scholarly journals Analysis of myocardial enzyme spectrum in 230 COVID-19 patients of Chongqing, China.

2020 ◽  
Author(s):  
Jiao CaiLing ◽  
Li Wen Fa ◽  
Xie YeHong ◽  
Miao JiaWei ◽  
Wu YunFang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Creatine Kinase ◽  
Lactic Acid ◽  
Cardiac Injury ◽  
Three Gorges ◽  
Cardiac Enzymes ◽  
Creatine Kinase Isoenzyme ◽  
Heart Injury ◽  
Novel Coronavirus ◽  
Major Target

Abstract Background A novel coronavirus disease COVID-19 outbreak caused pandemic in China and worldwide. In addition to pneumonia, Cardiac failure is also a clinical outcome of coronavirus (COVID-19) patients and one of the leading causes for the death of COVID-19 patients. This study focused on a spectrum of cardiac enzymes to provide biomarkers for the severity of cardiomyopathy, and provide guidance of clinical treatment. Methods 230 coronavirus patients (182 mild and 48 severe cases) enrolled in Three Gorges Hospital of Chongqing University from January to March 2020 were analyzed for a spectrum of cardiac injury enzymes including α-hydroxybutyric dehydrogenase (αHBDH), lactic acid dehydrogenase (LDH), creatine kinase (CK), and creatine kinase isoenzyme (CK-MB). Results The severe cases had significantly higher myocardial enzyme levels than mild cases, regardless of male and females. Males appeared to be more susceptible than females to COVID-19 induced heart injury, having higher CK and CK-MB in mild cases, and higher αHBDH and LDH levels in severe cases. Age is also a susceptible factor to COVID-19, but affected males were younger than females. Conclusions This study reveals that the heart is also a major target of COVID-19 infection, and myocardial enzyme spectrum assays could help the diagnosis, prognosis and guide the treatments to prevent heart failure in COVID-19 patients.

scholarly journals Cardiovascular system and COVID-19: perspectives from a developing country

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Shekhar Kunal ◽  
Kashish Gupta ◽  
Shashi Mohan Sharma ◽  
Vijay Pathak ◽  
Shruti Mittal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular System ◽  
Care Delivery ◽  
Cardiac Injury ◽  
Coronary Syndrome ◽  
Infectivity Rate ◽  
The Common ◽  
Artery Disease ◽  
Novel Coronavirus ◽  
Cardiovascular Care

A novel coronavirus, SARS-CoV-2, thought to have originated from bats causes COVID-19 infection which was first reported from Wuhan, China in December 2019. This virus has a high infectivity rate and has impacted a significant chunk of the population worldwide. The spectrum of disease ranges from mild to severe with respiratory system being the most commonly affected. Cardiovascular system often gets involved in later stages of the disease with acute cardiac injury, heart failure and arrhythmias being the common complications. In addition, the presence of cardiovascular co-morbidities such as hypertension, coronary artery disease in these patients are often associated with poor prognosis. It is still not clear regarding the exact mechanism explaining cardiovascular system involvement in COVID-19. Multiple theories have been put forward however, more robust studies are required to fully elucidate the “heart and virus” link. The disease has already made its presence felt on the global stage and its impact in the developing countries is going to be profound. These nations not only have a poorly developed healthcare system but there is also a huge burden of cardiovascular diseases. As a result, COVID-19 would adversely impact the already overburdened healthcare network leading to impaired cardiovascular care delivery especially for acute coronary syndrome and heart failure patients.

scholarly journals Increased myocardial fat supply improves cardiac energetics and function in heart failure

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
W Watson ◽  
P.G Green ◽  
S Neubauer ◽  
O.J Rider
Keyword(s):  
Heart Failure ◽  
Creatine Kinase ◽  
Ejection Fraction ◽  
Funding Source ◽  
Cardiac Energetics ◽  
Fat Emulsion ◽  
Euglycaemic Clamp ◽  
Fat Infusion ◽  
And Function ◽  
Glucose Supply

