Continuous Vectorcardiography in Patients with Chest Pain Indicative of Acute Ischemic Heart Disease

Abstract Serum cardiac troponin T (cTnT) concentrations are frequently increased in chronic dialysis patients as measured by the first-generation ELISA immunoassay, as is creatine kinase (CK) MB mass in the absence of acute ischemic heart disease. We designed this study to compare four serum markers of myocardial injury [CK-MB mass, first-generation ELISA cTnT, second-generation Enzymun cTnT, and cardiac troponin I (cTnI)] in dialysis patients without acute ischemic heart disease. We also evaluated skeletal muscle from dialysis patients as a potential source of serum cTnT. No patients in the clinical evaluation group (n = 24) studied by history and by physical examination, electrocardiography, and two-dimensional echocardiography had evidence of ischemic heart disease. Biochemical markers were measured in serial predialysis blood samples with specific monoclonal antibody-based immunoassays. For several patients at least one sample measured above the upper reference limit: CK-MB, 7 of 24 (30%); ELISA cTnT, 17 of 24 (71%); Enzymun cTnT, 3 of 18 (17%); and cTnI, 1 of 24 (4%). In a separate group of dialysis patients (n = 5), expression of cTnT, but not cTnI, was demonstrated by Western blot analysis in 4 of 5 skeletal muscle biopsies. Chronic dialysis patients without acute ischemic heart disease frequently had increased serum CK-MB and cTnT. The specificity of the second-generation cTnT (Enzymun) assay was improved over that of the first-generation (ELISA) assay; cTnI was the most specific of the currently available biochemical markers. cTnT, but not cTnI, was expressed in the skeletal muscle of dialysis patients.

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Societal costs of non-cardiac chest pain compared with ischemic heart disease - a longitudinal study

BMC Health Services Research ◽

10.1186/1472-6963-13-403 ◽

2013 ◽

Vol 13 (1) ◽

Cited By ~ 27

Author(s):

Ghassan Mourad ◽

Jenny Alwin ◽

Anna Strömberg ◽

Tiny Jaarsma

Keyword(s):

Heart Disease ◽

Longitudinal Study ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Ischemic Heart ◽

Societal Costs

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Abstract 16708: Cathelicidin Related Antimicrobial Peptide Treated Bone Marrow Derived Mononuclear Cells Improves Cardiac Function in a Mouse Model of Acute Myocardial Infarction: Potential Therapeutic Targets in Ischemic Heart Disease

Circulation ◽

10.1161/circ.130.suppl_2.16708 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Yuri M Klyachkin ◽

Prabhakara R Nagareddy ◽

Ahmed Asfour ◽

Shaojing Ye ◽

Erhe Gao ◽

...

Keyword(s):

Heart Disease ◽

Cardiac Function ◽

Ischemic Heart Disease ◽

Infarct Size ◽

Left Ventricular ◽

Ischemic Heart ◽

In Vivo Studies ◽

Boyden Chamber ◽

Acute Ischemic Heart Disease

Introduction: Limited stem cell retention following intracoronary administration for ischemic heart disease has reduced the clinical efficacy of this novel therapy. Cathelicidins have been shown to prime BMMNC migration towards low gradients of SDF-1 suggesting a potential role in BMMNC retention. We sought to assess the safety and efficacy of BMMNC pre-treatment with CRAMP for treatment of acute ischemic heart disease. METHODS: BMMNCs isolated from GFP mice were incubated with recombinant CRAMP (2.5 μg/ml) or placebo for 1 hour followed by chemotaxis studies towards low levels of SDF-1 (2 ng/ml) using a Boyden chamber in vitro. During the in vivo studies, mice were randomized into 3 groups: AMI followed by injection of phosphate buffered saline (PBS), BMMNCs alone, or BMMNCs incubated with CRAMP. Scar size, survival and retention of injected BMNNCs were examined by immunohistochemistry at 5 weeks. Left ventricular function was measured by echocardiography at baseline, 48 hours, and 5 weeks after MI. Changes in infarct size between 5 days and 5 weeks after AMI was assessed by cardiac MRI utilizing delayed gadolinium enhancement. RESULTS: Treatment of BMNNCs with CRAMP enhanced their migration towards low, yet physiological, levels of SDF-1 (Fig 1A). In vivo, a greater proportion of cell survival and retention was observed in the BMNNC+CRAMP group than in the BMNNC-alone group (Fig 1B) and this was associated with higher percentage of BrdU positive cells (Fig 1C). Moreover, BMNNC+CRAMP administration led to significantly better survival, improvement of cardiac function (Fig 1D-H) and reduction in infarct size compared with other control groups (Fig 1I). CONCLUSIONS: Cathelicidins enhance BMMNC retention after intramyocardial administration for acute ischemic heart disease resulting in enhanced recovery. Therapies employing this strategy may represent an effective method for improving cardiac recovery and survival rate after AMI in human studies.

