Biomarkers Of Myocardial Damage Research Articles

Metabolic dysfunction and incidence of heart failure subtypes among Black individuals: The Jackson Heart Study.

The extent to which metabolic syndrome (MetS) severity influences subclinical myocardial remodelling, heart failure (HF) incidence and subtypes, remains unclear. We assessed the association of MetS with incident HF (including ejection fraction subtypes) among Black individuals. We included 4069 Jackson Heart Study participants (mean age 54.4 years, 63.8% women, 37.2% with MetS) without HF. We categorized participants based on MetS status and MetS severity scores (based on waist circumference [MetS-Z-WC] and body mass index [MetS-Z-BMI]). We assessed the associations of MetS indices with echocardiographic parameters, biomarkers of myocardial damage (high-sensitivity cardiac troponin I [hs-cTnI] and B-type natriuretic peptide [BNP]) and incident HF hospitalizations including HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). MetS severity was associated with subclinical cardiac remodelling (assessed by echocardiographic measures and biomarkers of myocardial damage). Over a median of 12 years, 319 participants developed HF (157 HFpEF, 149 HFrEF and 13 HF of unknown type). MetS was associated with a twofold greater risk of HF (hazard ratio [HR] 2.07, 95% confidence interval [CI] 1.64-2.61). Compared to the lowest quartile (Q1) of MetS-Z-WC, the highest quartile (Q4) conferred a higher risk of HF (HR 2.35, 95% CI 1.67-3.30), with a stronger association for HFpEF (Q4 vs. Q1: HR 4.94, 95% CI 2.67-9.14) vs. HFrEF (HR 1.69, 95% CI 1.06-2.70). Metabolic syndrome severity was associated with both HF subtypes among Black individuals, highlighting the importance of optimal metabolic health for preventing HF.

In-silico binding affinity of a phage display library screened novel peptide against various FABPs.

In accordance to the American Heart Association (AHA), cardiovascular diseases (CVDs) are the leading cause of death around the globe, causing more than 19.1million deaths in 2020. Heart-type fatty acid binding protein (H-FABP) is required for the metabolism of fatty acids (FA) inside cardiomyocytes is reported as a biomarker for myocardial damage. As early as one hour after an Acute myocardial infarction (AMI), H-FABP can be used to detect myocardial ischemia. Thus, H-FABP based detection can reduce the burden on the emergency department. A peptide-based detection system can provide point-of-care diagnostics for CVDs. There is a lot of research being done on peptide-based detection, and it has a lot of potential to help with unmet medical diagnostic needs. A twelve (12) amino acid peptide has been discovered using Phage Display Library Screening. The affinity of peptide with H-FABP and other FABPs has been done using molecular docking and ADMET profile has been done. Molecular docking of small peptides against the target protein can play a crucial role in recognizing peptide binding sites and poses. The docking study was done using the HDOCK server and the visualization of the docked complex was done using Pymol and UCSF chimera. The molecular simulation study of three protein-peptide complexes were done which also validated the binding affinity of peptide with the proteins. The RMSD, RMSF and radius of gyration are also analyzed. The results indicate that H-FABP shows higher level of binding interaction with the peptide having bond length ranging from 2.3 to 3.4 Å. The screened peptide is suitable for H-FABP binding and can be used for prognosis purposes in the heart ischemic conditions.

Application of the Artificial Intelligence Model for Detection of Electrocardiographic Signs of Coronary Occlusion in Patients with Non ST-Elevation Acute Coronary Syndrome