Abstract Introduction The failing heart is starved of energy, in part accounting for its contractile dysfunction. Reduced uptake of fat and sugar required for energy production has frequently been demonstrated in heart failure, therefore altering metabolism of glucose and/or fat is therefore attractive as a therapy. We hypothesized increasing glucose supply would be beneficial over increasing fat supply so measured ATP usage (via PCr/ATP ratio and flux through creatine kinase) and cardiac function during fat emulsion infusion or euglycaemic hyperinsulinaemic clamp. Methods 11 patients with a diagnosis of heart failure and nonischaemic cardiomyopathy were recruited, mean age 66 (range 49–80), mean BMI 27.7 (range 21.3–37.5), F:M 3:8, 3 diabetic and 8 non-diabetic. On the first visit they had a baseline cardiac magnetic resonance (CMR), collecting cardiac volumes and function, then were randomised to receive either fat infusion or euglycaemic clamp. Following an hour of infusion, CMR was repeated followed by 31P cardiac magnetic resonance spectroscopy, then a dobutamine stress sequence at 65% maximum heart rate. They received the alternate infusion at the next visit. Results Data was normally distributed. Baseline ejection fraction was 37±9%. PCr/ATP ratio was greater with the fat infusion compared to euglycaemic clamp (1.82±0.26 vs 1.68±0.24, p=0.04). Fat emulsion infusion also brought about a greater ejection fraction increase over the baseline, compared to the euglycaemic clamp in which there was little difference (+5.3±5.3% vs −0.6±3.1%, p=0.004). Calculated cardiac work was greater in the fat infusion group than the Insulin/glucose group (682±156 L.mmHg/min vs 581±85 L.mmHg/min, p=0.009). There was no significant difference in creatine kinase first order rate constant (fat infusion 0.2±0.09/s vs euglycaemic clamp 0.16±0.07/s, p=0.32) nor creatine kinase flux (fat infusion 1.85±0.92 μmol/g/s vs euglycaemic clamp 1.46±0.58 μmol/g/s, p=0.22). The increment in cardiac output on stress over baseline was not significantly different between arms (fat infusion +3.39±3.07 L/min vs euglycaemic clamp +3.08±2.57 L/min, p=0.42). The PCr/ATP ratio showed positive correlation with the stress ejection fraction (R2=0.656, p=0.001), but not with resting ejection fraction. Conclusions Increased supply of fat to the myocardium brought about improved contractility and cardiac energetics compared to an increased glucose supply. The increase in PCr/ATP ratio would imply (given ATP concentrations are kept constant in the myocardium) there is a greater availability of phosphocreatine, suggesting increased mitochondrial ATP synthesis. These results were unexpected as it has traditionally been thought that increased glucose metabolism would yield greater cardiac function in the failing heart. These data suggest targeting myocardial fat metabolism may provide novel treatments for cardiac dysfunction. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): British Heart Foundation

scholarly journals Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China

2020 ◽  
Vol 15 (8) ◽  
pp. 1139-1145 ◽  
Author(s):  
Jun Wu ◽  
Jushuang Li ◽  
Geli Zhu ◽  
Yanxia Zhang ◽  
Zhimin Bi ◽  
...  
Keyword(s):  
Clinical Features ◽  
Troponin I ◽  
Clinical Laboratory ◽  
Cardiac Injury ◽  
Hemodialysis Patients ◽  
Hospitalized Patients ◽  
Maintenance Hemodialysis ◽  
Computed Tomographic ◽  
Risk Of Death ◽  
Novel Coronavirus

Background and objectivesPrevious reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis.Design, setting, participants, & measurements In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020.ResultsThe median age of 101 patients was 62 years (interquartile range, 49–72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase–muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died.ConclusionsThe main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

scholarly journals Association of Cardiac Injury and Malignant Left Ventricular Hypertrophy With Risk of Heart Failure in African Americans

