EVALUATION OF CARDIAC SPECIFIC MARKER CARDIAC TROPONIN I AFTER CORONARY BYPASS SURGERY

Background: Cardiac troponin I (cTnI) is reported to be very specific formyocardial cell damage without cross reactivity with skeletal muscle isoform.Evaluation of cTnI after CABG will be useful as an early marker of excessivepost operative myocardial damage when a specific therapeutic intervention canstill be efficient and improve outcome.Methodology: The study comprised of 50 patients who undergo Coronary arterybypass surgery at V.S group of Hospital. Blood sample were taken after 12 hour (T12) and 24 hour ( T24 ) of post CABG. The sample were analysed for cTnI.Results: Our results show that Troponin I levels after 2 hours, 12 hours and 24hours in patients who had better outcome after CABG was 9.2 ng/ml, 13.9 ng/mland 10.9 ng/ml respectively. Whereas, Troponin I levels after 2 hours, 12 hoursand 24 hours in patients who had adverse outcome like death of patients afterCABG was 10.6 ng/ml, 38.7 ng/ml and 28.9 ng/ml respectively.Conclusion: Routine measurement of cardiac troponin levels after cardiactroponin can identify group of patients at increased risk of complications ordeath.

Diagnostic utility of heart type fatty acid binding protein (H-FABP) versus cardiac troponin I in myocardial infarction

Background: Acute myocardial infarction (AMI) management is one of the therapeutic challenges faced by the emergency physician. In the field of investigational cardiology advancements, the search of superior cardiac biomarkers has led to the discovery of sensitive biomarkers which help in the early confirmation of MI as timely intervention is the primary goal in acute coronary syndrome (ACS). Present study was aimed to evaluate the diagnostic performance of the novel biomarker H- FABP in patients with AMI especially in ST elevation MI (STEMI) and comparison of its diagnostic accuracy with the other biomarkers.Methods: We studied 66 patients with persistent STEMI presenting within 12 hours of symptom to the department of General Medicine, Sri Manakula Vinayagar Medical College and Hospital (SMVMCH), Puducherry. Quantitative and qualitative estimation and analysis of serum biomarkers of acute myocardial infarction such as CK-MB, cardiac Troponin I (cTnI) and H-FABP were done.Results: The sensitivity and specificity of H-FABP were 80.7 and 88.9% respectively. The positive percentage of the serum biomarkers among these patients were 64%, 65%, 86% for CK-MB, cardiac troponin I, and H-FABP respectively. The area under the curve was observed to be 0.695, with 95% confidence interval (0.514-0.876) at the optimum cut-off value of 7.0ng/ml for H-FABP.Conclusions: H-FABP the novel biomarker, because of its early appearance in the blood stream and due to its superior sensitivity and specificity compared to Troponin I and CK-MB can be used in the early diagnosis of acute ST elevation Myocardial Infarction

Evaluation of Cardiopulmonary biomarkers during different stages of Canine Visceral Leishmaniasis / Evaluación de biomarcadores cardiopulmonares durante diferentes etapas de Leishmaniasis visceral canina

ABSTRACT Objective. The purpose of the present study was to test the hypothesis that cardiac alterations participate within different stages of CVL. Materials and methods. Dogs were diagnosed with CVL, were classified as follows; group I (mild disease), group II (moderate disease), group III (severe disease), group IV (very severe disease) and group V included healthy controls. Results. Ig G antibodies against Leishmaniasis in group as tested by IFAT, were deemed 1/64 to 1/16000 among infected groups. Considering the cTnI levels, there were significant differences (p=0.018) between stage IV (group IV) and healthy control group, besides between group IV and group I. Considering D-dimer levels, there was difference between healthy control group and group II, III and IV (p=0.005). Regareing NT-pro BNP levels, there were differences between healthy control group and stage III, IV, besides between stage I with stage III, IV (p=0.000). Conclusions. The results showed that levels of cTnI, Nt pro-BNP and D-dimer were higher in dogs infected with CVL in contrast to healthy dogs, in which levels of those biomarkers were below detection limits. Obtained results suggested the possibility of cTnI and NT pro-BNP as markers for cardiac damage and D-dimer as a supportive tool for a diagnosis of probable thromboembolism in dogs with CVL.

