scholarly journals Cardiac biomarkers and blood metabolites in cows with clinical ketosis

2019 ◽  
Vol 40 (6Supl3) ◽  
pp. 3525 ◽  
Author(s):  
Gliére Silmara Leite Soares ◽  
Ana Clara Sarzedas Ribeiro ◽  
Jobson Filipe de Paula Cajueiro ◽  
Rodolfo José Cavalcanti Souto ◽  
Emanuel Felipe de Oliveira Filho ◽  
...  

The increase in energy imbalance at the beginning of lactation leads to metabolic disorders, especially clinical ketosis, in highly productive dairy cows. The objective of this study is to evaluate the clinical characteristics, biochemical parameters, and cardiac biomarkers creatine kinase MB isoenzyme (CK-MB) and cardiac troponin I (cTnI) of 15 cows diagnosed with clinical ketosis treated at the Bovine Clinic of Garanhuns at the Federal Rural University of Pernambuco. Nine of the 15 cows were diagnosed with primary ketosis and six had concomitant diseases, including left abomasal displacement, metritis, pneumonia, and renal failure. The observed clinical signs were non-specific and included decreased appetite and milk production and weight loss. Approximately 53% of the animals had central nervous system involvement. For biochemical evaluation, 15 high-production healthy dairy cows at the initial stage of lactation served as the control group. The data were subjected to analysis of variance for simultaneous comparison between two means allowing testing the hypothesis on the means of the different groups and subjected to Pearson correlation at a level of significance of 5%. The levels of ?-hydroxybutyrate (BHB), non-esterified fatty acids (NEFA), glucose, fructosamine, total protein, albumin, creatinine, aspartate aminotransferase, creatine kinase, CK-MB, and cTnI were higher in the group with ketosis. The diseased animals presented changes in glycemia, reduction in tissue sensitivity to insulin, and a lower RQUICKI-BHB index, especially hyperglycemic animals. The increase in the levels of cardiac biomarkers suggests the occurrence of myocardial injury associated with bovine ketosis.

2011 ◽  
Vol 21 (3) ◽  
pp. 266-270 ◽  
Author(s):  
Wanjun Luo ◽  
Ming Zhu ◽  
Rimao Huang ◽  
Yangde Zhang

AbstractBackgroundRemote ischaemic pre-conditioning and cardiac ischaemic post-conditioning provide myocardial protection in cardiac surgery. However, these two endogenous strategies have not been directly compared in a clinical setting. The purpose of this study was to compare the efficacy of remote ischaemic pre-conditioning and post-conditioning in providing myocardial protection to children undergoing cardiopulmonary bypass for surgical repair of ventricular septal defect.MethodsWe randomly assigned 60 paediatric patients scheduled for surgical correction of congenital ventricular septal defect to the post-conditioning group (n = 20), remote pre-conditioning group (n = 20), or control group (n = 20). Post-conditioning consisted of 30 seconds of ischaemia and 30 seconds of reperfusion achieved by clamping and unclamping the aorta, repeated three times over 3 minutes immediately after cardioplegic arrest. Remote ischaemic pre-conditioning consisted of 5 minutes of lower limb ischaemia followed by 5 minutes of reperfusion using a blood-pressure cuff inflated to a pressure of 200 millimetres of mercury, also repeated three times over 30 minutes. We assayed creatine kinase-MB, troponin I.ResultsMean age, cardiopulmonary bypass times, and aortic cross-clamp times were matched across groups. Both post-conditioning and remote ischaemic pre-conditioning reduced the peak release of creatine kinase-MB (86.1 plus or minus 24.1 units per litre and 92.8 plus or minus 20.6 units per litre, respectively, versus 111.0 plus or minus 44.6 units per litre in the control, p less than 0.05) and troponin I (0.28 plus or minus 0.10 nanogram per millilitre and 0.26 plus or minus 0.09 nanogram per millilitre, respectively, versus 0.49 plus or minus 0.19 nanogram per millilitre in the control group, p less than 0.05).ConclusionsOur study demonstrates that ischaemic post-conditioning and remote ischaemic pre-conditioning provide comparable myocardial benefit in children undergoing cold blood cardioplegic arrest.


