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Takahashi L, Ishigami T, Tomiyama H, Kato Y, Kikuchi H, Tasaki K, Yamashita J, Inoue S, Taguri M, Nagao T, Chikamori T, Ishikawa Y, Yokoyama U. Increased Plasma Levels of Myosin Heavy Chain 11 Is Associated with Atherosclerosis. J Clin Med 2021; 10:jcm10143155. [PMID: 34300321 PMCID: PMC8304775 DOI: 10.3390/jcm10143155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 11/16/2022] Open
Abstract
Many studies have revealed numerous potential biomarkers for atherosclerosis, but tissue-specific biomarkers are still needed. Recent lineage-tracing studies revealed that smooth muscle cells (SMCs) contribute substantially to plaque formation, and the loss of SMCs causes plaque vulnerability. We investigated the association of SMC-specific myosin heavy chain 11 (myosin-11) with atherosclerosis. Forty-five patients with atherosclerosis and 34 control subjects were recruited into our study. In the atherosclerosis patients, 35 patients had either coronary artery disease (CAD) or peripheral artery disease (PAD), and 10 had both CAD and PAD. Coronary arteries isolated from five patients were subjected to histological study. Circulating myosin-11 levels were higher in the CAD or PAD group than in controls. The area under the receiver operating characteristic curve of myosin-11 was 0.954. Circulating myosin-11 levels in the CAD and PAD group were higher than in the CAD or PAD group, while high-sensitivity C-reactive protein concentrations did not differ between these groups. Multinomial logistic regression analyses showed a significant association of myosin-11 levels with the presence of multiple atherosclerotic regions. Myosin-11 was expressed in the medial layer of human atherosclerotic lesions where apoptosis elevated. Circulating myosin-11 levels may be useful for detecting spatial expansion of atherosclerotic regions.
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Affiliation(s)
- Lisa Takahashi
- Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (L.T.); (H.T.); (J.Y.); (T.C.)
- Department of Physiology, Tokyo Medical University, 6-6-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan;
| | - Tomoaki Ishigami
- Department of Cardio-Renal Medicine and Medical Science, Yokohama City University, 3-9 Fukuura, Yokohama 236-0004, Japan;
| | - Hirofumi Tomiyama
- Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (L.T.); (H.T.); (J.Y.); (T.C.)
| | - Yuko Kato
- Department of Physiology, Tokyo Medical University, 6-6-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan;
| | - Hiroyuki Kikuchi
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-6-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; (H.K.); (S.I.)
| | - Koichiro Tasaki
- Department of Pathology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (K.T.); (T.N.)
| | - Jun Yamashita
- Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (L.T.); (H.T.); (J.Y.); (T.C.)
| | - Shigeru Inoue
- Department of Preventive Medicine and Public Health, Tokyo Medical University, 6-6-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; (H.K.); (S.I.)
| | - Masataka Taguri
- Department of Data Science, Yokohama City University, 22-2 Seto, Kanazawa-ku, Yokohama 236-0027, Japan;
| | - Toshitaka Nagao
- Department of Pathology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (K.T.); (T.N.)
| | - Taishiro Chikamori
- Department of Cardiology, Tokyo Medical University, 6-7-1 Nishi-shinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; (L.T.); (H.T.); (J.Y.); (T.C.)
