scholarly journals Troponin I Changes in Patients with Subarachnoid Hemorrhage

2018 ◽  
Vol 27 (2) ◽  
pp. 39-43
Author(s):  
A Sarker ◽  
MA Hoque ◽  
MMR Khan ◽  
MK Rahman ◽  
SM Alam ◽  
...  

Background : Subarachnoid hemorrhage (SAH) is a catastrophic neurological event. Aside from its neurological morbidities, SAH is associated with significant medical complications. Cardiac manifestations are common and can impact morbidity and mortality in SAH patients. Myocardial enzyme release occur frequently after Subarachnoid hemorrhage that reflect adverse intracranial events .These changes often are unrecognized or misinterpreted, potentially placing patients at risk for inappropriate management.Objective : The aim of this study was to assess Troponin I changes after acute SAH and these changes were compared with neurological severity. The result of the study might be helpful for better understanding diagnostic and therapeutic implications of acute neurocardiogenic injury after SAH.Patients and methods : This cross sectional descriptive study was conducted over 30 patients with SAH in medicine, neuromedicine and intensive care unit of Rajshahi Medical College Hospital during the period of January 2015 to December 2016. Predictor variables reflecting demographic (age, sex, occupation), hemodynamic (pulse, systolic and diastolic blood pressure) and neurological (WFNS score) informations were recorded. We evaluated their cTnI level, which had been measured at admission. A cTnI level above 0.12 ng/ml was defined as an indicator of cardiac injury following SAH.Results : Out of 30 patients 26.7% were both in between 40-49 years and 60-69 years age group & 50% were male and 50% were female. Among the risk factors 60% of patient had history of hypertension, 40% smoking, 10% Diabetes mellitus and 3.3% alcohol abuse. On admission the mean GCS was 12.53±2.69,. The most frequently occurring WFNS grading were grade 1 and grade 4 (both were 43.3% of patients). Out of Thirty, 43.3% of patients demonstrated elevations of Troponin I. WFNS score ≥ 3 (92.3%, p = <0.001) significantly correlated with elevated Troponin I concentration.Conclusion : serum troponin I reveal a higher incidence of myocardial injury in patients with SAH. The present study also demonstrates that raised serum cTnI is associated with more severe neurological injury. These findings support a neurocardiogenic cause of cardiac injury after SAH.TAJ 2014; 27(2): 39-43

2014 ◽  
Vol 42 (1) ◽  
pp. 3-6
Author(s):  
SS Shahina ◽  
JU Ahmed ◽  
S Ahmed ◽  
E Shahriar ◽  
MN Uddin ◽  
...  

Troponin I (cTnI) isoform is cardiac muscle specific protein and shown to have several features as a preferred marker of myocardial injury. It rises early in acute myocardial infarction (AMI) and attains levels that are clearly separated from baseline values. It remains elevated for several days providing a long window for detection of cardiac injury. The objective of the study was to evaluate for the profile of cTnI level among symptomatic AMI patients. The study was conducted at National Institute of Cardiovascular Disease, Dhaka, Bangladesh from July 2007 to June 2008 and total 9552 patients with type 1 or type 2 MI were included. Blood Sample was taken within 3 days of symptoms and cTnI was measured by chemiluminescent immunometric assay method. cTnI was considered positive when the value was >1ng/ml and study population was divided as per age, sex and cTnI level. The mean (+ SD) age of all patients was 55(+ 12.8) years and majority was males (82.20%). Seasonal variation showed highest positive cases in winter. In case of circadian variation positive cTnI results were suggestive of morning peak of AMI. Positive results were obtained in 32.3% of Cases. cTnI is now considered as a better indicator of myocardial injury. Further study in depth is necessary to correlate with clinical symptoms and other diagnostic tests to make a complete profile of AMI according to the latest subtypes. DOI: http://dx.doi.org/10.3329/bmj.v42i1.18969 Bangladesh Med J. 2013 Jan; 42 (1): 3-6


Cells ◽  
2021 ◽  
Vol 10 (9) ◽  
pp. 2436
Author(s):  
Laura Mañas-García ◽  
Charlotte Denhard ◽  
Javier Mateu ◽  
Xavier Duran ◽  
Joaquim Gea ◽  
...  