2015 ◽  
Vol 156 (24) ◽  
pp. 964-971
Author(s):  
Ferenc Kovács ◽  
Ibolya Kocsis ◽  
Marina Varga ◽  
Enikő Sárváry ◽  
György Bicsák

Introduction: Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. Aim: The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. Method: Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. Results: The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confidence interval: 0.77–0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specificity were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classification in 62.5% and 98.9% of patients, respectively). Conclusions: Until a more sensitive and specific cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3–6 hours. Orv. Hetil., 2015, 156(24), 964–971.


2020 ◽  
Vol 48 ◽  
Author(s):  
Ana Clara Sarzedas Ribeiro ◽  
Gliére Silmara Leite Soares ◽  
Luiz Teles Coutinho ◽  
Jobson Filipe De Paula Cajueiro ◽  
Rodolfo José Cavalcanti Souto ◽  
...  

Background: Displaced abomasum (DA) is a common and economically important disorder that affects dairy cattle. Nutritional factors and adaptive responses that occur in the peripartum play a central role in the pathogenesis. The measurement of blood metabolites represents a useful tool for monitoring and prognostic determination in affected animals. Therefore, the objective was to evaluate cardiac, energy and hormonal blood markers, lactatemia, and insulin sensitivity in cows diagnosed with right displaced abomasum (RDA) and left displaced abomasum (LDA), comparing them with each other.Materials, Methods & Results: Nineteen cases of abomasum displacement in cows were studied, including 9 cases of RDA and 10 cases of LDA. The diagnosis was established by means of physical examination and measurement of the concentration of chlorides in the ruminal fluid (> 30mEq/L). After diagnosis, clinical-surgical therapeutic management was instituted. At the time of diagnosis (M1) and at the resolution of the case (M2), blood samples were collected to assess the variables: non-esterified fatty acids (NEFA), beta hydroxybutyrate (βHB), L-lactate, creatine kinase (CK), creatine kinase MB (CK-MB), cardiac troponin I (cTnI), lactate dehydrogenase (LDH), glucose, insulin, and cortisol. In addition, insulin sensitivity was estimated using the Revised Quantitative Insulin Sensitivity Check Index (RQUICKI) and RQUICKI-βHB. The means of the variables were compared, separating the effects of groups (RDA and LDA) and moments (M1 and M2), at the level of 5% probability. The concentrations of NEFA, CK-MB, L-lactate, glucose, insulin, and cortisol were higher at M1 and the RQUICKI and RQUICKI-βHB indices were lower at this moment. L-lactate, CK, and CK-MB were higher in the RDA group, while cTnI, βHB, and LDH did not present a group or moment effect. Cardiac markers correlated with the energy profile metabolites, L-lactate, and cortisol.Discussion: The high concentrations of NEFA at M1 reflected the condition of negative energy balance. βHB concentrations were stable, that may be related to the number of days postpartum in which the animals were diagnosed. The hyperglycemic condition and the increase in serum cortisol concentrations found at M1 can be induced by the condition of metabolic stress resulting from the disease. Hyperinsulinemia were recorded in the present study could be an important factor related to the pathogenesis of DA, since there seems to be a correlation between hyperinsulinemia and decreased abomasal emptying rate. The RQUICKI and RQUICKI-βHB indices was significantly lower at M1, which may indicate lower sensitivity of peripheral tissues to insulin at this time. Changes in serum activity of LDH and CK may result from tissue damage due to organ displacement, in addition to damage associated with surgery and the administration of injectable drugs, mainly intramuscularly. The elevation in plasma L-lactate at M1 and in the RDA group may be associated with abomasal hypoperfusion. The high positive correlations found between L-lactate and the variables glucose, insulin, and cortisol reinforcing the association between the concentration of L-lactate and the moment of greatest stress. The increase in cardiac biomarkers may be related to the occurrence of ischemia/reperfusion injury in the abomasum, which involves oxidative stress and the production of inflammatory mediators. The hyperglycemic condition and the higher concentrations of NEFA can also contribute to the occurrence of myocardial injury. The correlations found between cardiac biomarkers and plasma L-lactate, strengthen the idea that there is a relationship between L-lactate and myocardial injury. In this sense, the measurement of blood concentrations of cTnI, CK-MB, and L-lactate could contribute as severity markers and prognosis indicators in cattle with DA. 