| | - Yoshihiro Ishikawa
- Cardiovascular Research Institute, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;
| | - Utako Yokoyama
- Department of Physiology, Tokyo Medical University, 6-6-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan;
- Cardiovascular Research Institute, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan;
- Correspondence: ; Tel.: +81-03-351-6141
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Huang K, Gao L, Yang M, Wang J, Wang Z, Wang L, Wang G, Li H. Exogenous cathepsin V protein protects human cardiomyocytes HCM from angiotensin Ⅱ-Induced hypertrophy. Int J Biochem Cell Biol 2017; 89:6-15. [PMID: 28522343 DOI: 10.1016/j.biocel.2017.05.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/01/2017] [Accepted: 05/12/2017] [Indexed: 12/29/2022]
Abstract
Angiotensin (Ang) Ⅱ-induced cardiac hypertrophy can deteriorate to heart failure, a leading cause of mortality. Endogenous Cathepsin V (CTSV) has been reported to be cardioprotective against hypertrophy. However, little is known about the effect of exogenous CTSV on cardiac hypertrophy. We used the human cardiomyocytes HCM as a cell model to investigate the effects of exogenous CTSV on Ang Ⅱ-induced cardiac cell hypertrophy. Cell surface area and expression of classical markers of hypertrophy were analyzed. We further explored the mechanism of CTSV cardioprotective by assessing the levels and activities of PI3K/Akt/mTOR and MAPK signaling pathway proteins. We found that pre-treating cardiomyocytes with CTSV could significantly inhibit Ang Ⅱ-induced hypertrophy. The mRNA expression of hypertrophy markers ANP, BNP and β-MHC was obviously elevated in Ang Ⅱ-treated cardiac cells. Whereas, exogenous CTSV effectively halted this elevation. Further study revealed that the protective effects of exogenous CTSV might be mediated by repressing the phosphorylation of proteins in the PI3K/Akt/mTOR and MAPK pathways. Based on our results, we concluded that exogenous CTSV inhibited Ang Ⅱ-induced hypertrophy in HCM cells by inhibiting PI3K/Akt/mTOR. This study provides experimental evidence for the application of CTSV protein for the treatment of cardiac hypertrophy.
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Affiliation(s)
- Kun Huang
- Institution of Cardiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei, China
| | - Lu Gao
- Department of Cardiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Ming Yang
- Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022 China
| | - Jiliang Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022 China
| | - Zheng Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022 China
| | - Lin Wang
- Center for Tissue Engineering and Regenerative Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Guobin Wang
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022 China
| | - Huili Li
- Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022 China.
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Abstract
Conventional and promising new markers of myocardial injury have become an important diagnostic tool and their prognostic significance is also recognized. In addition, they help identify patients who will derive the most benefit from therapeutic interventions. The literature was searched from the websites of the National Library of Medicine (http://www.ncbi.nlm.nih.gov/) and PubMed Central, the U.S. National Library of Medicine’s digital archive of life sciences journal literature (http://www.pubmedcentral.nih.gov/). The data were accessed from books and journals that published relevant articles in this field. The diagnosis of acute myocardial infarction (AMI) has traditionally relied on the combination of chest pain, ECG features, and elevation in serum markers. However, chest symptoms are frequently atypical or absent and ECG changes may be nonspecific or absent. Hence, the diagnosis of acute coronary syndromes has become increasingly dependent on serum markers of cardiac injury. Among them, creatine kinase (CK) is an effective and widely used test, with the recent CKMB assay offering greater specificity and sensitivity. Cardiac troponins facilitate early and rapid diagnosis, enable effective risk stratification in patients with AMI (with or without traditional criteria for MI), and identify those who will benefit from aggressive medical or surgical intervention. Recent data suggest the potential of myoglobin and CKMB isoforms as sensitive markers in the early hours after symptom onset. Cardiac-specific troponins help in rapid diagnosis, prognostication, and treatment of AMI. Troponins also facilitate early detection of recent infarction owing to their prolonged diagnostic window and also aid in the detection of “microinfarction.” CKMB is used to detect reinfarction or infarct extension, if levels rise again after declining. Finally, novel biochemical markers are receiving attention in ongoing trials. They may prove to be more effective in diagnosis and prognosis than their existing counterparts.