RESUMEN Objetivo. El propósito del presente estudio fue probar la hipótesis de que las alteraciones cardíacas participan en diferentes estadios de CVL. Materiales y métodos. Perros fueron diagnosticados con CVL, se clasificaron de la siguiente manera; Grupo I (enfermedad leve), grupo II (enfermedad moderada), grupo III (enfermedad grave), grupo IV (enfermedad muy grave) y grupo V controles sanos incluidos. Resultados. Los anticuerpos Ig G contra la leishmaniasis en el grupo como probado por IFAT, se consideraron 1/64 a 1/16000 entre los grupos infectados. Considerando los niveles de cTnI, hubo diferencias significativas (p=0.018). Entre el grupo IV y el grupo control sano, además entre el grupo IV y el grupo I. Considerando los niveles D-dímero, hubo diferencia entre el grupo control sano y el grupo II, III y IV (p=0.005). Teniendo en cuenta los niveles de NT-proBNP, hubo diferencia estadística entre el grupo de control sano y el estadio III, IV, además entre la etapa I con estadio III, IV (p=0.000). Conclusiones. Los resultados mostraron que los niveles de cTnI, Nt pro-BNP y D-dímero fueron mayores en perros infectados con CVL en contraste con perros sanos, en los que los niveles de estos biomarcadores estaban por debajo de los límites de detección. Los resultados obtenidos sugirieron la posibilidad de que cTnI y NT pro-BNP como marcadores de daño cardíaco y D-dímero como una herramienta de apoyo para un diagnóstico de tromboembolismo probable en perros con CVL.

A retrospective analysis of cardioversion for paroxysmal supraventricular tachycardia in emergency department / 中华急诊医学杂志

Objective To analyze retrospectively the cardioversion for paroxysmal supraventricular tachycardia (PSVT) in emergency department in order to explore rational guidance for the diagnosis and treatment for PSVT.Methods A retrospective analysis of PSVT patients in the emergency department admitted from June 2015 to December 2015 was carried out.First,all the patients were divided into two groups according to the cardioversion achieved by Valsalva's maneuvre or not.Forty patients were enrolled in study.There were 11 patients got cardioversion successfully achieved by the Valsalva's maneuvre and 29 patients failed to get cardioversion.Then,comparisons of demographics,vital sign,serum CTNI,potassium and NTproBNP level were carried out between these groups of patients using statistical analysis.The categorical variable was expressed in percentage and the continuous variable was described by mean±standard deviation and the comparisons of parameters were conducted by group t-test and chi-square test.Results The success rate of PSVT maneuvre cardioversion was 27.5％.In addition,there were no significant differences in demographics vital sign,TNI and NTproBNP between the two groups while there were significant differences in serum potassium level between the two groups [(3.8±0.4)mmol/L vs.(3.5±0.35)mmol/L P＜0.05].There was no significant difference in successful rate of cardioversion between the standard Valsalva's maneuvre(n=6) the modified Valsalva's maneuvre(n=5).The second-line treatment mainly included propafenone,adenosine,electroversion,verapamil and amiodarone.The propafenone was the most common second-line agent used for PSVT cardioversion accounting for 58.6％.Conclusions The success rate of Valsalva's maneuver cardioversion was low.Keeping properly a higher level of serum potassium could increase the success rate of cardioversion by Valsalva's maneuvre.

Efficacy of Yanhuning injection in the treatment of acute viral myocarditis with Xiedu Qinxin syndrome / 中国基层医药

Objective To investigate the effect of Yanhuning injection antiviral therapy in the treatment of acute viral myocarditis patients with Xiedu Qinxin syndrome.Methods From May 2016 to August 2017,84 acute viral myocarditis patients with Xiedu Qinxin syndrome in the Integrated Traditional Chinese and Western Medicine Hospital of Wenzhou were enrolled in this study.According to the digital table,they were randomly divided into observation group and the control group,with 42 cases in each group.The control group received conventional antiviral therapy,and the observation group was given Yanhuning injection.The heart type free fatty acid binding protein (H－FABP),serum troponin Ⅰ (cTnI),macrophage migration inhibitory factor(MIF)and interleukin 4(IL－4)were measured before and after treatment for 4 weeks.The clinical symptoms score and the effective rate were compared between the two groups at the same time.Results The serum levels of cTnI,H－FABP,MIF and IL－4 of the two groups after treatment were lower than those before treatment(all P＜0.05 ),which of the observation group after treatment were significantly lower than those of the control group (t＝3.012,P＝0.039;t＝2.835,P＝0.040;t＝3.534,P＝0.032;t＝3.323,P＝0.033).The effective rate of the observation group was significantly higher than that of the control group (90.48% vs.80.95%,χ2＝3.432,P＝0.038).The scores of palpitations,sore throat,upsetting the chest tightness of the observation group after treatment were significantly lower than those of the control group (t＝3.045,P＝0.038;t＝2.946,P＝0.039;t＝3.467,P＝0.031;t ＝3.358,P＝0.032).Conclusion Yanhuning injection antiviral therapy in the treatment of acute viral myocarditis patients with Xiedu Qinxin syndrome can signifi-cantly improve the efficacy of patients.

