Heart Disease, Clinical Proteomics and Mass Spectrometry

Heart disease is the leading cause of mortality and morbidity in the world. As such, biomarkers are needed for the diagnosis, prognosis, therapeutic monitoring and risk stratification of acute injury (acute myocardial infarction (AMI)) and chronic disease (heart failure). The procedure for biomarker development involves the discovery, validation, and translation into clinical practice of a panel of candidate proteins to monitor risk of heart disease. Two types of biomarkers are possible; heart-specific and cardiovascular pulmonary system monitoring markers. Here we review the use of MS in the process of cardiac biomarker discovery and validation by proteomic analysis of cardiac myocytes/tissue or serum/plasma. An example of the use of MS in biomarker discovery is given in which the albumin binding protein sub-proteome was examined using MALDI-TOF MS/MS. Additionally, an example of MS in protein validation is given using affinity surface enhanced laser desorption ionization (SELDI) to monitor the disease-induced post-translational modification and the ternary status of myoctye-originating protein, cardiac troponin I in serum.

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Effects of environmental conditions on point-of-care cardiac biomarker test performance during a simulated rescue: Implications for emergency and disaster response

American Journal of Disaster Medicine ◽

10.5055/ajdm.2013.0126 ◽

2013 ◽

Vol 8 (3) ◽

pp. 205-212 ◽

Cited By ~ 8

Author(s):

Richard F. Louie, PhD, FACB ◽

William J. Ferguson, BS ◽

Corbin M. Curtis, BS ◽

John H. Vy, BS ◽

Chloe S. Tang, BS ◽

...

Keyword(s):

Test Performance ◽

Troponin I ◽

Point Of Care ◽

False Negative ◽

Environmental Stresses ◽

Marshall Islands ◽

Rank Test ◽

Cardiac Biomarker ◽

Mortality And Morbidity ◽

The Impact

Objective: To characterize the effects of environmental stress on point-of-care (POC) cardiac biomarker testing during a simulated rescue.Design: Multiplex test cassettes for cardiac troponin I (cTnI), brain natriuretic peptide (BNP), CKMB, myoglobin, and D-dimer were exposed to environmental stresses simulating a 24-hour rescue from Hawaii to the Marshall Islands and back. We used Tenney environmental chambers (T2RC and BTRC) to simulate flight conditions (20°C, 10 percent relative humidity) and ground conditions (22.3-33.9°C, 73-77 percent). We obtained paired measurements using stressed versus control (room temperature) cassettes at seven time points (T1-7 with T1,2,6,7 during flight and T3-5 on ground). We analyzed paired differences (stressed minus control) with Wilcoxon signed rank test. We assessed the impact on decision-making at clinical thresholds.Results: cTnI results from stressed test cassettes (n = 10) at T4 (p 0.05), T5 (p 0.01), and T7 (p 0.05) differed significantly from control, when testing samples with median cTnI concentration of 90 ng/L. During the ground rescue, 36.7 percent (11/30) of cTnI measurements from stressed cassettes generated significantly lowered results. At T5, 20 percent (2/10) of cTnI results were highly discrepant—stressed cassettes reported normal results, when control results were 100 ng/L. With sample median concentration of 108 pg/mL, BNP results from stressed test cassettes differed significantly from controls (p 0.05).Conclusion: Despite modest, short-term temperature elevation, environmental stresses led to erroneous results. False negative cTnI and BNP results potentially could miss acute myocardial infarction and congestive heart failure, confounded treatment, and increased mortality and morbidity. Therefore, rescuers should protect POC reagents from temperature extremes.

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Glutamine Is Cardioprotective in Patients with Ischemic Heart Disease following Cardiopulmonary Bypass

The Heart Surgery Forum ◽

10.1532/hsf98.20111074 ◽

2011 ◽

Vol 14 (6) ◽

pp. 384 ◽

Cited By ~ 17

Author(s):

Vladimir V. Lomivorotov ◽

Sergey M. Efremov ◽

Vladimir A. Shmirev ◽

Dmitry N. Ponomarev ◽

Vladimir N. Lomivorotov ◽

...