The aim. This study aimed to determine the effectiveness of the OMI AI deep learning model for the diagnosis of myocardial infarction in patients with non ST-elevation acute coronary syndrome. Materials and methods. This single-center retrospective observational study analyzed the data of 238 patients admitted to the National Amosov Institute of Cardiovascular Surgery of the National Academy of Medical Sciences of Ukraine with a primary diagnosis of non ST-elevation acute coronary syndrome. The inclusion criteria for the study were: age ≥18 years, symptoms of acute coronary syndrome, at least one 10-second 12-lead electrocardiography on admission, no changes typical of ST-segment elevation myocardial infarction on electrocardiography, and at least one laboratory blood test for biomarkers of myocardial damage. Results. The final analysis included data from 116 patients, 69 (59.5%) men and 47 (40.5%) women aged 43 to 88 years (mean age 67±11 years), of whom 34 were older patients (≥75 years). Of these, 29 (25%) patients were discharged with a diagnosis of acute myocardial infarction, 60 (51.7%) with a diagnosis of unstable angina, and 27 (23.3%) patients with other diagnoses. When analyzing electrocardiographic data by the OMI AI model, true positive results were obtained in 23 cases (19.8%), true negative results in 76 cases (65.5%), false positive results in 11 cases (9.5%), and false negative results in 6 cases (5%). Accordingly, the model’s sensitivity was 67% and specificity was 93%. The positive and negative predictive values for the model under study were 0.793 and 0.874, respectively. The accuracy of the model was 85.34% (95% CI: 77.78% to 90.64%). Conclusions. The use of the artificial intelligence tools has the potential to improve the accuracy of diagnosis of myocardial infarction during hospitalization, accelerate the provision of specialized care and improve prognosis in patients with non ST-elevation acute coronary syndrome.

Association of α-HBDH levels with the severity and recurrence after acute ischemic stroke

Objectiveα-HBDH serves as a biomarker of myocardial damage and is implicated in adverse outcomes across various critical illnesses. Our study aimed to assess the correlation between α-HBDH levels, and severity and recurrence of acute ischemic stroke (AIS).MethodsWe enrolled patients with mild-to-moderate AIS within 72 h of onset. Based on the baseline score of the National Institutes of Health Stroke Scale (bNIHSS) at registration, patients were categorized into mild (bNIHSS ≤ 4 points) and moderate AIS groups (4 < bNIHSS ≤ 10 points). Subsequently, based on the normal upper limit of α-HBDH, patients were divided into low-level α-HBDH (≤ 180 U/L) and high-level α-HBDH (> 180 U/L) groups. Multivariate logistic regression analysis and Cox proportional hazard regression analysis were employed to evaluate the relationship between α-HBDH levels and bNIHSS scores as well as the risk of recurrent AIS within 90 days.ResultsWe observed a significant association between higher baseline levels of α-HBDH and increased bNIHSS scores, indicating a more severe AIS (odds ratio = 24.449; 95% confidence interval [CI], 8.749–68.324; p < 0.01). Additionally, the risk of recurrent AIS within 90 days was 4.666 times higher in the high-level α-HBDH group compared to the low-level group (hazard ratio = 4.666; 95% CI, 2.481–8.777; p < 0.01).ConclusionsThe baseline level of α-HBDH is significantly correlated with the severity of AIS and the risk of recurrent AIS within 90 days.

Usefulness of myocardial damage biomarkers in predicting cardiogenic shock in patients undergoing heart valve surgery.

Usefulness of myocardial damage biomarkers in predicting cardiogenic shock in patients undergoing heart valve surgery.

Predictive Factors of Therapy-Related Cardiovascular Events in Patients with Lymphoma Receiving Anthracyclines.

Cancer-therapy-related cardiac dysfunction (CTRCD) is a growing concern for public health, with a growing incidence due to improved survival rates of patients with hematological malignancies due to diagnostic and therapeutic advances. The identification of patients at risk for CTRCD is vital to developing preventive strategies. A single-center retrospective cohort study was conducted between 1 January 2017 and 15 February 2023. Medical records of patients with lymphoma treated with first-line anthracyclines were reviewed. Demographic data, cardiovascular risk factors, biomarkers of myocardial damage, and echocardiographic information were collected. A total of 200 patients were included. The incidence of CTRCD was 17.4% (35/200). Patients with CTRCD were older than those without CTRCD, with a mean age of 65.17 years vs. 56.77 (p = 0.008). Dyslipidemia (DL) (31.4% vs. 13.4% p = 0.017) and previous cardiovascular disease (40% vs. 13.3%; p < 0.001) were more frequent in the group who developed an event. Mean baseline NT-proBNP levels in the subgroup with cardiovascular events were 388.73 kg/L ± 101.02, and they were 251.518 kg/L ± 26.22 in those who did not (p = 0.004). Differences in Troponin I levels were identified during and after treatment without exceeding the laboratory's upper reference limit. Patients were followed for a median of 51.83 months (0.76-73.49). The presence of a CTCRD event had a negative impact on overall mortality from any cause (HR = 2.23 (95% CI: 1.08-2.93); p = 0.031). Early identification of risk factors is crucial to manage patients at risk for CTRCD.

