
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Shuzhe Yang
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongqiong Wei
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yao Deng
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Xia Yu
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Lei Zhang
- Pediatric Respiratory Department, Chengdu Women's and Children's Central Hospital, The Affiliated Women's and Children's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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Tu Y, Zhang J, Zhang M, Li Z, Zong W, Zhou Q. Effect of the therapy of amiodarone combined with atorvastatin on cardiac function of patients with acute myocardial infarction after percutaneous coronary intervention (PCI). Pak J Pharm Sci 2021; 34:2035-2040. [PMID: 34862870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study aimed to investigate the effect of the therapy of amiodarone combined with atorvastatin on cardiac function of patients with acute myocardial infarction after percutaneous coronary intervention (PCI). A total of 90 patients with acute myocardial infarction who underwent PCI in the tertiary care hospital from January 2019 to January 2020 were selected as the subjects and randomly assigned into the control group and the study group, with 45 cases in each group. All the subjects had undergone PCI. The control group received amiodarone while those the study group received atorvastatin additionally. Comparison was done on the clinical efficacy, cardiac function, myocardial injury indicator and inflammatory factor between the two groups. The overall response rate (ORR) in the study group was significantly higher than that in the control group (P<0.05); patients in the study group had markedly better cardiac function compared with those in the control group (P<0.001); patients in the study group had considerably lower creatine kinase (CK) index, creatine kinase-MB (CK-MB) index, tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) as opposed to those in the control group (P<0.001). It was observed that the therapy of amiodarone combined with atorvastatin could effectively improve the clinical indicators and cardiac function of patients with acute myocardial infarction after PCI. It is effective and worthy of wide promotion and application.
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Affiliation(s)
- Yanming Tu
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
| | - Jingyi Zhang
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
| | - Ming Zhang
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
| | - Zhiyong Li
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
| | - Wenxia Zong
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
| | - Qiyu Zhou
- Department of Cardiology, Hubei No.3, People's Hospital of Jianghan University, Hubei, China
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Zinellu A, Sotgia S, Fois AG, Mangoni AA. Serum CK-MB, COVID-19 severity and mortality: An updated systematic review and meta-analysis with meta-regression. Adv Med Sci 2021; 66:304-314. [PMID: 34256241 PMCID: PMC8260505 DOI: 10.1016/j.advms.2021.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/25/2021] [Accepted: 07/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES We conducted a systematic review and meta-analysis with meta-regression of creatine kinase-MB (CK-MB), a biomarker of myocardial injury, in COVID-19 patients. METHODS We searched PubMed, Web of Science and Scopus, for studies published between January 2020 and January 2021 that reported CK-MB, COVID-19 severity and mortality (PROSPERO registration number: CRD42021239657). RESULTS Fifty-five studies in 11,791 COVID-19 patients were included in the meta-analysis. The pooled results showed that CK-MB concentrations were significantly higher in patients with high disease severity or non-survivor status than patients with low severity or survivor status (standardized mean difference, SMD, 0.81, 95% CI 0.61 to 1.01, p<0.001). The rate of patients with CK-MB values above the normal range was also significantly higher in the former than the latter (60/350 vs 98/1,780; RR = 2.84, 95%CI 1.89 to 4.27, p<0.001; I2 = 19.9, p = 0.254). Extreme between-study heterogeneity was observed (I2 = 93.4%, p<0.001). Sensitivity analysis, performed by sequentially removing each study and re-assessing the pooled estimates, showed that the magnitude and direction of the effect size was not modified (effect size range, 0.77 to 0.84). Begg's (p = 0.50) and Egger's (p = 0.86) t-tests did not show publication bias. In meta-regression analysis, the SMD was significantly and positively associated with the white blood count, aspartate aminotransferase, myoglobin, troponin, brain natriuretic peptide, lactate dehydrogenase, and D-dimer. CONCLUSIONS Higher CK-MB concentrations were significantly associated with severe disease and mortality in COVID-19 patients. This biomarker of myocardial injury might be useful for risk stratification in this group.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Salvatore Sotgia
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Alessandro G Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Arduino A Mangoni
- Discipline of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia.
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Shen YJ, Shen YC, Lee WS, Yang KT. Methyl palmitate protects heart against ischemia/reperfusion-induced injury through G-protein coupled receptor 40-mediated activation of the PI3K/AKT pathway. Eur J Pharmacol 2021; 905:174183. [PMID: 34015318 DOI: 10.1016/j.ejphar.2021.174183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/08/2021] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate whether methyl palmitate (MP) exerts cardioprotective effect against the ischemia/reperfusion (I/R) injury and its mechanisms underlying. The cultured adult cardiomyocytes were treated with vehicle or lactic acid ischemic buffer (pH 6.8) during hypoxia/reoxygenation. In addition, the cardioprotective effect of MP was evaluated using the ex vivo heart model of I/R injury. Here, we found that MP significantly reduced the I/R-induced cardiomyocyte death. Treatment with GW1100 (a GPR40-antagonist) or wortmannin (a phosphatidylinositol 3-kinase, PI3K, specific inhibitor) significantly attenuated the level of phospho-AKT (p-AKT) and abolished the MP-induced cardioprotection against the I/R-induced injury. Using the ex vivo I/R model, we also demonstrated that pretreatment with MP significantly reduced the size of myocardial infarction and the levels of cleaved-caspase 3 and MDA, and increased the protein levels of GPR40 and p-AKT induced by I/R. The cardioprotective effect of MP was evaluated also using the in vivo heart model of I/R injury. We demonstrated that post-ischemic treatment with MP significantly attenuated the size of myocardial infarction and the serum level of CK-MB induced by in vivo I/R model. Taken together, our data suggest that MP could provide significant cardioprotection against the I/R injury, and the underlying mechanisms by which MP prevented the cardiomyocyte death might be mediated through the GPR40-activated PI3K/AKT signaling pathways. These findings suggest the potential applications of MP in the treatment of I/R-induced heart injury.
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Affiliation(s)
- Yan-Jhih Shen
- Ph.D. Program in Pharmacology and Toxicology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Yan-Cheng Shen
- Ph.D. Program in Pharmacology and Toxicology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Wen-Sen Lee
- Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kun-Ta Yang
- Department of Physiology, School of Medicine, Tzu Chi University, Hualien, Taiwan.
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Wu S, Zhou Y, Xuan Z, Xiong L, Ge X, Ye J, Liu Y, Yuan L, Xu Y, Ding G, Xiao A, Guo J, Yu L. Repeated use of SSRIs potentially associated with an increase on serum CK and CK-MB in patients with major depressive disorder: a retrospective study. Sci Rep 2021; 11:13365. [PMID: 34183728 PMCID: PMC8239012 DOI: 10.1038/s41598-021-92807-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/16/2021] [Indexed: 12/27/2022] Open
Abstract
There is a large amount of evidence that selective serotonin reuptake inhibitors (SSRIs) are related to cardiovascular toxicity, which has aroused concern regarding their safety. However, few studies have evaluated the effects of SSRIs on cardiac injury biomarkers, such as creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). The purpose of our study was to determine whether SSRIs elevated CK and CK-MB levels of prior medicated depressive patients (PMDP) compared to first-episode drug-naïve depressive patients (FDDPs). We performed an observational and retrospective study involving 128 patients with major depressive disorder. Patients who had never used any type of antidepressant were designated FDDP; patients who had used only one type of SSRI but were not treated after a recent relapse were designated PMDP. Serum CK and CK-MB levels were measured before and after using SSRIs for a period of time. The duration of current treatment in the FDDP and PMDP groups was 16.200 ± 16.726 weeks and 15.618 ± 16.902 weeks, respectively. After SSRI treatment, levels of serum CK in the PMDP group were significantly higher than in the FDDP group. Univariate ANCOVA results revealed that PMDP was 22.313 times more likely to elevate CK (OR 22.313, 95% CI 9.605-35.022) and 2.615 times more likely to elevate CK-MB (OR 2.615, 95% CI 1.287-3.943) than FDDP. Multivariate ANCOVA revealed an interaction between the group and sex of CK and CK-MB. Further pairwise analysis of the interaction results showed that in female patients, the mean difference (MD) of CK and CK-MB in PMDP was significantly greater than that in FDDP (MD = 33.410, P = 0.000, 95% CI 15.935-50.886; MD = 4.613, P = 0.000, 95% CI 2.846-6.381). Our findings suggest that patients, especially females, who had previously used SSRI antidepressants were more likely to have elevated CK and CK-MB, indicators of myocardial muscle injury. Use of SSRIs should not be assumed to be completely safe and without any cardiovascular risks.
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Affiliation(s)
- Shengwei Wu
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Yufang Zhou
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China
| | - Zhengzheng Xuan
- Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou, 510120, China
| | - Linghui Xiong
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Xinyu Ge
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Junrong Ye
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Yun Liu
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Lexin Yuan
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Yan Xu
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Guoan Ding
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China
| | - Aixiang Xiao
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China.
| | - Jianxiong Guo
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China.
| | - Lin Yu
- Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No. 36, Mingxin Road, Liwan District, Guangzhou, 510370, Guangdong, China.
- Guangzhou University of Chinese Medicine, Guangzhou, 510006, China.
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11
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König KC, Lahm H, Dreßen M, Doppler SA, Eichhorn S, Beck N, Kraehschuetz K, Doll S, Holdenrieder S, Kastrati A, Lange R, Krane M. Aggrecan: a new biomarker for acute type A aortic dissection. Sci Rep 2021; 11:10371. [PMID: 33990642 PMCID: PMC8121825 DOI: 10.1038/s41598-021-89653-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 04/19/2021] [Indexed: 12/27/2022] Open
Abstract
Acute type A aortic dissection (ATAAD) constitutes a life-threatening aortic pathology with significant morbidity and mortality. Without surgical intervention the usual mortality rate averages between 1 and 2% per hour. Thus, an early diagnosis of ATAAD is of pivotal importance to direct the affected patients to the appropriate treatment. Preceding tests to find an appropriate biomarker showed among others an increased aggrecan (ACAN) mRNA expression in aortic tissue of ATAAD patients. As a consequence, we investigated whether ACAN is a potential biomarker for diagnosing ATAAD. Mean ACAN protein concentration showed a significantly higher plasma concentration in ATAAD patients (38.59 ng/mL, n = 33) compared to plasma of patients with thoracic aortic aneurysms (4.45 ng/mL, n = 13), patients with myocardial infarction (11.77 ng/mL, n = 18) and healthy volunteers (8.05 ng/mL, n = 12). Cardiac enzymes like creatine kinase MB and cardiac troponin T showed no correlation with ACAN levels in ATAAD patients. Receiver-operator characteristics (ROC) curve analysis for ATAAD patients versus control subjects an optimum discrimination limit of ACAN plasma levels at 14.3 ng/mL with a corresponding sensitivity of 97% and specificity of 81%. According to our findings ACAN is a reliable potential biomarker in plasma samples to detect ATAAD with high sensitivity and specificity.
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Affiliation(s)
- Karl C König
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany.
| | - Harald Lahm
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany.
| | - Martina Dreßen
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
| | - Stefanie A Doppler
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
| | - Stefan Eichhorn
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
| | - Nicole Beck
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
| | - Kathrin Kraehschuetz
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
| | - Sophia Doll
- Department of Proteomics and Signal Transduction, Max Planck Institute of Biochemistry, Martinsried, Germany
| | - Stefan Holdenrieder
- Institute of Laboratory Medicine, German Heart Center Munich, Munich, Germany
| | - Adnan Kastrati
- Department of Cardiology, German Heart Center Munich, Munich, Germany
| | - Rüdiger Lange
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
- DZHK (German Center for Cardiovascular Research) - Partner Site Munich Heart Alliance, Munich, Germany
| | - Markus Krane
- Division of Experimental Surgery, Department of Cardiovascular Surgery, Institute Insure, German Heart Center Munich, Lazarettstrasse 36, 80636, Munich, Germany
- DZHK (German Center for Cardiovascular Research) - Partner Site Munich Heart Alliance, Munich, Germany
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12
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Onodera M, Tsukada Y, Suzuki T, Sorimachi K, Ebihara K, Sato L, Zenda R, Ueno S, Sugaya K, Iseki K. Development of delayed neurologic sequelae in acute carbon monoxide poisoning cases caused by briquette-based kotatsu: A case-control study. Medicine (Baltimore) 2021; 100:e25009. [PMID: 33879655 PMCID: PMC8078257 DOI: 10.1097/md.0000000000025009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 02/11/2021] [Indexed: 01/04/2023] Open
Abstract
Briquette-based kotatsu, a traditional Japanese heating system, is still used in rural areas and has been linked to the development of acute carbon monoxide (CO) poisoning. This study aimed to investigate the occurrence of delayed neurologic sequelae (DNS) in patients with acute CO poisoning caused by briquette-based kotatsu.This retrospective study included 17 patients treated for acute CO poisoning due to briquette-based kotatsu, between April 2017 and March 2020. Patients were divided into either a sequelae group (3 patients) or a non-sequelae group (14 patients) based on the presence or absence, respectively, of DNS. Demographic data, kotatsu characteristics, clinical findings, and therapies were compared between the 2 groups.Significant differences were noted in patient posture during their initial discovery. Specifically, all non-sequelae patients only had their legs under the kotatsu quilt and all sequelae patients had their entire bodies under the kotatsu quilt (P = .001). There were no statistically significant differences in carbon monoxide levels in hemoglobin (CO-Hb) or the creatine-kinase myocardial band (CK-MB), between the 2 groups; however, troponin-I levels were significantly higher in the sequelae group (P = .026). Abnormal head imaging findings were noted in 2 sequelae-group patients, with a significant difference between the groups (P = .025).We speculate that acute CO poisoning, caused by briquette-based kotatsu, may lead to DNS more frequently in patients in who cover their entire body with the kotatsu quilt and are found in this position. Patients should be warned about the dangers of acute CO poisoning when using briquette-based kotatsu.
