Plasma immunoreactive endothelin in the acute and subacute phases of myocardial infarction in patients undergoing fibrinolysis

1993 ◽  
Vol 39 (6) ◽  
pp. 955-959 ◽  
Author(s):  
P Lechleitner ◽  
N Genser ◽  
J Mair ◽  
J Maier ◽  
E Artner-Dworzak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Plasma Concentrations ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Early Reperfusion ◽  
Ventricular Ejection Fraction ◽  
Creatine Kinase Mb ◽  
Time Courses ◽  
Time Of Admission

Abstract Endothelin is a potent vasoconstrictor of coronary arteries. We measured plasma concentrations of immunoreactive endothelin (irET) in 46 patients with confirmed acute myocardial infarction (AMI). When compared with irET concentrations in healthy individuals who served as controls, irET concentrations in patients were already significantly elevated at the time of admission (P = 0.002) and remained significantly elevated for at least 2 days after AMI (P < 0.01). IrET concentrations peaked 1 h (mean) after admission (8.5 +/- 3.9 ng/L, P = 0.02 compared with values at time of admission). Reperfusion of the infarct-related artery markedly influenced irET release. Before the start of thrombolytic therapy, irET concentration in patients with early reperfusion did not differ significantly from that of those without early reperfusion. However, irET time courses were significantly (P = 0.03 by analysis of variance) different in patients who did and did not have early reperfusion. In the latter, peak irET concentrations correlated closely with the angiographic left ventricular ejection fraction (r = -0.71, P = 0.03), maximum creatine kinase MB mass concentrations (r = 0.69, P = 0.01), and creatine kinase activities (r = 0.59, P = 0.03). Reflow and reversion of myocardial ischemia are associated with a reduced irET release in patients with AMI.

scholarly journals Effects of Cyclosporine on Reperfusion Injury in Patients: A Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Kangxing Song ◽  
Shuxia Wang ◽  
Dake Qi
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Reperfusion Injury ◽  
Meta Analysis ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Randomized Controlled ◽  
Creatine Kinase Mb ◽  
Significant Difference

Mitochondrial permeability transition pore (mPTP) opening due to its role in regulating ROS generation contributes to cardiac reperfusion injury. In animals, cyclosporine (cyclosporine A, CsA), an inhibitor of mPTP, has been found to prevent reperfusion injury following acute myocardial infarction. However, the effects of CsA in reperfusion injury in clinical patients are not elucidated. We performed a meta-analysis using published clinical studies and electronic databases. Relevant data were extracted using standardized algorithms and additional data were obtained directly from investigators as indicated. Five randomized controlled blind trials were included in our meta-analysis. The clinical outcomes including infarct size (SMD: −0.41; 95% CI: −0.81, 0.01;P= 0.058), left ventricular ejection fraction (LVEF) (SMD: 0.20; 95% CI: −0.02, 0.42;P= 0.079), troponin I (TnI) (SMD: −0.21; 95% CI: −0.49, 0.07;P= 0.149), creatine kinase (CK) (SMD: −0.32; 95% CI: −0.98, 0.35;P= 0.352), and creatine kinase-MB isoenzyme (CK-MB) (SMD: −0.06; 95% CI: −0.35, 0.23;P= 0.689) suggested that there is no significant difference on cardiac function and injury with or without CsA treatment. Our results indicated that, unlike the positive effects of CsA in animal models, CsA administration may not protect heart from reperfusion injury in clinical patients with myocardial infarction.

scholarly journals Relation between three-dimensional and two-dimensional echocardiography and biochemical analysis in patients with ST-segment elevation myocardial infarction percutaneously treated

2010 ◽  
Vol 8 (1) ◽  
pp. 53-61
Author(s):  
Marcelo Luiz Campos Vieira ◽  
Wercules Antônio Oliveira ◽  
Alexandre Ferreira Cury ◽  
Adriana Cordovil ◽  
Ana Clara Tude Rodrigues ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Left Ventricular Ejection Fraction ◽  
Ejection Fraction ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
Ventricular Ejection ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Creatine Kinase Mb

