ABSTRACT
In the review article, the authors present current knowledge of biomarkers of myocardial ischemia and necrosis. They comment new definition of myocardial infarction resulted as consensus of European Society of Cardiology and American Heart Association. They added clinically interested data about routinely used cardiomarkers (cardiac troponins and creatinkinase). At the second part, the authors focused on new biomarkers (fatty acids binding proteins, ischemia-modified albumin, glycogen phosphorylase isoenzyme BB) and its significance in diagnosis of myocardial ischemia/necrosis and their prognostic significance. Some of new promising molecules are discussed in the last part of the article.
Subject(s)
Biomarkers/blood , Myocardial Ischemia/diagnosis , Humans , Myocardial Infarction/diagnosis , NecrosisABSTRACT
Cardiac toxicity of preparative regimen (PR) containing high-dose Cyclophosphamide (120 mg/kg) followed by hematopoietic cell transplantation (HCT) was evaluated with 6 biomarkers of cardiac injury: N-terminal pro brain natriuretic peptide (NT-proBNP), creatine kinase MB (CK-MB mass), cardiac troponins (cTnT, cTnI), heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB). Twenty-three patients (mean age 44.5+/-10.6 years, 15 males) with acute leukemia were studied. All biomarkers were measured the day before PR, the day after PR, the day after HCT and 14 days after HCT. We found NT-proBNP elevations above 500 ng/L in 6 (26.1 %) patients after PR, in 9 (39.1 %) after HCT and in 7 (30.4 %) 14 days after HCT. GPBB became elevated (above 7.30 microg/L) in 5 (21.7 %) patients after PR, remained elevated in 5 (21.7 %) after HCT and in 2 (8.7 %) 14 days after HCT. A significant correlation between elevation in NT-proBNP and GPBB was found. Other markers remained within the reference range early after PR and HCT. Our findings show that administration of PR and HCT for acute leukemia is associated with acute neurohumoral activation of cardiac dysfunction (significant rise in NT-proBNP) and may lead to GPBB elevation. These changes could indicate acute cardiac toxicity due to treatment and require further follow-up. The predictive value for development of cardiomyopathy in the future is unclear. Further studies will be needed to define the potential role of new biomarkers in this context.
Subject(s)
Biomarkers/analysis , Cyclophosphamide/adverse effects , Heart Diseases/chemically induced , Hematopoietic Stem Cell Transplantation , Leukemia/therapy , Acute Disease , Adult , Female , Heart Diseases/diagnosis , Heart Diseases/therapy , Humans , Male , Middle Aged , Myeloablative Agonists/adverse effectsABSTRACT
AIM: To assess cardiac toxicity of anthracycline treatment with six biomarkers of cardiac injury: myoglobin, creatine kinase MB (CK-MB mass), cardiac troponin T (cTnT), cardiac troponin I (cTnI), heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB). METHODS: We evaluated anthracycline-induced cardiotoxicity in 12 acute myeloid leukemia patients (mean age 51.3-/+10.7 years, 7 females). All biomarkers were measured at the baseline, after first chemotherapy (CT) with anthracyclines, after last CT with anthracyclines (total cumulative dose 479.8-/+106.2 mg/m2) and 6 months thereafter. Values above the reference range were considered elevated. RESULTS: GPBB increased above the cut-off (7.30 microg/L) in 2 (16.7%) patients after first CT, in 3 (25.0%) patients after last CT and remained elevated in 2 (16.7%) patients within 6 months after CT. CTnI became elevated (above 0.40 microg/L) in 1 (8.3%) patient after first and last CT and within 6 months after CT. CTnT remained negative (below 0.01 microg/L) during CT in all patients. Six months after CT, delayed cTnT positivity was found in 1 (8.3%) patient. All patients with cTnI or cTnT positivity had elevated GPBB. Other biomarkers (myoglobin, CK-MB mass, H-FABP) remained within the reference range in all patients. CONCLUSION: Our preliminary results suggest that GPBB could be a new promising marker for detection of anthracycline-related cardiotoxicity and probably superior to cardiac troponins. The predictive value for development of cardiomyopathy in the future is not clear and will be evaluated during a prospective follow-up.
Subject(s)
Anthracyclines/toxicity , Biomarkers, Tumor/biosynthesis , Heart/drug effects , Leukemia, Myeloid, Acute/complications , Leukemia, Myeloid, Acute/drug therapy , Neoplasms/complications , Neoplasms/drug therapy , Aged , Biomarkers/metabolism , Female , Glycogen Phosphorylase/metabolism , Humans , Male , Middle Aged , Time FactorsABSTRACT
OBJECTIVE: The study describes a method of quantitatively examining vascular catheters with the aid of hemocultural devices BacT/Alert. MATERIAL AND METHODS: The amount of bacteria present on the surface of the vascular catheters was determined based on the time to detection (TTD) in hemocultural vials inoculated with bacterial suspension stirred off the catheter surface. RESULTS: A total number of 348 vascular catheters was examined with this new method. Positive cultures were detected in 26 (7.5 %) catheters. Accordance to the results of microbiological catheter examination with clinical condition of the patient was found in 93.1 %. False positivity occurred in 1.1 % (4) and false negativity in 5.7 % (20) of cases. On the basis of clinical symptoms 42 cases of catheter sepsis were diagnosed out of which 22 (52.4 %) positive microbiological quantitative examinations of vascular catheters were established. The most frequent pathogen was coagulase negative staphylococci. CONCLUSIONS: The new method, when compared with present methods, is simpler, faster and able to detect the most frequent agent of catheter infection.