The new biomarker that predicts in-hospital mortality in myocardial infarction: glucose/potassium ratio

Aims: Acute myocardial infarction (AMI) remains one of the leading causes of cardiovascular mortality. However, the parameters used to predict short-term mortality are limited. Glucose-potassium ratio (GPR) is a new biomarker that has been recently used. This study aimed to investigate the usefulness of GPR in predicting short-term mortality in patients diagnosed with AMI in the emergency department. Methods: This retrospective cohort study was conducted between January 1, 2022, and June 30, 2022, and included patients registered in the hospital emergency health system with IRB (Institutional Review Board) approval. Patients were identified based on inclusion criteria, and their demographic data, laboratory findings, and outcomes were recorded in the hospital registration system. Data comparisons between deceased and non-deceased patients were performed using the Student's t-test. Correlation analysis was performed using Spearman's correlation coefficients. A binary logistic regression model was created to determine the predictive parameters, and odds ratios and 95% confidence intervals (CI) were presented. Results: A total of 665 patients diagnosed with AMI were included in the study, with 75.9% of all patients being male and an average age of 62.14±11.62. A total of 6.6% of the patients included in the study died due to various causes during hospitalization. When laboratory values of deceased AMI patients were examined, statistically significant increases in glucose, urea, creatinine, WBC, neutrophil, lymphocyte, troponin, ckmb, and lactate levels were observed. The effects of GPR, NLR, PLR, lactate, and troponin levels on in-hospital mortality were analyzed using univariate logistic regression. GPR (95% CI 1.015-1.036, p=0.000), troponin (95% CI 1.001-1.001, p=0.000), and lactate (95% CI 1.437-1.908, p=0.000) were found to be the most important factors associated with mortality in patients with AMI. The ability to predict in-hospital mortality in AMI was compared, and GPR was found to have a higher predictive ability than troponin, a biomarker of myocardial damage (AUC: 0.729; P?=?0.000; Sensitivity:70%; Specificity:70%; Cut-off: 38.21). Conclusion: GPR, as a new and inexpensive biomarker, can be used to determine in-hospital mortality in patients with AMI. This index has a better predictive ability than troponin, NLR, and PLR, but is weaker than lactate.

A Multicentric Observational Study to Determine Myocardial Injury in Severe Community-Acquired Pneumonia (sCAP).

Background: Severe community-acquired pneumonia (sCAP) is the most frequent admission for acute respiratory failure in intensive care medicine. Observational studies have found a correlation between patients who were admitted with CAP and the development of cardiovascular events. The risk of acute myocardial damage in patients with CAP is particularly high within the first 30 days of hospitalization. Research design and methods: Multicenter prospective cohort analysis conducted in consecutive patients admitted to an ICU with microbiologically confirmed diagnoses of sCAP. The aim was to determine any structural cardiac damage detected by advanced imagining techniques (cardiac MRI) and cardiac biomarkers in patients with sCAP. The patients were stratified, according to their etiology, into pneumococcal or not-pneumococcal sCAP. The primary outcome was cardiac damage at day 5 and 7 of clinical presentation. Results: A total of 23 patients were consecutively and prospectively enrolled for two winter periods. No significant differences were observed between the median troponin when comparing the pneumococcal vs. non-pneumococcal. The incidence of myocardial damage was numerically higher in the pneumococcal subgroup (70% vs. 50%, p = 0.61) on day 5 and on day 7 (53% vs. 40%, p = 0.81) but did not achieve significance. Confirming a correlation between the biomarkers of cell damage and the biomarkers of myocardial damage, only a positive and significant correlation was observed between h-FABP and DNA on day 1 (r = 0.74; p < 0.01) and day 3 (r = 0.83; p < 0.010). Twenty cardiac MRIs were performed on the 23 patients (87%). No presence of fibrosis was observed in any of the studies carried out within the first 15 days of admission. Conclusions: No significant myocardial damage was found in patients with sCAP independent of the bacterial etiology in accordance with biomarker alterations (Troponin and/or h-FABP) or cardiac MRI. Using cardiac MRI, we could not find any presence of myocardial fibrosis within the first 15 days of admission.