We hypothesized that the phenolic compound resveratrol mitigates muscle protein degradation and loss and improves muscle fiber cross-sectional area (CSA) in gastrocnemius of mice exposed to unloading (7dI). In gastrocnemius of mice (female C57BL/6J, 10 weeks) exposed to a seven-day period of hindlimb immobilization with/without resveratrol treatment, markers of muscle proteolysis (tyrosine release, systemic troponin-I), atrophy signaling pathways, and muscle phenotypic features and function were analyzed. In gastrocnemius of unloaded mice treated with resveratrol, body and muscle weight and function were attenuated, whereas muscle proteolysis (tyrosine release), proteolytic and apoptotic markers, atrophy signaling pathways, and myofiber CSA significantly improved. Resveratrol treatment of mice exposed to a seven-day period of unloading prevented body and muscle weight and limb strength loss, while an improvement in muscle proteolysis, proteolytic markers, atrophy signaling pathways, apoptosis, and muscle fiber CSA was observed in the gastrocnemius muscle. These findings may have potential therapeutic implications in the management of disuse muscle atrophy in clinical settings.


2018 ◽  
Vol 46 (1) ◽  
pp. 64-69 ◽  
Author(s):  
Konstantinos Tselios ◽  
Dafna D. Gladman ◽  
Paula Harvey ◽  
Shadi Akhtari ◽  
Jiandong Su ◽  
...  

Objective.Cardiac involvement in systemic lupus erythematosus (SLE) is often undiagnosed in its early phases. Specific heart biomarkers may identify patients at risk. We sought to investigate the prevalence and associated factors for such biomarkers in SLE.Methods.Brain natriuretic peptide (BNP) and cardiac troponin I (cTnI) were measured simultaneously in 151 consecutive patients with no history of heart disease or pulmonary arterial hypertension (PAH). None had electrocardiographic abnormalities suggestive of acute coronary syndrome. Cross-sectional comparisons and logistic regression analyses were performed. Patients with abnormal biomarkers were investigated to delineate the specific cause.Results.Sixteen patients (16/151, 10.6%) had elevated BNP, and 9 of them also had abnormal cTnI. Compared to subjects with normal biomarkers, they were older, had longer disease and antimalarial (AM) use duration, and more frequently persistent creatine phosphokinase (CPK) elevation. Multivariable regression analysis showed prolonged AM treatment (> 5.6 yrs) and persistent CPK elevation to be important predictors for elevated cardiac biomarkers. Six patients were diagnosed with definite (based on endomyocardial biopsy, n = 2) or possible (based on cardiac magnetic resonance after exclusion of other causes) AM-induced cardiomyopathy (AMIC); all had both BNP and cTnI elevated. Alternative causes were identified in 5, while no definitive diagnosis could be made in the remaining patients.Conclusion.About 10% of patients with SLE had elevated myocardial biomarkers, in the absence of prior cardiac disease or PAH. One-third of them were diagnosed with AMIC. Prolonged AM therapy and persistent CPK elevation conferred an increased risk for abnormal BNP and cTnI, which might predict AMIC.


2016 ◽  
Vol 27 (2) ◽  
pp. 14-19 ◽  
Author(s):  
Md Abu Zahid ◽  
HI Lutfur Rahman Khan ◽  
Abdul Wadud Chowdhury ◽  
Khandker Md Nurush Sabah ◽  
SM Eftar Zahan Kabir ◽  
...  

Acute coronary syndrome (ACS) remains the leading cause of death in the developed world and second leading cause of death in developing countries. Elevated troponin levels and extent of ST-segment depressions are clinically important because they may act as an effective prognostic marker .This cross-sectional study has been designed to see the correlation of ST-segment depression and level of troponin I with in-hospital outcome of NSTEMI patients. The study was conducted in the Department of Cardiology, Dhaka Medical College Hospital, Dhaka during the period of April, 2011- March, 2012. A total of 90 patients were selected by purposive sampling. In this study,the mean ±SD age of the patients was 55.9±9.1 years with a range of 36-80 years with a male -female ratio of 2:1.Over all dyslipidaemia was the most common risk factor present in 55(61.10%) patients followed by smoking in 48(53.3%) patients then obesity in 32(35.60%) then hypertension in 31(34.4%) patients. Troponin I level was significantly high in patients who developed acute LVF (10.36±7.4 vs 7.0124±6.8, p=.027), and cardiogenic shock (13.72±11.37 vs 8.64±7.35, p=.033). Troponin I was significantly high in patients who developed complication (10.72±8.84 vs 6.24±5.41, p=.005) than the patients who were discharged without complication. ST segment depression was significantly more in patients who developed acute LVF(1.07±1.63 vs.55±.74, p=.048). Logistic regression analysis of acute LVF with Troponin I and ST-segment depression showed that ST-segment depression and level of Troponin I were important correlates of acute LVF .Medicine Today 2015 Vol.27(2): 14-19