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Affiliation(s)
- Medha Rajappa
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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Atmaca Y, Gülec S, Ertas F, Pamir G, Oral D. The prevention of minor myocardial injury with ticlopidine pretreatment in patients undergoing elective coronary stenting. Int J Cardiol 2003; 87:151-7. [PMID: 12559534 DOI: 10.1016/s0167-5273(02)00315-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The aim of the study was to determine whether ticlopidine treatment prior the coronary stenting would be associated with lower rates of procedure-related minor myocardial injury (MMI) in patients undergoing elective coronary stenting. In this retrospective, nonrandomized, uncontrolled study, a total of 153 consecutive patients with a mean age of 63.4+/-8.9 years were divided into two groups based on the duration of ticlopidine treatment: group I (n=81), ticlopidine >/=3 days before the procedure, group II (n=72), on the same day as stent placement. Cardiac troponin T (cTnT) was measured immediately before and 12 h after the procedures. All patients were followed-up during the hospital stay with respect to MMI and major clinical events (MCE). The increase frequency and the amount of cTnT level in group I was found to be significantly lower compared with group II (4 vs. 13; P<0.01, and 0.35+/-0.06 vs. 0.52+/-0.11 ng/ml; P<0.01, respectively). In general, patients with elevated cTnT levels are more likely to have C type lesion and multivessel procedure than those of normal cTnT level (41 vs.10%; P<0.002 and 47 vs. 17%; P<0.009, respectively). Though there was a trend toward increased MCE rates in group II than that of group I, this did not reached statistical significance (3 vs.1; P=NS). The present study shows that an anti-platelet treatment with ticlopidine prior the coronary stenting of adequate duration to allow for the development of maximal inhibition is associated with a markedly decreased incidence of procedure-related MMI. Therefore, ticlopidine pretreatment may be a cost alternative for the prevention of platelet-rich microembolism in patients undergoing elective coronary stenting.
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Affiliation(s)
- Yusuf Atmaca
- Ankara University Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
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Bleier J, Vorderwinkler KP, Falkensammer J, Mair P, Dapunt O, Puschendorf B, Mair J. Different intracellular compartmentations of cardiac troponins and myosin heavy chains: a causal connection to their different early release after myocardial damage. Clin Chem 1998. [DOI: 10.1093/clinchem/44.9.1912] [Citation(s) in RCA: 98] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AbstractWe investigated the net myocardial release of creatine kinase isoenzyme MB (CKMB), myoglobin, cardiac troponin T (cTnT), cardiac troponin I (cTnI), and cardiac β-type myosin heavy chain (β-MHC) into the coronary circulation after cardioplegic cardiac arrest in humans. Cardiac markers were measured in paired arterial, central venous, and coronary sinus blood in 19 patients undergoing elective coronary artery bypass grafting (CABG) before aortic cross-clamping and 1, 5, 10, and 20 min after aortic declamping. cTnT and cTnI were released into the coronary sinus in parallel to each other and almost simultaneously to myoglobin and CKMB within 20 min of reperfusion. In contrast, no β-MHC was released in the same patients during the study period. The average soluble cTnT and cTnI pools in right atrial appendages of 11 patients with right atrial and right ventricular pressures within reference values were comparable and were ∼8% of total myocardial troponin content. The soluble β-MHC pool was <0.1% in all patients. Our results demonstrate the impact of the different intracellular compartmention of regulatory and contractile proteins on their early release from damaged myocardium.
