Kinase Fraction Research Articles

Prevalence and impact of viral myocarditis in patients with severe fever with thrombocytopenia syndrome.

To explore the association and impact between viral myocarditis and mortality in patients with severe fever with thrombocytopenia syndrome. A dynamic analysis was conducted between fatal group and nonfatal group regarding the daily epidemiology data, clinical symptoms, and electrocardiogram (ECG), echocardiogram, and laboratory findings. Outcomes of patients with and without viral myocarditis were compared. The association between viral myocarditis and mortality was analyzed. Among 183 severe fever with thrombocytopenia syndrome patients, 32 were in the fatal group and 151 in the nonfatal group; there were 26 (81.25%) with viral myocarditis in the fatal group, 66 (43.70%) with viral myocarditis in the nonfatal group (p < 0.001), 79.35% of patients had abnormal ECG results. The abnormal rate of ECG in the fatal group was 100%, and in the nonfatal group was 74.83%. Univariate analysis found that the number of risk factors gradually increased on Day 7 of the disease course and reached the peak on Day 10. Combined with the dynamic analysis of the disease course, alanine aminotransferase, aspartate aminotransferase, creatine kinase, creatine kinase fraction, lactate dehydrogenase, hydroxybutyrate dehydrogenase, neutrophil count, serum creatinine, Na, Ca, carbon dioxide combining power, amylase, lipase, activated partial thromboplastin time and thrombin time had statistically significant impact on prognosis. The incidence of fever with thrombocytopenia syndrome combined with viral myocarditis is high, especially in the fatal group of patients. Viral myocarditis is closely related to prognosis and is an early risk factor. The time point for changes in myocarditis is Day 7 of the course of the disease.

Association between apelin-12 and creatine kinase-MB, depending on success of reperfusion in STEMI patients.

Acute myocardial infarction is characterised by an imbalance in the supply and demand of oxygen in the heart. It requires urgent reperfusion, and poor outcomes are attributed to myocardial ischaemia-reperfusion injury. We aimed to evaluate the association between apelin-12 levels and creatine kinase-MB activity in predicting the effectiveness of reperfusion therapy in ST-segment elevation myocardial infarction (STEMI) patients. In this study we included 72 patients with the following criteria: chest pain suggestive of myocardial ischaemia for at least 30 minutes, an electrocardiogram with ST-segment elevation (measured at the J-point) ≥ 2 mm in leads V2-V3 and/or ≥ 1 mm in the other leads, rise of specific biomarkers such as cardiac troponin and the MB fraction of creatine kinase (CK-MB), and those who underwent reperfusion therapy. Blood samples for the measurement of apelin-12 and creatine kinase-MB were collected 12 hours after the reperfusion therapy. In patients with thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2, the median of the apelin-12 level was 1.80 ng/ml (0.46-9.20), and with TIMI flow 3, it was 5.76 ng/ml (1.14-15.2). Variability was observed in the apelin values (Mann-Whitney test) based on TIMI flow grade (p < 0.001), while no variability was observed for creatine kinase-MB (p < 0.18). The degree of association between apelin-12 and creatine kinase-MB levels was analysed with Pearson's correlation, enabling us to determine patients with successful reperfusion (determined as TIMI flow 3) (p < 0.004), and those with unsuccessful reperfusion (with TIMI flow ≤ 2) (p = 0.86). In STEMI patients undergoing reperfusion therapy, Apelin-12 level was associated with creatine kinase-MB activity according to the success of the reperfusion.

Effect of Xuebijing injection on myocardium during cardiopulmonary bypass: A prospective, randomized, double blind trial.