2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Yazdan Ghandi ◽  
Fakhreddin Sharitmadari ◽  
Danial Habibi ◽  
Saeid Sadrnia

Objectives: Cardiac troponin I (CTnI) is recognized as a proper marker for early detection of cardiac damage. Generalized tonic-clonic (GTC) seizures may lead to cardiac ischemia or myocardial injury associated with elevated CTnI. The present study aimed at evaluating the level of CTnI in children with status GTC seizures. Methods: 50 patients with GTC seizures and a normal cardiac function referred to Amirkabir Hospital, Arak, Iran were evaluated. The medical history of all patients was taken, and clinical examinations were performed. For all patients were performed Serum CTnI measurements, electroencephalography (EEG), electrocardiography (ECG), and echocardiography. Results: The patients’ mean age was 7.80 ± 4.01 years and 26 (52%) children were female (female: male ratio, 1.08). the mean duration of seizure was 31.54 ± 1.56 minutes. Abnormal EEG patterns were documented in 83 (86%) patients, while abnormal CT scan was not found in any of the patients. The mean level of CTnI was at the high end of the range in patients (57.02 ± 10.80 ng/mL). There was a positive correlation between serum CTnI and age (P = 0.001, R = 0.492). Also, the serum level of CTnI was significantly correlated with the onset of GTC seizure (R = 0.004, P = 0.001). Conclusion: The serum CTnI level exceeded the normal level in children with seizures. Therefore, cardiac monitoring of patients with status GTC seizures may be helpful in the ictal and postictal phases for evaluating cardiac injury, especially in children with risk factors for coronary diseases, such as Kawasaki disease, cardiomyopathy, or coronary anomalies.


2021 ◽  
Author(s):  
Hasan Shemirani ◽  
Masoumeh Sadeghi ◽  
Azadeh Davoudian Dehkordi ◽  
Farzad Gheshlaghi

Abstract Background: Methadone is a synthetic opioid mostly used for detoxification therapy, as its use increases; the possibility for methadone-induced cardiotoxicity may rise. The aim of this study was to determine the association of high-sensitivity troponin I levels as a predictor of cardiac injury in methadone toxicity.Methods: Sixty methadone toxicity patients included in this prospective cross-sectional study from October 2018-November 2020. High-sensitivity troponin I level and electrocardiogram were assessed in patients at admission. All patients underwent echocardiography at admission and 30 days later and compared this findings between two groups based on high-sensitivity troponin I results.Results: Mean age of the patients was 34.5±11.1 years (males: 66%). Twelve (20%) patients had positive high sensitive-troponin results. Long QT interval and inverted T in precordial leads were mostly observed in individuals with positive high-sensitivity troponin I (75% vs. 35%, P=0.013 and 83% vs. 16%, P<0.001, respectively). Patients with elevated troponin had reduced left ventricular ejection fraction in comparison to normal group during admission (43.1±15.4% vs. 55%, P<0.001) and this left ventricular ejection fraction remained abnormal after 30 days (43.7±21.6%). Patients in positive high-sensitivity troponin I group had higher regional wall motion abnormality frequency both at admission and 30 days later compared to the other group (0 day: 42% vs. 0, P<0.001, 30th days: 25% vs. 4%, P=0.020).Conclusion: Patients with simultaneous methadone toxicity and positive high-sensitivity troponin I had worse cardiac outcomes and this biomarker could be probably used for better implementation of therapeutic interventions and prognosis.


Molecules ◽  
2021 ◽  
Vol 26 (16) ◽  
pp. 4904
Author(s):  
Antonio Penedo-Vázquez ◽  
Xavier Duran ◽  
Javier Mateu ◽  
Adrián López-Postigo ◽  
Esther Barreiro