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Affiliation(s)
- Jürgen Bleier
- Departments of Medical Chemistry and Biochemistry, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Karl-Paul Vorderwinkler
- Departments of Cardiac Surgery, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Jürgen Falkensammer
- Departments of Medical Chemistry and Biochemistry, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Peter Mair
- Departments of General Intensive Care Medicine,University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Otto Dapunt
- Departments of Cardiac Surgery, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Bernd Puschendorf
- Departments of Medical Chemistry and Biochemistry, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
| | - Johannes Mair
- Departments of Medical Chemistry and Biochemistry, University of Innsbruck School of Medicine, A-6020 Innsbruck, Austria
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Shyu KG, Kuan PL, Cheng JJ, Hung CR. Cardiac troponin T, creatine kinase, and its isoform release after successful percutaneous transluminal coronary angioplasty with or without stenting. Am Heart J 1998; 135:862-7. [PMID: 9588418 DOI: 10.1016/s0002-8703(98)70047-x] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cardiac troponin T is a sensitive and specific marker for the detection of minor myocardial injury. However, it has been rarely used to monitor myocardial injury after coronary stenting. The purpose of the study was to measure troponin T after apparently successful percutaneous transluminal coronary angioplasty (PTCA) with or without coronary stenting and to compare its result with serum creatine kinase and its isoform, CKMB. METHODS The incidence of cardiac troponin T elevation was compared with that of creatine kinase or CKMB in 120 consecutive patients with symptomatic ischemia undergoing visually successful PTCA with (n = 59) or without stenting (n = 61). Troponin T, creatine kinase, and CKMB were measured before, immediately after, and 18 to 24 hours after the procedures were performed. RESULTS No patient had abnormal troponin T, creatine kinase, or CKMB levels before and immediately after the procedures. Moreover, no patient showed electrocardiographic evidence of myocardial infarction. Troponin T was elevated in 17 patients at 18 to 24 hours after coronary stenting and in eight patients after PTCA. Both creatine kinase and CKMB were elevated in five patients after coronary stenting and in three patients after PTCA. The frequency of abnormal troponin T levels was significantly higher than that of creatine kinase or CKMB after coronary interventions (21% vs 6.7%; p < 0.01), and it was significantly higher after stenting when compared with angioplasty alone (29% vs 13%; p < 0.05). Patients with abnormal troponin T levels were more likely to undergo repeat revascularization than those without (24% vs 6%; p < 0.01). CONCLUSION Cardiac troponin T is more sensitive than creatine kinase and CKMB in detecting minor myocardial injury after coronary interventions. The incidence of troponin T release is higher in the patients undergoing stent implantation than in patients treated with angioplasty alone.
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Affiliation(s)
- K G Shyu
- Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan, Republic of China
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Abstract
Anesthetic care of the cardiac surgery patient is a continuum, beginning with the preoperative visit and ending when the patient is ambulatory and breathing well on the postoperative floor. Anesthesiologists are well-suited to provide postoperative care because the respiratory and cardiovascular management techniques are an extension of OR management. Attention to details is as important in the ICU as in the OR and offers the opportunity to forestall or reduce morbidity.
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Affiliation(s)
- T L Higgins
- Department of Cardiothoracic Anesthesia, Cleveland Clinic Foundation, OH., USA
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Astorri E, Contini GA, Fiorina P, Gavaruzzi G, Fesani F. Myocardial indium-111 antimyosin uptake after uncomplicated coronary artery bypass surgery. Int J Cardiol 1996; 55:239-44. [PMID: 8877423 DOI: 10.1016/0167-5273(96)02691-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The prevalence of myocardial damage after coronary artery bypass grafting is related to the criteria of its evaluation. Indium-111 monoclonal antimyosin antibody scintigraphy has been shown to be highly sensitive and specific for even small areas of myocardial necrosis or injury like those of myocarditis or transplant rejection. Our purpose was to evaluate, by using this method, myocardial damage after uncomplicated coronary artery bypass grafting. Uptake of this radio tracer was evaluated after coronary artery bypass grafting in 14 informed and consenting consecutive patients without previous myocardial infarction, with no post-surgical complications and a favorable postoperative course, following coronary artery bypass grafting for stable angina pectoris. Monoclonal antimyosin antibody indium-111 74 MBq (Myoscint Centocor) was injected on the third postoperative day; planar images in the anterior, left anterior oblique 45 degrees and 70 degrees projections were obtained 24 and 48 h later and analyzed for myocardial uptake. Indium-111 antimyosin uptake was present in 10 out of 14 patients (71.4%); it was diffuse in 6 and localized in 4. The ratio of the maximal counts in the myocardium to the counts in the adjacent lung background was measured and found elevated: 1.94 +/- 0.23, higher than the normal values reported in the literature. Indium-111 antimyosin uptake was clear in a group of patients after uncomplicated coronary artery bypass grafting. No correlation was observed between indium-111 antimyosin uptake or heart to lung ratio and creatine kinase, creatine kinase isoenzyme MB, glutamic oxalacetic transferase levels, duration of cardiopulmonary bypass or aortic cross-clamp time, while elevated serum beta myosin heavy chain fragments (IRMA Pasteur) were observed (1378 +/- 238 microU/l). This study suggests that some degree of myocardial damage, though silent, is common after coronary artery bypass grafting.