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Affiliation(s)
| | - Yasuhiko Tsukada
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Tsuyoshi Suzuki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Kotaro Sorimachi
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Kenichi Ebihara
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Lubna Sato
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
| | - Rie Zenda
- Department of Regional Emergency Medicine
| | | | | | - Ken Iseki
- Department of Emergency and Critical Care Medicine, Fukushima Medical University, Fukushima City, Fukushima, Japan
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Abstract
BACKGROUND Malignant hyperthermia is a rare but life-threatening pharmacogenetic muscle disorder characterized by abnormal hypermetabolic reactions and commonly triggered in susceptible individuals by volatile anesthetics or succinylcholine, or both. Unfortunately, the specific medicine dantrolene is not readily available in many countries including China. The aim of this study was to find the characteristics of malignant hyperthermia under the situation that dantrolene is not readily available. METHODS The cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. The inclusion criteria were the MH episodes only related to anesthesia. The exclusion criteria were dubious MH episodes only caused by Ketamine administration or MH episodes irrelevant to anesthesia. Independent samples t-test and Pearson's chi-squared test were applied to assess the difference between the survived and death cases. RESULTS Ninety-two cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. Median (IQR [range]) age was 18.5 (11.8-37.0 [0-70.0]) years. Compared with the survived cases, the death cases had higher maximum end-tidal partial pressure of CO2 (P = 0.033), the maximum arterial partial pressure of CO2 (P = 0.006), temperature first measured when the patient was first discovered abnormal (P = 0.012), and maximum temperature (P < 0.001). Besides, the death cases had less minimum pH (P < 0.001) and higher potassium (P < 0.001) and were more likely to have coagulation disorders (p = 0.018). Concerning treatment, cases used furosemide (P = 0.024), mannitol (P = 0.029), blood purification treatment (P = 0.017) had the advantage on the outcome. Creatine phosphokinase, myoglobin, and MB isoenzyme of creatine phosphokinase differed greatly among cases during the first week. 43 (46.7%) cases had congenital diseases. 12 (13.0%) cases were reported with abnormal laboratory test results or abnormal signs that are possibly relevant before anesthesia. CONCLUSIONS In countries that dantrolene is not readily available, early warning, diagnosis, and prompt effective therapies are crucial for MH patients to survive.
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Affiliation(s)
- Xiaodan Gong
- Department of Cardiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité University Medicine, Campus Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
- Department of Anesthesiology, The Second Clinical Medical College, Yangtze University, Jingzhou, 434020, China.
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14
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Gür F, Cengiz M, Kutlu HM, Cengiz BP, Ayhancı A. Molecular docking analyses of Escin as regards cyclophosphamide-induced cardiotoxicity: In vivo and in Silico studies. Toxicol Appl Pharmacol 2021; 411:115386. [PMID: 33383042 DOI: 10.1016/j.taap.2020.115386] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/21/2020] [Accepted: 12/24/2020] [Indexed: 01/08/2023]
Abstract
This study aims to investigate whether Escin (ES) can protect against Cyclophosphamide (CPM)-induced cardiac damage. The experimental rats were categorized as Control, CPM (200 mg/kg), ES (10 mg/kg), and CPM + ES Groups, each having 6 members. Their heart tissues were stained with Hematoxylin and Eosin and the structural changes were investigated under the light microscope. The biochemical markers of ischemia modified albumin (IMA), creatine kinase (CK-MB), antioxidant activity indicators Catalase (CAT), and superoxide dismutase (SOD) activities were measured using blood samples. Besides, the effects of CPM, ES, and CPM + ES upon CAT and SOD activities were shown via molecular docking studies. In the Single-Dose CPM group, CK-MB and IMA levels significantly increased while SOD and CAT levels significantly decreased. However, the heart tissues were damaged. CK-MB and IMA levels significantly decreased in CP+ ES Group. On the other hand, SOD, and CAT levels significantly increased and reduced the damage remarkably. Our findings showed that ES treatment successfully reduced the toxic effects upon the rats. The conclusion is that ES treatment can help protect the heart tissue against CPM-induced toxicity. Both in-vivo results and molecular modeling studies showed that the negative effects of CPM upon SOD activity were bigger than that of CAT.
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Affiliation(s)
- Fatma Gür
- Department of Medical Services and Techniques, Health Services Vocational School, Ataturk University, Erzurum 25240, Turkey
| | - Mustafa Cengiz
- Department of Elementary Education, Faculty of Education, Siirt University, Siirt, Turkey.
| | - Hatice Mehtap Kutlu
- Department of Biology, Faculty of Education, Eskisehir Technical University, Eskisehir, Turkey
| | - Betül Peker Cengiz
- Department of Pathology, Yunus Emre State Hospital, Eskisehir, Eskişehir, Turkey
| | - Adnan Ayhancı
- Department of Biology, Faculty of Arts and Science, Eskişehir Osmangazi University, Eskisehir, Turkey
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15
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Youssef ME, Abdelrazek HM, Moustafa YM. Cardioprotective role of GTS-21 by attenuating the TLR4/NF-κB pathway in streptozotocin-induced diabetic cardiomyopathy in rats. Naunyn Schmiedebergs Arch Pharmacol 2021; 394:11-31. [PMID: 32776158 DOI: 10.1007/s00210-020-01957-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/30/2020] [Indexed: 12/13/2022]
Abstract
The cholinergic anti-inflammatory pathway (CAP) was investigated in a variety of inflammatory conditions and constitutes a valuable line in their treatment. In the current study, we investigated the anti-inflammatory effect of GTS-21 (GTS) as a partial selective α7 nicotinic acetylcholine receptor (α7-nAchR) agonist in diabetic cardiomyopathy model in rats. This mechanism was elaborated to study whether it could alleviate the electrocardiographic, histopathological, and molecular levels of Toll-like receptor 4 (TLR4)/nuclear factor κB (NF-κB) pathway proteins. Diabetes was induced by the injection of streptozotocin (STZ) (50 mg/kg). Diabetic rats were treated with GTS (1 or 2 mg/kg/day), methyllycaconitine (MLA), a selective α7-nAchR antagonist (2 mg/kg/day) plus GTS (2 mg/kg/day), or the vehicle. All treatments were given by the intraperitoneal route. Ventricular rate and different electrocardiograph (ECG) anomalies were detected. Plasma levels of cardiac troponin T (cTnT) and creatine kinase MB (CK-MB) were measured by ELISA. Additionally, we elucidated the levels of several proteins involved in the TLR4/NF-κB pathway. Cardiac levels of TLR4 and phosphorylated protein kinase B (p-Akt) were detected by ELISA. The cardiac expression of myeloid differentiation primary response 88 (Myd88), tumor necrosis factor receptor-associated factor 6 (TRAF6), NF-κB, interleukin 1β (IL-1β), and active caspase-1 were evaluated by immunohistochemical staining. Finally, the cardiac levels of interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were determined by ELISA. Diabetic rats showed (i) ECG signs of cardiomyopathy such as significant ST segment elevations, prolonged QRS, QT intervals, and ventricular tachycardia; (ii) increased plasma levels of cTnT and CK-MB; (iii) increased expression of cardiac TLR4; (iv) elevated immunohistochemical expression of cardiac, Myd88, TRAF6, and NF-κB; (v) diminution in the cardiac expression of p-Akt; and (vi) adaptive increases in cardiac expression of TNF-α and IL-6. These effects were ameliorated in diabetic rats treated with both doses of GTS. Pretreatment with MLA did not completely reverse the ameliorative effect of GTS on cTnT, TRAF6, TNF-α, and IL-6, thereby reinforcing the presence of possible α7-nAchR-independent mechanisms. The activation of α7-nAchR with GTS offers a promising prophylactic strategy for diabetic cardiomyopathy by attenuating the TLR4/NF-κB pathway.
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Affiliation(s)
- Mahmoud E Youssef
- Department of pharmacology and biochemistry, Faculty of pharmacy, Delta University for Science and Technology, Mansoura, Egypt.
| | - Heba M Abdelrazek
- Department of Physiology, Faculty of veterinary medicine, Suez Canal University, Ismailia, Egypt
| | - Yasser M Moustafa
- Department of Pharmacology and Toxicology, Dean of the Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
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16
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Lin Z, Bao Y, Hong B, Wang Y, Zhang X, Wu Y. Salvianolic acid B attenuated cisplatin-induced cardiac injury and oxidative stress via modulating Nrf2 signal pathway. J Toxicol Sci 2021; 46:199-207. [PMID: 33952797 DOI: 10.2131/jts.46.199] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Cardiovascular complications have been well documented as the downside to conventional cancer chemotherapy. As a notable side effect of cisplatin (CDDP), cardiotoxicity represents a major obstacle to the successful treatment of cancer. It has been reported that Salvianolic acid B (SalB) possesses cardioprotective quality. However, the effect of SalB on cardiac damage caused by conventional cancer chemotherapy remains unclear. In this study, we clarified the protective effect of SalB on cisplatin-induced heart injury. Furthermore, in H9c2 cells, SalB dramatically reduced cisplatin-induced apoptosis and oxidative stress by modulating the nuclear factor erythroid-2-related factor 2 (Nrf2) signaling pathway. In conclusion, SalB had great potential in mitigating cisplatin-induced cardiac injury. Furthermore, more attention should be placed on natural active compounds containing SalB with antioxidant effects for the treatment of cardiomyopathy.
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Affiliation(s)
- Zhenjian Lin
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
| | - Yuyan Bao
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
| | - Bing Hong
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
| | - Yangyang Wang
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
| | - Xiaomin Zhang
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
| | - Yaping Wu
- Department of Pharmacy, Sanmen People's Hospital of Zhejiang, China
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17
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Jiang W, Xiong X, Du X, Ma H, Li W, Cheng F. Safety and efficacy study of prourokinase injection during primary percutaneous coronary intervention in acute ST-segment elevation myocardial infarction. Coron Artery Dis 2021; 32:25-30. [PMID: 32310850 PMCID: PMC7713758 DOI: 10.1097/mca.0000000000000898] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 03/22/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety of intracoronary administration of prourokinase via balloon catheter during primary percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction. METHODS Acute ST-segment elevation myocardial infarction patients underwent primary percutaneous coronary interventions were randomly divided into two groups: intracoronary prourokinase group (n = 125) and control group (n = 135). During primary percutaneous coronary interventions, prourokinase or saline was injected to the distal end of the culprit lesion via balloon catheter after balloon catheter dilatation. Demographic and clinical characteristics, infarct size, myocardial reperfusion, and cardiac functions were evaluated and compared between two groups. Hemorrhagic complications and major averse cardiovascular events (MACE) occurred in the 6-months follow-up were recorded. RESULTS No significant differences were observed between two groups with respect to baseline demographic, clinical, and thrombolysis in myocardial infarction grade (P > 0.05). In the intracoronary prourokinase group, more patients had ST-segment resolution (>50%) compared with control group (P < 0.05). Patients in the intracoronary prourokinase group showed lower levels of serum CK, creatine kinase-MB fraction, and troponin I than those in control group (P < 0.05). No significant differences in bleeding complications were observed between the two groups (P > 0.05). At 6-months follow-up, there was no statistically different of MACE between the two groups (P > 0.05). CONCLUSIONS Intracoronary administration of prourokinase via balloon catheter during primary percutaneous coronary interventions effectively improved myocardial perfusion and no increased bleeding in ST-segment elevation myocardial infarction patients.