Takotsubo cardiomyopathy in locally advanced rectosigmoid junction cancer: a case report

Background. takotsubo cardiomyopathy (tcm) occurs more frequently in cancer patients than in the general population. The triggers for tcm in cancer patients include not only the inflammatory state of the cancer itself, but also the significant emotional stress of a cancer diagnosis and the physical stress associated with invasive diagnostic and treatment procedures.Case presentation. We describe the case of a 54-yearold woman with histologically verified rectosigmoid junction cancer (cT4bcN2M0) complicated by acute intestinal obstruction. In the early postoperative period, a sudden drop in blood pressure, t-wave inversion and Qt-interval prolongation on ecg, decrease in the left ventricle contractility and presence of wall motion abnormalities on echocardiography (ecHo), as well as an increase in biomarkers of myocardial damage were initially regarded as acute coronary syndrome, which was subsequently excluded according to the findings of coronary angiography, which did not reveal coronary artery obstruction. taking into account the rapid and complete inverse dynamics of changes, acute myocardial infarction without coronary artery obstruction and acute myocarditis were excluded. Ultimately, the diagnosis of takotsubo cardiomyopathy was established.Conclusion. this case report indicates that cancer can be a trigger for the development of tcm; therefore, the assessment of cardiological status and timely detection of cardiac complications in cancer patients during cancer treatment is extremely important and is aimed at increasing the overall survival in this category of patients.

ST-segment elevation myocardial infarction heart of Charlotte one-year (STEMI HOC-1) study: a prospective study protocol

BackgroundST-segment elevation myocardial infarction (STEMI) is a clinically distinguishable yet lethal sequela of ischaemic heart disease (IHD). In sub-Saharan Africa (SSA), death due to acute STEMI is increasing. In South Africa, there is a paucity of data available on the clinical outcomes of acute STEMI within one year for individuals treated in the public healthcare sector. This study primarily seeks to determine the one-year all-cause mortality rate of acute STEMI. The study also assesses the value of serum cardiac biomarkers of myocardial damage and serum uric acid in predicting all-cause mortality in STEMI.MethodsThis is a single-centre observational prospective cohort of all consecutive individuals presenting with an acute STEMI to the Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) in Johannesburg, South Africa. Research data will be sourced on admission through electronic medical records, blood laboratory results and coronary angiography reports, and at follow-up through periodic telephonic interviews and standardised echocardiograms. At least 355 eligible participants will be continuously followed over one year, and clinical outcomes will be measured 30 days, three months, six months and one year after the index hospitalisation.DiscussionThis study provides insights into the demographic, risk factors and clinical profiles of individuals with STEMI in South Africa. Its findings may improve the risk stratification, prognostication, and therapeutic management of STEMI patients in our setting. By comparing the clinical outcomes between the different coronary reperfusion strategies, our results may guide clinicians in providing better patient treatment, particularly in sub-Saharan Africa, where access to percutaneous coronary intervention may be limited. Furthermore, the study offers insights into the routine use of baseline serum uric acid as a potential low-cost prognostic biomarker of all-cause mortality in STEMI. Finally, this study’s findings may be of public health significance to local policymakers to aid in reinforcing primary prevention strategies and developing structured referral networks for timely coronary reperfusion of acute STEMI.