BACKGROUNDCardiopulmonary bypass (CPB) is an essential procedure for maintaining the blood supply to vital organs in patients undergoing cardiac surgery. However, perioperative cardiac injury related to CPB remains a severe complication in these patients. Cardiac protection is important for patients undergoing CPB. AIMTo evaluate the potential cardioprotective efficacy of the Chinese medicine preparation Xuebijing injection (XBJ) in patients undergoing CPB.METHODSSixty patients undergoing cardiac surgery with CPB were randomly allocated to the XBJ and control groups (saline). XBJ was administered intravenously three times: 12 h prior to surgery, at the beginning of the surgery, and 12 h after the second injection. Cardiac function was evaluated by echocardiography 48 h after surgery. Circulating inflammation- and oxidative-stress-related markers were measured. Clinical outcomes related to intensive care unit (ICU) stay were recorded.RESULTSCompared to control treatment, XBJ was associated with improved PaO2/FiO2 and cardiac systolic function, but reduced troponin I and creatine kinase fraction after surgery (all P < 0.05). The circulating concentrations of tumor necrosis factor-α, interleukin (IL)-1β and IL-8 in the XBJ group were significantly lower than those in the control group (all P < 0.05), whereas the circulating concentration of IL-10 was significantly higher in the XBJ group (P < 0.05). In addition, the lengths of ICU stay and hospitalization after surgery tended to be shorter in the XBJ group than in the control group, although the differences were not significant. CONCLUSIONPerioperative administration of XBJ was associated with attenuated cardiac injury during CPB, likely via anti-inflammatory and antioxidative mechanisms.

Creditability of Cardiac Biomarkers in Sudden Cardiac Death

Background: Natural deaths constitute a significant portion of total deaths cases received for autopsy ingeneral. Cardiovascular system occupies the vast majority of natural death causes. Sudden cardiac deathis a catastrophic complication of a number of cardiovascular diseases and affect all ages. Death is mostlyunexpected and has a devastating impact on both the surviving family and community. Clinicians use cardiacmarkers, highly sensitive and specific for detection of myocardial damage to screen living patients for acutemyocardial infarction (AMI), however to that point, the utility of those markers for diagnosis of cardiacdeath in autopsy setting has not been fully established. Materials and Methods: A prospective postmortemcase control study was carried out on 103 medico-legal cases referred to the Medico-Legal directorate inBaghdad during 6 months period in 2020. The cases under study were classified in to two groups, those dieddue to cardiac causes (53) as cases group, and those died due to traumatic causes (50) as control group. Bloodsamples were collected using disposable syringes to withdraw 3-5ml of blood then immediately centrifugedto separate the serum and stored at -20°C till biochemical analysis for cardiac biomarkers (High sensitivetroponin I, MB fraction of Creatin kinase and Lactate dehydrogenase). Results: Males constituted 77%from the total number while females constituted 23%. The mean age of the total study group was 42.57±15.125 years with a range between 11-72 years. The total number of cases group were 53 case( 77% maleand 23% female) with a mean age of 48.89±12.566, compared with 50 cases as controls group from the totalnumber(76%male and 24% female) with mean age of 35.88±14.825. Sensitivity of High sensitive troponinI was 96.2% which was acceptable and it’s specificity for diagnosis of sudden cardiac causes of death was22% which was very low. While Sensitivities of MB fraction of Creatin kinase and Lactate dehydrogenasewere 96.2% and 94.3% respectively and their specificities were 6% and 14% respectively. There were nocorrelations between post mortem interval and all three biochemical parameters levels. Conclusion: Highsensitive troponin I, MB fraction of Creatin kinase and Lactate dehydrogenase were not reliable as diagnosticbiomarkers for sudden cardiac deaths without gross postmortem and histopathological examination. Therewere no correlations between the three biomarkers (High sensitive troponin I, MB fraction of Creatin kinaseand Lactate dehydrogenase) and the post mortem interval .

Impact of cellular myocardial infiltration on clinical outcome in non-ischaemic heart failure

AimsSo far, little has been known on whether myocardial inflammatory infiltration influences heart failure (HF) progression. Thus, the aim of this study was to test the impact of intramyocardial infiltration...