2019 ◽  
Vol 4 (1) ◽  
pp. 51 ◽  
Author(s):  
Ambarish Pandey ◽  
Neil Keshvani ◽  
Colby Ayers ◽  
Adolfo Correa ◽  
Mark H. Drazner ◽  
...  
Keyword(s):  
Heart Failure ◽  
African Americans ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Cardiac Injury ◽  
Left Ventricular

scholarly journals Intracellular pH in the Brain following Transient Ischemia

1983 ◽  
Vol 3 (1) ◽  
pp. 109-114 ◽  
Author(s):  
Hideo Mabe ◽  
Photjanee Blomqvist ◽  
Bo K. Siesjö
Keyword(s):  
Creatine Kinase ◽  
Lactic Acid ◽  
Intracellular Ph ◽  
Adenine Nucleotides ◽  
Recovery Period ◽  
Transient Ischemia ◽  
Vessel Occlusion ◽  
Atp Production ◽  
Creatine Kinase Reaction ◽  
The Brain

The objective of the present study was to discover whether or not intracellular alkalosis develops in the brain in the recovery period following transient ischemia. Forebrain ischemia of 15-min duration was induced by four-vessel occlusion in rats, with recovery periods of 15, 60, and 180 min. Intracellular pH was derived both by the HCO3−–H2CO3 method and from the creatine kinase equilibrium. The ischemia was associated with energy failure and marked accumulation of lactic acid in the cerebral cortex. Recirculation brought about rapid rephosphorylation of adenine nucleotides and gradual normalization of lactic acid levels. After 15 min of recovery, the HCO3−–H2CO3 method indicated persisting acidosis, but the creatine kinase reaction did not. After 60 min, a shift of pH in the alkaline direction was demonstrated in both methods. This alkalosis had disappeared after 3 h of recovery. It is concluded that resumption of ATP production after ischemia is followed by a rapid rise in intracellular pH, which transiently increases above normal.

scholarly journals QSYQ Attenuates Oxidative Stress and Apoptosis Induced Heart Remodeling Rats through Different Subtypes of NADPH-Oxidase

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Yong Wang ◽  
Chun Li ◽  
Yuli Ouyang ◽  
Tianjiao Shi ◽  
Xiaomin Yang ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Heart Failure ◽  
Nadph Oxidase ◽  
Caspase 3 ◽  
Ventricular Remodeling ◽  
Cardiac Injury ◽  
Myocardial Tissue ◽  
Therapeutic Effects ◽  
Histological Changes ◽  
Nadph Oxidase 4

We aim to investigate the therapeutic effects of QSYQ, a drug of heart failure (HF) in clinical practice in China, on a rat heart failure (HF) model. 3 groups were divided: HF model group (LAD ligation), QSYQ group (LAD ligation and treated with QSYQ), and sham-operated group. After 4 weeks, rats were sacrificed for cardiac injury measurements. Rats with HF showed obvious histological changes including necrosis and inflammation foci, elevated ventricular remodeling markers levels(matrix metalloproteinases-2, MMP-2), deregulated ejection fraction (EF) value, increased formation of oxidative stress (Malondialdehyde, MDA), and up-regulated levels of apoptotic cells (caspase-3, p53 and tunnel) in myocardial tissue. Treatment of QSYQ improved cardiac remodeling through counter-acting those events. The improvement of QSYQ was accompanied with a restoration of NADPH oxidase 4 (NOX4) and NADPH oxidase 2 (NOX2) pathways in different patterns. Administration of QSYQ could attenuate LAD-induced HF, and AngII-NOX2-ROS-MMPs pathway seemed to be the critical potential targets for QSYQ to reduce the remodeling. Moreover, NOX4 was another key targets to inhibit the p53 and Caspase3, thus to reduce the hypertrophy and apoptosis, and eventually provide a synergetic cardiac protective effect.

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