ABSTRACT Objective: The prognosis of patients with acute myocardial infarction depends on multiple features that can demonstrate myocardial injury degree (such as serum markers of cardiac necrosis), and also on adaptive mechanisms relative to the acute event. The aim of the study was to assess the relation between biochemical and echocardiographic findings from three-dimensional echocardiographic (3D Echo) analysis and echocardiographic two-dimensional (2D Echo) left ventricular ejection fraction in patients with ST-segment elevation acute myocardial infarction, submitted to primary percutaneous treatment. Methods: A prospective study with 2D Echo and 3D Echo of 23 patients (17 males, mean age of 57 ± 13 years) with ST-segment elevation acute myocardial infarction, primarily percutaneously treated (stent). Serum cardiac markers (creatine kinase MB, Troponin I and Myoglobin) and serum brain natriuretic peptide were compared to echocardiographic parameters (volumes, left ventricular ejection fraction and ventricular dyssynchrony index). The statistical analysis was performed using Pearson's correlation coefficient, 95% CI, p < 0.05, linear regression equation and Bland & Altman test. Results: Pearson's correlation coefficient (r)relative to 3D left ventricular ejection fraction: 1- brain natriuretic peptide: r: - 0.7427, p < 0.0001; 2- creatine kinase MB: r: - 0.660, p = 0.001. Left ventricular ejection fraction 2D (r) : 1- brain natriuretic peptide: r: - 0.5478, p = 0.001; 2- creatine kinase MB: r: - 0.4800, p < 0.0277. Other associations were not significant. Conclusions: In this series, it was observed better correlation in regard to serum creatine kinase MB, brain natriuretic peptide and 3D Echo left ventricular ejection fraction, when compared to 2D Echo left ventricular ejection fraction.

scholarly journals The importance of chronic kidney disease for the assessment of risk of adverse outcomes after myocardial infarction

2017 ◽  
Vol 95 (6) ◽  
pp. 563-570 ◽  
Author(s):  
V. N. Karetnikova ◽  
V. V. Kalaeva ◽  
Maria V. Evseeva ◽  
O. V. Gruzdeva ◽  
M. V. Zykov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Renal Dysfunction ◽  
Acute Phase ◽  
Myocardial Revascularization ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Group I ◽  
Time Of Admission

Renal dysfunction (RD) in the acute phase of myocardial infarction (MI) is pivotal for the risk stratification of adverse long-term outcomes after myocardial infarction and, therefore, requires further study. Purpose. To determine the role of CKD and renal dysfunction (in the acute phase of MI) in the adverse long-term post-MI prognosis. Material and methods. 954 patients with ST-segment elevation myocardial infarction (STEMI) were enrolled in a registry study, performed in the period from 2008 to 2010 at the Kemerovo Cardiology Dispensary. All patients were assigned to two groups according to the presence of concomitant CKD. Serum creatinine levels were measured at the time of admission and on 10-12th days, with further calculation of glomerular filtration rate (GFR) using the CKD-EPI equation. Patients without CKD were assigned to Group I (n = 616 (64.5%), and STEMI patients with CKD to Group II (n=338 (35.4%). Observations during the three-year follow-up period were evaluated from the end-points. Results. The factors associated with mortality among patients with CKD were as follows: left ventricular ejection fraction (LVEF) < 40% at the time of admission (OR 2.1; 95% CI 1.0-4.4), signs of RD at the time of discharge (OR 2.5, 95% CI 1.0-5.9), non-performance of myocardial revascularization (OR 3.1, 95% CI 1.4-6.8). The long-term prognosis in the group of patients without CKD depended on the following factors: non-performance of PCI (OR 2.1, 95% CI 1.0-4.3), severe AHF (Killip class) (OR 3.5, 95% CI 1.9-6.7), LVEF < 40% (OR 2.0, 95% CI 1.0-3.8), and older age (OR 2.0, 95% CI 1.0-3.9). Conclusion. Renal dysfunction (regardless of the presence of CKD) diagnosed in the acute phase of MI as well as left ventricular dysfunction (EF < 40%) were found to affect long-term mortality risk in the post-MI period.