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A study on the clinical profile and risk factors of ischemic heart disease in women

Medpusle International Journal of Medicine ◽

10.26611/102119310 ◽

2021 ◽

Vol 19 (3) ◽

pp. 130-132

Author(s):

Sarath Kumar Reddy B ◽

Keyword(s):

Risk Factors ◽

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Stable Angina ◽

Heart Diseases ◽

Chronic Stable Angina ◽

Clinical Profile ◽

Ischemic Heart ◽

Ischemic Heart Diseases

Background: Ischemic heart disease (IHD) is one of the principle causes of morbidity and of mortality in women1. Ischemic heart disease may manifest clinically as either chronic stable angina or acute coronary syndrome2 (ACS). Traditional risk factors (hypertension, diabetes, etc.) contribute to the development of IHD in both women and men. Some risk factors are unique to women (e.g., pregnancy-related complications, menopause), which cause increased mortality in women Aim: To study the risk factors and clinical profile of ischemic heart disease in women. Materials And Methods: Hospital-based prospective, cross-sectional study done in 50 patients with ischemic heart disease. Patients with a history of Chest pain suggestive of ischemic heart diseases and Electrocardiogram and cardiac biomarkers suggestive of ischemic heart disease were included in the study. Results: Maximum incidence of ischemic heart diseases is seen in the 6th decade. Mean age is 58.92 + 2.8years. 64%of the patients presented with chest pain, and 36% patients presented without any chest pain. After chest pain, the most common symptom was palpitations, seen in 56% patients, followed by sweating (44%). 30% presented to the medical facility within 3hours. 88% were diagnosed with acute coronary syndrome, and 12% were diagnosed with chronic stable angina. Women specific risk factors include the pregnancy-related complications seen in 10% patients, menopause attained in 86% patients, PCOS seen in 08% patients, use of oral contraceptive pills noticed in 08% patients, Other risk factors identified were hypothyroidism in 16% patients, connective tissue disorders like rheumatoid arthritis seen in 12% of the patients. Conclusion: Awareness regarding atypical symptoms as well as other symptoms of IHD should be created among women to avoid delayed complications. Simple lifestyle modifications like physical activity, diet modifications, etc., will reduce the number of women at risk for IHD.

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Abstract 14953: Temporal Trends in Non-invasive Diagnostic Tests for Ischemic Heart Disease Among Us Adults Age 64 Years or Younger: Results From the Marketscan Survey, 2010-2018

Circulation ◽

10.1161/circ.142.suppl_3.14953 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Soyoun Park ◽

Yuling Hong ◽

Cathleen Gillespie ◽

Robert Merritt ◽

Laurence Sperling

Keyword(s):

Heart Disease ◽

Chest Pain ◽

Ischemic Heart Disease ◽

Single Photon ◽

Adult Population ◽

Photon Emission ◽

Temporal Trends ◽

Ischemic Heart ◽

Non Invasive ◽

Exercise Ecg

Introduction: Heart disease is the leading cause of death in the U.S. Ischemic heart disease (IHD) accounts for two thirds of heart disease deaths. Non-invasive cardiovascular tests (NITs) are often the first step to establish an IHD diagnosis. Methods: We analyzed 2010-2018 IBM® MarketScan® Commercial Databases. NITs including exercise ECG, stress echocardiography, CT coronary artery calcification score (CT-CAC), single-photon emission computerized tomography (SPECT), cardiac CT angiography (CTA), nuclear positron emission tomography/myocardial perfusion imaging (PET/MPI), stress MRI, were identified using current procedural terminology (CPT) codes. IHD using ICD 9/10 codes (410-414, 429.2/I20-I25) and chest pain (786.59/R07.89) or unspecified chest pain (786.50/R07.9) were identified. The 2000 Census population was used to calculate the age standardized prevalence. Results: The data included 20,726,587 individuals (48.1% men, mean age (standard deviation) of 49.1 (13.5) years), among which 67,339 had a diagnosis of IHD or chest pain in 2018. The age standardized prevalence of the overall population that had at least one of the 7 tests is 1.60% in 2018, down from 2.47% in 2010. The responding prevalence for those with IHD or chest pain was 54.3% in 2018 and 61.6% in 2010. Exercise ECG was the most utilized test for the overall population: 0.94% in 2018 down from 1.31% in 2010; SPECT was second most often used with 0.75% in 2018 and 1.24% in 2010. However, SPECT was the most often utilized test among those with CHD or chest pain: 38.2% in 2018, down from 45.0% in 2010, and exercise ECG second most often with 32.6% in 2018 and 34.9% in 2010. An increase in use of CT-CAC, PET/MPI, and CTA tests was observed since 2010, but the prevalence of all were low in 2018. 0.02%. 0.01%, and 0.04% for the overall population and 0.20%, 0.95% and 3.20% for those with IHD or chest pain, respectively. Conclusions: Almost 2% of the general younger US adult population and over half of those with IHD or chest pain had undergone at least one of 7 NITs in 2018. While the utilization of overall NITs for both the general population and those with IHD or chest pain has declined since 2010, it has increased for CT-CAC, PET/MPI, and CTA but still less than 1% for CT-CAC and PET/MPI..

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