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Affiliation(s)
- Wenlong Jiang
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
| | - Xiaoshuan Xiong
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
| | - Xiaohui Du
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
| | - Hua Ma
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
| | - Wen Li
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
| | - Fangzhou Cheng
- Department of Cardiovascular, Shenzhen Yantian People’s Hospital, Shenzhen, China
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18
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Baroni S, Gabrielli M, Ferrigno F, Franceschi F, Urbani A. Lack of utility of CK-MB in combination with troponin I for the diagnosis of acute coronary syndrome. Intern Emerg Med 2020; 15:1345-1346. [PMID: 32564290 DOI: 10.1007/s11739-020-02399-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 06/03/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Silvia Baroni
- Department of Basic Biotechnological Sciences, Intensivological and Perioperative Clinics, UOC of Clinical Chemistry, Biochemistry and Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Maurizio Gabrielli
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Federica Ferrigno
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Franceschi
- Department of Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Urbani
- Department of Basic Biotechnological Sciences, Intensivological and Perioperative Clinics, UOC of Clinical Chemistry, Biochemistry and Molecular Biology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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19
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Zhang J, Tang H, Wang Y, Cai H, Zou R, Wang S, Wang C. Clinical values of creatine kinase and its isoenzymes in children and adolescents with vasovagal syncope. Nutr Metab Cardiovasc Dis 2020; 30:1848-1854. [PMID: 32807636 DOI: 10.1016/j.numecd.2020.06.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/09/2020] [Accepted: 06/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND AND AIM Vasovagal syncope (VVS) in children and adolescents is a common disorder. There may be an internal relationship between creatine kinase (CK) and its isoenzymes (CKMB) and syncope. The aim of this study was to evaluate the changes of CK and CKMB in children and adolescents with VVS. METHODS AND RESULTS The VVS group included 218 patients (93 male and 125 female). The control group included 129 healthy children (78 male and 51 female). Serum CK and CKMB levels were estimated. We founded ①Serum CK and CK-MB levels decreased in VVS group than that in control group (P < 0.05). ②The CK levels of female were significantly lower than those of male in VVS group (P < 0.05). ③Serum level of CK-MB were in negative correlation with age, height, weight, BMI whereas in positively correlation with HR. ④CK was effected by CK-MB (β = 0.147, P = 0.037) while CK-MB was independently influenced by age (β = -0.203, P = 0.002) and DBP (β = 0.171, P = 0.011). ⑤Both CK and CK-MB significantly influenced on VVS occurrence after adjusting for the effects of gender, age, height, weight, BMI and HR. CONCLUSION The serum CK and CKMB levels decrease in children and adolescents with VVS. CK and CK-MB are the independent protective factors with VVS.
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Affiliation(s)
- Juan Zhang
- Department of Pediatric Cardiovascular, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Haoneng Tang
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Yuwen Wang
- Department of Pediatric Cardiovascular, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Hong Cai
- Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Runmei Zou
- Department of Pediatric Cardiovascular, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, China
| | - Shuo Wang
- Jishou University School of Medicine, Jishou, 416000, China.
| | - Cheng Wang
- Department of Pediatric Cardiovascular, Children's Medical Center, The Second Xiangya Hospital, Central South University, Changsha, 410011, China.
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Borges L, Gorjão R, Gray SR, Martins TR, Santos VC, Momesso CM, Pithon-Curi TC, Hatanaka E. Lymphocyte activation after a high-intensity street dance class. PLoS One 2020; 15:e0239516. [PMID: 32956398 PMCID: PMC7505442 DOI: 10.1371/journal.pone.0239516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/09/2020] [Indexed: 01/15/2023] Open
Abstract
Intense dance training leads to inflammation, which may impair the health and performance of the practitioners. Herein, we evaluate the effect of a single street dancing class on the profile of muscle enzymes, lymphocyte activation, and cell surface CD62L expression. We also investigated the correlation between muscle enzymes, adhesion molecules, and lymphocyte activation in dancers. Fifteen male participants (mean ± standard error: age 22.4 ± 1.08 years, body mass index 24.8 ± 0.69 kg/m2, body fat 12.3 ± 1.52%), who were amateur dancers, had blood samples collected previously and subsequent to a high-intensity street dance class. After the class, dancers showed an increase in total lymphocyte count (2.0-fold), creatine kinase (CK)-NAC (4.87%), and CK-MB (3.36%). We also observed a decrease (2.5-fold) in reactive oxygen species (ROS) produced by lymphocytes, under phorbol myristate acetate-stimulated environments. Following the dance class, CD62L expression in lymphocytes decreased (51.42%), while there was a negative correlation between the intensity of the exercise and CD62L expression (r = -0.73; p = 0.01). Lymphocytes were less responsive to stimuli after a single bout of street dancing, indicating transient immunosuppression.
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Affiliation(s)
- Leandro Borges
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Renata Gorjão
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Stuart R. Gray
- Institute of Cardiovascular & Medical Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Thaís Reis Martins
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Vinicius Coneglian Santos
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Cesar Miguel Momesso
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Tania Cristina Pithon-Curi
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
| | - Elaine Hatanaka
- Institute of Physical Activity and Sport Sciences (ICAFE), Cruzeiro do Sul University, São Paulo, SP, Brazil
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21
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Prasad R, Kumar A, Jain D, Das BK, Singh UK, Singh TB. Echocardiography versus cardiac biomarkers for myocardial dysfunction in children with scorpion envenomation: An observational study from tertiary care center in northern India. Indian Heart J 2020; 72:431-434. [PMID: 33189207 PMCID: PMC7670248 DOI: 10.1016/j.ihj.2020.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/18/2020] [Accepted: 07/24/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE This study was done to evaluate myocardial function by 2D Echocardiography and Cardiac biomarkers (cTnI, CK-MB, BNP) changes in patients of scorpion envenomation of grade II-IV and correlate mortality of envenomed children with myocardial dysfunction. METHODS A total of 40 patients admitted consecutively with grade II and more scorpion envenomation from October 2015 to July2018 were enrolled in the study. The data included demographics, the time of presentation, clinical features, echocardiographic findings, electrocardiographic findings, cardiac biomarker levels at admission and discharge, use of inotropic medication, oral prazosin, time of discharge, and their outcome. RESULTS The most common ECG abnormality was sinus tachycardia 28 (70%) followed by low voltage complex 13 (32.5%) which got normalized at the time of discharge in majority. Cardiac troponin I (cTnI) levels were more than 0.1 ng/mL, suggesting myocarditis was present in 25 (62.5%) and got normalized at discharge. CK-MB levels were increased in 26 (65%) patients suggesting myocardial involvement. BNP levels were also increased in 24 (60%) patients suggesting heart failure and its value got normalized at discharge. Abnormal 2D Echo findings as reduced left ventricular ejection fraction (LVEF) was present in 18 (45%) cases suggesting myocardial dysfunction and became normal at discharge. The sensitivity, specificity, positive predictive value and negative predictive value of Cardiac troponin I (cTnI) considering ECHO cardiograph as gold standard were 100, 68.1, 72 and 100% respectively. One patient had died whose Ejection fraction was less than 30%. CONCLUSION Echocardiography and cTnI can identify subgroup of patients, who require early aggressive therapy. Echocardiography, if not available, cardiac troponin I level can guide early therapy and indicates the prognosis.
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Affiliation(s)
- Rajniti Prasad
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Anil Kumar
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Dharmendra Jain
- Department of Cardiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.
| | - B K Das
- Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
| | - Utpal Kant Singh
- Department of Pediatrics, Nalanda Medical College, Patna, 800013, India
| | - T B Singh
- Division of Biostatistics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India
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22
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Cui X, Zhang T, Zheng J, Zhang J, Si P, Xu Y, Guo W, Liu Z, Li W, Ma J, Dong C, Shen Y, Cai C, He S. Children with coronavirus disease 2019: A review of demographic, clinical, laboratory, and imaging features in pediatric patients. J Med Virol 2020; 92:1501-1510. [PMID: 32418216 PMCID: PMC7276885 DOI: 10.1002/jmv.26023] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/11/2020] [Accepted: 05/12/2020] [Indexed: 12/15/2022]
Abstract
There is a current outbreak of coronavirus disease 2019 (COVID-19), with a global spread. With the rapid increase in the number of infections, an increase is observed in the number of children with COVID-19. Most research findings are regarding adult cases, which are not always transferrable to children. Evidence-based studies are still expected to formulate clinical decisions for pediatric patients. In this review, we included 2597 pediatric patients that reported recently and evaluated the demographic, clinical, laboratory, and imaging features of children with COVID-19. We found that even lymphopenia was the most common lab finding in adults; it infrequently occurred in children (9.8%). Moreover, elevated creatine kinase MB isoenzyme was much more commonly observed in children (27.0%) than that in adults, suggesting that heart injury would be more likely to occur in pediatric patients. Our analysis may contribute to determine the spectrum of disease in children and to develop strategies to control the disease transmission.
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Affiliation(s)
- Xiaojian Cui
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Tongqiang Zhang
- Department of RespiratoryChildren's Hospital of Tianjin UniversityTianjinChina
- Graduate School of Tianjin Medical UniversityTianjinChina
| | - Jiafeng Zheng
- Department of RespiratoryChildren's Hospital of Tianjin UniversityTianjinChina
| | - Jiayi Zhang
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Ping Si
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Yongsheng Xu
- Department of RespiratoryChildren's Hospital of Tianjin UniversityTianjinChina
| | - Wei Guo
- Department of RespiratoryChildren's Hospital of Tianjin UniversityTianjinChina
| | - Zihui Liu
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Wenliang Li
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Jia Ma
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Cuicui Dong
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Yongming Shen
- Department of Clinical LabChildren's Hospital of Tianjin UniversityTianjinChina
| | - Chunquan Cai
- Department of NeurosurgeryChildren's Hospital of Tianjin UniversityTianjinChina
| | - Sijia He
- School of Systems BiologyNational Center for Biodefense and Infectious Diseases, George Mason UniversityManassasVirginia
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23
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Shafi AMA, Shaikh SA, Shirke MM, Iddawela S, Harky A. Cardiac manifestations in COVID-19 patients-A systematic review. J Card Surg 2020; 35:1988-2008. [PMID: 32652713 PMCID: PMC7404674 DOI: 10.1111/jocs.14808] [Citation(s) in RCA: 95] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The coronavirus disease-2019 (COVID-19) pandemic has resulted in the worst global pandemic of our generation, affecting 215 countries with nearly 5.5 million cases. The association between COVID-19 and the cardiovascular system has been well described. We sought to systematically review the current published literature on the different cardiac manifestations and the use of cardiac-specific biomarkers in terms of their prognostic value in determining clinical outcomes and correlation to disease severity. METHODS A systematic literature review across PubMed, Cochrane database, Embase, Google Scholar, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed risk factors for cardiovascular manifestations, cardiac manifestations in COVID-19 patients, and cardiac-specific biomarkers with their clinical implications on COVID-19. RESULTS Sixty-one relevant articles were identified which described risk factors for cardiovascular manifestations, cardiac manifestations (including heart failure, cardiogenic shock, arrhythmia, and myocarditis among others) and cardiac-specific biomarkers (including CK-MB, CK, myoglobin, troponin, and NT-proBNP). Cardiovascular risk factors can play a crucial role in identifying patients vulnerable to developing cardiovascular manifestations of COVID-19 and thus help to save lives. A wide array of cardiac manifestations is associated with the interaction between COVID-19 and the cardiovascular system. Cardiac-specific biomarkers provide a useful prognostic tool in helping identify patients with the severe disease early and allowing for escalation of treatment in a timely fashion. CONCLUSION COVID-19 is an evolving pandemic with predominate respiratory manifestations, however, due to the interaction with the cardiovascular system; cardiac manifestations/complications feature heavily in this disease, with cardiac biomarkers providing important prognostic information.
