Laboratory biochemical markers of cardiac injury by COVID-19: an integrative review.

OBJECTIVES/SPECIFIC AIMS: The overall objective of this study is to develop a novel, clinically-relevant, image-guided mouse model for radiation-induced cardiotoxicity, which can be used to gain insight into clinically-targetable, pathophysiologic mechanisms of cardiac injury in thoracic radiotherapy patients. METHODS/STUDY POPULATION: Photon or sham radiation will be administered at differential doses to a defined portion of the heart and/or lungs of C57BL/6 female mice using micro-CT visualization of the heart with Xstrahl’s MuriSlice Software applied to the Small Animal Radiation Research Platform (SARRP). Cardiac and lung segments from a subset of mice will be harvested at specific time points for confirmation of radiation targeting, local apoptosis assessment, and evaluation of fibrosis and vascular tissue morphology. Quantitative echocardiography, myocardial 18F-fluorodeoxyglucose positron emission tomography computed tomography (18F-FDG PET/CT), and myocardial perfusion imaging (MPI) with Technicium-99 (Tc-99) sestamibi will be implemented to identify sensitive imaging measures of cardiac injury and asses myocardial mechanics, inflammation, and perfusion deficits, respectively. Concurrently, a multiparametric analysis will be conducted to identify novel, circulating biomarkers of cardiotoxicity. RESULTS/ANTICIPATED RESULTS: We hypothesize that a clinically-relevant mouse model can be generated by the in situ, focal irradiation of a portion of heart and/or lung tissue segments, and can be used to elucidate molecular mechanisms of radiation-induced cardiac damage. We anticipate time-dependent and dose-dependent, focal histopathologic changes in the mouse heart, with cardiac fibrosis development, vascular damage, and cellular apoptosis in irradiated mice. Additionally, we anticipate that our mouse model of focal heart irradiation will reveal radiologic and biochemical changes that can be used to characterize and predict radiation-induced cardiac injury. Specifically, we expect our quantitative echocardiography, FDG-PET, and MPI parameters to identify and characterize cardiac damage that topographically matches histopathological analysis, and expect levels of select biochemical markers to differentially vary with time. DISCUSSION/SIGNIFICANCE OF IMPACT: Our mouse model of radiation-induced cardiotoxicity has the potential to shift current preclinical research paradigms to more closely mimic the radiation plans most commonly administered in clinical practice. The primary technologic innovation to be developed here is the use of the SARRP to deliver image-guided, in situ, focal radiation to a defined portion of the mouse heart. From a conceptual perspective, we propose a novel approach for phenotyping radiation-induced cardiac damage in patients undergoing chest radiation therapy, integrating sensitive radiomic and biochemical markers into a predictive model of cardiotoxicity.

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Diagnostic efficacy of cardiac troponin in post‐mortem examination of acute myocardial infarction

INTERNATIONAL JOURNAL OF ETHICS TRAUMA & VICTIMOLOGY ◽

10.18099/ijetv.v1i1.27 ◽

2015 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Dr. Gulam Hasan Mustafa ◽

Dr R K Gorea ◽

Dr. Shakilur Rahman ◽

Dr. Mohammed Sarosh Khan

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Troponin ◽

Biochemical Markers ◽

Cardiac Death ◽

Biochemical Marker ◽

Cardiac Injury ◽

Myocardial Necrosis ◽

Postmortem Examination ◽

Diagnostic Efficacy

Major challenges for forensic experts include selection of best effective diagnostic tests in the time sensitive identification of cause of death to avoid delay in postmortem examination cases. Sudden cardiac death due to acute myocardial infarction constitutes a significant portion of the autopsies that are conducted by forensic pathologists. Lack of specificity of clinical and conventional markers causes misdiagnosis and prevents or delays in the detection. Conventional biochemical markers like creatine kinase (CK), myoglobin, and lactate dehydrogenase is no longer a best choice in the detection, because of their low specificity to cardiac injury. Recent reports indicate cardiac troponin as an extremely sensitive biochemical marker which can detect even microscopic zones of myocardial necrosis. We herein, review cardiac troponin as a biochemical marker in autopsy cases of AMI and its impact on postmortem management that will lead to guidance for early detection with quick and reliable diagnostics methods.

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Histopathological findings in fatal COVID-19 severe acute respiratory syndrome: preliminary experience from a series of 10 Spanish patients

Thorax ◽

10.1136/thoraxjnl-2020-215577 ◽

2020 ◽

Vol 75 (12) ◽

pp. 1116-1118

Author(s):

Borja Recalde-Zamacona ◽

Laura García-Tobar ◽

Alan Argueta ◽

Laura Álvarez ◽

Carlos Eduardo De Andrea ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Biochemical Markers ◽

Inflammatory Infiltrate ◽

Diffuse Alveolar Damage ◽

Cardiac Injury ◽

Medium Size ◽

Cytokine Storm ◽

Paraffin Sections ◽

Histopathological Findings ◽

Lung Histopathology

In December 2019, an outbreak of severe acute respiratory syndrome associated to SARS-CoV2 was reported in Wuhan, China. To date, little is known on histopathological findings in patients infected with the new SARS-CoV2. Lung histopathology shows features of acute and organising diffuse alveolar damage. Subtle cellular inflammatory infiltrate has been found in line with the cytokine storm theory. Medium-size vessel thrombi were frequent, but capillary thrombi were not present. Despite the elevation of biochemical markers of cardiac injury, little histopathological damage could be confirmed. Viral RNA from paraffin sections was detected at least in one organ in 90% patients.

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