Protective effect of Dendrobium candidum on isoproterenol induced cardiac hypertrophy in rats / 中国中药杂志

To study the effect and mechanism of Dendrobium candidum on isoproterenol-induced myocardial hypertrophy in rats, 60 healthy SD rats(30 males and 30 females) were randomly divided into 5 groups(12 in each group): normal group, model group, three D. candidum preventive administration groups(0.09, 0.18, 1.1 g·kg⁻¹). Except for the normal group, rats of other groups were injected back subcutaneously with ISO(5 mg·kg⁻¹) for 10 consecutive days. At the same time, preventive administration groups began to give different doses of the sample for 30 days and model group began to give normal saline. Left ventricular systolic pressure(LVSP) was measured in each group by common carotid artery cannulation, and the left ventricle(LW)/tibia length, heart weight index(HWI) and myocardial hydroxyproline(Hydro) content were calculated. Myocardial tissue HE staining and Masson staining were used to observe the myocardial structure and the degree of myocardial fibrosis respectively. Atrial natriuretic peptide(ANP), brain natriuretic peptide(BNP), and cardiac troponin I(cTN-I) concentration were measured by enzyme-linked immunosorbent assay(ELISA). The results showed that as compared with the normal group, the levels of ANP, BNP and cTN-I in plasma were significantly increased in ISO-induced hypertrophic rats; as compared with the model group, D. candidumcan inhibit ISO-induced ventricular pressure and ventricular hypertrophy, reduce myocardial collagen synthesis, improve myocardial fibrosis and ventricular remodeling, and significantly down-regulate ANP, BNP and cTN-I levels in plasma. This study shows that D. candidum has a protective effect on isoproterenol-induced cardiac hypertrophy.

Effect of sevoflurane preconditioning on serum GDF-15,TNF-α,cTnI expression during perioperative pe-riod in patients in congenital heart diseases combined with pulmonary artery hypertension / 实用医学杂志

Objective To observe the effect of sevoflurane preconditioning on serum GDF-15,TNF-α, cTnI expression during perioperative period in patients in congenital heart diseases(CHD)with pulmonary artery hypertension(PAH),and to investigate the mechanism of myocardial protection. Methods Forty adult patients of CHD with PAH who received open-heart surgery under extracorporeal circulation were randomly divided into two groups(n=20):sevoflurane preconditioning group(Group S)and the control group(Group C). In the group S, 1MAC sevoflurane was inhaled for 20 min from beginning of operation ,and followed with oxygen elution for 10 min,in twice;only inhaling pure oxygen in the Group C. The artery blood samples were collected for measurements of serum GDF-15,TNF-α,cTnI immediately before anesthesia induction(T0),at 2 h(T1),12 h(T2),24 h (T3)after aorta declamping and 7 d(T4)after operation. The restoration of spontaneous heart beat ,reperfusion arrhythmia scores,preoperative and postoperative pulmonary artery systolic pressure were recorded. Results Com-pared with preoperative pumonary artery systolic pressure(PASP),it became low in the two groups at 7 days after operation(P<0.05);compared with the group C,the rate of restoration of spontaneous heart beat was promoted, and reperfusion arrhythmia scores were decreased in the group S(P<0.05);compared with the group C,GDF-15 were increased,TNF-α,cTnI were decreased in the group S at T1～3(P < 0.05);Compared with T0,GDF-15, TNF-α,cTnI were increased in the two groups at T1～3,GDF-15 in the two groups were decreased at T4(P <0.05). Conclusion Sevoflurane preconditioning may reduce inflammatory reaction during perioperative period in patients of CHD with PAH by promoting the expression of GDF-15,inhibiting the expression of TNF-α and then improve myocardial ischemia-reperfusion injury.