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Affiliation(s)
- Ahmed M. A. Shafi
- Department of Cardiothoracic Surgery, Barts Heart CentreSt Bartholomew's HospitalLondonUK
| | | | | | - Sashini Iddawela
- Department of Respiratory MedicineUniversity Hospitals BirminghamBirminghamUK
| | - Amer Harky
- Department of Cardiothoracic SurgeryLiverpool Heart and Chest HospitalLiverpoolUK
- Faculty of Health and Life SciencesUniversity of LiverpoolLiverpoolUK
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24
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Henry BM, Benoit SW, de Oliveira MHS, Hsieh WC, Benoit J, Ballout RA, Plebani M, Lippi G. Laboratory abnormalities in children with mild and severe coronavirus disease 2019 (COVID-19): A pooled analysis and review. Clin Biochem 2020; 81:1-8. [PMID: 32473151 PMCID: PMC7251358 DOI: 10.1016/j.clinbiochem.2020.05.012] [Citation(s) in RCA: 88] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 05/16/2020] [Accepted: 05/22/2020] [Indexed: 12/21/2022]
Abstract
Limited data exists to-date on the laboratory findings in children with COVID-19, warranting the conduction of this study, in which we pool the currently available literature data on the laboratory findings seen in children with mild and severe COVID-19. Following an extensive literature search, we identified 24 eligible studies, including a total of 624 pediatric cases with laboratory-confirmed COVID-19, which report data on 27 different biomarkers. We then performed a meta-analysis to calculate the pooled prevalence estimates (PPE) for these laboratory abnormalities in mild COVID-19. As data was too limited for children with severe COVID-19 to allow pooling, results were presented descriptively in a summary of findings table. Our data show an inconsistent pattern of change in the leukocyte index of mild and severe cases of COVID-19 in children. Specifically, changes in leukocyte counts were only observed in 32% of the mild pediatric cases (PPE: 13% increase, 19% decrease). In mild disease, creatine kinase-MB (CK-MB) was frequently elevated, with a PPE of 33%. In severe disease, c-reactive protein (CRP), procalcitonin (PCT), and lactate dehydrogenase (LDH) were frequently elevated. Based on data obtained from early COVID-19 studies, leukocyte indices in children appear inconsistent, differing from those reported in adults that highlight specific leukocyte trends. This brings into question the utility and reliability of such parameters in monitoring disease severity in the pediatric population. Instead, we suggest physicians to serially monitor CRP, PCT, and LDH to track the course of illness in hospitalized children. Finally, elevated CK-MB in mild pediatric COVID-19 cases is indicative of possible cardiac injury. This highlights the importance of monitoring cardiac biomarkers in hospitalized patients and the need for further investigation of markers such as cardiac troponin in future studies.
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Affiliation(s)
- Brandon Michael Henry
- Cardiac Intensive Care Unit, The Heart Institute, Cincinnati Children's Hospital Medical Center, OH, USA.
| | - Stefanie W Benoit
- Division of Nephrology and Hypertension, Cincinnati Children's Hospital Medical Center, OH, USA; Department of Pediatrics, University of Cincinnati, College of Medicine, OH, USA
| | | | - Wan Chin Hsieh
- Pediatric COVID-19 Open Data Analysis Group, Cincinnati, OH, USA
| | - Justin Benoit
- Department of Emergency Medicine, University of Cincinnati, College of Medicine, OH, USA
| | - Rami A Ballout
- Lipoprotein Metabolism Section, Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute (NHLBI), National Institutes of Health, Bethesda, MD, USA
| | - Mario Plebani
- Department of Laboratory Medicine, University Hospital of Padova, Padova, Italy
| | - Giuseppe Lippi
- Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy
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25
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Chen C, Zhu XY, Zhou K, Li D, Lin Q. Cardioprotective effect of acupuncture for percutaneous coronary intervention-related myocardial injury in patients with coronary artery disease: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e20135. [PMID: 32443326 PMCID: PMC7254684 DOI: 10.1097/md.0000000000020135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Although patients with coronary artery disease (CAD) rely increasingly upon percutaneous coronary intervention (PCI), this therapy causes subsequent the complications of myocardial injury. Acupuncture safely protects the heart from ischemic injury; however, the efficacy of acupuncture for periprocedural myocardial injury after PCI remains unclear. METHODS Seven databases in English and Chinese including PubMed, Web of Science, Cochrane Library, Embase, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, and Wanfang Database will be searched. Randomized controlled trials (RCTs) that use acupuncture to treat PCI-related myocardial injury in patients with CAD, regardless of blinding. The crossover randomized trials will be included, but only the pre-crossover data will be analyzed to avoid carryover effects. We will exclude non-RCTs, qualitative studies, uncontrolled clinical trials, and laboratory studies. The measurement of concentration of cardiac troponin (T or I) and MB isoenzyme of creatine kinase will be used as primary outcome. Postprocedural cardiac function and the major adverse cardiac/cerebrovascular event rate will be assessed as secondary outcome. Relevant data were collected independently by 2 reviewers and the third reviewer was responsible for resolving discrepancies through discussion. The Review Manager V.5.3.3 s will be used to perform the data synthesis and subgroup analysis. DISCUSSION This systematic review and meta-analysis would provide convincing evidence of various types of acupuncture that specifically focuses on cardioprotective effect of acupuncture on PCI-related myocardial injury. REGISTRATION Open Science Framework (OSF) registries (osf.io/n2e6t) with the registration DOI: 10.17605/OSF.IO/79H2E.
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Affiliation(s)
- Cong Chen
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing
| | - Xue-ying Zhu
- Shandong University of Traditional Chinese Medicine, Shandong, Jinan
| | - Kun Zhou
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Dong Li
- Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Lin
- Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing
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Lin YC, Chen SC, Huang CM, Hu YF, Chen YY, Chang SL, Lo LW, Lin YJ, Chen SA. Clinical features and diagnosis of new malignancy in patients with acute pulmonary embolism and without a history of cancer. J Chin Med Assoc 2020; 83:245-250. [PMID: 31972832 DOI: 10.1097/jcma.0000000000000259] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Pulmonary embolism (PE) is frequently associated with cancer. This study aimed to assess patients with acute PE and identify diagnostic predictors of new cancer after 1 year of follow-up. METHODS One hundred and twenty-one patients with PE were enrolled consecutively from the emergency department of a single medical center in Taiwan. Data from computed tomography angiography, echocardiogram, electrocardiogram and for baseline comorbidities, clinical presentation, and laboratory parameters were recorded. The surviving discharged patients without a cancer diagnosis were followed-up for 1 year, and new malignancies were recorded. RESULTS Of 121 patients with acute PE, 44 (36%) had an underlying cancer history (cancer group), and 77 (64%) did not (noncancer group). Baseline demographic characteristics, comorbidities, clinical symptoms, biochemical parameters, echocardiogram data, and electrocardiogram data of the two groups were similar except for a higher hospital mortality rate (56.8% vs 9.1%; p < 0.001), lower body mass index (22.6 ± 4.1 vs 25.5 ± 4.9; p =0.02), higher systolic blood pressure (139.7 ± 33.7 vs 125.4 ± 24.1; p = 0.02), lower low-density lipoprotein level (67.4 ± 38.3 vs 90.4 ± 33.8; p = 0.04), lower creatinine kinase (CK; 43.0 ± 43.0 vs 83.5 ± 83.1; p = 0.01), higher myocardial band (MB) form of CK ratio (0.2 ± 0.2 vs 0.1 ± 0.1; p < 0.01), higher partial pressure of arterial oxygen (122.81 ± 81.2 vs 90.2 ± 59.4; p = 0.03), and less presentation of chest pain (15.9% vs 40.3%; p = 0.01) in the cancer group. Kaplan-Meier curve analysis revealed that the 30-day survival rate was higher in the noncancer group than in the cancer group (log-rank p = 0.04). After 1 year of follow-up, 6 of 59 (10.17%) initial non-cancer-related PE survivors were diagnosed with malignancies. After multivariate analysis, only the initial CK-MB level was associated with a diagnosis of new cancer (hazard ratio [HR]: 1.37, 95% confidence interval [CI]: 1.029-1.811; p = 0.03). CONCLUSION This study suggests that the CK-MB level is associated with future malignancy in patients with PE. Patients with cancer-related PE had a worse 30-day survival rate.
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Affiliation(s)
- Yen-Chung Lin
- Division of Nephrology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC
| | - Su-Chan Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Chi-Ming Huang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Yu-Feng Hu
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yun-Yu Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Epidemiology and Preventive Medicine College of Public Health, National Taiwan University, Taipei, Taiwan, ROC
| | - Shih-Lin Chang
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Li-Wei Lo
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Yenn-Jiang Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Shih-Ann Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan, ROC
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27
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Abstract
BACKGROUND Prevailing hospital practice dictates a protracted phase of observation for patients with chest pain to establish or exclude the diagnosis of myocardial infarction. Early diagnosis of acute myocardial infarction may improve patient care and reduce both complications and hospital costs. A study was performed to investigate the feasibility of early diagnosis of myocardial infarction within the first 9 hours of the hospital stay. METHODS The records of all patients admitted with chest pain within one calendar year were analyzed. The timing of creatine kinase-MB (CK-MB) quantification was determined with reference to the initial phlebotomy (time 0). An enzymatic diagnosis of myocardial infarction was assigned if any determination of CK-MB exceeded the upper limit of normal, and the diagnosis of each patient at or before 9 hours (early diagnosis) was compared to the ultimate diagnosis at 14 to 24 hours (final diagnosis) beyond initial assessment. RESULTS Of the 528 included patients, 523 patients (99.1%) had identical early and final diagnostic outcomes; 5 patients (0.9%) had conflicting results. An early diagnosis of myocardial infarction was assigned to 195 of the 528 patients (36.9%). Of these, 190 achieved the diagnosis within 9 hours (sensitivity 97.4%). The negative predictive value was 98.5%. CONCLUSION Standard CK-MB mass measurements within 9 hours of arrival provided an accurate clinical assessment in > 99% of the cases. The high sensitivity and negative predictive values suggest that early diagnosis of myocardial infarction is feasible and reliable.
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Affiliation(s)
- Gregory Engel
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California
| | - Stanley G Rockson
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California.
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28
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Taniguchi Y, Oyama N, Fumoto S, Kinoshita H, Yamashita F, Shimizu K, Hashida M, Kawakami S. Tissue suction-mediated gene transfer to the beating heart in mice. PLoS One 2020; 15:e0228203. [PMID: 32027678 PMCID: PMC7004367 DOI: 10.1371/journal.pone.0228203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Accepted: 01/09/2020] [Indexed: 11/28/2022] Open
Abstract
We previously developed an in vivo site-specific transfection method using a suction device in mice; namely, a tissue suction-mediated transfection method (tissue suction method). The aim of this study was to apply the tissue suction method for cardiac gene transfer. Naked plasmid DNA (pDNA) was intravenously injected in mice, followed by direct suction on the beating heart by using a suction device made of polydimethylsiloxane. We first examined the effects of suction conditions on transgene expression and toxicity. Subsequently, we analyzed transgene-expressing cells and the transfected region of the heart. We found that heart suction induced transgene expression, and that −75 kPa and −90 kPa of suction achieved high transgene expression. In addition, the inner diameter of the suction device was correlated with transgene expression, but the pressure hold time did not change transgene expression. Although the tissue suction method at −75 kPa induced a transient increase in the serum cardiac toxicity markers at 6 h after transfection, these markers returned to normal at 24 h. The cardiac damage was also analyzed through the measurement of hypertrophic gene expression, but no significant differences were found. In addition, the cardiac function monitored by echocardiography remained normal at 11 days after transfection. Immunohistochemical analysis revealed that CD31-positive endothelial cells co-expressed the ZsGreen1-N1 reporter gene. In conclusion, the tissue suction method can achieve an efficient and safe gene transfer to the beating heart in mice.
