Cardiac Troponin I Levels in Patients with Left Heart Failure and Cor Pulmonale

Angiology ◽  
2001 ◽  
Vol 52 (5) ◽  
pp. 317-322 ◽  
Author(s):  
Niyazi Güler ◽  
Mehmet Bilge ◽  
Beyhan Eryonucu ◽  
Kürcat Uzun ◽  
Mehmet Emin Avci ◽  
...  
Keyword(s):  
Heart Failure ◽  
Creatine Kinase ◽  
Pulmonary Disease ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Creatine Kinase Mb

Cardiac troponin levels are regarded as the most specific of currently available biochemical markers of myocardial damage. Elevated levels of troponin have been previously reported in patients with left heart failure, reflecting small areas of undetected myocardial cell death. The aim of this study was to compare the levels of the cardiac troponin I (cTnl) in patients with left- and right-sided heart failure. Cardiac troponin I levels were studied with immunochemical methods in patients with right heart failure (n = 17) resulting from chronic obstructive pulmonary disease, ischemic left heart failure (n = 23), and nonischemic left heart failure (n = 18) who were admitted to departments of cardiology and chest diseases. Also, cTnl levels were measured in 32 healthy subjects as control group. Protein markers of myocardial injury (cTnl and myoglobin) in patients with left and right heart failure were collected approximately 12 to 36 hours after onset of obvious symptoms. Serum creatine kinase MB band was determined on admission and thereafter twice a day during the first 3 days. Elevated levels of serum cTnl were found in patients with nonischemic (0.83 ±0.6 ng/mL, p<0.01) and ischemic left heart failure (0.9 ±0.5 ng/mL, p<0.01) when compared to healthy subjects, whereas serum cTnl levels in patients with right heart failure due to chronic obstruc tive pulmonary disease were not significantly different from those of control subjects (0.22 ±0.1 vs 0.16 ±0.1 ng/mL, p> 0.05). In addition, creatine kinase MB band and myoglobin levels were not significantly different between patient and healthy groups. The mean of cTnl levels in ischemic and even nonischemic left heart failure were increased compared to the mean of values in healthy individuals but without significant creatine kinase MB band and myoglobin elevations. But cTnl levels were not increased in patients with right heart failure due to chronic obstructive pulmonary disease. These data indicate that the cTnl levels are abnormal in left heart failure but not in cor pulmonale.

Pickwick syndrome

1982 ◽  
Vol 63 (3) ◽  
pp. 48-51
Author(s):  
V. I. Zhukov
Keyword(s):  
Heart Failure ◽  
Right Heart Failure ◽  
Cor Pulmonale ◽  
Left Heart ◽  
Obesity Hypoventilation Syndrome ◽  
Right Heart ◽  
Left Heart Failure ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Obesity, as you know, is often combined with atherosclerosis, hypertension and their characteristic left-heart failure. Least of all, in our opinion, obesity is associated with cor pulmonale and right-heart failure. "Pickwick syndrome", it is also known as "Ioe syndrome", "cardiopulmonary syndrome of patients with obesity", "obesity-hypoventilation syndrome".

P4511Characteristic hemodynamic and metabolic response patterns differ between patients with stable chronic left vs right heart failure

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Dumitrescu ◽  
H Ten Freyhaus ◽  
H Hagmanns ◽  
F Gerhardt ◽  
S Baldus ◽  
...  
Keyword(s):  
Heart Failure ◽  
Stroke Volume ◽  
Stress Echocardiography ◽  
Right Heart Failure ◽  
Response Patterns ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Group 2 ◽  
Group 1