Effect of sevoflurane preconditioning on serum GDF-15,TNF-α,cTnI expression during perioperative pe-riod in patients in congenital heart diseases combined with pulmonary artery hypertension / 实用医学杂志

Objective To observe the effect of sevoflurane preconditioning on serum GDF-15,TNF-α, cTnI expression during perioperative period in patients in congenital heart diseases(CHD)with pulmonary artery hypertension(PAH),and to investigate the mechanism of myocardial protection. Methods Forty adult patients of CHD with PAH who received open-heart surgery under extracorporeal circulation were randomly divided into two groups(n=20):sevoflurane preconditioning group(Group S)and the control group(Group C). In the group S, 1MAC sevoflurane was inhaled for 20 min from beginning of operation ,and followed with oxygen elution for 10 min,in twice;only inhaling pure oxygen in the Group C. The artery blood samples were collected for measurements of serum GDF-15,TNF-α,cTnI immediately before anesthesia induction(T0),at 2 h(T1),12 h(T2),24 h (T3)after aorta declamping and 7 d(T4)after operation. The restoration of spontaneous heart beat ,reperfusion arrhythmia scores,preoperative and postoperative pulmonary artery systolic pressure were recorded. Results Com-pared with preoperative pumonary artery systolic pressure(PASP),it became low in the two groups at 7 days after operation(P<0.05);compared with the group C,the rate of restoration of spontaneous heart beat was promoted, and reperfusion arrhythmia scores were decreased in the group S(P<0.05);compared with the group C,GDF-15 were increased,TNF-α,cTnI were decreased in the group S at T1～3(P < 0.05);Compared with T0,GDF-15, TNF-α,cTnI were increased in the two groups at T1～3,GDF-15 in the two groups were decreased at T4(P <0.05). Conclusion Sevoflurane preconditioning may reduce inflammatory reaction during perioperative period in patients of CHD with PAH by promoting the expression of GDF-15,inhibiting the expression of TNF-α and then improve myocardial ischemia-reperfusion injury.

A Comparative Study on Effects of Exercise Intensity and Duration on Left and Right Ventricular / 中国运动医学杂志

Objective To examine the effects of exercise intensity and duration on the structure,function and fibrosis of the left and right ventricular,and to discuss the potential mechanism in these processes.Methods Forty-eight male Sprague-Dawley rats were randomly divided into a sedentary(Sed)group,a moderate exercise(ME)group and an intensive exercise(IE) group,each of 16.Rats in Sed group were not given any training,while those in ME group and IE group run on treadmill at the speed of 15.2 m/min with the slope gradient of 5° and 28 m/min with the slope gradient of 10 degree 1 hour per day,5 days per week.Eight and 16 weeks after the training,we recorded the body weight and measure end-diastolic diameter,end-diastolic wall thickness,and ejection fraction of both ventriculars using the ultrasonic testing.All rats were then sacrificed after blood sampling.Elisa was used to measure serum cTnI concentration,and sirius red staining was applied to evaluate collagen volume fraction of both ventriculars.Results Eight or sixteen weeks after the training,the average bi-ventricular end-diastolic diameter of ME and IE rats was bigger than Sed group.There were no differences in end-diastolic diameter of both ventricular between ME group and IE group after sixteen-week training,but the left ventricular end-diastolic diameter of IE group was greater than ME group.As exercise intensive increased and time accumulated,the end-diastolic wall thickness of both ventriculars increased but without statistical significance.At sixteen-week intervention,the bi-ventricular ejection fraction of IE rats was significantly lower than Sed and ME groups,while there was a decreasing trend eight weeks earlier without significant differences.After 8 or 16 weeks of training,the serum cTnI was significantly higher in IE rats than Sed group or ME group,but there was no significant differences between ME group and Sed group.After 16 weeks' exercises,the average bi-ventricular collagen volume fraction of ME or IE group was greater than that after 8 weeks' exercises.The average collagen volume fraction of the right ventricular was greater than Sed group at the same time points,and after sixteenweek training the right ventricular collagen volume fraction in IE group was significantly greater than ME group.However,there were no significant differences in the measurement of the left side among different groups.The serum cTnI was negatively correlated with the left and right ventricular systolic function(r=-0.327,P=0.029 and r=-0.582,P=0.000).Moreover,it was positively correlated with the right ventricular collagen volume fraction moderately,but had no correlation with the left ventricular collagen volume fraction.Conclusion(1)Sixteen-week moderate and intensive exercise result in left ventricular dilation,and the dilation increases with the increase of the exercise intensity.Only 8 weeks' exercise at the same intensity can lead to right ventricular dilation,but exercise intensity has little influence on the right ventricular dilation.(2)Long-term moderate or intensive endurance exercises may cause bi-ventricular hypertrophy potentially.The left ventricular hypertrophy and dilation may not be synchronous with hypertrophy followed by dilation,while the right ventricular hypertrophy and dilation is synchronous.(3)The temporary decrease in bi-ventricular systolic function after intensive endurance exercise may be caused by ventricular injury,with more serious injury in the right ventricular than in the left.Moderate exercises don't cause ventricular injury,thus there is little or no influence on ejection fraction.(4) Long-term (8 or 16 weeks)moderate or intensive endurance exercises can increase the right ventricular collagen volume fraction,which may indicate cardiac fibrosis following right ventricular injury but not in the left ventricular.The bi-ventricular collagen volume fraction at sixteenth week in ME and IE rats are greater than corresponding rats at eighth week.It may result from the hypertrophy of bi-ventricular cardiomyocyte after 8-week training,followed by increase in the extracellular matrix but not cardiac fibrosis.