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Affiliation(s)
- E Astorri
- Cattedra di Cardiologia, Università di Parma, Italy
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Astorri E, Fiorina P, Gavaruzzi G, Contini GA, Fesani F. Perioperative myocardial cell damage assessed by immunoradiometric assay of beta-myosin heavy chain serum levels in patients undergoing coronary bypass surgery. Int J Cardiol 1996; 55:157-62. [PMID: 8842785 DOI: 10.1016/0167-5273(96)02673-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In order to investigate myocardial cell damage in patients undergoing coronary bypass surgery, serum levels of cardiac myosin fragments, using monoclonal antibodies to myosin beta heavy chains, were measured in serial blood samples of 85 patients, 79 male and 6 female, 43-66 years old, after a total of 86 internal mammary artery and 137 saphenous vein graft implants. Eight patients had perioperative acute myocardial infarction (MI), detected by abnormal Q waves and a rise of CK-MB levels. After surgery, beta-myosin levels increased from post-operative day 3 and reached peak values on day 5 in patients without and in day 7 in patients with perioperative MI, in these 8 patients, myosin peak levels were greater as compared to 77 patients without perioperative MI (3452 +/- 1596 vs. 761 +/- 494; P < 0.01). There was a correlation between myosin peak levels and creatine kinase (CK) (r = 0.71; P < 0.05) and CK-MB peak levels (r = 0.74; P < 0.05) only in the patients with perioperative MI, but not in the patients without MI. There was no correlation between myosin peak levels and the times of aortic cross clamping or cardiopulmonary bypass. Peak myosin levels over 75% confidence limits of the mean were found in 23 patients; post-operative low output syndrome occurred in 10 of these 23 patients and in 7 out of 62 patients with peak myosin levels within 75% of the mean (P < 0.005). The increase in beta-myosin heavy chain serum levels observed in almost all patients undergoing coronary surgery suggests lesser perioperative damage of the contractile apparatus, which could be detected by the usual enzyme and ECG criteria. The higher prevalence of low output syndrome in patients with higher increases in myosin levels suggests more pronounced damage to the contractile apparatus in these patients. The higher myosin levels clearly indicate the presence of perioperative MI.