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Affiliation(s)
- Yota Taniguchi
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamotomachi, Nagasaki, Japan
| | - Natsuko Oyama
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamotomachi, Nagasaki, Japan
| | - Shintaro Fumoto
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamotomachi, Nagasaki, Japan
| | - Hideyuki Kinoshita
- Department of Community Medicine Supporting System, Kyoto University Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Fumiyoshi Yamashita
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida-shimoadachi cho, Sakyo-ku, Kyoto, Japan
| | - Kazunori Shimizu
- Graduate School of Engineering, Nagoya University, Furo-cho, Chikusa-ku, Nagoya, Japan
| | - Mitsuru Hashida
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Yoshida-shimoadachi cho, Sakyo-ku, Kyoto, Japan
| | - Shigeru Kawakami
- Graduate School of Biomedical Sciences, Nagasaki University, Sakamotomachi, Nagasaki, Japan
- * E-mail:
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29
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Shamshirian A, Alizadeh-Navaei R, Abedi S, Jafarpour H, Fazli H, Hosseini S, Hessami A, Karimifar K, Yosefi S, Zahedi M, Motamen S, Ghorbanpour A, Zarandi B, Esfahani A, Rostamian-Moghaddam Y, Mehdipour S, Heydari K, Aghajanian S, Mehdi SP, Azad A, Azizi S. Levels of Blood Biomarkers among Patients with Myocardial Infarction in Comparison to Control Group. Ethiop J Health Sci 2020; 30:5-12. [PMID: 32116427 PMCID: PMC7036464 DOI: 10.4314/ejhs.v30i1.2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/24/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) as a term for a heart attack happens due to reduced blood flow to heart myocardium and lack of oxygen supply caused by plaques in the interior walls of coronary arteries. With respect to the importance of MI etiology, we aimed to study the relationship of MI and blood examination variables. METHODS This study was conducted in Mazandaran Heart Center as a hospital-based case-control Comprising 894 participants including 465 cases and 429 controls, individually matched by sex and age. Considered blood markers were analyzed using routine laboratory methods and equipment. RESULTS Of all participants, 64.3% of the cases and 51.0% of the controls were males with a mean age of 61.2 (±13.8) in cases and 62.4 (±14.) in controls. We could not find any differences between cases and controls for total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and alkaline-phosphatase (ALP) (P>0.05). However, levels of creatine-kinase-muscle/brain (CK-MB) (P<0.0001), fasting-blood-sugar (FBS) (P<0.0001), aspartate-aminotransferase (AST) (P<0.0001), alanine-transferase (ALT) (P<0.0001) and erythrocyte sedimentation rate (ESR) (P=0.001) were significantly higher in cases compared to the controls (P<0.05). Multivariable analyses revealed that the risk of MI was associated with high levels of AST (adjusted OR=24.3, 95%CI=3.5±165.6, P=0.001) and LDL (adjusted OR=7.4, 95%CI=1.0±51.8, P=0.001). CONCLUSION Our investigation indicated that the levels of CK-MB, FBS, AST, ALT and ESR were significantly higher in patients with MI. Besides, our findings showed that the risk of MI in cases with high levels of AST and LDL was about 24 and 7 times more than the control group respectively.
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Affiliation(s)
- Amir Shamshirian
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Iran
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Reza Alizadeh-Navaei
- Gastrointestinal Cancer Research Center, Mazandaran University of Medical Sciences, Iran
| | - Samira Abedi
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Hamed Jafarpour
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Hanieh Fazli
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Samira Hosseini
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Amirhossein Hessami
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Keyvan Karimifar
- Student Research committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sedighe Yosefi
- Department of Biochemistry, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Zahedi
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Sepideh Motamen
- Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Iran
| | - Atiyeh Ghorbanpour
- Department of Hematology, Student Research Committee, Iran University of Medical Sciences, Iran
| | - Bahman Zarandi
- Department of Hematology, Student Research Committee, Iran University of Medical Sciences, Iran
| | - Aliakbar Esfahani
- Student Research committee, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Shirin Mehdipour
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Keyvan Heydari
- Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences, Iran
| | - Sedigheh Aghajanian
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
| | - Somayeh Pour Mehdi
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Alireza Azad
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
| | - Soheil Azizi
- Department of Medical Laboratory Sciences, School of Allied Medical sciences, Mazandaran University of Medical Sciences, Iran
- Mazandaran Heart Center, Mazandaran University of Medical Sciences, Iran
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Armstead WM, Vavilala MS. Cerebral Perfusion Pressure Directed-Therapy Modulates Cardiac Dysfunction After Traumatic Brain Injury to Influence Cerebral Autoregulation in Pigs. Neurocrit Care 2019; 31:476-485. [PMID: 31115824 PMCID: PMC6868312 DOI: 10.1007/s12028-019-00735-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) is an important contributor to morbidity and mortality. Low cerebral perfusion pressure (CPP, mean arterial pressure [MAP] minus intracranial pressure) after TBI is associated with cerebral ischemia, impaired cerebral autoregulation, and poor outcomes. Normalization of CPP and limitation of cerebral autoregulation impairment is a key therapeutic goal. However, some vasoactive agents used to elevate MAP such as phenylephrine (Phe) improve outcome in females but not male piglets after TBI while dopamine (DA) does so in both sexes. Clinical evidence has implicated neurological injuries as a cause of cardiac dysfunction, and we recently described cardiac dysfunction after TBI. Cardiac dysfunction may, in turn, influence brain health. One mechanism of myocyte injury may involve catecholamine excess. We therefore tested the hypothesis that TBI caused cardiac dysfunction and catecholamine excess which may reciprocally be modulated by vasoactive agent choice to normalize CPP and prevent impairment of cerebral autoregulation after injury. METHODS TBI was produced in anesthetized pigs equipped with a closed cranial window, and Phe or DA administered to normalize CPP. RESULTS Plasma cardiac enzymes troponin and creatine kinase and catecholamines epinephrine and norepinephrine were elevated by TBI, such release potentiated by Phe in males but blocked in female piglets and blocked in both sexes after DA. Cerebral autoregulation was impaired after TBI, worsened by Phe in males but protected in females and males treated with DA. Papaverine-induced dilation was unchanged by fluid percussion brain injury, DA, and Phe. CONCLUSIONS These data indicate that pressor choice in elevation of CPP is important in limiting cardiac dysfunction and suggest that DA protects cerebral autoregulation in both sexes via reduction of cardiac biomarkers of injury and catecholamines released after TBI.
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Affiliation(s)
- William M Armstead
- Departments of Anesthesiology and Critical Care, University of Pennsylvania, 3620 Hamilton Walk, JM3, Philadelphia, PA, 19104, USA.
- Pharmacology, University of Pennsylvania, Philadelphia, PA, 19104, USA.
| | - Monica S Vavilala
- Department of Anesthesiology, Pediatrics, and Neurological Surgery, University of Washington, Seattle, WA, USA
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Jiang M, Yin Y, Xie L, He H. Plasma miR-18 Screens Acute Myocardial Infarction from Healthy Controls by Targeting Hypoxia Inducible Factor 1α. Clin Lab 2019; 64:1207-1212. [PMID: 30146846 DOI: 10.7754/clin.lab.2018.180208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND This study aims to evaluate the expression of plasma miR-18, thereby evaluating its potential use as a biomarker to screen acute myocardial infarction (AMI) patients from healthy controls. METHODS Real time PCR was carried out to evaluate the level of miR-18 in AMI patients and healthy controls. ROC analysis was performed to evaluate whether miR-18 could be used as a potential biomarker. Dual luciferase assay was used to identify the potential target of miR-18. RESULTS We showed novel data that plasma miR-18 was significantly greater in AMI patients than in healthy controls. ROC analysis indicated that plasma miR-18 could screen AMI patients from healthy controls with high sensitivity and specificity. Further study demonstrated that plasma miR-18 was positively correlated with serum cardiac troponin I (cTnI) and creatine phosphokinase-MB (CK-MB) concentrations. Additionally, plasma miR-18 was increased in AMI patients with more stenosed coronary vessels. More importantly, plasma miR-18 was decreased in AMI patients after receiving percutaneous coronary intervention (PCI). Dual luciferase reporter assay indicated that overexpression of miR-18 significantly suppressed the relative luciferase activity of pmirGLO- HIF1α-3´UTR. CONCLUSIONS In summary, enhanced plasma miR-18 could be used as a potential biomarker to screen AMI patients from healthy controls via targeting HIF1α.
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Ahmed OE, Abohamr SI, Alharbi SA, Aldrewesh DA, Allihimy AS, Alkuraydis SA, Alhammad IM, Elsheikh E, Azazy AS, Mohammed AA, Dar MA, Abazid RM. In-hospital mortality of acute coronary syndrome in elderly patients. Saudi Med J 2019; 40:1003-1007. [PMID: 31588478 PMCID: PMC6887884 DOI: 10.15537/smj.2019.10.24583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Objectives: To analyze predictors of death in elderly patients diagnosed with acute coronary syndrome (ACS). Methods: A record-based study carried out between January 2016 and January 2018 at The central province in Saudi Arabia. All elderly patients (>75 years) with definite diagnosis of ACS were retrospectively included. Demographic data, echocardiographic, and angiographic parameters were reported. Results: A total of 179 patients were enrolled, 129 (72%) were male. The mean age was 79±4.7 years. Approximately 102 (57%) patients were diagnosed with ST-segment elevation myocardial infarction (STEMI). Of all 125 (70%) underwent invasive coronary angiography, we found that 43 (24%) had significant single vessel disease (1VD), 29 (16.2%) had 2 vessel disease (2VD), and 41 (22.9%) had 3 vessel disease (3VD) or left main stenosis. During hospitalization 21 (11.7%) patients died, t-test analysis showed patients who died were significantly older (82±6.7 versus [vs.] 79±4.2 years, p=0.003). In addition we found that ejection fraction was lower in death group (30.2%±10.7) vs. (36.5%±1.1) in survivors, p=0.017); STEMI was more common in death group (90.5%) vs. (52.5%) in survivors, p=0.001); similarly, the prevalence of 3VD was higher in death group (38.1%) vs. (20.9%) in survivors, p=0.018). Importantly, PCI was not significantly different between death and survival groups (40% vs. 53.8%, p=0.177). A multivariate regression analysis demonstrated that predictors of death were: age (hazard ratio [HR], 1.214; 95% confidence interval [CI], 1.122-1.384; p<0.0001), intubation (HR, 10.106; 95% CI, 9.844-10.792; p<0.0001), and raised creatinine kinase-MB (CK-MB) (HR, 1.005; 95% CI, 1.002-1.013; p=0.04) predicted in hospital death. Conclusion: Older age, mechanical ventilation and raised CK-MB can significantly predict death in elderly patients (>75-year-old) diagnosed with ACS; nevertheless, PCI showed no survival benefits.
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Affiliation(s)
- Omima E Ahmed
- Department of Cardiology, Prince Sultan Cardiac Center Qassim, Qassim, Buraydah, Kingdom of Saudi Arabia.
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Abstract
Stanford type A aortic dissection (AD) is a lethal disease requiring surgery. Evidence regarding the prognostic ability of perioperative myocardiac markers on long-term outcome is limited.In this cohort study, we measured perioperative myocardiac markers level in 583 surgical patients with type A AD in our hospital between 2015 and 2017. All patients were followed up after surgery for a median period of 864 days to determine short- and long-term mortality.About one-fifth of patients has a positive preoperative myocardial markers, which was increased significantly after operation. Increase log10 post-creatine kinase MB isoenzyme (CK-MB) (hazard ratio [HR], 4.64; 95% confidence interval [CI] 1.89-11.43; P = .0008), log10 post-TnI (HR, 3.11; 95% CI 1.56-6.21; P = .0013), log10 post-Mb (HR, 3.00; 95% CI 1.40-6.43; P = .0048), log10 pre-CK-MB (HR,1.82; 95% CI 1.03-3.21; P = .0377), and upper tertile of post-CK-MB (HR,1.52; 95% CI 1.05-2.20; P = .0261) were the independent risk factor for 30 days mortality adjusted for potential confounders. None of cardiac markers was significantly associated with long-term outcome independent of other factors.Perioperative myocardiac predicts early outcome in type A AD patients undergoing surgery. Increasing perioperative myocardial markers do not appear to be a predictor for long-term all-cause mortality.