Comparison Between Soluble ST2 and High-Sensitivity Troponin I in Predicting Short-Term Mortality for Patients Presenting to the Emergency Department With Chest Pain

BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed. RESULTS: The incidence of ACS was 37%; 33 patients were diagnosed with ST elevation myocardial infarction (STEMI), and 25 were diagnosed with non-ST elevation myocardial infarction (NSTEMI). Compared with the no acute coronary syndrome (NO ACS) group, the median level of hs-cTnI was higher in ACS patients: 7.22 (5.24-14) pg/mL vs 68 (15.33-163.50) pg/mL (P35 ng/mL at ED arrival died during the 30-day follow-up. CONCLUSIONS: sST2 has a greater prognostic value for 30-day cardiac mortality after discharge in patients presenting to the ED for chest pain compared with hs-cTnI. In STEMI patients, an sST2 value >35 ng/mL at ED arrival showed the highest predictive power for short-term mortality.

Study on Relationship between Red Blood Cell Distribution Width Changes and Prognosis of Acute ;Myocardial Infarction / 实用医学杂志

Objective To explore the value of? red blood cell distribution width (RDW) changes in acute myocardial infarction (AMI) prognosis by analysing relationship between red blood cell distribution width, cardiac troponin I (cTnI) and high-sensitivity C-reactive protein. Methods 140 hospitalized patients with AMI were selected from May 2014 to October 2014 and devided into 2 groups. 70 patients without heart failure were AMI1 group and the other 70 patients with heart failure were AMI2 group. 70 cases of healthy persons were selected as control group. RDW was compared between three groups and the relationship between the level of RDW, cTnI and hs-CRP was analyzed. Evaluating value of RDW in predicting heart failure in AMI patients by using univariate logistic regression analysis and ROC curve analysis. Results In the comparison of AMI1 group, AMI2 group and control group, either of RDW, cTnI and hs-CRP showed a trend of increasing (P < 0.01). In the AMI patients , RDW level and cTnI level were positive correlation , and there was no linear correlation between RDW level and hs-CRP level. RDW≥14.55% was the independent risk factors in predicting heart failure in patients with AMI. Conclusion RDW≥14.55% can be an available independent predictor of the prognosis of AMI.

