Use of Anti-angiogenic Drugs Potentially Associated With an Increase on Serum AST, LDH, CK, and CK-MB Activities in Patients With Cancer: A Retrospective Study

Background: There is a large amount of evidence that anti-angiogenic drugs are effective safe. However, few studies have evaluated the specific effects of anti-angiogenic drugs on myocardial enzyme injury biomarkers: aspartate aminotransferase (AST), lactic dehydrogenase (LDH), creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). The purpose of our study was to determine whether anti-angiogenic drugs serum AST, LDH, CK, and CK-MB activities of cancer patients treated with anti-angiogenic drugs.Methods: This study retrospectively analyzed 81 cancer patients. Patients who had used anti-angiogenic drugs were selected. Serum AST, LDH, CK, and CK-MB activities were measured before and after treatment with anti-angiogenic drugs for 3 weeks.Results: A total of 16 cancer types were analyzed. The distribution of the cancer types in the patients was mainly concentrated in lung, gastric, and colorectal cancers. The anti-angiogenic treatment markedly increased AST, LDH, CK, and CK-MB activities by 32.51, 7.29, 31.25, and 55.56%, respectively in serum.Conclusions: Our findings suggest that patients, who had used anti-angiogenic drugs were likely to have elevated AST, LDH, and CK, indicators of myocardial muscle injury. Use of anti-angiogenic drugs should not be assumed to be completely safe and without any cardiovascular risks.

MYOCARDIALBRIDGINGOFA CORONARYARTERY

Myocardial (muscle) bridges are a common congenital anomaly of coronary arteries which is characterized by running of a coronary artery segment under the myocardial layer. According to literary data, the most frequent localization of myocardial bridges is observed in the middle segment of the anterior interventricular branch. In the majority of cases, the presence of a muscular bridge is not accompanied by clinical manifestations, and patients have a favorable long-term prognosis.Under certain circumstances, the course of the intramural course of the coronary artery may be accompanied by development of acute coronary syndrome, a sudden cardiac death. The main method of the diagnosis is coronary angiography. The article presents brief data on the prevalence, clinical picture, diagnosis, treatment of patients with myocardial bridges. Also, it describes a clinical case of a patient havinga myocardial bridge in the middle segment of the anterior interventricular branch with characteristic clinical symptoms confirmed by tool research methods.

Effect of Glucocorticoids on Ultrastructure of Myocardial Muscle in the Course of Experimentally Induced Acute Myocardial Ischemia

The search for effective methods of myocardial cytoprotection against ischemia is the most significant issue in modern cardiology and cardiac surgery. Glucocorticoids are deemed very strong modulators of inflammatory response and thus can potentially protect heart muscle from postreperfusion injury and myocardial ischemia during cardiac surgery. Ultrastructural examination of the left ventricle heart samples revealed that the intravenous application of dexamethasone and hydrocortisone proved to exert cytoprotective effect on cardiomyocytes during experimentally induced acute ischemia in rats.

CT-based Assessment of Myocardial Bridging in Patients with Acute Chest Pain and No Atherosclerotic Etiology

Introduction: The term “myocardial bridging” is used to describe an anatomic variant where a band of cardiac muscle overlies a segment of an epicardial coronary artery. It is a highly debated topic, because it can cause conditions such as acute coronary syndrome. Myocardial bridging (MB) can be diagnosed using invasive procedures, but also non-invasive ones, such as Multislice Computed Tomography Angiography (MSCTA). Objectives: A comparative analysis was performed on the patients who were admitted to the clinic with typical angina, ischemic ECG changes and muscular bridging shown on MSCTA, and patients with the same symptoms, but without MB. A sub-study was also undertaken in which the MB site and ischemia revealed by thickening of the myocardial muscle, using 3D Polar Mapping, were compared. Materials and methods: A retrospective study assessed 59 patients with typical angina pectoris, shortness of breath and clinical appearance of an acute coronary syndrome, and for whom MSCTA was carried out. Patients were divided into two groups: Group 1 — patients with MB, and Group 2 — patients without MB. Thirty patients in Group 1 had 3D polar mapping to evaluate the thickness of the myocardial muscle. Results: The mean age of our patients with muscular bridging was 55.51 ± 11.4 years, CI 51.57–59.45 years. Patients without MB had a mean age of 59.17 ± 9.6 years, CI 54.98–63.6 years, p = 0.211. 24.32% of the patients with MB were females and 60.86% from the patients without MB were males, p = 0.040. 40.54% of patients presented with MB in the first segment of the LAD and 15.62% had an MB in the second segment of LAD. In patients with an ischemic site smaller than 2 cm of the MB, the ischemic myocardial area was more pronounced compared to the patients with higher length MB (21.85 ± 6.123% vs. 17.62 ± 5.856%). Conclusions: MSCTA is an important procedure that contributes to the clinical investigations of patients with typical angina and suspected acute coronary syndrome. There is a good positive correlation between the location of the MB and the ischemic segments as shown on 3D CT-based polar maps.