Keyword(s):

Heart Disease ◽

Placebo Group ◽

Cardiopulmonary Bypass ◽

Ischemic Heart Disease ◽

Troponin I ◽

Left Ventricular ◽

Ischemic Heart ◽

Left Ventricular Ejection ◽

Study Group ◽

Cardioprotective Effects

Background: The aim of the present study was to investigate the cardioprotective effects of the perioperative use of N(2)-L-alanyl-L-glutamine (GLN) in patients with ischemic heart disease (IHD) who undergo their operations under cardiopulmonary bypass (CPB).Methods: This double-blind, placebo-controlled, randomized study included 50 patients who underwent cardiac surgery with CPB. Exclusion criteria were a left ventricular ejection fraction <50%, diabetes mellitus, <3 months since the onset of myocardial infarction, and emergency surgery. Patients in the study group (n = 25) received 0.4 g/kg GLN (Dipeptiven, 20% solution) per day. Patients in the control group (n = 25) were administered a placebo (0.9% NaCl). The primary end point was the dynamics of troponin I at the following stages: (1) prior to anesthesia, (2) 30 minutes after CPB, (3) 6 hours after CPB, (4) 24 hours after surgery, and (5) 48 hours after surgery. Secondary end points included measurements of hemodynamics with a Swan-Ganz catheter.Results: On the first postoperative day after the surgery, the median troponin I level was significantly lower in the study group than in the placebo group: 1.280 ng/mL (interquartile range [IQR], 0.840-2.230 ng/mL) versus 2.410 ng/mL (IQR, 1.060-6.600 ng/mL) (P = .035). At 4 hours after cardiopulmonary bypass (CPB), the median cardiac index was higher in the patients in the study group: 2.58 L/min per m2 (IQR, 2.34-2.91 L/min per m2) versus 2.03 L/min per m2 (IQR, 1.76-2.32 L/min per m2) (P = .002). The median stroke index also was higher in the patients who received GLN: 32.8 mL/m2 (IQR, 27.8-36.0 mL/m2) versus 26.1 mL/m2 (IQR, 22.6-31.8 mL/m2) (P = .023). The median systemic vascular resistance index was significantly lower in the study group than in the placebo group: 1942 dyn�s/cm5 per m2 (IQR, 1828-2209 dyn�s/cm5 per m2) versus 2456 dyn�s/cm5 per m2 (IQR, 2400-3265 dyn�s/cm5 per m2) (P = .001).Conclusion: Perioperative administration of GLN during the first 24 hours has cardioprotective effects in IHD patients following CPB. This technique enhances the troponin concentration at 24 hours after surgery and is associated with improved myocardial function.

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Estimation of the Safety of Intraoperative Fluid Therapy during Great Abdominal Surgery in Patients with Coronary Heart Disease

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs05.05.158 ◽

2020 ◽

Vol 5 (5) ◽

pp. 158-163

Author(s):

V. I. Lysenko ◽

◽

E. A. Karpenko ◽

Ya. V. Morozova

Keyword(s):

Heart Failure ◽

Coronary Heart Disease ◽

Heart Disease ◽

Fluid Therapy ◽

Troponin I ◽

Significant Proportion ◽

Myocardial Damage ◽

Enzyme Linked Immunosorbent Assay ◽

Cardiac Complications ◽

Fluid Regimen

The study of intraoperative fluid therapy tactics has been of great interest over the past few years, especially in people with concomitant coronary heart disease, as they make up a significant proportion of all surgical patients. The purpose of our study was to assess the risk of intraoperative myocardial damage in patients with concomitant coronary heart disease depending on the fluid regimen used based on monitoring of hemodynamic parameters, electrocardiogram and biomarkers of myocardial damage. Material and methods. The study involved 89 patients, who were divided into two groups depending on the tactics of intraoperative fluid therapy – restrictive and liberal. In order to detect cardiac complications at different stages, we assessed biomarkers of myocardial damage Troponin I, NT-proBNP by solid-phase enzyme-linked immunosorbent assay (ELISA). Results and discussion. Analysis of the obtained data showed that MINS (myocardial injury in noncardiac surgery) incidents were diagnosed in 5 patients (11.1%) in the first group and in 6 patients (13.6%) in the second. In patients of both groups there was an increase in NT-proBNP in the dynamics at all stages, and in the 2nd group, with a liberal regimen of intraoperative fluid therapy, it was more pronounced. It should be noted that the obtained values of NT-proBNP in all patients did not differ significantly from those allowed for this age group; such dynamics of NT-proBNP may indicate a relative risk of complications of liberal fluid therapy in patients with baseline heart failure. One of the important points when choosing the mode of fluid therapy in patients with high cardiac risk is the assessment of the initial volemic status and careful monitoring of water balance in the perioperative period with the desire for "zero" balance. The obtained dynamics of laboratory markers of myocardial damage indicates that in patients with a significant reduction in cardiac reserves compensated for heart failure, a restrictive fluid regimen is preferable, which is also confirmed by slight changes in the concentration of biomarkers. Conclusion. Thus, the study demonstrated the relative safety of selected fluid regimens in patients with concomitant coronary heart disease without signs of congestive heart failure