Circulating MicroRNA-146a and MicroRNA-21 Predict Left Ventricular Remodeling after ST-Elevation Myocardial Infarction

Cardiology ◽  
2015 ◽  
Vol 132 (4) ◽  
pp. 233-241 ◽  
Author(s):  
Xiaoxia Liu ◽  
Yumei Dong ◽  
Song Chen ◽  
Guangde Zhang ◽  
Mingyu Zhang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Circulating Microrna ◽  
Ventricular Ejection Fraction ◽  
Creatine Kinase Mb ◽  
Acute Mi

Objectives: MicroRNA (miR)-146a and miR-21 have been reported to participate in inflammatory reactions and fibrosis. Excessive inflammation and cardiac fibrosis may play important roles in the development of left ventricular remodeling (LVR). This study assessed whether miR-146a, miR-21 and other biomarkers could predict LVR after myocardial infarction (MI). Methods: Circulating miR-146a, miR-21 and other biomarker levels were measured in 198 patients with acute MI 5 days after primary percutaneous coronary intervention (PCI). All patients were assessed by transthoracic echocardiography on day 5 and 1 year after primary PCI. Results: Concentrations of circulating miR-146a, miR-21, C-reactive protein, creatine kinase MB type and troponin I, as well as estimated glomerular filtration rate (eGFR) and left ventricular ejection fraction (LVEF), were significantly higher in patients with than in those without LVR (p < 0.05). Multivariate logistic regression analysis showed that circulating miR-146a (odds ratio, OR = 2.127, p < 0.0001), miR-21 (OR = 1.119, p < 0.0001), eGFR (OR = 0.939, p = 0.0137) and LVEF (OR = 0.802, p = 0.0048) were independent predictors of LVR development. The area under the curve for the combination of miR-146a and miR-21 was significantly higher than for either alone. Conclusion: Circulating miR-146a and miR-21 may be novel biomarkers predictive of LVR after acute MI. Their combination may better predict LVR than either alone.

scholarly journals Role of B lymphocytes in the infarcted mass in patients with acute myocardial infarction

2021 ◽  
Vol 41 (2) ◽  
Author(s):  
Ana C.A. Casarotti ◽  
Daniela Teixeira ◽  
Ieda M. Longo-Maugeri ◽  
Mayari E. Ishimura ◽  
Maria E.R. Coste ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
B Lymphocytes ◽  
Troponin T ◽  
High Sensitivity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Early Reperfusion ◽  
Ventricular Ejection Fraction ◽  
High Sensitivity Troponin T

Abstract Despite early reperfusion, patients with ST segment elevation myocardial infarction (STEMI) may present large myocardial necrosis and significant impairment of ventricular function. The present study aimed to evaluate the role of subtypes of B lymphocytes and related cytokines in the infarcted mass and left ventricular ejection fraction obtained by cardiac magnetic resonance imaging performed after 30 days of STEMI. This prospective study included 120 subjects with STEMI submitted to pharmacoinvasive strategy. Blood samples were collected in subjects in the first (D1) and 30th (D30) days post STEMI. The amount of CD11b+ B1 lymphocytes (cells/ml) at D1 were related to the infarcted mass (rho = 0.43; P=0.033), measured by cardiac MRI at D30. These B1 cells were associated with CD4+ T lymphocytes at D1 and D30, while B2 classic lymphocytes at day 30 were related to left ventricular ejection fraction (LVEF). Higher titers of circulating IL-4 and IL-10 were observed at D30 versus D1 (P=0.013 and P&lt;0.001, respectively). Titers of IL-6 at D1 were associated with infarcted mass (rho = 0.41, P&lt;0.001) and inversely related to LVEF (rho = −0.38, P&lt;0.001). After multiple linear regression analysis, high-sensitivity troponin T and IL-6 collected at day 1 were independent predictors of infarcted mass and, at day 30, only HDL-C. Regarding LVEF, high-sensitivity troponin T and high-sensitivity C-reactive protein were independent predictors at day 1, and B2 classic lymphocytes, at day 30. In subjects with STEMI, despite early reperfusion, the amount of infarcted mass and ventricular performance were related to inflammatory responses triggered by circulating B lymphocytes.

scholarly journals The Prognostic Utility of Plasma NGAL Levels in ST Segment Elevation in Myocardial Infarction Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Ahmet Avci ◽  
Bahadir Ozturk ◽  
Kenan Demir ◽  
Fikret Akyürek ◽  
Bulent Behlul Altunkeser
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Mortality ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Roc Curve Analysis ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Plasma Ngal ◽  
Creatine Kinase Mb