Evaluation of omentin levels in patients with unstable angina pectoris, non-ST elevated myocardial infarction (NSTEMI) and STEMI

Aim: Acute coronary syndrome (ACS) is an ischemic cardiac disease that could result in myocardial necrosis with prolonged ischemia. Omentin (intelectin-1) is a new biomarker that is released from adipose tissue. It is associated with coronary artery disease (CAD) and has an acute ischemic injury-reducing effect. This study aimed to assess the omentin levels in patients with unstable angina pectoris (USAP), Non-ST segment elevation myocardial infarction (NSTEMI), and ST-segment elevated myocardial infarction (STEMI). Methods: This case-control prospective study included 59 patients with ACS and 22 healthy subjects. MB fraction of creatine kinase (CKMB), troponin, myoglobin, and omentin levels were measured from venous blood obtained from each patient within six hours after the onset of symptoms. Plasma omentin levels were determined with an omentin enzyme-linked immunosorbent assay kit. Results: The patient group was older than the control group (P 0.05). The rate of smoking was higher in the patient group, and the patient group was heavier than the control group (P>0.05). Omentin levels were similar in ACS patients and control subjects (6.0 (1.7) vs. 6.3 (1.3), P=0.40). There was no significant correlation among CKMB, troponin, myoglobin, and omentin levels. Moreover, omentin levels were similar in ACS subgroups (P=0.58). There was no significant correlation between body mass index and omentin levels (r =-0.186, P=0.09). Conclusion: This study revealed that there was no significant relationship between omentin and myoglobin levels in ACS patients. The potential usefulness of blood concentrations of omentin levels in understanding the relationship with ACS warrants further studies.

Fecal blood tests-screening methods for identification of pre-tumor changes and tumors at the early stage

Mortality due to cancer of the rectal colon is currently increasing in all groups of the adult population. Various screening methods are used to identify the pre-tumor and early stages of the development of tumor pathology of the colon: occult blood tests in feces, computer colonography (virtual colonoscopy), colonoscopy, DNA testing, tumor marker M2-PK (tumor fractional pyruvate kinase fraction M2). All of these colorectal cancer screening methods give good results, but there is no consensus among experts regarding the choice of the most optimal method. One of the first tests to detect hidden blood in the stool was biochemical tests: guaiac test (gFOBT guaiac fecal occult-blood test ), in which hemoglobin in the stool was detected by a biochemical method that exploited the pseudoperoxidase activity of hemoglobin and the Gregersen reaction, which is a benzidine test in which benzidi was used instead of guaiac resin And instead of a hydrogen peroxide barium peroxide. Enzyme-linked immunosorbent assays, in contrast to biochemical ones, use antibodies specific only to human hemoglobin, which excludes false-positive results obtained using the biochemical method. The FIT test (Fecal Immunochemical Test or Immunochemical Fecal occult blood test) specifically determines human hemoglobin in feces at lower threshold values (40300 g HB/1 g feces) compared to g-FOBT. Due to its high accuracy, Enzyme-linked immunosorbent assays are successfully used to detect occult blood in inflammatory bowel diseases, allergic enteropathies, acute intestinal infections, and erosive gastritis.

D-dimer Düzeyi Koroner Arter Baypas Cerrahisinden Sonra İskemi/Reperfüzyon Hasarının Bir Bulgusudur

Introduction: Myocardial Ischaemia-Reperfusion (I-R) injury produces a spectrum of clinical cardiovascular outcomes after cardiac surgery. The pathogenesis of I-R injury is complex and involves the activation and amplification of several systemic and local proinflammatory pathways. The process of restoring blood flow to the ischaemic myocardium can induce injury and paradoxically reduce the beneficial effects of myocardial reperfusion. The objective of this study was to determine the correlation between cardiac markers such as the Mb fraction of the creatine kinase (CK-MB), troponin I (cTnI) and D-dimer levels as a marker of myocardial injury secondary to I-R injury after coronary artery bypass surgery. Patients and Methods: Herein, a prospective study was designed that included 50 consecutive coronary artery bypass grafting (CABG) patients. Pre and postoperative blood samples were taken due to study protocol and such markers as Mb fraction of the creatine kinase (CK-MB), troponin I (cTnI) and D-dimer were measured. Results: All three markers were significantly elevated in postoperative blood samples. The D-dimer level reached its peak at the first and another peak at 12th hour postoperatively. However, the peak serum values of CK-MB and cTnI occurred at 6th and 12th hour, respectively. Conclusion: We demonstrated that D-dimer levels as a marker of generated thrombin during reperfusion correlated with other well-known biochemical markers of myocardial damage in the postoperative period. In other words, D-dimer levels may stand as a marker of I-R-induced myocardial damage.