Comprehensive Evaluation of the Diagnostic Value of the Combined Detection of IMA,NLR,hs-CRP and CK-MB for Acute Myocardial Infarction Based on ROC Curve and Logistic Regression Analysis / 现代检验医学杂志

Objective To assess the diagnostic value of IMA,NLR,hs-CRP and CK-MB individually and the combined detec-tion for early acute myocardial infarction using ROC curve and Logistic regression.Methods To detect levels of IMA,NLR, hs-CRP,CK-MB and cTnI in serum or whole blood of AMI patients that had chest pain within 3 hours or between 3 and 6 hours,compared with 60 healthy people from Physical Examination Center.Applied Logistic regression,plotted ROC curve and calculated the area under ROC curve (AUC)to assess the diagnostic value of each index.Results The serum IMA,hs-CRP,CK-MB and cTnI or whole blood NLR levels of AMI patients with 3 hours were remarkably higher than normal con-trol,showing significant statistical difference (P<0.01)(AMI group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 96.04 U/L,3.77,13.39 mg/L,43.26 U/L and 0.063 ng/ml;normal control group:mean values of IMA,NLR,hs-CRP,CK-MB and cTnI were 78.10 U/L,2.02,3.12 mg/L,19.37 U/L and 0.040 ng/ml.The serum IMA,NLR,hs-CRP, CK-MB and cTnI levels of AMI patients in the group between 3~6 hours were higher than in the group within 3 hours (P<0.05).The AUC of combined detection of IMA,NLR,hs-CRP and CK-MB for early AMI was 0.98,higher than solo de-tection of IMA,NLR,hs-CRP and CK-MB,which were 0.89,0.83,0.79 and 0.85 respectively.Meanwhile,the AUC of com-bined detection for four markers also surpassed that of cTnI alone that was recognized as a classic serological marker to diag-nose AMI (AUC=0.78).Conclusion The combined detection of IMA,NLR,hs-CRP and CK-MB is superior to a single in-dex detection,which can significantly improve diagnostic efficiency for early AMI.

Clinical application value of hs-cTnT and cTnI in early diagnosis of acute myocardial infarction / 国际检验医学杂志

Objective To detect hs‐cTnT and cTnI for exploring their application value in the early diagnosis of acute myocardial infarction(AMI) .Methods From October 2015 to March 2016 ,100 patients with AMI in the cardiology department of our hospital were selected as the observation group(AMI group) and contemporaneous 100 adults undergoing physical examination as the con‐trol group .The chemiluminescence immunoassay was used to detect the levels of hs‐cTnT and cTnI .The positive rate ,sensitivity and specificity of the hs‐cTnT and cTnI in the AMI group for early diagnosis of AMI were compared .Results The level of hs‐cT‐nT in the AMI group was (4 .89 ± 1 .83)ng/mL ,which was higher than that in the healthy population by 99 percentile value 0 .014 ng/mL ;the cTnI level in the AMI group was (28 .82 ± 12 .32)ng/mL ,which was higher than that in the healthy population by the upper limit of normal reference value 0 .4 ng/mL ,both of them were significantly higher than those in the control group ( P<0 .05) ,the positive rate and sensitivity of hs‐cTnT was both 92 .0% ,which was significantly higher than 79 .0% of cTnI both(P<0 .05) ,the specificity of cTnI was 96 .0% ,which was significantly higher than 76 .0% of hs‐cTnT(P<0 .05) .Conclusion The pos‐itive rate and the sensitivity of hs‐cTnT are high ,the specificity of cTnI is high ,their joint detection has an important significance for the early diagnosis of AMI .

Clinical evaluation of H-FABP,hs-cTnI,Hcy and Cys-C in early diagnosis acute myocardial infarction / 国际检验医学杂志

Objective To study the clinical value of heart‐type fatty acid binding protein(H‐FABP) ,high‐sensitive cTnI(hs‐cT‐nI),homocysteine(Hcy)andcystatinc(Cys‐C)intheearlydiagnosisofacutemyocardialinfarction(AMI).Methods 150casesof AMI patients with coronary arteriography (AMI group) were selected from the cardiovascular department admitted within the first 6hours of chest pain attack .An additional 30 case for control group .The level of four novel cardiac marker were measured in each group of serum .Results The level of serum H‐FABP ,hs‐cTnI ,Hcy and Cys‐C in AMI group were markedly higher than control group(P<0 .05) ,and rose with the increase of coronary artery lesions with statistical difference (P<0 .05) .Each cardiac markers showed high specificity in the diagnosis of AMI ,amongst which H‐FABP and hs‐cTnI ,stood out with sensitivity of 97 .34% and 89 .98% respectively .With Youden index ,positive likelihood ration ,negative likelihood ration ,positive predictive value and negative predictive value ,H‐FABP and hs‐cTnI appeared to have higher diagnostic value than Hcy and Cys‐C in AMI .Conclusion H‐FABP and hs‐cTnI displayed significant clinical value as a most sensitive indicator in the early diagnosis of AMI (within 6 hours of attack) . The level of H‐FABP ,hs‐cTnI ,Hcy and Cys‐C elevated as coronary artery lesions increase .