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CURRENT ASPECTS OF CORONARY HEART DISEASE DIAGNOSIS AND TREATMENT

International Medical Journal ◽

10.37436/2308-5274-2020-1-1 ◽

2020 ◽

pp. 5-10

Author(s):

O. M. Korzh

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Drug Therapy ◽

Coronary Arteries ◽

Artery Bypass ◽

Myocardial Revascularization ◽

Disease Diagnosis ◽

Percutaneous Coronary Angioplasty ◽

Mortality And Morbidity ◽

Intravascular Thrombosis

Among the cardiovascular diseases associated with atherosclerosis, chronic coronary heart disease, including angina, is the most common form. It is the myocardium lesion that develops as a result of an imbalance between the coronary circulation and metabolic needs of heart muscle. The presence of angina symptoms often indicates a pronounced narrowing of one or more coronary arteries, but also occurs in non−obstructive arterial impairment and even in normal coronary arteries. Factors of functional damage to the coronary arteries are spasm, temporary platelet aggregation and intravascular thrombosis. Today there are opportunities not only to use the therapy with proven effectiveness, aimed at reducing the risk of complications, including fatal, but also to treat angina (ischemia), which improves the patient's life quality. The drug protocol includes the ones with a proven positive effect on this disease prognosis, which are mandatory if there are no direct contraindications to use, as well as a large group of antianginal or anti−ischemic drugs. The choice of a particular drug or its combinations with other drugs is carried out in accordance with generally accepted recommendations: taking into account the individual approach, the severity of angina, hemodynamic parameters (heart rate and blood pressure, presence of comorbid conditions). If drug therapy is ineffective, the option of coronary myocardial revascularization (percutaneous coronary angioplasty or coronary artery bypass grafting) is considered. Due to the high mortality and morbidity rates of coronary heart disease worldwide, one of the priorities of practical health care is the prevention of diseases caused by atherosclerosis. Key words: coronary heart disease, angina, family physician, prognosis, drug therapy.

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Mortality and morbidity from heart disease under industrial and group insurance

American Heart Journal ◽

10.1016/s0002-8703(29)90271-4 ◽

1929 ◽

Vol 4 (4) ◽

pp. 448-454

Author(s):

Wade Wright

Keyword(s):

Heart Disease ◽

Mortality And Morbidity ◽

Group Insurance

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Incidence, pattern and presentation of Congenital Heart Disease in neonates in southern part of Bangladesh

Mediscope ◽

10.3329/mediscope.v8i1.52201 ◽

2021 ◽

Vol 8 (1) ◽

pp. 27-32

Author(s):

Md Barkot Ali ◽

Syed Didarul Haque ◽

Amar Kumar Saha ◽

Faruquzzaman ◽

Muhammad Ashraful Kabir ◽

...

Keyword(s):