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Affiliation(s)
- Ming Gong
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University
- Beijing Institute of Heart, Lung and Blood Vessel Diseases
- Beijing Lab for Cardiovascular Precision Medicine
- Beijing Aortic Disease Center, Cardiovascular Surgery Center
- Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Zining Wu
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University
- Beijing Institute of Heart, Lung and Blood Vessel Diseases
- Beijing Lab for Cardiovascular Precision Medicine
- Beijing Aortic Disease Center, Cardiovascular Surgery Center
- Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Xinliang Guan
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University
- Beijing Institute of Heart, Lung and Blood Vessel Diseases
- Beijing Lab for Cardiovascular Precision Medicine
- Beijing Aortic Disease Center, Cardiovascular Surgery Center
- Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Wenjian Jiang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University
- Beijing Institute of Heart, Lung and Blood Vessel Diseases
- Beijing Lab for Cardiovascular Precision Medicine
- Beijing Aortic Disease Center, Cardiovascular Surgery Center
- Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
| | - Hongjia Zhang
- Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University
- Beijing Institute of Heart, Lung and Blood Vessel Diseases
- Beijing Lab for Cardiovascular Precision Medicine
- Beijing Aortic Disease Center, Cardiovascular Surgery Center
- Beijing Engineering Research Center for Vascular Prostheses, Beijing, China
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Hong F, Song L, Zhu YY, Ji JH, Zhu MJ, Xu M. Cardiac troponin I, myoglobin, and creatine kinase-Mb as new biomarkers for diagnosis of neonatal hypoxic ischemic encephalopathy. J BIOL REG HOMEOS AG 2019; 33:1201-1207. [PMID: 31304730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- F Hong
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
| | - L Song
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
| | - Y Y Zhu
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
| | - J H Ji
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
| | - M J Zhu
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
| | - M Xu
- Department of Pediatrics, Affiliated Hospital 2 of Nantong University, Nantong City, Jiangsu Province, China
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Butt A, Waris N, Baqa K, Nazim U, Naz A, Abbasi SR, Begum S. Comparative effect of Beta blocker-Atenolol and Murraya koenigii (L.) spreng (Curry leaves) on cardiac enzyme (CK-MB) level in male albino rats. Pak J Pharm Sci 2019; 32:1643-1648. [PMID: 31608885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Murraya koenigii (L.) spreng (curry leaves) have traditionally been used for its various medicinal properties. The current study was conducted to assess the comparative effect of Murraya koenigii (L.) spreng (curry leaves) and market available beta blocker drug Atenolol on cardiac enzyme (CK-MB) level in male albino rats. Out of total 26 locally bred male Albino Wistar rats (180 to 200gm weight) two rats were treated with only voltral for dose adjustment. Remaining 24 rats were randomly categorized into following 1 control (C) group and 3 experimental groups Model (M), Test 1 (T1) and Test 2 (T2) containing 6 rats in each group. Rats in C group were orally fed by 0.9% saline solution while rats of M and both test groups T1 and T2 were orally treated with voltral tablet (30mg /kg body weight) for three weeks to increase the level of CK-MB heart enzyme. After voltral treatment rats in test group T1 were treated orally with Atenolol (30 mg/kg body weight) and T2 with Murraya koenigii (L.) spreng (curry leaves) extract (180 mg/kg body weight) for last three weeks. Results show that rats treated with Atenolol showed a decrease in level of heart enzyme as compare to M group, while Murraya koenigii (L.) spreng treated rats group T2 showed more significant decrease of heart enzyme (CK-MB) level as compared to M and T1 groups with significantly improved behavioral activity including increased locomotor activity, short-term memory and reduction in depression. These results demonstrate that natural herbal treatment by curry leaves extract play an effective role in lowering the cardiac enzyme (CK-MB) level to its normal range which helps reducing the risk of CVD and CHD.
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Affiliation(s)
- Anum Butt
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Nazish Waris
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Kulsoom Baqa
- Department of Research, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University, Karachi, Pakistan
| | - Urooj Nazim
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, University of Karachi, Karachi, Pakistan
| | - Afshan Naz
- Department of Biochemistry, Federal Urdu University of Arts Science and Technology, Karachi, Pakistan
| | - Sumera Rais Abbasi
- Department of Biochemistry, Federal Urdu University of Arts Science and Technology, Karachi, Pakistan
| | - Sumreen Begum
- Stem Cell Research Laboratory, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
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López E, Sánchez-Margallo FM, Álvarez V, Blázquez R, Marinaro F, Abad A, Martín H, Báez C, Blanco V, Crisóstomo V, Casado JG. Identification of very early inflammatory markers in a porcine myocardial infarction model. BMC Vet Res 2019; 15:91. [PMID: 30898123 PMCID: PMC6427889 DOI: 10.1186/s12917-019-1837-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 03/05/2019] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Acute myocardial infarction (AMI) is one of the most deleterious conditions leading to cardiovascular diseases and mortality. The importance of an early and accurate diagnosis assures immediate medical treatments, which are fundamental to reduce mortality and improve prognoses. AMI is associated to an inflammatory response which includes the increase of circulating inflammatory cytokines, chemokines and immune cell activation. This study aimed to identify which are the very early immune-related biomarkers that may be used as predictors of myocardial infarction severity. In order to mimic the pathophysiological events involved in human myocardial infarction, a temporary occlusion (90 min) of the mid-left anterior descending coronary artery was performed in a swine animal model. RESULTS Lymphocyte subsets analysis in peripheral blood revealed significant alterations in CD4+/CD8+ ratio and naïve and effector/memory T cell percentages at 1 h post-myocardial infarction. Changes in TH1/TH2-related cytokine, monocyte and neutrophil markers gene expression were observed in peripheral blood lymphocytes, as well. Additionally, significant correlations between cardiac parameters (cardiac enzymes, left ventricular ejection fraction and % infarct) and blood-derived parameters (cytokine expression and lymphocyte subset distribution) were found. CONCLUSIONS Peripheral blood lymphocyte alterations are easily and swiftly detectable, so they may be good biomarkers for a very early prognosis and to predict myocardial infarction severity.
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Affiliation(s)
- Esther López
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
| | - Francisco Miguel Sánchez-Margallo
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
| | - Verónica Álvarez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
| | - Rebeca Blázquez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
| | - Federica Marinaro
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
| | - Ana Abad
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
| | - Helena Martín
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
| | - Claudia Báez
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
| | - Virginia Blanco
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
| | - Verónica Crisóstomo
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
| | - Javier García Casado
- Stem Cell Therapy Unit, Jesús Usón Minimally Invasive Surgery Centre, 10071 Cáceres, Spain
- CIBER de Enfermedades Cardiovasculares, 28029 Madrid, Spain
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Abstract
This study aimed to explore the risk factors for acute myocardial injury (AMI) caused by acute organophosphorus pesticide poisoning (AOPP).The clinical data of 98 patients, who were treated in our hospital due to oral AOPP from April 2013 to April 2017, were retrospectively analyzed. These patients were divided into two groups: AMI group and control group. The incidence of AMI was analyzed. Furthermore, the dosage forms and dose of the pesticide, and the interval between pesticide taking and doctor visit were compared between these two groups. Moreover, their clinical symptoms were observed; the serum cholinesterase levels, myocardial injury, and heart failure markers were detected, and the occurrence of arrhythmia and the structure and function of the heart were investigated through continuous electrocardiographic monitoring and transthoracic echocardiography.Among these 98 AOPP patients, 51 patients were complicated with AMI, and the incidence was 52.0%. The main manifestations of these 51 patients with AMI were as follows: the serum levels of myocardial injury markers (creatine kinase-Mb [CK-Mb] and cardiac troponin I [cTnI]) and heart failure markers (N-terminal pro B-type natriuretic peptide [NT-pro BNP]) were significantly higher, when compared with the control group (P < .001), and the incidence of arrhythmia (FVPB, P = .02; RAA, P = .03; RVA, P = .02; ST-T changes, P = .01) and heart failure (P = .04) was also significantly higher when compared with the control group. With regard to dosage forms of the pesticides, the number of patients taking the pesticides with solvents containing aromatic hydrocarbons was significantly higher in the AMI group than in the control group (P = .001). And the number of patients taking over 100 mL of pesticides was also significantly higher in the AMI group than in the control group (P < .001). Significantly more patients in the AMI group had an interval of over 1 h between pesticide taking and doctor visit than in the control group (P < .001).Risk factors for AMI after AOPP may include the dose and dosage form of the pesticide, and the interval between pesticide taking and doctor visit.
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Golubovic M, Peric V, Stanojevic D, Lazarevic M, Jovanovic N, Ilic N, Djordjevic M, Kostic T, Milic D. Potential New Approaches in Predicting Adverse Cardiac Events One Month after Major Vascular Surgery. Med Princ Pract 2019; 28:63-69. [PMID: 30391950 PMCID: PMC6558343 DOI: 10.1159/000495079] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/04/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The aim of our study was to find the best model with sufficient power to improve the risk stratification in major vascular surgery patients during the first 30 days after this procedure. The discriminatory power of 4 biomarkers (troponin I [TnI], N-terminal prohormone of brain natriuretic peptide [NT-proBNP], creatine kinase-MB isoenzyme [CK-MB], high-sensitivity C-reactive protein [hs-CRP]) was tested as well as 2 risk assessment models and 13 different combinations of them. SUBJECTS AND METHODS The study included 122 patients (77% men, 23% women) with an average age of 67.03 ± 4.5 years. An aortobifemoral bypass was performed in 6.56% of the patients, a femoropopliteal bypass in 18.85%, and 49.18% received open surgical reconstruction of the carotid arteries. A total of 25.41% of the patients were given an aortobi-iliac bypass. RESULTS During the first 30 days, 13 patients (10.7%) had 17 cardiac complications. The most common complication was the new onset of atrial fibrillation (35.3%). During the first 10 days, 10 patients had 1 complication and 2 patients had 2 cardiac events, while 1 patient had 3 complications. By comparing combinations of scores and markers, it was shown that revised cardiac risk index (RCRI) + Vascular Portsmouth Physiological and Operative Severity Score (V-POSSUM) + hsTnI and RCRI + V-POSSUM + hsTnI + NT-proBNP with 100% sensitivity, > 80% specificity had the best discriminatory ability (AUC 0.924 and 0.933, respectively; p < 0.001 for both models) for cardiac complications during the 30 days after surgery. CONCLUSION Combinations of traditional preoperative risk factors and scores can enhance the assessment of major adverse cardiac events (MACE) in patients preparing for large vascular surgery. Using only one risk score in these patients seems to be underperforming in preoperative risk assessment.
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Affiliation(s)
- Mladjan Golubovic
- Clinic for Anesthesiology and Reanimatology, Clinical Center Nis, Nis, Serbia,
| | | | | | - Milan Lazarevic
- Clinic for Cardiovascular and Transplantation Surgery, Clinical Center Nis, Nis, Serbia
| | - Nenad Jovanovic
- Clinic for Anesthesiology and Reanimatology, Clinical Center Nis, Nis, Serbia
| | - Nenad Ilic
- Clinic for Cardiovascular and Transplantation Surgery, Clinical Center Nis, Nis, Serbia
| | | | - Tomslav Kostic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Clinic for Cardiology, Clinical Center Nis, Nis, Serbia
| | - Dragan Milic
- Faculty of Medicine, University of Nis, Nis, Serbia
- Clinic for Cardiovascular and Transplantation Surgery, Clinical Center Nis, Nis, Serbia
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Sharma R, Tiwari RK, Maheshwari S, Jain R, Gokhroo A. A Study of Relation of CPK-MB Levels with ECG Parameters in Organophosphorous Poisoning Cases. J Assoc Physicians India 2019; 67:26-29. [PMID: 30935168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Rishab Sharma
- Senior Resident, Fortis Escorts Hospital, Jaipur, Rajasthan
| | - Ravindra K Tiwari
- Assistant Professor, Jawaharlal Nehru Medical College, Ajmer, Rajasthan
| | | | - Rajesh Jain
- Professor, Jawaharlal Nehru Medical College, Ajmer, Rajasthan
| | - Archana Gokhroo
- Professor, Jawaharlal Nehru Medical College, Ajmer, Rajasthan
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Li J, Zhao Y, Zhou N, Li L, Li K. Dexmedetomidine Attenuates Myocardial Ischemia-Reperfusion Injury in Diabetes Mellitus by Inhibiting Endoplasmic Reticulum Stress. J Diabetes Res 2019; 2019:7869318. [PMID: 31886285 PMCID: PMC6914963 DOI: 10.1155/2019/7869318] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/24/2019] [Accepted: 10/25/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE With the increasing incidence of diabetes mellitus (DM) combined with myocardial ischemia, how to reduce myocardial ischemia-reperfusion injury in DM patients has become a major problem faced by clinicians. We investigated the therapeutic effects of dexmedetomidine (DEX) on myocardial ischemia-reperfusion injury in DM rats and its effect on endoplasmic reticulum stress. METHODS SD rats with SPF grade were randomly divided into 6 groups: non-DM rats were divided into the sham operation group (NDM-S group), ischemia-reperfusion group (NDM-IR group), and dexmedetomidine group (NDM-DEX group); DM rats were divided into the diabetic sham operation group (DM-S group), diabetes-reperfusion group (DM-IR group), and diabetes-dexmedetomidine (DM-DEX) group, with 10 rats in each group. Then the effects of DEX on the changes of CK-MB and cTnT levels were examined. The effects of myocardial pathological damage and myocardial infarct size were detected. The apoptosis of cardiomyocytes was detected. The apoptosis of heart tissue cells was also tested through the expressions of cleaved caspase-3, Bcl-2, and Bax proteins. The expression of endoplasmic reticulum stress-related proteins GRP78, CHOP, ERO1α, ERO1β, and PDI was examined. The hypoxia/reoxygenation (H/R) injury cell model was established, the effects of DEX, DEX+ ERS agonist on cell apoptosis was also detected. RESULTS The myocardial damage of DM-IR was more severe than that of NDM-IR rats. DEX could reduce the expression of CK-MB and cTnT, reduce pathological damage, and reduce scar formation and improve fibrosis. DEX can reduce the expression of GRP78, CHOP, ERO1α, ERO1β, and PDI proteins in vivo and in vitro. And the effect of DEX on cell apoptosis could be blocked by ERS agonist. CONCLUSION DEX attenuates myocardial ischemia-reperfusion injury in DM rats and H/R injury cell, which is associated with the reduction of ERS-induced cardiomyocyte apoptosis.