2016 ◽  
Vol 64 (1) ◽  
pp. 38-46 ◽  
Author(s):  
Ugur Aydogdu ◽  
Ramazan Yildiz ◽  
Hasan Guzelbektes ◽  
Alparslan Coskun ◽  
Ismail Sen

The aim of this study was to determine the clinical relevance of cardiac biomarkers [troponin I and T, creatine kinase-MB fraction (CK-MB) and lactate dehydrogenase (LDH)] in premature calves with respiratory distress syndrome. Seventy premature calves were admitted to the clinic within 24 h after birth. Respiratory distress syndrome was diagnosed in premature calves by clinical examination and venous blood gas analysis. Ten healthy calves, aged 5 days, were used as control. Cardiac troponin I and T were analysed using ELISA and ELFA, respectively. Serum CK-MB and LDH were also analysed in an automatic analyser. The calves had low venous pH, pO2, O2 saturation and high pCO2 values consistent with dyspnoea, hypoxaemia, and inadequate oxygen delivery. Mean serum troponin I, troponin T, CK-MB and LDH levels were increased in the premature calves compared to the control group. In conclusion, the results in this study demonstrated that serum CK-MB, troponin I and troponin T concentrations could be used for evaluating myocardial injury in premature calves with respiratory distress syndrome.


2017 ◽  
Vol 21 (2) ◽  
pp. 106-111
Author(s):  
Sangita M Patil ◽  
Mangesh Bankar ◽  
Ramchandra Padalkar ◽  
Abhijit Phatak

ABSTRACT Introduction Because of the varied presentation and associated high mortality, the identification of patients with acute myocardial infarction (MI) is very critical for patient management and has a bearing on the prognosis. The goal of present study was to correlate the diagnostic value of cardiac biomarkers in MI with survival and MI without survival. Materials and methods Diagnostic case—control study was conducted on 110 MI patients presenting to the Emergency Department within 12 hours of acute chest pain, and 120 healthy age- and sex-matched volunteers formed the control group. Serum ischemia-modified albumin (IMA), troponin I (TnI), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), and aspartate transaminase (AST) were measured. Statistical software SYSTAT version 12 was used to analyze the data. The results were expressed in mean ± standard deviation. Comparisons of study groups and study groups with control groups were done by applying Z test. Correlation was tested by Student's t-test at 5% (p = 0.05) and 1% (p = 0.01) level of significance. Results Mean levels of serum IMA, TnI, CK-MB, LDH, and AST levels were significantly higher (p < 0.01) in patients with MI as compared with healthy controls. Serum levels of cardiac biomarkers were significantly elevated (p < 0.01) in MI patients without survival as compared with MI with survival. Conclusion The serum levels of biomarkers were increased in MI without survival as compared with MI with survival. These study data prove that these changes might be helpful to obtain a comprehensive view of the infarct size and severity of vascular stenotic lesions. How to cite this article Patil SM, Bankar M, Padalkar R, Phatak A. Comparative Study of Potential Diagnostic Biomarkers in Myocardial Infarction with Survival and Myocardial Infarction without Survival. Indian J Med Biochem 2017;21(2):106-111.