Abstract Background Patients with chronic left and right heart failure show a reduction in peak oxygen uptake (VO2), even with optimal medical therapy. A non-invasive determination whether the mechanism of exercise limitation is primarily due to left or right-heart failure may be a challenge in clinical practice. The simultaneous analysis of metabolic and hemodynamic responses during exercise may allow an improved differentiation of exercise limitation. However, only little is known about the combined hemodynamic/metabolic exercise response patterns in these patients. OBJECTIVES We sought to characterize the simultaneous hemodynamic and metabolic response to exercise in stable patients with chronic, isolated left vs right heart failure. Methods We analyzed a cohort of highly selected patients with isolated right heart failure (group 1) and isolated left heart failure (group 2). All patients were in functional class II and III, and under stable medical Treatment. All patients had received right heart catheterization before enrollment. All of the patients in group 1 and none of the patients in group 2 showed an elevated pulmonary vascular resistance (PVR). All patients received a cardiopulmonary exercise test (CPET) with a ramp protocol up to maximal exercise tolerance. During a second visit, a combined CPET/stress echocardiography was performed with a two step constant work rate protocol. For step 1, a workrate below the patients' anaerobic threshold was chosen. For step 2, 80% of the patients' maximum workrate from the ramp test was chosen. Each step was performed until a complete echocardiographic image acquisition was obtained. Echocardiographic parameters, including stroke volume measurements, were obtained once at rest and for each of the two exercise steps. Results We recruited 18 patients (n=9 in group 1, n=9 in group 2). There were no significant differences in demographic baseline characteristics. There were no adverse events. In the inital ramp CPET, both groups showed a moderate reduction in peak VO2 (53,0±12,4 vs 63,3±12,8% of predicted). The absolute peak VO2 values, corrected for body weight, showed no significant difference (16,7±4,5 vs 16,5±5,1 ml/min/kg). While the increase in VO2 (Figure 1A) and cardiac index (Figure 1B) during step 1 and step 2 of the simultaneous CPET/stress echocardiography was similar between both groups, the increase of stroke volume index with exercise was significantly reduced in the group with right heart failure, while the group with left heart failure increased stroke volume index during exercise (Figure 1C). Figure 1 Conclusions The simultaneous evaluation of hemodynamic and metabolic parameters by CPET/stress echocardiography is safe and may reveal characteristic response patterns to exercise in patients with chronic left vs right heart failure. Patients with right heart failure seem to be less able to increase stroke volume during exercise than patients with left heart failure. Acknowledgement/Funding This project was partly funded by Actelion Pharmaceuticals

Body composition changes assessment by bioelectrical impedance vectorial analysis in right heart failure and left heart failure

Heart & Lung ◽  
2020 ◽  
Vol 49 (1) ◽  
pp. 42-47 ◽  
Author(s):  
Dulce González-Islas ◽  
Estefanía Arámbula-Garza ◽  
Arturo Orea-Tejeda ◽  
Lilia Castillo-Martínez ◽  
Candace Keirns-Davies ◽  
...  
Keyword(s):  
Heart Failure ◽  
Body Composition ◽  
Bioelectrical Impedance ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure ◽  
Composition Changes

Differences in Exercise Capacity in Patients with Chronic Left Heart Failure and Chronic Right Heart Failure

2014 ◽  
Vol 23 (11) ◽  
pp. 1036-1040 ◽  
Author(s):  
Wei-Hua Liu ◽  
Qin Luo ◽  
Zhi-Hong Liu ◽  
Qing Zhao ◽  
Qun-Ying Xi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Capacity ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure

Differences in the Quality of Life Between Patients with Left Heart Failure and Right Heart Failure Secondary to COPD

2020 ◽  
Author(s):  
Karen Aide Santillan Reyes ◽  
Viridiana Peláez Hernández ◽  
Laura Arely Martínez Bautista ◽  
Karla Leticia Rosales Castillo ◽  
Lizzbett Luna Rodríguez ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Left Heart Failure

scholarly journals Frontal QRS-T angle as a predictive marker for myocardial damage in acute carbon monoxide poisoning