Myocardial damage biomarkers and the first case of macrotroponin I detection in endurance athletes

Background. High levels of cardiac troponin in the blood indicates myocardial injury, including those caused by intense exercises. Recent studies have shown that an elevation in the troponin concentration in the patients can be caused by the macrotroponin circulation. There is no data in the scientific literature describing this problem in athletes.The aim. To identify the cases and possible causes of high blood levels of cardiac markers in athletes before and after endurance exercises.Materials and methods. The study was conducted on 11 male cross-country skiers aged 15–21 years. The study included two stages: the first was conducted at the end of the preparatory period (November, 2020–2021), the second – in the middle (March) of the 2020–2021 competitive period. At each stage, two blood samples were taken from a vein: the first – in the morning on an empty stomach after a day of rest, the second – 12–14 hours after a high-intensity exercise. In the blood serum, the activity of total creatine kinase (CK), weight concentration of the cardiac isoenzyme of creatine kinase (CK-MB), and concentration of high sensitive troponin I (Tn) were measured.Results. The activity of CK in athletes exceeded the upper limit threshold, and decreased from the preparatory (November) to the competitive (March) period. The concentration of CK-MB in response to exercise increased by 2 times and was not accompanied by the signs of myocardial injury. The most sensitive indicator, responsive to physical activity, was troponin I. However, the highest elevation of Tn in blood of one athlete, both before and after the exercise, was associated with the presence of macrotroponin without signs of myocardial injury.Conclusions. An increase of muscle tissue injury biomarkers in blood, including the heart muscle (CK, CK-MB, and Tn), by 2–4 times is a typical reaction for the body of a cross-country skier to an intense exercise. High levels of troponin in the blood, both before and after training or competition, may be associated with the presence of macrotroponin.

Assessment of the risk of cardiovascular complications in cancer surgery

Cardiac complications of non-cardiac surgeries are an actual and unresolved interdisciplinary problem of clinical medicine today. The incidence of cardiovascular events after non-cardiac surgery is higher than in the general population and does not tend to decrease. The risk of cardiac complications in cancer surgery is the highest. Evidence-based approaches to risk assessment and prevention of cardiovascular events in surgical patients with malignant neoplasms have not been developed. In current clinical guidelines on the prevention, prognosis and treatment of cardiac complications of non-cardiac surgeries, the aspects of this problem in surgical oncology are not considered separately.The aim of this review was to analyze the current sources of literature on the prediction of cardiovascular complications in surgical treatment of cancer patients. The distinctive features of cancer surgery and additional factors causing an increased risk of adverse cardiac outcomes in patients with malignant neoplasms are described. The article presents the results of large cohort studies on the search for reliable predictors of cardiac complications in non-cardiac surgery and on the development of stratification scales and algorithms for preoperative risk assessment. Particular attention is paid to the possibilities and prospects of using these predictive tools in the surgical treatment of cancer. The surgical risks of interventions for malignant neoplasms are described, as well as methods for calculating cardiac risk and functional status assessment that have been validated in oncological patients cohorts. The data of recent studies on the role of serum biomarkers of myocardial damage and increased cardiovascular risk (cardiac troponins and brain natriuretic peptide) in predicting postoperative cardiac events in non-cardiac surgery are presented. Further prospects for the inclusion of biomarkers in risk stratification systems in patients with malignant neoplasms are discussed.