Rhabdomyolysis After Cocaine Consumption-Case Report

Clinical laboratory measurement of serum showed a significant increase in the levels of indirect markers of muscle lysis. Serum creatine kinase fraction MM (CK) level increased up to 99.500 U/L and creatine kinase MB fraction (CK-MB) up to 6.500U/L. Changes in electrolytes also increased (sodium=1.730mmol/L, potassium=42.1mmol/L, phosphorus =48.3mg/dl, chlorine =1.243mmol/L and magnesium=36.1mg/dl). Changes in kidney functions also occurred (urea =302.6mg/dl and creatinine=11.1mg/dL). The levels of albumin (33.4g/dl) and lactate dehydrogenase LDH (22,545U/L) also increased. Further, qualitative tests for troponin and myoglobin were positive. Intervention: The soldier stayed in the intensive care unit (ICU) for five days.

Long-term treatment with valganciclovir improves lentiviral suicide gene therapy of glioblastoma.

Suicide gene therapy for malignant gliomas has shown encouraging results in the latest clinical trials. However, prodrug application was most often restricted to short-term treatment (14 days), especially when replication-defective vectors were used. We previously showed that a substantial fraction of herpes simplex virus thymidine kinase (HSV-TK) transduced tumor cells survive ganciclovir (GCV) treatment in an orthotopic glioblastoma (GBM) xenograft model. Here we analyzed whether these TK+ tumor cells are still sensitive to prodrug treatment and whether prolonged prodrug treatment can enhance treatment efficacy. Glioma cells positive for TK and green fluorescent protein (GFP) were sorted from xenograft tumors recurring after suicide gene therapy, and their sensitivity to GCV was tested in vitro. GBM xenografts were treated with HSV-TK/GCV, HSV-TK/valganciclovir (valGCV), or HSV-TK/valGCV + erlotinib. Tumor growth was analyzed by MRI, and survival as well as morphological and molecular changes were assessed. TK-GFP+ tumor cells from recurrent xenograft tumors retained sensitivity to GCV in vitro. Importantly, a prolonged period (3 mo) of prodrug administration with valganciclovir (valGCV) resulted in a significant survival advantage compared with short-term (3 wk) application of GCV. Recurrent tumors from the treatment groups were more invasive and less angiogenic compared with primary tumors and showed significant upregulation of epidermal growth factor receptor (EGFR) expression. However, double treatment with the EGFR inhibitor erlotinib did not increase therapeutic efficacy. Long-term treatment with valGCV should be considered as a replacement for short-term treatment with GCV in clinical trials of HSV-TK mediated suicide gene therapy.

Time-Dependent Change in Omentin-1 Level Correlated with Early Improvement of Myocardial Function in Patients with First Anterior ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention.