Congenital Heart Disease ◽

Heart Disease ◽

Live Birth ◽

Congenital Heart ◽

Average Weight ◽

Mortality And Morbidity ◽

Co Morbidity ◽

Age Of Diagnosis ◽

Common Clinical Presentation ◽

High Index Of Suspicion

Background: Congenital heart disease (CHD) has already been recognized as one of the important cause of neonatal mortality and morbidity. The reported prevalence of CHD in live newborns tends to vary a lot due to various unrecognizable lesions at birth and lack of technical expertise. Aims & objectives: The ultimate aim of this study was to assess the birth incidence and pattern of congenital heart disease (CHD) using echocardiography in babies born in different government and private hospitals and also in different households. Results: Overall incidence of congenital heart disease in neonate in this study was 4.9 per 1000 live birth. Mean age of diagnosis was 22.5±4.6 days. Average weight of these neonates was 26.70 gm. 61.5 % neonates were female. 30.8% was preterm. Respiratory distress was the most common clinical presentation (76.9%). The commonest type of congenital heart disease was Ventricular septal defect (VSD) (61.5%). Maternal co-morbidity may have influence. 30.8% mothers had gestational diabetes mellitus. Hypothyroidism, hypertension and maternal infection may have co-relation. Conclusion: In this study, we have found that the overall incidence of neonatal congenital heart disease is 4.9 per 1000 live birth. A high index of suspicion and routine neonatal cheek-up may have key role in diagnosis. Mediscope Vol. 8, No. 1: January 2021, Page 27-32

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Troponin I Elevation Occurs Early in Blunt Chest Trauma in the Absence of Underlying Heart Disease

Heart Lung and Circulation ◽

10.1016/j.hlc.2012.05.642 ◽

2012 ◽

Vol 21 ◽

pp. S262

Author(s):

M. Fryer ◽

S. Butterly ◽

A. Ng ◽

D. Harrop ◽

B. Lowe ◽

...

Keyword(s):

Heart Disease ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Troponin I

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Troponin I as a Predictor of Coronary Heart Disease and Mortality in 70-Year-Old Men

Circulation ◽

10.1161/circulationaha.105.570762 ◽

2006 ◽

Vol 113 (8) ◽

pp. 1071-1078 ◽

Cited By ~ 196

Author(s):

Björn Zethelius ◽

Nina Johnston ◽

Per Venge

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Troponin I ◽

Old Men

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Making Meaningful Clinical Use of Biomarkers

Biomarker Insights ◽

10.1177/1177271917715236 ◽

2017 ◽

Vol 12 ◽

pp. 117727191771523 ◽

Cited By ~ 46

Author(s):

Matthew J Selleck ◽

Maheswari Senthil ◽

Nathan R Wall

Keyword(s):

Biomarker Discovery ◽

Therapeutic Monitoring ◽

Clinical Use ◽

Current State

This review discusses the current state of biomarker discovery for the purposes of diagnostics and therapeutic monitoring. We underscore relevant challenges that have defined the gap between biomarker discovery and meaningful clinical use. We highlight recent advancements in and propose a way to think about future biomarker development.

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Modern statin therapy in clinical practice: The lower the better

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1302104s ◽

2013 ◽

Vol 141 (1-2) ◽

pp. 104-106 ◽

Cited By ~ 1

Author(s):

Edita Stokic

Keyword(s):

Heart Disease ◽

Cardiovascular Risk ◽

Ischemic Heart Disease ◽

Statin Therapy ◽

Meta Analysis ◽

Ischemic Heart ◽

Mortality And Morbidity ◽

Increased Risk ◽

Coronary Events ◽

Risk Treatment

Lipid and lipoprotein disorders are well known risk factors for atherosclerosis and its complications. The level of atherogenic LDL-cholesterol (LDL-C) is directly related to an increased risk of occurrence and progression of ischemic heart disease. Epidemiological and clinical studies have shown that the use of statin therapy to decrease LDL-C can significantly reduce the incidence of mortality, major coronary events and the need for revascularization procedures in the different groups of patients. The findings of a large meta-analysis conducted by the Cholesterol Treatment Trialists? (CTT) collaborators showed that every 1.0 mmol/l reduction of atherogenic LDL-C is associated with a 22% reduction in cardiovascular diseases mortality and morbidity. However, despite the impressive results of the benefits of statin therapy, the EUROASPIRE study showed that about 50% of patients with ischemic heart disease did not achieve target LDL-C levels. According to the new ESC/EAS Guidelines for the Management of Dyslipidaemias in patients with a very high cardiovascular risk, treatment goal should be to decrease LDL-C below 1.8 mmol/l or ?50% of initial values. In the majority of patients that can be achieved by statin therapy. For this reason an adequate choice of statins is of crucial importance, whereby the needed reduction in atherogenic LDL-C, after the identification of its target level based on the assessment of total cardiovascular risk, can be achieved.

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