Muscle wasting and cachexia are prominent comorbidities in cancer. Treatment with polyphenolic compounds may partly revert muscle wasting. We hypothesized that treatment with curcumin or resveratrol in cancer cachectic mice may improve muscle phenotype and total body weight through attenuation of several proteolytic and signaling mechanisms in limb muscles. In gastrocnemius and soleus muscles of cancer cachectic mice (LP07 adenocarcinoma cells, N = 10/group): (1) LC-induced cachexia, (2) LC-cachexia+curcumin, and (3) LC-cachexia + resveratrol, muscle structure and damage (including blood troponin I), sirtuin-1, proteolytic markers, and signaling pathways (NF-κB and FoxO3) were explored (immunohistochemistry and immunoblotting). Compared to nontreated cachectic mice, in LC-cachexia + curcumin and LC-cachexia + resveratrol groups, body and muscle weights (gastrocnemius), limb muscle strength, muscle damage, and myofiber cross-sectional area improved, and in both muscles, sirtuin-1 increased, while proteolysis (troponin I), proteolytic markers, and signaling pathways were attenuated. Curcumin and resveratrol elicited beneficial effects on fast- and slow-twitch limb muscle phenotypes in cachectic mice through sirtuin-1 activation, attenuation of atrophy signaling pathways, and proteolysis in cancer cachectic mice. These findings have future therapeutic implications as these natural compounds, separately or in combination, may be used in clinical settings of muscle mass loss and dysfunction including cancer cachexia.


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Louise E. See Hoe ◽  
Karin Wildi ◽  
Nchafatso G. Obonyo ◽  
Nicole Bartnikowski ◽  
Charles McDonald ◽  
...  

Abstract Background Heart transplantation (HTx) from brainstem dead (BSD) donors is the gold-standard therapy for severe/end-stage cardiac disease, but is limited by a global donor heart shortage. Consequently, innovative solutions to increase donor heart availability and utilisation are rapidly expanding. Clinically relevant preclinical models are essential for evaluating interventions for human translation, yet few exist that accurately mimic all key HTx components, incorporating injuries beginning in the donor, through to the recipient. To enable future assessment of novel perfusion technologies in our research program, we thus aimed to develop a clinically relevant sheep model of HTx following 24 h of donor BSD. Methods BSD donors (vs. sham neurological injury, 4/group) were hemodynamically supported and monitored for 24 h, followed by heart preservation with cold static storage. Bicaval orthotopic HTx was performed in matched recipients, who were weaned from cardiopulmonary bypass (CPB), and monitored for 6 h. Donor and recipient blood were assayed for inflammatory and cardiac injury markers, and cardiac function was assessed using echocardiography. Repeated measurements between the two different groups during the study observation period were assessed by mixed ANOVA for repeated measures. Results Brainstem death caused an immediate catecholaminergic hemodynamic response (mean arterial pressure, p = 0.09), systemic inflammation (IL-6 - p = 0.025, IL-8 - p = 0.002) and cardiac injury (cardiac troponin I, p = 0.048), requiring vasopressor support (vasopressor dependency index, VDI, p = 0.023), with normalisation of biomarkers and physiology over 24 h. All hearts were weaned from CPB and monitored for 6 h post-HTx, except one (sham) recipient that died 2 h post-HTx. Hemodynamic (VDI - p = 0.592, heart rate - p = 0.747) and metabolic (blood lactate, p = 0.546) parameters post-HTx were comparable between groups, despite the observed physiological perturbations that occurred during donor BSD. All p values denote interaction among groups and time in the ANOVA for repeated measures. Conclusions We have successfully developed an ovine HTx model following 24 h of donor BSD. After 6 h of critical care management post-HTx, there were no differences between groups, despite evident hemodynamic perturbations, systemic inflammation, and cardiac injury observed during donor BSD. This preclinical model provides a platform for critical assessment of injury development pre- and post-HTx, and novel therapeutic evaluation.


Author(s):  
Monika Kushwaha ◽  
Sanjeev Narang

Background: This study is cross-sectional, observational and comparative study, at Index Medical College, Hospital & Research Centre, Indore, Madhya Pradesh from July 2017 to July 2019 with sample size 100 placentae. Method: The placenta received was evaluated blinded of maternal pregnancy outcome. The pattern of morphology was evaluated both qualitatively (type of lesion) and quantitatively (number of lesions). Result: In Present study 79% of the deliveries were term deliveries and 21% were preterm deliveries. On placental macroscopy, placenta weight was significantly low among the neonates of preterm deliveries (370.00±60.49) as compared to term deliveries (440.89±55.22). Preterm placenta had higher number of abnormal placental lesion compared to term pregnancies. Conclusion: The uteroplacental insufficiency defined as placental infarct, fibrosis of chorionic villi, thickening of blood vessels, and poor vascularity of chorionic villi. Placental histopathological lesions are strongly associated with maternal under perfusion and uteroplacental insufficiency. These are the reasons for preterm birth. Thus, knowledge of the etiological factor can be use to reduce maternal and neonatal morbidity and mortility. Keywords: Placenta, Term & Preterm.


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