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Objective: To investigate the changes of the levels of amino-terminal pro-brain natriuretic peptide (NT-pro BNP) and lipoprotein a [Lp (a)], and to clarify the relationships between the severity of coronary artery lesions and the prognosis in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCD. Methods: A total of 316 AMI patients underwent emergency PCI were selected. According to the number of stenosed coronary vessels, the patients were divided into single-vessel disease group (n=135), double-vessel disease group (n= 99) and three-vessel disease group (n=82). According to the Gensini score, there were 79 cases in 83. 00 group. The patients' general data, biochemical parameters, echocardiography results, and coronary angiography findings were recorded, and the major adverse cardiovascular events (MACE) were also recorded during a 12-month folow-up. The relationships between the serum NT-pro BNP and Lp (a) levels of the AMI patients in different lesion counts and Gensini scores, and the recent Accurrence of MACE were analyzed. The receiver operating characteristic (ROC) curve was drawn to investigate the values of NT-pro BNP and Lp (a) levels on predicting the recent MACE in the patients with AMI. Results: The serum NT-pro BNP levels of the patients in three-vessel disease group and double-vessel disease group were higher than that in single-vessel disease group (P< 0.01); the serum Lp (a) level of the patients in three-vessel disease group was higher than that in single-vessel disease group (P<0.05). According to Spearman correlation analysis, there were positive correlations between the serum NT-pro BNP level, Lp (a) level of the AMI patients and the number of coronary vessels (r=0.285, P< 0.01; r=0.144, P=0.010); there were positive correlation between the serum NT-pro BNP level, Lp (a) level and Gensini score of coronary lesions (r=0.156, P=0.006; r=0.164, P=0.003). The serum NT-pro BNP and Lp (a) levels of the patients with MACE during follow-up were higher than those in the patients without MACE. The ROC curve showed that the area under the curve (AUC) of the levels of serum NT-pro BNP and Lp (a) was 0.747 (95%CI: 0.679-0.814). Conclusion: The serum NT-pro BNP and Lp (a) levels have the certain relationships with the severity of coronary artery lesions in the AMI patients after PCI. The simultaneous detection A serum NT-pro BNP and Lp (a) levels has certain predictive value for the recent Accurrence of MACE in the AMI patients underwent emergency PCI.
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PURPOSE: Changes in serum biomarkers of cardiac and muscle damage have been studied in ultra-marathon runners for distances up to 308 km. We investigated these biomarker changes following a 622-km super-ultramarathon race. METHODS: A group of men with a mean age of 52.7±4.8 years participated. Blood samples were obtained pre-race, during the race, and post-race, to analyze the aforementioned biomarkers. RESULTS: Creatine kinase and creatine kinase-MB (CK-MB) levels increased during the race, and both steadily declined post-race with CK-MB declining at a slower rate. Lactic acid dehydrogenase levels overall were increased over pre-race levels. White blood cell counts increased during the race. Red blood cell decreased from pre-race to 300 km and 622 km. Platelet increased only in the recovery period. High-sensitivity C-reactive protein levels were increased throughout the race and at day 3 compared to pre-race levels. Cardiac troponin I (cTnI) levels increased during the race. N-terminal pro b-type natriuretic peptide (NT-proBNP) levels increased during the race. CONCLUSION: The rise in cTnI was not clinically significant, and highly elevated NT-proBNP levels during the race indicates that myocardial burden rose linearly as running distance increased. However, no clinical risk was found as most of the markers returned to normal range during the recovery.