Aim: Omentin-1, as a novel adipocytokine, ameliorates obesity-associated disorders and suppresses the development of atherosclerotic lesions. The present research investigated the correlation between serum omentin-1 and post-infarction myocardial function.Methods: A total of 52 patients with first anterior ST-segment elevation myocardial infarction (STEMI) were recruited into this study. Participants were divided into two subgroups according to median admission omentin-1 concentration. δ1 was defined as (admission omentin-1 level) - (serum omentin-1 at 24 hours after admission) and δ2 was defined as (admission omentin-1 level) - (serum omentin-1 at 72 hours after admission). The change in left ventricular ejection fraction (LVEF) was regarded as (LVEF at 3 months post-STEMI) – (LVEF at 2 days post-STEMI).Results: Admission omentin-1 level was the highest, while omentin-1 decreased over the following 3 days. The high admission omentin-1 group had lower peak muscle brain fraction of creatine kinase (CK–MB). Additionally, the change in LVEF and the global LVEF at 3 months post-STEMI all ameliorated significantly in the high admission omentin-1 group. For the time-dependent change in omentin-1, there were negative associations among δ1, δ2, and peak CK–MB. δ1 and δ2 also correlated positively with LVEF at 3 months post-STEMI. Most importantly, δ1 (r = 0.346, p = 0.012) and δ2 (r = 0.439, p = 0.001) also correlated positively with the change in LVEF. After multivariate linear regression analysis, δ1 (Beta = 0.026, 95% CI 0.011 to 0.041, p = 0.001) and δ2 (Beta = 0.024, 95% CI 0.009 to 0.038, p = 0.003) also remained associated with the change in LVEF.Conclusions: The admission omentin-1 and time-dependent change in omentin-1 level all have a significant correlation with the early improvement of post-infarction myocardial function. While only the time-dependent change in omentin-1 (δ1 and δ2) remained associated with the early improvement of post-infarction myocardial function after multivariate linear regression analysis. The present research indicated that omentin-1 represents a promising adipocytokine to retard negative cardiac remodeling after STEMI.

Short infusion of paclitaxel imbalances plasmatic lipid metabolism and correlates with cardiac markers of acute damage in patients with breast cancer.

Although paclitaxel-based chemotherapy is widely used for treating breast cancer, paclitaxel therapy has been associated with several adverse effects. Such adverse effects have primarily been associated with long-term regimens, but some acute effects are being increasingly reported in the literature. In this context, the present study analyzed the systemic proteomic profiles of women diagnosed with breast cancer at the first cycle of short paclitaxel infusion (n=30). Proteomic profiles thus obtained were compared with those of breast cancer patients without chemotherapy (n=50), as well as with those of healthy controls (n=40). Plasma samples were evaluated by label-free LC-MS to obtain systemic proteomic profiles. Putative dysregulated pathways were identified and validated by in silico analysis of proteomic profiles. Our results identified 188 proteins that were differentially expressed in patients who received a single short paclitaxel infusion when compared to patients who did not receive the infusion. Gene ontology analysis indicated that the cholesterol pathway may be dysregulated by paclitaxel in these patients. Validation analysis showed that paclitaxel treatment significantly reduced plasma high-density lipoprotein levels and increased plasma hydroperoxide levels when compared to breast cancer patients without chemotherapy. Furthermore, augmented C-reactive protein and creatine kinase fraction MB were found to be significantly higher in paclitaxel-treated patients in comparison with healthy controls. Taken together, these data suggest that a single dose of short paclitaxel infusion is sufficient to trigger significant alterations in lipid metabolism, which puts breast cancer patients at risk for increased incidence of cardiovascular disease.