The study of serum cardiac troponin I control materials / 国际检验医学杂志

Objective To prepare a set of serum cardiac troponin I quality control materials for testing and evaluate the homoge‐neity and stability .Methods Mixed serum were collected ,filtered ,distributed ,storaged at -20 ℃ according to the experimental design .The homogeneity of serum pools was evaluating according to the CNAS‐GL03 Guidance .The stability of cTnI in human ser‐um was examined using an accelerated stability testing protocol according to the Arrhenius equation .Further ,the effect of stability was verified by long term test .Results In the homogeneity evaluation the results showed that there were insignificant difference between the control materials (P>0 .05) .Stability analysis ,the control should not exceed 2 times by freeze‐thawing ;constant tem‐perature accelerated test results showed that the serum levels of cTnI degraded in accordance with the change of chemical first‐order reaction kinetics .Arrhenius‐plots indicated that the cTnI control materials were stable for at least 7 days at 4 ℃ and 19 months at-20 ℃ ,respectively .Control materials were monitored for 9 months ,the results are stable ,and consistent with the constant tem‐perature acceleration .Conclusion The homogeneity and stability of serum cTnI is good and can be used in clinical quality control .

The value of cardiac troponin-I, B-type natriuretic peptide and blood lactic acid on evaluation of severity and prognosis in patients with septic myocardial dysfunction / 实用医学杂志

Objective To explore the value of cardiac troponin-I (cTnI), B-type natriuretic peptide (BNP) and blood lactic acid (Lac) on evaluation of severity and prognosis in patients with septic myocardial dysfunction (SMD). Methods According to retrospective analysis of clinical data,161 cases with sepsis were divided in to SMD group and non-SMD group. And the SMD group was further divided in to death group and survival group. Blood cTnI, BNP and Lac value in each group were detected respectively. The ROC curve was used to evaluate the forecast value of cTnI, BNP and Lac on prognosis for patients. Results The value of cTnI, BNP and Lac in SMD group were significantly higher than those in non-SMD group(P<0.05);The value of cTnI, BNP and Lac in death group among the SMD patients were significantly higher than those in survival group(P<0.05);cTnI, BNP and Lac contribute to predict the 28 day mortality rate of SMD. Conclusions Blood cTnI, BNP and Lac contributes to the assessment of the severity and the prognosis of septic patients with myocardial dysfunction.

Development of a time-resolved fluorescence immunoassay for rapid determinat-ion of levels of cardiac troponin Ⅰantigen in human serum / 中国免疫学杂志

To establish a method to detect cardiac troponin I by using time-resolved fluoroimmunoassay ( TRFIA) and apply to the clinic.Methods:The assay were measured by TRIFA and double antibody sandwich method .Standard protocols were evaluated with the standard curve , the limit of detection , stability, precision and cross reaction .Healthy reference populations and clinical serum specimens were measured to established the reference interval and evaluated the perspective of the clinical application . Results:The standard curve was Y=7485 .878+1400.924 X with a correlation coefficient of 0.999.The limit of detection was 0.052 ng/ml.The intra-and inter-assay coefficients of variation ( CV) were all 0.05 ).There was significant difference in statistics compared before and after treatment with AMI ( P<0.001 ) .Conclusion: The TRFIA method for detecting cTnI achieves clinical application standards and may be used for the diagnosis and serosurveillance of acute myocardial infarction patients.

Clinical application value of point-of-care combined detection of cardiac markers for diagnosing acute myocardial infarction / 国际检验医学杂志