2020 ◽  
Vol 7 (2) ◽  
pp. 41-46
Author(s):  
Dr. Dhananjay V. Andure ◽  
Dr. Sangita. M. Patil ◽  
Dr. M. P. Bankar ◽  
Dr. R. K. Padalkar ◽  
Dr. A. P. Pathak

Background: Because of the varied presentation and associated high mortality the identification of patients with acute myocardial infarction is very critical for the patient management and has a bearing on the prognosis. Only about 22% patients admitted to cardiac care centers with chest pain having truly myocardial infarction. Aim: The goal of present study was to assess diagnostic value of serum ischemia modified albumin and compare it with sensitive cardiac troponin I and Creatine Kinase-MB in acute myocardial infarction. Methods: A diagnostic case control study was conducted on 102 patients presenting to the Emergency Department within 6 hrs of acute chest pain and 115 healthy age and sex matched volunteers formed the control group. Serum ischemia modified albumin level was estimated by albumin cobalt binding test using digital spectrophotometer, while troponin I was measured by immunofluroscence assay and creatine Kinase-MB was determined by immunoinhibition method.  The sensitivity and specificity of ischemia modified albumin, troponin I and creatine kinase-MB for detection of acute myocardial infarction were analyzed. The results of ischemia modified albumin, troponin I and creatine kinase-MB alone and in combination were correlated. Results: Ischemia modified albumin (p<0.05) and troponin I (p<0.001) concentrations were significantly higher in acute myocardial infarction than healthy controls. Sensitivity, specificity, positive predictive value and negative predictive value of ischemia modified albumin for detection of acute myocardial infarction was 88.24%, 93.91%, 92.78% and 90.00% compared to 86.27%, 93.04%, 91.67% and 88.43% respectively for the troponin I and 78.43%, 100%, 100%, and 83.94% for creatine kinase-MB. Combined use of ischemia modified albumin, troponin I, creatine kinase-MB significantly enhanced the sensitivity to 96%. The area under the receiver operating characteristic curve of ischemia modified albumin in acute myocardial infarction was 0.90. Conclusion: Ischemia modified albumin is a new potential diagnostic biomarker used together with other gold standard cardiac biomarkers can improve early diagnosis of acute myocardial infarction.


2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
R Ong ◽  
C Chacon ◽  
S Javier

Abstract Background There is overwhelming volume of confirmed cases of COVID-19, despite this numerous knowledge gaps remain in the diagnosis, management, and prognostication of this novel coronavirus infection, making prevention and control a challenge. Methods This retrospective cohort study included patients with real-time reverse transcriptase polymerase chain reaction (rRT-PCR)-confirmed COVID-19. Binary logistic regression was used to determine the association between the cardiac biomarkers and in-hospital mortality. ROC, AUC, and cutoff analyses were used to determine optimal cutoff values for the cardiac biomarkers. Results A total of 90 subjects with a complete panel of cardiac biomarkers out of the 224 rRT-PCR confirmed cases were included. The median age was 57 years (IQR, 47–67 years), majority were males. Sixty-six (77.6%) subjects survived while 19 (22.4%) expired. The most common presenting symptom was fever (75.6%), and the most common comorbidity was hypertension (67.8%). Spearman rho correlation analysis showed moderate positive association of high sensitivity troponin I (hsTnI) with in-hospital mortality (R, 0.434, p = &lt;0.001). Multivariate binary logistic regression analysis showed that creatine kinase and hsTnI were independently associated with in-hospital mortality (OR, 4.103 [95% CI, 1.241–13.563], p=0.021; and OR, 7.899 [95% CI, 2.430–25.675], p=0.001, respectively). ROC curve analysis showed that hsTnI was a good predictor for in-hospital mortality (AUC, 0.829 [95% CI, 0.735–0.923], p = &lt;0.001) and that creatine kinase was a poor predictor (AUC, 0.677 [95% CI, 0.531–0.823], p=0.018). Optimal cutoff point derived from the ROC curve for hsTnI was 0.010 ng/ml (J, 0.574) with a sensitivity of 84% (TPR, 0.842 [95% CI, 0.604–0.966]), specificity of 73% (TNR, 0.732 [95% CI, 0.614–0.386]), and an adjusted negative predictive value of 99% (Known prevalence*adjusted NPV, 0.989), a positive likelihood ratio of 20% (LR+, 3.147 [95% CI, 2.044–4.844]) and a negative likelihood ratio of 30% (LR−, 0.216 [95% CI, 0.076–0.615]). Conclusion High sensitivity troponin I level was a good tool with a very high negative predictive value in significantly predicting in-hospital mortality among rRT-PCR positive COVID-19 patients. FUNDunding Acknowledgement Type of funding sources: None. ROC Curve


2021 ◽  
pp. 096032712110434
Author(s):  
Yusuf K Tekin ◽  
Gülaçan Tekin ◽  
Naim Nur ◽  
İlhan Korkmaz ◽  
Sefa Yurtbay

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.