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Affiliation(s)
- E Astorri
- Cattedra di Cardiologia, Università di Parma, Italy
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Hornykewycz S, Gabriel H, Huber K. Biochemical markers of myocardial necrosis in acute myocardial infarction and thrombolysis. Ann Hematol 1994; 69:S59-63. [PMID: 7948300 DOI: 10.1007/bf02215959] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- S Hornykewycz
- Department of Cardiology, University of Vienna, Austria
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Pietri S, Séguin JR, d'Arbigny PD, Culcasi M. Ascorbyl free radical: a noninvasive marker of oxidative stress in human open-heart surgery. Free Radic Biol Med 1994; 16:523-8. [PMID: 8005538 DOI: 10.1016/0891-5849(94)90131-7] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
To assess the development of oxidative stress in cardiac ischemia/reperfusion, the resulting depletion of plasma ascorbate was monitored by electron spin resonance spectroscopic detection of ascorbyl free radical (AFR) in a homogeneous group of 12 patients undergoing aortic valve replacement. Dimethyl sulfoxide (DMSO) was used as an enhancer and stabilizer for AFR in plasma separated from blood samples collected 15 min before incision, 10 min before aortic declamping, and sequentially during the initial 30 min of reperfusion. Plasma DMSO/AFR levels of patients were found to be significantly lower than in healthy subjects (-25%), further decreased upon ischemia (-35%), dropped to their lowest values within the first 10 min of reperfusion (-46%), and did not recover their initial values within 30 min following reflow. Cardiac index measurements revealed a still depressed heart function 4 h postdeclamping and a more delayed tissue injury was evidenced by cardiac myosin and myoglobin release in plasma. DMSO/AFR levels at early reperfusion were slightly (+ 12%) higher in plasma obtained from coronary sinus samples than in plasma from peripheral blood, suggesting an extra ascorbate release from the injured heart tissue. The close analogy between these results and the reported measurements of other plasma markers of oxidative stress, including ascorbate, indicates that the present method could be of great value in clinical practice.
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Affiliation(s)
- S Pietri
- S.R.E.P., CNRS URA 1412, Université de Provence, Marseille, France
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Mair J, Puschendorf B, Michel G. Clinical significance of cardiac contractile proteins for the diagnosis of myocardial injury. Adv Clin Chem 1994; 31:63-98. [PMID: 7879674 DOI: 10.1016/s0065-2423(08)60333-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- J Mair
- Department of Medical Chemistry, University of Innsbruck School of Medicine, Austria
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Mair P, Mair J, Seibt I, Wieser C, Furtwaengler W, Waldenberger F, Puschendorf B, Balogh D. Cardiac troponin T: a new marker of myocardial tissue damage in bypass surgery. J Cardiothorac Vasc Anesth 1993; 7:674-8. [PMID: 8305656 DOI: 10.1016/1053-0770(93)90051-l] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The purpose of this study was to evaluate cardiac troponin T (TnT) in the diagnosis of minor perioperative myocardial tissue damage and small myocardial infarctions during aortocoronary bypass surgery. In 15 patients without enzymatic or electrocardiographic signs of perioperative myocardial ischemia (group 1, uncomplicated bypass surgery), TnT did not exceed 3.55 micrograms/L. In 3 patients with perioperative non-Q-wave infarctions (group 2), TnT was significantly higher than in group 1 patients. In all 3 patients, TnT peak concentrations exceeded 3.5 micrograms/L. Thirteen patients (group 3, borderline cases) showed either signs of perioperative myocardial ischemia by creatine kinase isoenzyme MB (CKMB) activity levels (CKMB > 20 U/L on the first postoperative day, 3 patients) or by electrocardiography (new ST-T segment alterations, 10 patients). TnT concentrations were comparable to group 1 patients and indicated uncomplicated bypass surgery in all 3 patients with solely elevated CKMB activities. On the other hand, TnT concentrations in 3 patients with electrocardiographic signs of perioperative myocardial ischemia were significantly higher than in uncomplicated patients (group 1) with peak values exceeding 3.5 micrograms/L. Thus, TnT indicated perioperative non-Q-wave infarctions not detected by CKMB activity in these 3 patients. These results are in accordance with findings in nonsurgical patients. They suggest a higher sensitivity and specificity of cardiac TnT compared to CKMB activity in the diagnosis of small perioperative myocardial infarctions after bypass surgery.