Subject(s)
Humans , Male , Biomarkers , Blood Platelets , C-Reactive Protein , Racial Groups , Creatine , Creatine Kinase , Erythrocytes , Lactic Acid , Leukocyte Count , Natriuretic Peptide, Brain , Oxidoreductases , Reference Values , Rhabdomyolysis , Running , Troponin IABSTRACT
Objective To evaluate the risk factors,diagnostic index of the restrictive right ventricle physiology(rRV) and the impact of the mid-term outcome of the patients.Methods Eighty patients(30 in rRV group and 50 in non-rRV group) undergoing TOF repair admitted in our department from Oct 2011 to May 2012 were studied.Perioperative clinical data were collected and echo data were recorded after operation.Mixed linear regression for repeated measures was used to compare the variables and analyze the correlations.Results Patients in rRV group were younger with longer cardiopulmonary bypass(CPB) time,aortic cross clamp time,ventilation time,intensive care unit and hospital stay compared with those in non-rRV group(P<0.01,respectively).The younger patients with longer CPB time had high risk of rRV by logistic regression analysis.Within 7 days post operation,the increase of saturation of venous oxygenation and decrease of oxygen extraction ration were slower in rRV group than those in non-rRV group(P<0.05,respectively).Lactate decreased in both groups,but was higher in rRV group throughout the 7 days(P=0.03).NT-proBNP was higher in rRV group throughout the 7 days than that in non-rRV group.NT-proBNP≥4750pg/ml often indicated the patients in the state of rRV.CRP slightly increased in 1-2 days post operation,and decreased thereafter,and the decrease was slower in rRV group(P=0.08).With regard to the mid-term outcome,there was no significant differences in the incidences of the obstruction of the right ventricle outflow and main pulmonary artery,the stenosis of the branch of pulmonary artery and the degree of the pulmonary valve regurgitation.Conclusion rRV is associated with significantly higher levels of NT-proBNP and CRP.The incidence of rRV correlates with age on operation and positively correlates with CPB time.NT-proBNP would be regarded as an indicator of the incidence of rRV.The study indicated the rRV would have impact on the early outcome of the patients but there was no significant effect on mid-term outcome.
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Objective To study the early diagnostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) for acute lung injury/acute respiratory distress syndrome (ALI/ARDS) in children and its influence on prognosis.Methods Fifty-two children with ALI/ARDS were selected as the experiment group,and 36 children with cardiac disease merging dyspnea were selected as the control group.The serum levels of NT-pro-BNP were measured in the 2 groups.The pediatric critical illness score(PCIS),lung injury score (LIS) and 28-day mortality were analyzed in the experiment group.The serum level of NT-pro-BNP,and the different condition and prognosis were compared in 2 groups,and the difference of the NT-pro-BNP levels were compared in children with ALI/ARDS.Results The NT-proBNP levels in experiment group were significantly higher than the control group (P ＜ 0.05).But the NT-pro-BNP levels in children with cardiaogenic pulmonary edema were significantly higher than ALI/ARDS(P ＜ 0.05).The NT-pro-BNP levels of the children who died in 28 d,or with LIS ＞ 2.5 scores or PCIS≤70 scores were higher than that of children who were survived,or with LIS ≤ 2.5 scores or PCIS ＞ 70 scores (P =0.001,0.013,0.002).The NT-pro-BNP levels were negatively correlated with PCIS(P ＜ 0.05),and the NT-pro-BNP levels were positively correlated with the 28-day mortality and LIS(all P ＜ 0.05).Conclusions The measurement of serum NT-pro-BNP can help to evaluate the severity and prognosis of ALI/ARDS children.
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PURPOSE: Cardiac dysfunction and hyperdynamic systemic circulation may be present in patients with cirrhosis. The purpose of this study was to identify relations between plasma levels of N-terminal-proBNP (NT-proBNP), reflecting early ventricular dysfunction, and the severity of liver disease and cardiac dysfunction in cirrhotic patients. MATERIALS and METHODS: Sixty-three cirrhotic patients and 15 controls (group 1) were enrolled in this study. Plasma levels of NT-proBNP were determined in echocardiographically examined patients, which were allocated to 1 of 3 groups according to Child-Pugh classification or into 2 groups, i.e., a compensated group without ascites (group 2) and decompensated group with ascites (group 3). RESULTS: Plasma NT-proBNP levels were significantly higher in cirrhotic patients (groups 2 and 3) than in age-matched controls (155.9 and 198.3 vs. 40.3pg/mL, respectively, p < 0.05). NT-proBNP levels were significantly increased in Child class C patients than in classes B and A (250.0 vs. 168.6 and 119.6pg/mL, respectively, p < 0.05). Left atrial dimension, wall thickness of left ventricle, and EF or E/E' were significantly increased, and EDT was prolonged in cirrhotic patients than in controls. Increased LVMI and decreased E/A ratio were noted in the group of patients with ascites as compared with the other groups. CONCLUSION: Plasma NT-proBNP levels were high in cirrhotic patients and are likely to be related to the severity of disease. Advanced cirrhosis is associated with advanced cardiac dysfunction, and NT-proBNP levels has predictive value for concomitant cardiac dysfunction and cirrhosis progression.