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MESH Headings
- Animals
- Apoptosis/drug effects
- Cell Line
- Creatine Kinase, MB Form/blood
- Dexmedetomidine/pharmacology
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Endoplasmic Reticulum Stress/drug effects
- Fibrosis
- Heat-Shock Proteins/metabolism
- Male
- Membrane Glycoproteins/metabolism
- Myocardial Infarction/metabolism
- Myocardial Infarction/pathology
- Myocardial Infarction/prevention & control
- Myocardial Reperfusion Injury/complications
- Myocardial Reperfusion Injury/metabolism
- Myocardial Reperfusion Injury/pathology
- Myocardial Reperfusion Injury/prevention & control
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Protein Disulfide-Isomerases/metabolism
- Rats, Sprague-Dawley
- Signal Transduction
- Transcription Factor CHOP/metabolism
- Troponin T/blood
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Affiliation(s)
- Jinjie Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
| | - Ying Zhao
- Department of Nephrology, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun Jilin 130021, China
| | - Nan Zhou
- Department of Anesthesia, The General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Longyun Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
| | - Kai Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
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Tan H, Qi J, Fan BY, Zhang J, Su FF, Wang HT. MicroRNA-24-3p Attenuates Myocardial Ischemia/Reperfusion Injury by Suppressing RIPK1 Expression in Mice. Cell Physiol Biochem 2018; 51:46-62. [PMID: 30439713 DOI: 10.1159/000495161] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 11/07/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study was developed to investigate a potential therapeutic method for myocardial ischemia/reperfusion injury involving the promotion of miR-24-3p expression. METHODS Microarray analysis was used to screen differentially expressed genes in a myocardial ischemia/reperfusion (I/R) injury mouse model. Gene set enrichment analysis was utilized to determine vital signaling pathways. Targeting verification was conducted with a luciferase reporter assay. Myocardial I/R injury was developed in mice, and the expression levels of RIPK1 and miR-24-3p were investigated by qRT-PCR and Western blot. Hemodynamic parameters and the activity of serum myocardial enzymes were measured to evaluate cardiac function. Infarct area was observed through HE and TTC staining. Myocardial cell apoptosis was examined by TUNEL staining and caspase-3 activity analysis. RESULTS RIPK1 was an upregulated mRNA found by microarray analysis and a verified target of the downregulated miRNA miR-24-3p. The upregulation of RIPK1 (1.8-fold) and the downregulation of miR-24-3p (0.3-fold) were confirmed in I/R mice. RIPK1 led to impaired cardiac function indexes, increased infarct area and cell apoptosis, while miR-24-3p could reverse the injury by regulating RIPK1. The TNF signaling pathway was proven to be involved in myocardial I/R injury through the detection of the dysregulation of related proteins. CONCLUSION In conclusion, RIPK1 was upregulated and miR-24-3p was downregulated in a myocardial I/R injury mouse model. RIPK1 could aggravate myocardial I/R injury via the TNF signaling pathway, while miR-24-3p could suppress RIPK1 and therefore exert cardioprotective effects in myocardial I/R injury.
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Helmi N, Choudhry H, Qari M, Kumosani TA, Al-Malki AL, Moselhy SS, Kumosani AT. Association of serum asymmetric dimethyl-arginine and troponin I levels as a risk of myocardial infarction in thalassemia. Afr Health Sci 2018; 18:720-726. [PMID: 30603005 PMCID: PMC6307029 DOI: 10.4314/ahs.v18i3.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its association to cardiac biomarkers in thalassemia patients for early diagnosis of abnormality in myocardial infarction. SUBJECTS AND METHODS This study was conducted on 80 subjects divided into four groups each with 20 subjects. Group I: Control: healthy subjects. Group II: Myocardial infarction: Patients with elevated serum troponin T. Group III: thalassemia patients. Group IV: thalassemia with myocardial infarction patients: Included 20 thalassemia patients with Myocardial infarction. Serum samples were subjected for assay of creatine kinase (CK:MB), Lactate dehydrogenase, troponin I, ADMA, Serum MDA level was determined. RESULTS Data obtained showed that serum CKMB, LDH1, AST, Troponin T and ADMA levels were significant elevated in MI with or without Thalassemia compared with control groups. Serum MDA was statistically significantly elevated in MI with or without Thalassemia compared with control groups. The serum level of troponin T showed an area under curve (AUC) of 0.92, (sensitivity 91.0 % and specificity, 88%). Also, the ADMA supported the diagnostic profile, showing an AUC of 0.85 with (sensitivity, 92.0%; specificity, 91,9%). CONCLUSION Serum ADMA is sensitive marker for incidence of MI in thalassemia patients.
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Affiliation(s)
- Nawal Helmi
- Biochemistry Department, Faculty of science, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia
| | - Hani Choudhry
- Biochemistry Department, Faculty of science, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia
- Cancer Metabolism and Epigenetic Unit, Faculty of Science (KAU) ; Cancer and Mutagenesis Unit, King Fahd Medical Research Center (KAU)
| | - M Qari
- Hematology department, Faculty of medical science, King Abdulaziz University, Saudi Arabia
| | - Taha A Kumosani
- Biochemistry Department, Faculty of science, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia
- Cancer Metabolism and Epigenetic Unit, Faculty of Science (KAU) ; Cancer and Mutagenesis Unit, King Fahd Medical Research Center (KAU)
- Experimental biochemistry unit, King Fahd Medical Research center, KAU
- Production of bio products for industrial applications research Group, KAU
| | - Abdulrahman L Al-Malki
- Biochemistry Department, Faculty of science, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia
- Cancer Metabolism and Epigenetic Unit, Faculty of Science (KAU) ; Cancer and Mutagenesis Unit, King Fahd Medical Research Center (KAU)
- Bioactive Natural Products Research Group, KAU
| | - Said Salama Moselhy
- Biochemistry Department, Faculty of science, King Abdulaziz University (KAU), Jeddah, Kingdom of Saudi Arabia
- Experimental biochemistry unit, King Fahd Medical Research center, KAU
- Bioactive Natural Products Research Group, KAU
- Biochemistry department, Faculty of science, Ain Shams University, Cairo, Egypt
| | - Afnan T Kumosani
- Department of pathology and Laboratory Medicine, Blood Bank Transfusion medicine, King Abdulaziz Medical City, Jeddah, National Guards, Jeddah, 21423
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Gomaa AMS, Abdelhafez AT, Aamer HA. Garlic (Allium sativum) exhibits a cardioprotective effect in experimental chronic renal failure rat model by reducing oxidative stress and controlling cardiac Na +/K +-ATPase activity and Ca 2+ levels. Cell Stress Chaperones 2018; 23:913-920. [PMID: 29679284 PMCID: PMC6111091 DOI: 10.1007/s12192-018-0898-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 04/07/2018] [Accepted: 04/09/2018] [Indexed: 12/13/2022] Open
Abstract
Gentamicin (GNT)-induced nephrotoxicity culminates into renal failure with a possible cardiovascular impact. Garlic extract (GE) is a cardiovascular protectant with limited mechanistic data. Therefore, we assessed the disturbance in specific cardiac parameters and the potential protective effect of GE supplementation against them in a rat model of GNT-induced chronic renal failure (CRF). Adult male rats (n = 24) were randomly assigned into four groups (n = 6 each): normal controls (CON), garlic extract controls (GE; 250 mg kg-1, orally), GNT-induced CRF (GNT; 100 mg kg-1, i.p.), and GNT + GE (GNT and GE in the same previous doses) groups. GNT and GE were given daily for 3 weeks. Animals co-treated with GNT and GE exhibited improved renal functions, body weight (BW), and heart weight (HW)/BW ratio; declined blood pressure; lowered plasma levels of lactate dehydrogenase (LDH), creatine kinase-MB (CK-MB), and total peroxides (TP); and elevated total antioxidant capacity (TAC) levels. Moreover, the heart tissue contained raised levels of TAC and Na+/K+-ATPase activity and lowered levels of TP and Ca2+. Findings provide evidence that administration of GE in experimental CRF model helped protect the heart through reducing oxidative stress and controlling cardiac Na+/K+-ATPase activity and Ca2+ levels.
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Affiliation(s)
- Asmaa M S Gomaa
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.
| | - Alaa T Abdelhafez
- Department of Pharmacology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hazem A Aamer
- Department of Animal, Poultry and Environment Hygiene, Faculty of Veterinary Medicine, Sohag University, Sohag, Egypt
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Ombrato A, Manzi AV, Palmieri D, Ferrara K, Catalano L, Savoia M. Multiple myeloma and macro creatine kinase type 1: the first case report. Clin Chem Lab Med 2018; 56:e239-e242. [PMID: 29652663 DOI: 10.1515/cclm-2018-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 03/09/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Angela Ombrato
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Antonio Valerio Manzi
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Daniela Palmieri
- Department of Laboratory Medicine, University of Naples Federico II, Naples, Italy
| | - Katia Ferrara
- Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Lucio Catalano
- Department of Clinical Medicine, University of Naples Federico II, Naples, Italy
| | - Marcella Savoia
- Department of Laboratory Medicine, University of Naples Federico II, Naples, Italy
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, Via Sergio Pansini, 5, 80131, Naples, Italy
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Wei C, Zhang S, Liu J, Yuan R, Liu M. Relationship of cardiac biomarkers with white matter hyperintensities in cardioembolic stroke due to atrial fibrillation and/or rheumatic heart disease. Medicine (Baltimore) 2018; 97:e11892. [PMID: 30113487 PMCID: PMC6112985 DOI: 10.1097/md.0000000000011892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
White matter hyperintensities (WMHs), which are common in elderly people and contribute to age-related disability, can coexist with cardiac injury. It remains unclear whether cardiac biomarkers are associated with WMHs.To investigate this question, we prospectively recruited patients with cardioembolic stroke due to atrial fibrillation (AF) and/or rheumatic heart disease (RHD). Four cardiac biomarkers were measured: myoglobin, high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB, and terminal pro-brain natriuretic peptide. WMHs in periventricular and deep white matter were assessed separately.In the entire sample of 171 patients, 120 (70.2%) presented with WMHs, of whom 18 (10.5%) presented with moderate to severe deep white matter hyperintensities (DWMH) and 55 (32.2%) presented with moderate to severe periventricular hyperintensities (PVH). Risk of moderate to severe PVH, after adjusting for confounders, was 2.460-fold higher in patients with high myoglobin levels than in those with low levels, and the risk was 2.608-fold higher in patients with high hs-cTnT levels than in those with low levels. There were no significant associations between any of the 4 cardiac biomarkers and moderate to severe DWMH.This prospective observational study provides new evidence of the potential relationship of cardiac biomarkers with WMHs in patients with cardioembolic stroke due to AF and/or RHD. We found that elevated myoglobin levels and high hs-TnT levels were independently associated with the presence of moderate to severe PVH. Further studies are required to test our findings and explore whether cardiac biomarkers contribute directly to WMHs pathogenesis.