Effects of Si-Miao-Yong-An decoction on myocardial I/R rats by regulating gut microbiota to inhibit LPS-induced TLR4/NF-κB signaling pathway

BackgroundCoronary Artery Disease (CAD) is primarily caused by inflammation which is closely linked to the gut microbiota. Si-Miao-Yong-An (SMYA) decoction is a traditional Chinese herbal formula with anti-inflammatory properties that found to be effective against CAD. However, it is still unclear whether SMYA can modulate gut microbiota and whether it contributes to the improvement of CAD by reducing inflammation and regulating the gut microbiota.MethodsThe identification of components in the SMYA extract was conducted using the HPLC method. A total of four groups of SD rats were orally administered with SMYA for 28 days. The levels of inflammatory biomarkers and myocardial damage biomarkers were measured through ELISA, while echocardiography was used to assess heart function. Histological alterations in the myocardial and colonic tissues were examined following H&E staining. Western blotting was performed to evaluate protein expression, whereas alterations in gut microbiota were determined by 16 s rDNA sequencing.ResultsSMYA was found to enhance cardiac function and decrease the expression of serum CK-MB and LDH. SMYA was also observed to inhibit the TLR4/NF-κB signaling pathway by downregulating the protein expression of myocardial TLR4, MyD88, and p-P65, leading to a reduction in serum pro-inflammatory factors. SMYA modified the composition of gut microbiota by decreasing the Firmicutes/Bacteroidetes ratio, modulating Prevotellaceae_Ga6A1 and Prevotellaceae_NK3B3 linked to the LPS/TLR4/NF-κB pathway, and increasing beneficial microbiota such as Bacteroidetes, Alloprevotella, and other bacterial species. Moreover, SMYA was found to safeguard the intestinal mucosal and villi structures, elevate the expression of tight junction protein (ZO-1, occludin), and reduce intestinal permeability and inflammation.ConclusionsThe results indicate that SMYA has the potential to modulate the gut microbiota and protect the intestinal barrier, thereby reducing the translocation of LPS into circulation. SMYA was also found to inhibit the LPS-induced TLR4/NF-κB signaling pathway, leading to a decrease in the release of inflammatory factors, which ultimately mitigated myocardial injury. Hence, SMYA holds promise as a therapeutic agent for the management of CAD.

Introducing a new perspective for the electrochemical detection of cardiac troponin I in the presence of human serum albumin (HSA), cardiac troponin C (cTnC) and C-reactive protein (CRP) based on molecular modeling and electrocatalytic activity towards ascorbic acid

Cardiac troponin I (cTnI) is a specific biomarker of myocardial damage. Several techniques have been reported for cTnI detection, which is based on immunoaffinity, aptamers, and molecular imprinting polymers. Using computational methods, we introduced a novel chemical receptor for cTnI, named tetrabromophenol blue (TBPB), which interacted with cTnI selectivity in the presence of human serum albumin (HSA), cardiac troponin C (cTnC) and C reactive protein (CRP). Employing TBPB as a chemical receptor, a novel electrochemical sensor was constructed for the electrochemical sensing of cTnI. A glassy carbon electrode surface was modified with layered double hydroxide nanostructures (LDHNS) and TBPB. The modified electrode showed electrocatalytic activity toward ascorbic acid (AA) in a phosphate buffer solution (pH 7.4). The results revealed that using AA as a signal enhancer for cTnI detection could be a good idea. The linear range (50.00–3.50 × 105 pM) and detection limit (2.77 pM) were calculated using differential pulse voltammetry to measure cTnI at the TBPB/meso-Fe/CoLDHNS/GCE in a pH 7.40 buffer solution containing 1 mM of AA. Firstly, based on our docking studies, TBPB showed a very low tendency towards HSA, cTnC, and CRP. Additionally, the selectivity of TBPB/meso-Fe/CoLDHNS/GCE for cTnI was studied electrochemically in the presence of HSA, cTnC, and CRP.