2021 ◽  
pp. 096032712110434
Author(s):  
Yusuf K Tekin ◽  
Gülaçan Tekin ◽  
Naim Nur ◽  
İlhan Korkmaz ◽  
Sefa Yurtbay
Keyword(s):  
Carbon Monoxide ◽  
Creatine Kinase ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Myocardial Damage ◽  
Cardiac Troponin I ◽  
Arterial Oxygen ◽  
Co Poisoning ◽  
Arterial Blood ◽  
Creatine Kinase Mb

Introduction The present study was undertaken to investigate the prognostic value of the frontal QRS-T angle associated with adverse cardiac outcomes in patients with carbon monoxide (CO) poisoning in early stages in the emergency department. Materials and methods The data of 212 patients with CO poisoning who were admitted to the ED between January 2010 and May 2020 were retrospectively analyzed. The frontal QRS-T angle was obtained from the automatic reports of the EKG device. Results Compared to patients without myocardial damage, among patients with myocardial damage, statistically high creatinine, creatine kinase MB, cardiac troponin I, and frontal QRS-T angle values were found ( p < 0.001 for all parameters), while the saturation of arterial blood pH and arterial oxygen values were found to be lower ( p = 0.002 and p < 0.001, respectively). The frontal QRS-T angle values were correlated with creatine kinase, creatine kinase-MB, cardiac troponin I, and oxygen saturation (SpO2) in arterial blood (r = 0. 232, p = 0.001; r = 0. 253, p = < 0.001; r = 0. 389, p = < 0.001; r = −0. 198, p = 0.004, respectively). The optimum cut-off value of the frontal QRS-T angle was found to be 44.5 (area under the curve: 0.901, 95% confidence interval: 0.814–0.988, sensitivity: 87%, specificity: 84%). Conclusions The frontal QRS-T angle, a simple and inexpensive parameter that can be easily obtained from 12-lead surface electrocardiography, can be used as an early indicator in the detection of myocardial damage in patients with CO poisoning.

scholarly journals Impact of Antibody Specificity and Calibration Material on the Measure of Agreement between Methods for Cardiac Troponin I

1999 ◽  
Vol 45 (6) ◽  
pp. 822-828 ◽  
Author(s):  
David J Newman ◽  
Yemi Olabiran ◽  
William D Bedzyk ◽  
Suzette Chance ◽  
Eileen G Gorman ◽  
...  
Keyword(s):  
Creatine Kinase ◽  
Regression Analysis ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Antibody Specificity ◽  
Serum Pool ◽  
Creatine Kinase Mb ◽  
Patient Values ◽  
Calibration Material

Abstract Background: Available assays for cardiac troponin I (cTnI) yield numerically different results. The aim of this study was to compare patient values obtained from four cTnI immunoassays. Methods: We studied the Stratus® II assay, the Opus® II assay, the Access® assay, and a research-only cTnI heterogeneous immunoassay that uses the Dade Behring aca® plus immunoassay system equipped with two new noncommercial monoclonal antibodies. Because the aca plus cTnI assay is for research only, we first evaluated and analytically validated it for serum and citrated plasma. Initially, each method was calibrated using the method-specific calibrator supplied by each manufacturer; however, the aca plus cTnI assay was calibrated using patient serum pools containing cTnI and selected on the basis of increased creatine kinase MB isoenzyme and with values assigned by use of the Stratus cTnI assay. For method comparisons, individual patient sample cTnI values were determined and compared with the Stratus II assay. Results: Passing and Bablock regression analysis yielded slopes of 1.44 (r = 0.96; n = 72) for the Opus II vs Stratus II assays; 0.07 (r = 0.91; n = 72) for the Access vs Stratus II assays; and 0.90 (r = 0.91, n = 72) for the aca plus vs Stratus II assays. The recalibration of each method with a Stratus II-assigned serum pool improved, but did not entirely eliminate, the slope differences between the different assays (range, 1.00–1.16). The observed scatter in the correlation curves remained. Conclusion: There is a need to further explore the specificities of these assays with respect to the different circulating forms of cTnI.

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