Ratio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome

BackgroundTakotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio of high-sensitivity cardiac troponin T (hs-TnT) to the myocardial fraction of creatine kinase (CKMB) could be a potent discriminator between TT and MI patients. MethodsWe separately present analysis of data from retrospective files and prospectively recruited patients presenting with TT (35 retrospective and 42 prospective), NSTEMI (48 retrospective and 75 prospective) and STEMI (20 retrospective and 39 prospective). We compared ratios of hs-TnT to CKMB on admission to the hospital between TT, NSTEMI and STEMI patients. Receiver operating characteristic (ROC) curves were analysed to determine optimal cut-off values. ResultsOn admission, hs-TnT/CKMB ratio was significantly higher in TT patients than in NSTEMI and STEMI patients in both the retrospective phase (median and interquartile range, TT 0.024 [0.018–0.047] vs NSTEMI 0.009 [0.006–0.022], p<0.0001; TT vs STEMI 0.011 [0.006–0.016], p=0.0002) and the prospective cohort (median and interquartile range, TT 0.032 [0.018–0.040] vs NSTEMI 0.009 [0.006–0.015], p<0.0001; TT vs STEMI 0.009 [0.005–0.017], p<0.0001). A cut-off hs-TnT/CKMB ratio of 0.015 distinguished TT from MI with a sensitivity of 85.7% and a specificity of 67.6% (AUC 0.796; 95%CI: 0.71–0.89) in the retrospective phase. In the prospective phase, a ratio of 0.017 distinguished TT from MI with a sensitivity of 83.3% and a specificity of 78.1% (AUC 0.88; 95%CI: 0.83–0.94). Conclusionhs-TnT/CKMB ratio is a novel, readily available parameter that could be used alongside clinical risk scores, other biomarkers and ECG findings to discriminate between TT and MI.

High sensitivity cardiac troponins: Can they help in diagnosing myocardial ischaemia?

Cardiac troponin is the most sensitive marker of myocardial injury, but controversy still exists about its role in detecting ischaemia. To investigate the role of troponin as a marker of stress-induced ischaemia, circulating high sensitivity cardiac troponin T (hs-cTnT) was measured and compared with the MB fraction of creatine kinase (CK-MB) in 125 patients undergoing a stress test (53 electrocardiogram/echo exercise, 42 echo dipyridamole and 30 echo dobutamine tests). Plasma concentrations of hs-cTnT increased after the tests in 90/125 patients, while an increase of CK-MB was seen in 31/125 patients ( p<0.0001). Overall, hs-cTnT significantly increased from 17.5±16.9 ng/l to 25.5±27.9 ng/l ( p<0.0001), without significant changes of CK-MB. Significant increments in hs-cTnT were documented after exercise test (from 15.9±11.9 ng/l to 19.5±13.6 ng/l, p<0.0001) and dobutamine test (from 20.6±20.8 ng/l to 37.8±31.1 ng/l, p=0.0006), in absence of changes in CK-MB according to each stressor. Among the 125 tests, 84 were diagnosed as negative and 41 as positive for myocardial ischaemia. Significant increments in hs-cTnT were detected after both negative (from 18.6±19.2 ng/l to 27.1±32.1 ng/l, p=0.0018) and positive test (from 15.2±10.8 ng/l to 22.3±16.2 ng/l, p=0.0005), without significant changes of CK-MB according to the test result. Despite a positive correlation between stress-induced increase of hs-cTnT and obstructive coronary artery disease, the release of troponin was observed also in a significant proportion of patients without coronary stenoses. Left ventricular hypertrophy markedly enhanced myocardial release of troponin. Circulating troponin increases in most patients undergoing a stress test, irrespective of the test result and of coronary artery disease. Plasma release of troponin depends on multiple pathogenetic mechanisms, making the biomarker a not reliable tool in detecting transient ischaemia.

Cardiac Troponin T and creatine kinase MB fraction levels among patients with acute ischemic stroke in Nigeria

Stroke has been a global burden, with increasing morbidity and mortality. Serum cardiac troponin t (cTnT) and creatine kinase (CK-MB) fraction are reported to be elevated in patients admitted with acute ischaemic stroke and high level of these biomarkers indicated more severe stroke and neurologic deficit in some of the patients. To evaluate the serum levels cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in patients with acute ischaemic stroke and relate the analytes to severity of stroke. Patients with clinical diagnosis of ischaemic stroke diagnosed, confirmed by brain Computerized Tomography scan and equal number of apparently healthy age and sex-matched were recruited. Serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) were analysed using ELISA method and Stroke severity was determined using National Institute of Health Stroke Score (NIHSS). Mean serum cardiac troponin t (cTnT) and creatine kinase MB fraction (CK-MB) in stroke patients were found to be higher than age sex matched control (p<0.05). NIHS Score of 12.2 ± 5.43 and 9.78 ± 3.97 were observed in Patients with elevated and normal cTnT respectively (p=0.009) while NIHS Score were similar in patients with elevated and normal CK-MB (p = 0.772). The mean values of serum cTnT and CK-MB were higher in acute ischaemic stroke patients compared to controls. Serum cardiac Troponin t level may be a significant biomarker of the severity of stroke.