Molecular targets for anti-oxidative protection of açaí berry against diabetes myocardial ischemia/reperfusion injury

Myocardial ischemia/reperfusion injury (MIRI) is the principal cause of death and occurs after prolonged blockage of the coronary arteries. Diabetes represents one of the main factors aggravating myocardial injury. Restoring blood flow is the first intervention against a heart attack, although reperfusion process could cause additional damage, such as the overproduction of reacting oxygen species (ROS). In recent years, açaí berry has gained international attention as a functional food due to its antioxidant and anti-inflammatory properties; not only that but this fruit has shown glucose-lowering effects. Therefore, this study was designed to evaluate the cardioprotective effects of açaí berry on the inflammatory and oxidative responses associated with diabetic MIRI. Diabetes was induced in rats by a single intravenous inoculation of streptozotocin (60 mg/kg) and allowed to develop for 60 days. MIRI was induced by occlusion of the left anterior descending coronary artery for 30 min followed by 2 h of reperfusion. Açaí (200 mg/kg) was administered 5 min before the end of ischemia and 1 h after reperfusion. In this study, we clearly demonstrated that açaí treatment was able to reduce biomarkers of myocardial damage, infarct size, and apoptotic process. Moreover, açaí administrations reduced inflammatory and oxidative response, modulating Nf-kB and Nrf2 pathways. These results suggest that açai berry supplementation could represent a useful strategy for pathological events associated to MIRI.

Evaluation of heart fatty acid-binding protein as a biomarker for canine leishmaniosis.

Myocarditis frequently occurs in canine leishmaniosis (CanL). Heart fatty acid-binding protein (HFABP) is a biomarker of myocardial damage. This study aimed to compare HFABP concentration (HFABPc) in healthy dogs and dogs at different stages of CanL and evaluate the correlation of this biomarker with several clinicopathological and echocardiographic variables. Thirty-one dogs diagnosed with CanL and 10 healthy dogs were included. HFABPc was not statistically different (p > 0.05) between groups of dogs at different LeishVet stages of CanL or between groups with high versus low to intermediate serology titres. In 70% of CanL dogs, HFABPc was within the 95% confidence interval limits of the mean of healthy dogs. A moderate negative correlation with globulin (r = -0.519; p = 0.03) and haematocrit (HCT) (r = -0.538; p = 0.02) was observed. No other significant correlation (p > 0.05) was observed with any other variable. Many statistical tests were performed, and therefore, type I error cannot be ruled out. HFABPc is not consistently elevated in dogs with CanL and is not associated with the severity of the disease, or most echocardiographic or clinicopathological variables studied. The correlation with globulin and HCT was not strong and not considered clinically significant. HFABPc lacks sufficient predictive capacity in dogs with CanL, discouraging further research or clinical use of this biomarker in this disease.

Plasma Troponins Identify Patients with Very Low-Risk Acute Pulmonary Embolism

Although in the non-vitamin K oral anticoagulants (NOAC) era majority of low-risk acute pulmonary embolism (APE) patients can be treated at home, identifying those at very low risk of clinical deterioration may be challenging. We aimed to propose the risk stratification algorithm in sPESI 0 point APE patients, allowing them to select candidates for safe outpatient treatment. Post hoc analysis of a prospective study of 1151 normotensive patients with at least segmental APE. In the final analysis, we included 409 sPESI 0 point patients. Cardiac troponin assessment and echocardiographic examination were performed immediately after admission. Right ventricular dysfunction was defined as the right ventricle/left ventricle ratio (RV/LV) > 1.0. The clinical endpoint (CE) included APE-related mortality and/or rescue thrombolysis and/or immediate surgical embolectomy in patients with clinical deterioration. CE occurred in four patients who had higher serum troponin levels than subjects with a favorable clinical course (troponin/ULN: 7.8 (6.4-9.4) vs. 0.2 (0-1.36) p = 0.000). Receiver operating characteristic (ROC) analysis showed that the area under the curve for troponin in the prediction of CE was 0.908 (95% CI 0.831-0.984; p < 0.001). We defined the cut-off value of troponin at >1.7 ULN with 100% PPV for CE. In univariate and multivariate analysis, elevated serum troponin level was associated with an increased risk of CE, whereas RV/LV > 1.0 was not. Solely clinical risk assessment in APE is insufficient, and patients with sPESI 0 points require further assessment based on myocardial damage biomarkers. Patients with troponin levels not exceeding 1.7 ULN constitute the group of "very low risk" with a good prognosis.

Cardiotoxicity as a Possible Side Effect of Statins.