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Affiliation(s)
- P Mair
- Department of Anesthesia, University of Innsbruck Medical School, Austria
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15
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Staron RS, Johnson P. Myosin polymorphism and differential expression in adult human skeletal muscle. COMPARATIVE BIOCHEMISTRY AND PHYSIOLOGY. B, COMPARATIVE BIOCHEMISTRY 1993; 106:463-75. [PMID: 8281747 DOI: 10.1016/0305-0491(93)90120-t] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
1. Myosin heavy chain (HC) and light chain (LC) isoforms are expressed in a tissue-specific and developmentally-regulated manner in human skeletal muscle. 2. At least seven myosin HC isoforms are expressed in skeletal muscle of the adult. 3. Histochemically-delineated fibre types (based on the stability of myofibrillar actomyosin adenosine triphosphatase activity) in limb muscles correlate with the myosin HC content. 4. Alterations in the phenotypic expression of myosin provides a mechanism of adaptation to stresses placed upon the muscle (e.g. increased and decreased usage).
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Affiliation(s)
- R S Staron
- College of Osteopathic Medicine, Department of Biological Sciences, Ohio University, Athens 45701
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Kawauchi M, Gundry SR, Beierle F, de Begona JA, Bailey LL. Myosin light chain efflux after heart transplantation in infants and children and its correlation with ischemic preservation time. J Thorac Cardiovasc Surg 1993. [DOI: 10.1016/s0022-5223(19)34079-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Adams JE, Abendschein DR, Jaffe AS. Biochemical markers of myocardial injury. Is MB creatine kinase the choice for the 1990s? Circulation 1993; 88:750-63. [PMID: 8339435 DOI: 10.1161/01.cir.88.2.750] [Citation(s) in RCA: 339] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- J E Adams
- Cardiovascular Division, Washington University School of Medicine, St Louis, MO 63110
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Affiliation(s)
- U Jain
- University of California, San Francisco 94143
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Mair J, Dienstl F, Puschendorf B. Cardiac troponin T in the diagnosis of myocardial injury. Crit Rev Clin Lab Sci 1992; 29:31-57. [PMID: 1388708 DOI: 10.3109/10408369209105245] [Citation(s) in RCA: 114] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In the last several decades serum levels of cardiac enzymes and isoenzymes have become the final arbiters by which myocardial damage is diagnosed or excluded. Because conventionally used enzymes are neither perfectly sensitive nor specific, there is need for a new sensitive and cardiospecific marker of myocardial damage. Cardiac troponin T (TnT) is a contractile protein unique to cardiac muscle and can be differentiated by immunologic methods from its skeletal-muscle isoform. An enzyme immunoassay specific for cardiac TnT is now available in a commercial kit for routine use. The biggest advantage of this assay is its cardiospecificity. TnT measurements, however, are also highly sensitive in diagnosis of myocardial injury and accurately discern even small amounts of myocardial necrosis. TnT measurements are, therefore, particularly useful in patients with borderline CK-MB and in clinical settings in which traditional enzymes fail to diagnose myocardial damage efficiently because of lack of specificity--for example, perioperative myocardial infarction or blunt heart trauma. TnT release kinetics reveal characteristics of both soluble, cytoplasmic, and structurally bound molecules. It starts to increase a few hours after the onset of myocardial damage and remains increased for several days. TnT allows late diagnosis of myocardial infarction. The diagnostic efficiency remains at 98% until 6 d after the onset of infarct-related symptoms. TnT is also useful in monitoring the effectiveness of thrombolytic therapy in myocardial infarction patients. The ratio of peak TnT concentration on day 1 to TnT concentration at day 4 discriminates between patients with successful (greater than 1) and failed (less than or equal to 1) reperfusion. TnT measurements are very sensitive and specific for the early and late diagnosis of myocardial damage and could, therefore, provide a new criterion in laboratory diagnosis of the occurrence of myocardial damage.
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Affiliation(s)
- J Mair
- Department of Medical Chemistry and Biochemistry, University Innsbruck School of Medicine, Austria
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Beyersdorf F, Sarai K, Maul FD, Wendt T, Satter P, Buckberg GD. Immediate functional benefits after controlled reperfusion during surgical revascularization for acute coronary occlusion. J Thorac Cardiovasc Surg 1991. [DOI: 10.1016/s0022-5223(19)33935-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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