A Simple and Efficient Methodology for the Study of Cardioprotective Drugs in Animal Model of Cardiac Ischemia-Reperfusion

To study cardioprotective drugs, we developed a simple and efficient methodology to evaluate effects of drugs on cardiac electrical activity using electrocardiogram (ECG) in rats submitted to cardiac ischemia-reperfusion (I/R). Using adult male Wistar rats (14 - 16-week-old) anesthetized (urethane 1.25 g/kg, i.p.) and kept under mechanical ventilation, we used surgical procedures to induce cardiac I/R by means mechanical occlusion of left anterior descendent coronary artery for 10 min (ischemia) with silk suture (tourniquet) followed by its removal to allow coronary recirculation (reperfusion). To evaluate the effects of surgical process, a group of rats (SHAM-operated) was submitted to surgical procedures previously described, but without coronary occlusion. To evaluate cardiac electrical activity in rats submitted to cardiac I/R and SHAM-operated, the ECG system was coupled to animal body to determine the incidence of ventricular arrhythmia (VA), atrio-ventricular blockade (AVB) and lethality (LET). To evaluate injury biomarkers production in rats submitted to cardiac I/R and SHAM-operated, serum concentrations of creatine kinase fraction (MB/CK-MB) and troponin I were determined by biochemical techniques. Using the methodology proposed in this work, we observed that VA, AVB and LET incidence was significantly higher in cardiac I/R group (85%, 79% and 70%, respectively) than in SHAM-operated group (0%, 0% and 0%, respectively). Serum levels of CK-MB and troponin I were also significantly higher in cardiac I/R (1,850 ± 222 U/L and 0.031 ± 0.009 ng/mL, respectively) compared to SHAM-operated group (808 ± 72 U/L and 0.200 ± 0.027 ng/mL). To evaluate efficiency of methodology proposed in this work to study the effect of cardioprotective drugs, the effects of the L-type Ca2+ channel blocker (CCB) nifedipine (30 mg/kg, intravenously - IV) in rats submitted to cardiac I/R were studied. The treatment with nifedipine (before ischemia) significantly reduced the incidence of VA (from 85% to 28%), AVB (from 79% to 14%), and LET (from 70% to 14%). These results indicate that the methodology described in the present work is simple, and efficient, to evaluate cardiac functional and biochemical alterations induced by cardiac I/R, and also the study of cardioprotective drugs in rats. This methodology could contribute to the development of new pharmacological cardioprotective strategies for to treatment of ischemic cardiac diseases in humans, such as myocardial infarction.

A Randomized Trial of Creatine‐kinase Leak After Rosuvastatin in Elective Percutaneous Coronary Intervention (CLEAR‐PCI)

To determine the impact of percutaneous coronary intervention (PCI) performed at the same time of the peak concentration of rosuvastatin to reduce periprocedural myocardial infarction (PMI). Prior studies suggest that a high dose of statin before PCI reduce periprocedural myocardial infarction. However, there is no information regarding the elective PCI performed at the time of the peak of statin concentration to reduce PMI. From 2001 to 2013, at a single center in Brazil we enrolled 544 patients who underwent elective PCI and after exclusions for baseline biases in clinical and angiographic characteristics, yielding 528 patients, we prospectively randomly assigned them to either a high loading dose of Rosuvastatin before PCI (n = 264) or standard treatment (n = 264). After exclusions for biases in procedural characteristics a total of 487 patients underwent to end points analysis. The primary outcome was the incidence of MB fraction of creatine kinase (CK-MB) greater than three times the upper limit of normal. The primary end point occurred in 7.6% in the rosuvastatin and 4.8% in the control group (P = 0.200). There was a higher incidence in elevation of CK-MB than normal baseline in the rosuvastatin (67.1% vs 59.2%, P = 0.701). There was no difference in major adverse event (0% in the rosuvastatin group vs 0.8% in control).