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Xie J, Zhang X, Xu J, Zhang Z, Klingensmith NJ, Liu S, Pan C, Yang Y, Qiu H. Effect of Remote Ischemic Preconditioning on Outcomes in Adult Cardiac Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Studies. Anesth Analg 2018; 127:30-38. [PMID: 29210794 DOI: 10.1213/ane.0000000000002674] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Remote ischemic preconditioning (RIPC) has been demonstrated to prevent organ dysfunction in cardiac surgery patients. However, recent large, prospective, multicenter, randomized controlled trials (RCTs) had controversial results. Thus, a meta-analysis of RCTs was performed to investigate whether RIPC can reduce the incidence of acute myocardial infarction (AMI), acute kidney injury (AKI), and mortality in adult cardiac surgery patients. METHODS Study data were collected from Medline, Elsevier, Cochrane Central Register of Controlled Trials and Web of Science databases. RCTs involving the effect of RIPC on organ protection in cardiac surgery patients, which reported the concentration or total release of creatine kinase-myocardial band, troponin I/troponin T (TNI/TNT) after operation, or the incidence of AMI, AKI, or mortality, were selected. Two reviewers independently extracted data using a standardized data extraction protocol where TNI or TNT concentrations; total TNI released after cardiac surgery; and the incidence of AKI, AMI, and mortality were recorded. Review Manager 5.3 software was used to analyze the data. RESULTS Thirty trials, including 7036 patients were included in the analyses. RIPC significantly decreased the concentration of TNI/TNT (standard mean difference [SMD], -0.25 ng/mL; 95% confidence interval [CI], -0.41 to -0.048 ng/mL; P = .004), creatine kinase-myocardial band (SMD, -0.22; 95% CI, -0.07-0.35 ng/mL; P = .46), and the total TNI/TNT release (SMD, -0.49 ng/mL; 95% CI, -0.93 to -0.55 ng/mL; P = .03) in cardiac surgery patients after a procedure. However, RIPC could not reduce the incidence of AMI (relative risk, 0.89; 95% CI, 0.70-1.13; P = .34) and AKI (relative risk, 0.88; 95% CI, 0.72-1.06; P = .18), and there was also no effect of RIPC on mortality in adult cardiac surgery patients. Interestingly, subgroup analysis showed that RIPC reduced incidence of AKI and mortality of cardiac surgery patients who received volatile agent anesthesia. CONCLUSIONS Our meta-analysis demonstrated that RIPC reduced TNI/TNT release after cardiac surgery. RIPC did not significantly reduce the incidence of AKI, AMI, and mortality. However, RIPC could reduce mortality in patients receiving volatile inhalational agent anesthesia.
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Affiliation(s)
- Jianfeng Xie
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Xiwen Zhang
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Jingyuan Xu
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhongheng Zhang
- Department of Critical Care Medicine, Jinhua Municipal Central Hospital, Jinhua Hospital of Zhejiang University, Zhejiang, China
| | - Nathan J Klingensmith
- Department of Surgery, Emory Critical Care Center, Emory University School of Medicine, Atlanta, Georgia
| | - Songqiao Liu
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chun Pan
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yi Yang
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Haibo Qiu
- From the Department of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Peretti A, Mauri L, Masarin A, Annoni G, Corato A, Maloberti A, Giannattasio C, Vignati G. Cardiac Biomarkers Release in Preadolescent Athletes After an High Intensity Exercise. High Blood Press Cardiovasc Prev 2018; 25:89-96. [PMID: 29282696 DOI: 10.1007/s40292-017-0243-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/11/2017] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION An elevation of cardiac troponins has been described in healthy athletes after endurance exercises. The clinical significance of this increase is unclear and the lack of awareness of this phenomenon may lead to inappropriate management of these subjects. AIM We sought to determine wether an intensive cycling training could determine a biomarkers elevation. METHODS We evaluated serum high sensitivity cardiac troponin T, NH(2)-terminal pro-brain natriuretic peptide, CK-MB and CK in 21 healthy male preadolescent athletes (age 9.2 ± 1.7 years) after an intensive cycling training prolonged until muscular exhaustion (mean duration 16'41″). During exercise heart rhythm and rate were monitored with Holter. RESULTS 62% of the group had an elevation of cardiac biomarkers: specifically, 6 children had an increase in troponin levels; 3 of them had an elevation of pro-brain natriuretic peptides as well. Pro-brain natriuretic peptides resulted increased in 9 subjects. There was no relation between troponin elevation and heart rate, age or exercise duration; subjects with increased pro-brain natriuretic peptides had mean and maximal heart rates lower than children with normal natriuretic peptides levels. Other sports were performed in 50% of subjects with normal troponins and only in 17% of those with increased values. CONCLUSIONS A short, high-intensity exercise caused an elevation of cardiac biomarkers in 62% of our subjects. The grade of training may influence the release of troponin and this increase is probably related to a temporary discrepancy between O2 delivery and consumption. Increases in natriuretic peptides levels are possibly expression of different adaptations to exercise.
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Affiliation(s)
- A Peretti
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - L Mauri
- Pediatric Cardiology, Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy
| | - A Masarin
- Chemical Clinical Analysis and Microbiology, Laboratory Medicine Department, ASST GOM Niguarda Ca Granda, Milan, Italy
| | - G Annoni
- Pediatric Cardiology, Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy
| | - A Corato
- Pediatric Cardiology, Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy
| | - A Maloberti
- Cardiology 4-Diagnostic and Rehabilitative Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy
| | - Cristina Giannattasio
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
- Cardiology 4-Diagnostic and Rehabilitative Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy.
- Cardiologia IV, Dipartimento A. De Gasperis, AST Niguarda Ca' Granda, Piazza Ospedale Maggiore 3, 20159, Milan, Italy.
| | - G Vignati
- Pediatric Cardiology, Cardiothoracovascular Department, ASST GOM Niguarda Ca Granda, Milan, Italy
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Saddi AA, Mohamed AM, Shaikh AM. Prophylactic mechanisms of Cucumis melo var. flexuosus and Phoenix dactylifera fruit extracts against diabetic cardiomyopathy in streptozotocin induced diabetic rats. Pak J Pharm Sci 2018; 31:699-707. [PMID: 29625944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The aim of this investigation was to study the antidiabetic impact of Cucumis melo var. flexuosus and/or Phoenix dactylifera fruit aqueous extracts and their mechanisms in repressing diabetes induced cardio-myopathy in diabetic rats. Type 2 diabetes was promoted in rats by a single intraperitoneal injection of streptozotocin (30mg/kg body wight). C. flexuosus and P. dactylifera extracts (200mg/kg body weight, each) were ingested to diabetic rats daily for a month. The results showed that ingestion of either plant extract or their combination to diabetic rats significantly diminished the glucose level and boosted the insulin concentration in the blood. The plant extracts markedly ameliorated the serum inflammatory molecules, tumor necrosis factor (TNF-α) and C -reactive protein (CRP), as well as the alteration in the cardiac malondialdehyde (MDA) and glutathione peroxidase (GPx). The extracts attenuated the increase in cardiac apoptosis enzyme (caspase -3) and the oxidative DNA fragmentation. Treating diabetic rats with plant extracts also scaled down the serum cardiac function enzyme, creatine phosphokinase-MB (CPK-MB). The biochemical results were confirmed by histopathological examination. This study has proven that both the plant extracts particularly their combination have potential hypoglycemic effect and could attenuate cardiomyopathy in diabetic rats.
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Affiliation(s)
- Amna Ali Saddi
- Biology Department, Faculty of Science, Al Faisaliah, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Azza Mostafa Mohamed
- Therapeutic Chemistry Department, Drug Industry Division, National Research Center, Cairo, Egypt
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Li F, Fan XX, Chu C, Zhang Y, Kou JP, Yu BY. A Strategy for Optimizing the Combination of Active Components Based on Chinese Medicinal Formula Sheng-Mai-San for Myocardial Ischemia. Cell Physiol Biochem 2018; 45:1455-1471. [PMID: 29466787 DOI: 10.1159/000487572] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 01/23/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Traditional Chinese medicine (TCM) has been used in clinical practice for thousands of years and has accumulated considerable knowledge concerning the in vivo efficacy of targeting complicated diseases. TCM formulae are a mixture of hundreds of chemical components with multiple potential targets, essentially acting as a combination therapy of multi-component drugs. However, the obscure substances and the unclear molecular mechanisms are obstacles to their further development and internationalization. Therefore, it is necessary to develop new modern drugs based on the combination of effective components in TCM with exact clinical efficacy. In present study, we aimed to detect optimal ratio of the combination of effective components based on Sheng-Mai-San for myocardial ischemia. METHODS On the basis of preliminary studies and references of relevant literature about Sheng-Mai-San for myocardial ischemia, we chose three representative components (ginsenoside Rb1 (G), ruscogenin (R) and schisandrin (S)) for the optimization design studies. First, the proper proportion of the combination was explored in different myocardial ischemia mice induced by isoproterenol and pituitrin based on orthogonal design. Then, the different proportion combinations were further optimized through uniform design in a multi-model and multi-index mode. Finally, the protective effect of combination was verified in three models of myocardial ischemia injured by ischemia/reperfusion, chronic intermittent hypoxia and acute infarction. RESULTS The optimized combination GRS (G: 6 mg/kg, R: 0.75 mg/kg, S: 6 mg/kg) obtained by experimental screening exhibited a significant protective effect on myocardial ischemia injury, as evidenced by decreased myocardium infarct size, ameliorated histological features, decreased myocardial myeloperoxidase (MPO) and malondiadehyde (MDA), calcium overload, and decreased serum lactate dehydrogenase (LDH), creatine kinase MB isoenzyme (CK-MB), cardiac troponin I (cTn-I) activity. In addition, the interactions of three components in combination GRS were also investigated. The combination, compared to G, R and S, could significantly reduce the concentration of serum CK-MB and cTn-I, and decrease myocardial infarct size, which demonstrated the advantages of this combination for myocardial ischemia. CONCLUSION Our results demonstrated that the optimized combination GRS could exert significant cardioprotection against myocardial ischemia injury with similar effect compared to Sheng Mai preparations, which might provide some pharmacological evidences for further development of new modern Chinese drug for cardiovascular diseases basing on traditional Chinese formula with affirmative therapeutic effect.
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Pöyhönen P, Kylmälä M, Vesterinen P, Kivistö S, Holmström M, Lauerma K, Väänänen H, Toivonen L, Hänninen H. Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural myocardial infarction - a prospective CMR study. BMC Cardiovasc Disord 2018; 18:27. [PMID: 29422025 PMCID: PMC5806273 DOI: 10.1186/s12872-018-0767-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/01/2018] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Large myocardial infarction (MI) is associated with adverse left ventricular (LV) remodeling (LVR). We studied the nature of LVR, with specific attention to non-transmural MIs, and the association of peak CK-MB with recovery and chronic phase scar size and LVR. METHODS Altogether 41 patients underwent prospectively repeated cardiovascular magnetic resonance at a median of 22 (interquartile range 9-29) days and 10 (8-16) months after the first revascularized MI. Transmural MI was defined as ≥75% enhancement in at least one myocardial segment. RESULTS Peak CK-MB was 86 (40-216) μg/L in median, while recovery and chronic phase scar size were 13 (3-23) % and 8 (2-19) %. Altogether 33 patients (81%) had a non-transmural MI. Peak CK-MB had a strong correlation with recovery and chronic scar size (r ≥ 0.80 for all, r ≥ 0.74 for non-transmural MIs; p < 0.001). Peak CK-MB, recovery scar size, and chronic scar size, were all strongly correlated with chronic wall motion abnormality index (WMAi) (r ≥ 0.75 for all, r ≥ 0.73 for non-transmural MIs; p < 0.001). There was proportional scar size and LV mass resorption of 26% (0-50%) and 6% (- 2-14%) in median. Young age (< 60 years, median) was associated with greater LV mass resorption (median 9%vs.1%, p = 0.007). CONCLUSIONS Peak CK-MB has a strong association with chronic scar size and wall motion abnormalities after revascularized non-transmural MI. Considerable infarct resorption happens after the first-month recovery phase. LV mass resorption is related to age, being more common in younger patients.
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Affiliation(s)
- Pauli Pöyhönen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Minna Kylmälä
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Paula Vesterinen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Sari Kivistö
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Miia Holmström
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Kirsi Lauerma
- HUS Medical Imaging Center, Radiology, Helsinki University Hospital, Helsinki, Finland
| | - Heikki Väänänen
- Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
| | - Lauri Toivonen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
| | - Helena Hänninen
- Heart and Lung Center, Helsinki University Hospital and Helsinki University, Haartmaninkatu 4, 00029 HUS, Po BOX 340, Helsinki, Finland
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