Serial measurements of cardiac troponin I in heart failure secondary to canine mitral valve disease.

Serial measurements of cardiac troponin I (cTnI) levels are considered to be better predictors of cardiac death than single-time-point analyses in human medicine. We hypothesised that cTnI levels could reflect the severity of myxomatous mitral valve disease (MMVD), and that serial changes in the cTnI level had a prognostic value in dogs with congestive heart failure (CHF) secondary to MMVD. Seventy-six dogs were initially enrolled and classified by the American College of Veterinary Internal Medicine (ACVIM) staging system. The single-timepoint cTnI concentration in these dogs significantly increased with the ACVIM stage. Twenty-seven dogs with CHF subsequently underwent serial measurement of cTnI levels, and the results showed that those who demonstrated a decrease in cTnI levels from the first to the third visit exhibited a higher risk of cardiac death than did those without such changes (P=0.012). We suspect that the downward trend in cTnI levels may be affected by medical treatment for CHF. In conclusion, although cTnI levels could reflect the severity of MMVD to a certain extent, the serial changes may be affected by medical treatment. Therefore, caution should be exercised when cTnI is used for assessment of the prognosis of CHF secondary to MMVD in dogs.

Clinical characteristics of young-onset hypertension-implications for different genders.

BACKGROUND: Hypertension may develop early, before the age of 40 years, in both genders, so-called young-onset hypertension. The clinical characteristics of young-onset hypertension have not been well defined. METHODS: The personal history and clinical characteristics were evaluated in a series of patients with young-onset hypertension. With the individual-matching, case-controlled design, patients were initially matched for age, gender and residence with the first control (C1) group in either 2:1 or 1:1 fashion. They were then additionally matched for body mass index (BMI) with the second control (C2) group in 1:1 fashion. To elucidate the possible difference between genders, all the comparisons were conducted in males and females separately. RESULTS: A total of 82 consecutive patients, 56 males and 26 females, with young-onset hypertension were included. Compared with the 148 subjects in C1 group, hypertensive patients were relatively highly educated and had less alcohol drinking in either gender. BMI (25.10+/-0.49 vs. 22.34+/-0.31 kg/m(2), P<0.001) and serum triglyceride level (153.35+/-10.71 vs. 98.76+/-5.12 mg/dl, P<0.001) were significantly increased in male patients, while serum uric acid (5.74+/-0.34 vs. 4.78+/-0.17 mg/dl, P=0.006) and triglyceride level (121.39+/-12.71 vs. 76.58+/-4.88 mg/dl, P=0.002) were increased in female ones. Compared to that in C2 group, serum triglyceride level was still increased in patients of either gender. Interestingly, serum cholesterol level in female patients was lower than that in either C1 or C2 group. Further, serum triglyceride level was significantly correlated to BMI, serum cholesterol and glucose level in male patients but only to serum uric acid level in female ones. CONCLUSIONS: Clinical characteristics of young-onset hypertension were unique and different by gender. Though consistently increased in patients of either gender, serum triglyceride level was correlated to BMI, serum cholesterol and glucose level only in males, suggesting the gender-specific presence of metabolic syndrome in young-onset hypertension.