2021 ◽  
Author(s):  
Bo Zhang ◽  
Laxman Gyawali ◽  
Zengzhang Liu ◽  
Huaan Du ◽  
Yuehui Yin

Abstract Immune checkpoint inhibitors (ICIs) have emerged in recent years as a promising treatment option for several malignant tumors. However, ICI therapy has also been associated with various immune-related adverse events (irAEs), especially with pre-existing autoimmune status, which sometimes can be life-threatening. A 68-year-old woman diagnosed with metastatic thymoma was treated with camrelizumab as her initial anti-tumor protocol at a nearby hospital. On 11 days after the first dose of camrelizumab, the patient was admitted to our hospital with symptoms of dyspnea, fatigue, and poor appetite. Workup on admission indicated dramatically elevated transaminase, troponin I, creatine kinase, and creatine kinase MB and a new-onset conduction abnormality on electrocardiography. She had no other underlying disease prior to ICI treatment; therefore, ICI-related myocarditis, myositis and hepatitis were diagnosed, and intravenous methylprednisolone (80mg/day) and other supporting treatments were administered sequentially. Coronary angiography was performed on day 3 of hospitalization, but no abnormality was detected. On the same day, she lapsed into a coma with respiratory muscle failure, which was highly suspected of myasthenic crisis. Therefore, mechanical ventilation and higher dose of methylprednisolone (1 g/day) plus intravenous immunoglobulin (20g/day) were applied immediately. The third artrioventricular block occurred abruptly and an urgent temporary pacemaker was placed. Repeated ventricular tachycardia (VT) occurred, and even multiple antiarrhythmic drugs used in combination failed to alleviate the VT storm. On day 5 of hospitalization, she suffered from ventricular fibrillation and die of cardiac arrest. In conclusion, close follow-up should be conducted after ICI treatment, especially for patients already with or at high risk for autoimmune disorders. Once diagnosed with severe irAEs, prompt high dose of glucocorticoid alone or in combination with other immunomodulators if necessary should be administered. A multidisciplinary team approach is of importance for better management of patients with multiple organs involvement.


2019 ◽  
Vol 71 (4) ◽  
pp. 621-628
Author(s):  
Jong Choi ◽  
Moon Lee ◽  
Tatsuyoshi Fujii

The plasma neutrophil gelatinase-associated lipocalin (NGAL) level is elevated in myocardial infarction (MI) and affected by inflammation and kidney function. The aim of this study was to determine which of these conditions more critically affects the plasma NGAL level in MI. Patients with MI were evaluated by measuring the NGAL concentration and its corrected values. No significant association was observed between plasma NGAL concentration and cardiac biomarkers. However, the NGAL/inflammation index ratio (NGAL/Inf ratio) was positively correlated with troponin-I (r=0.289, p<0.001), and the NGAL/serum creatinine ratio (NGAL/sCr ratio) was significantly correlated with creatine kinase-MB (r=0.251, p<0.001). After adjusting for inflammation and kidney function, increased NGAL concentrations returned to baseline levels, which were not different from those of healthy individuals. The percent difference between NGAL and the NGAL/Inf ratio was 35.6%, significantly higher than that between NGAL and the NGAL/sCr ratio (15.4%; p<0.001). The severity of inflammation seems to play a more crucial role than renal and myocardial dysfunction in affecting plasma NGAL levels in MI. Plasma NGAL levels need to be corrected using the inflammation index and sCr levels for exactly evaluating patients with MI.


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