Introduction. Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. In addition, plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of myocardial infarction. In this study, we investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). Methods. 235 consecutive STEMI patients were enrolled in the study. Patients were divided into groups according to LVEF. Plasma NGAL, troponin I, creatine kinase MB (CKMB), and C-reactive protein (CRP) were measured. Finally, the study population examined with 34 reduced LVEF and 34 preserved LVEF consisted of a total of 68 patients (12 females; mean age, 61.5 ± 14.7). All patients were followed up prospectively for 6 months. This study group was divided into two subgroups as the patients who died (n = 14) and survived (n = 34), and plasma NGAL levels of the groups were compared. Results. The median of NGAL was 190.08 ng/ml. Age, troponin I, CKMB, CRP, glomerular filtration rate, and creatinine were higher in reduced LVEF groups. Plasma NGAL levels were also higher in reduced LVEF than in preserved LVEF, but statistically not significant (p=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients (p<0.001). In ROC curve analysis, the level to detect isolated cardiovascular mortality with a sensitivity of 86% and a specificity of 77% was 190 ng/mL for NGAL. Conclusion. Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.

scholarly journals Thyroid hormone and recovery of cardiac function in patients with acute myocardial infarction: a strong association?

2011 ◽  
Vol 165 (1) ◽  
pp. 107-114 ◽  
Author(s):  
Ioannis Lymvaios ◽  
Iordanis Mourouzis ◽  
Dennis V Cokkinos ◽  
Meletios A Dimopoulos ◽  
Savvas T Toumanidis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Thyroid Hormone ◽  
Cardiac Function ◽  
Experimental Studies ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Early Reperfusion ◽  
Ventricular Ejection Fraction ◽  
Potential Implication

ObjectiveThis study investigated whether changes in thyroid hormone (TH) in plasma are associated with the recovery of cardiac function in patients with acute myocardial infarction (AMI). Previous experimental studies have provided evidence of potential implication of TH signaling in post-ischemic recovery of cardiac function.MethodsA total of 47 patients with AMI and early reperfusion therapy were included in this study. Myocardial injury was analyzed by peak creatinine kinase–MB (CKMB) and cardiac function was assessed by echocardiographic left ventricular ejection fraction (LVEF%). Recovery of function (ΔEF%) was estimated as the difference of LVEF% between 48 h and 6 months (6 mo) after AMI. Total triiodothyronine (T3), thyroxine (T4), and TSH were measured in plasma at different time points (24 h, 48 h, 5 d, and 6 mo).ResultsA significant correlation between LVEF% and T3 (r=0.5, P=0.0004) was found early after AMI (48 h), whereas no correlation was observed between CKMB and T3 (r=−0.04, P=0.81). A strong correlation was found between ΔEF% and total T3 (r=0.64, P=10−6) at 6 mo after AMI. Furthermore, multivariate regression analysis revealed that T3 at 6 mo (r=0.64, r2=0.41, P=10−6) was an independent determinant of ΔEF%.ConclusionChanges in T3 levels in plasma are closely correlated with the early and late recovery of cardiac function after AMI. T3 levels at 6 mo appear to be an independent predictor of late functional recovery.

scholarly journals Circulating miR-181a as a Potential Novel Biomarker for Diagnosis of Acute Myocardial Infarction

2016 ◽  
Vol 40 (6) ◽  
pp. 1591-1602 ◽  
Author(s):  
Jianbing Zhu ◽  
Kang Yao ◽  
Qian Wang ◽  
Junjie Guo ◽  
Hongtao Shi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Dependent Manner ◽  
Ventricular Ejection Fraction ◽  
Creatine Kinase Mb

Background: In this study, we tested the hypothesis that miR-181a levels increase during acute myocardial infarction. We investigated circulating miR-181a as a potential novel biomarker for early diagnosis of acute myocardial infarction (AMI). Methods: From June 2014 to June 2016, 120 consecutive eligible patients with AMI (n = 60) or unstable angina (UA; n = 60) and 60 control subjects were enrolled. Plasma miR-181a levels were determined by quantitative reverse transcriptase-polymerase chain reaction. Results: Circulating miR-181a expression levels detected immediately after admission were higher in the AMI group than in the UA and control groups. Relative miR-181a levels in AMI patients were positively correlated with the concentrations of the creatine kinase-MB fraction and cardiac troponin I. Correlation analysis showed that plasma miR-181a was positively correlated with coronary Gensini score (r = 0.573, P < 0.05) and negatively correlated with left ventricular ejection fraction (r = -0.489, P < 0.05). Receiver operating characteristic curve analyses showed that plasma miR-181a was of significant diagnostic value for AMI (AUC, 0.834; 95% CI, 0.756-0.912, P < 0.05). Conclusion: Circulating miR-181a levels in patients with AMI were significantly changed in a time-dependent manner, indicating the value of plasma miR-181a as a novel biomarker for diagnosing AMI.

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