Objective To investigate the clinical application value of point-of-care combined detection of cTnI,MYO and CK-MB in the patients with acute myocardial infarction (AMI).Methods 74 cases of coronary syndrome were collected as the patients group,including 36 cases of AMI and 38 cases of unstable angina pectoris(UAP),and 40 individuals with healthy physical examina-tion were selected as the control group.The concentrations of cardiac marker cTnI,MYO and CK-MB in blood at different times were detected by using the point-of-care rapid immune quantitative method.Then the sensitivity and specificity for diagnosing AMI were compared for determining the best time of single detection and combined detection.Results The positive rates of cTnI,MYO and CK-MB within onset 2-12 h with the symptoms in the AMI group were higher than those in the control group and the UAP group,the difference had statistical significance (P <0.01).The combined detection of cTnI,MYO and CK-MB within onset 6-12 h with symptoms had the higher sensitivity and higher specificity for diagnosing AMI.The combined detection of cTnI and CK-MB within onset 12-24 h with symptoms could reach the optimal sensitivity and optimal specificity for the diagnosis.The sensitivity and specificity of cTnI within onset 24-72 h with symptoms for diagnosing AMI were 100.0% and 100.0% respectively.Conclu-sion The point-of-care combined detection of cTnI,MYO and CK-MB can conveniently and rapidly diagnose AMI.The sensitivty and specificity of various indexes in different time periods are different.Their combined detection can increase the diagnostic rate for AMI.

Diagnosis value of copeptin and cTnI in early diagnosis of non-ST-segment elevation myocardial infarction / 实用医学杂志

Objective To investigate the diagnostic accuracy and the clinical usefulness of the combination of troponin I (cTnI) and copeptin detected in patients with suspected non-ST elevation myocardial infarction. Methods 176 patients presenting to the emergency departments with chest chocking or chest pain within 6 hours and without ST elevation on a 12-lead electrocardiogram (ECG) were enrolled in this study. The level of copeptin and cTnI was measured. The diagnosis was adjudicated by 2 independent experts.The diagnostic performance of them was assessed using ROC analysis , and the sensitivity and specificity of them were inferred based on the positive rate of two cardiac markers. Results (1)The levels of copeptin and cTnI in NSTEMI patients were markedly higher than other groups (P<0.05).(2)The AUCs of copeptin and cTnI were 0.846 and 0.683, and the 95%CI of two markers were 0.786 ~ 0.906 and 0.577 ~ 0.789, respectively. (3)Using 10.85 pmol/L as cut off value,the sensitivity and specificity of copeptin were 90% and 64%,and the positive predictive value and the negative predictive valueof NSTEMI diagnose were 42.4% and 95.6%,respectively.Using 0.05 ng/mL as cut off value,the sensitivity and specificity of cTnI were 42.5% and 94.1%,the positive predictive value and the negative predictive value were 68%and 84.8% for diagnosis of NSTEMI. (4)The copeptin level over 10.85 pmol/L in combination with cTnI could be used to detect NSTEMI with higher sensitivity than that of copeptin or cTnI alone (95% vs 90% vs 42.5%). The negative predictive value of the combination of copeptin and cTnI was increased , compared to that of copeptin or cTnI alone (97.7% vs 95.6% vs 85.7%). Conclusions Determination of copeptin in addition to cTnI can improves diagnostic performance , especially early after chest pain onset. It seems to allow a rapid and reliable rule out of NSTEMI.

TNNI3K is a novel mediator of myofilament function and phosphorylates cardiac troponin I

The phosphorylation of cardiac troponin I (cTnI) plays an important role in the contractile dysfunction associated with heart failure. Human cardiac troponin I-interacting kinase (TNNI3K) is a novel cardiac-specific functional kinase that can bind to cTnI in a yeast two-hybrid screen. The purpose of this study was to investigate whether TNNI3K can phosphorylate cTnI at specific sites and to examine whether the phosphorylation of cTnI caused by TNNI3K can regulate cardiac myofilament contractile function. Co-immunoprecipitation was performed to confirm that TNNI3K could interact with cTnI. Kinase assays further indicated that TNNI3K did not phosphorylate cTnI at Ser23/24 and Ser44, but directly phosphorylated Ser43 and Thr143 in vitro. The results obtained for adult rat cardiomyocytes also indicated that enhanced phosphorylation of cTnI at Ser43 and Thr143 correlated with rTNNI3K (rat TNNI3K) overexpression, and phosphorylation was reduced when rTNNI3K was knocked down. To determine the contractile function modulated by TNNI3K-mediated phosphorylation of cTnI, cardiomyocyte contraction was studied in adult rat ventricular myocytes. The contraction of cardiomyocytes increased with rTNNI3K overexpression and decreased with rTNNI3K knockdown. We conclude that TNNI3K may be a novel mediator of cTnI phosphorylation and contribute to the regulation of cardiac myofilament contraction function.