According to current views, statins have a wide range of beneficial effects (lipid and non-lipid) on the cardiovascular system, so they are one of the most commonly used drugs for the prevention and management of patients with cardiovascular diseases. However, it is important to note that information about many beneficial effects of statins is contradictory. In addition, a number of side effects of statins, in particular, myotoxicity, hepatotoxicity, diabetogenic property, etc., may limit the possibility of using statins or even force doctors to cancel these drugs. Also, some concerns are caused by recent studies reporting cardiotoxicity of statins and increased serum concentrations of biomarkers of myocardial damage (highly sensitive cardiac troponins (hs-cTns)) in patients taking statins. This article discusses in detail the possible mechanisms of cardiotoxicity of statins and outlines the directions for further research in this area.

Course and Outcomes of Acute Coronary Syndrome in the Presence of New Coronavirus Infection COVID-19

Abstract We analyzed the clinical condition of patients with COVID-19 of varying severity, changes in instrumental and laboratory parameters, and assessed the impact of the severity of the course of a new coronavirus infection on the outcomes of acute coronary syndrome.AIM OF STUDY To study the mutual influence of acute coronary syndrome and the new coronavirus infection COVID-19 on the nature of the course and outcomes of the disease.Materia l and methods In March 21, 2020 – May 31, 2021, 3 625 patients were treated for COVID-19, including 131 patients with acute coronary syndrome due to COVID-19 disease. All patients underwent a number of studies: computed tomography of the chest, electrocardiography, echocardiography, monitoring of biomarkers of myocardial damage, diagnostic coronary angiography and, if necessary, intracoronary therapeutic intervention.Results Data on the distribution of patients with COVID-19 according to the presence or absence of ST segment elevation on the electrocardiogram and the degree of lung tissue damage, as well as information on mortality in these groups, are presented. The role of troponin I in the assessment of myocardial ischemia was analyzed. The direct dependence of its level on the volume of lung damage was found. The inverse relationship was shown between the degree of damage to the lung tissue and the indices of oxygen saturation in the blood. A poor prognostic value of low left ventricular ejection fraction in patients with COVID-19 disease has been described.Conclusions The development of acute coronary syndrome in the course of COVID-19 significantly worsens the prognosis of the disease, which requires the development of algorithms for providing medical care to patients in this category, as well as maximum vigilance in their treatment.

Imatinib induces diastolic dysfunction and ventricular early-repolarization delay in the halothane-anesthetized dogs: Class effects of tyrosine kinase inhibitors

Imatinib has been reported to induce heart failure and/or QTc prolongation. To better understand their underlying mechanisms, we assessed its effects on cardiohemodynamic, electrocardiographic and echocardiographic variables along with biomarkers of myocardial damage. Imatinib mesylate in doses of 1 and 10 mg/kg was intravenously administered to the halothane-anesthetized beagle dogs (n = 4). Effects of imatinib on each phase of isovolumetric contraction, ejection, isovolumetric relaxation and filling were studied, whereas its electrophysiological effects on early and late repolarization were analyzed by measuring J-Tpeak and Tpeak-Tend, respectively. The low and high doses of imatinib provided peak plasma concentrations of 3.23 and 17.39 μg/mL, reflecting clinically-relevant and supratherapeutic concentrations, respectively. Neither lethal ventricular tachyarrhythmia nor cardiohemodynamic collapse was observed. Imatinib decreased amplitude of peak −dP/dt, indicating suppression of isovolumetric relaxation, whereas no significant change was detected in the other phases. Imatinib prolonged QTc and J-Tpeakc without altering Tpeak-Tend, indicating increase of net inward current, which leads to intracellular Ca2+ overload. Thus, imatinib suppressed ventricular active relaxation and early repolarization, which may suggest the association of mitochondrial dysfunction-associated inhibition of ATP production. Since those findings were also reported for dasatinib, sunitinib and lapatinib, they could be common cardiac phenotype of tyrosine kinase inhibitors in vivo.