Preformed Soluble Chemoreceptor Trimers That Mimic Cellular Assembly States and Activate CheA Autophosphorylation.

Bacterial chemoreceptors associate with the histidine kinase CheA and coupling protein CheW to form extended membrane arrays that receive and transduce environmental signals. A receptor trimers-of-dimers resides at each vertex of the hexagonal protein lattice. CheA is fully activated and regulated when it is integrated into the receptor assembly. To mimic these states in solution, we have engineered chemoreceptor cytoplasmic kinase-control modules (KCMs) based on the Escherichia coli aspartate receptor Tar that are covalently fused and trimerized by a foldon domain (TarFO). Small-angle X-ray scattering, multi-angle light scattering, and pulsed-dipolar electron spin resonance spectroscopy of spin-labeled proteins indicate that the TarFO modules assemble into homogeneous trimers wherein the protein interaction regions closely associate at the end opposite to the foldon domains. The TarFO variants greatly increase the saturation levels of phosphorylated CheA (CheA-P), indicating that the association with a trimer of receptor dimers changes the fraction of active kinase. However, the rate constants for CheA-P formation with the Tar variants are low compared to those for autophosphorylation by free CheA, and net phosphotransfer from CheA to CheY does not increase commensurately with CheA autophosphorylation. Thus, the Tar variants facilitate slow conversion to an active form of CheA that then undergoes stable autophosphorylation and is capable of subsequent phosphotransfer to CheY. Free CheA is largely incapable of phosphorylation but contains a small active fraction. Addition of TarFO to CheA promotes a planar conformation of the regulatory domains consistent with array models for the assembly state of the ternary complex and different from that observed with a single inhibitory receptor. Introduction of TarFO into E. coli cells activates endogenous CheA to produce increased clockwise flagellar rotation, with the effects increasing in the presence of the chemotaxis methylation system (CheB/CheR). Overall, the TarFO modules demonstrate that trimerized signaling tips self-associate, bind CheA and CheW, and facilitate conversion of CheA to an active conformation.

Markers of myocardial damage in children of the first year of life with congenital heart disease in the early period after surgery with cardioplegic anoxia.

We measured the level of cardiac markers (high-sensitivity troponin T and MB fraction of creatine kinase) in children of the first year of life with congenital heart disease in the perioperative period. After cardiac surgery, plasma levels of the above markers exceed the reference limits in the examined children. The diagnosis of myocardial ischemia using biochemical markers in the postoperative period is possible only by dynamic monitoring of the cardiac marker level. The preoperative concentration of high-sensitivity troponin T in children of the first year of life with congenital heart disease can be regarded as a predictor of postoperative complications.

Platelet Indices in Patients with Acute Coronary Syndrome

The platelet indices Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and Plate-letcrit (PCT) provided by automated hematology analysis are rarely used in clinical practice. Platelets play a central role in the pathogenesis of acute coronary syndromes (ACS) and high MPV has been associated to more reactive platelets and regarded as an independent risk factor for myocardial infarction. In this study, platelet indices were evaluated in 39 patients with ACS presenting two altered biochemical parameters, C reactive protein (CRP) and creatine kinase fraction MB (CK-MB). The results obtained showed significantly higher MPV and PDW values in the group with ACS in comparison to the control group. Also observed was a weak but significant positive correlation between MPV and CK-MB. In view of findings of previous studies, which have associated macroplatelets with higher thrombotic potential our results suggest that the use of the MPV and PDW indices as additional and complementary markers may contribute to the investigation and follow-up of thrombotic risk in patients with ACS.