ABSTRACT
We have reviewed here studies of measurement of small concentrations of troponin in patients with myocardial infarction conducted in 2010-2011 which were most significant for the clinic. Troponin is a most specific and sensitive cardiomarker appearance of which in blood serum evidence for a necrotic process in cardiac muscle. We discuss the problem of interpretation of small troponin concentrations by clinicians as well as the states in which appearance of the cardiomarker in blood serum has noncardiac origin. We also discuss novel possibilities of application of troponin as a prognostic marker in patients with stable or unstable angina after revascularization procedures.
Subject(s)
Myocardial Infarction , Myocardium/pathology , Necrosis/blood , Troponin I , Troponin T , Antibodies, Monoclonal , Biomarkers , Evaluation Studies as Topic , Humans , Luminescent Measurements/methods , Myocardial Infarction/blood , Myocardial Infarction/diagnosis , Myocardial Infarction/pathology , Prognosis , Sensitivity and Specificity , Troponin I/analysis , Troponin I/blood , Troponin T/analysis , Troponin T/blood , Validation Studies as TopicABSTRACT
The paper analyzes the most important clinical studies dealing with the measurement of procalcitonin concentrations in patients with lower respiratory tract infections or sepsis. Procalcitonin is a marker of bacterial infection, which is successfully used for diagnosis and antimicrobial therapy monitoring in patients with pneumonia or in septic states. The review presents the latest algorithms for interpreting the concentrations of procalcitonin in clinical practice.
Subject(s)
Algorithms , Anti-Bacterial Agents/therapeutic use , Calcitonin , Protein Precursors , Respiratory Tract Infections , Sepsis , Biomarkers/analysis , Biomarkers/blood , Calcitonin/analysis , Calcitonin/blood , Calcitonin Gene-Related Peptide , Drug Monitoring/methods , Early Diagnosis , Humans , Protein Precursors/analysis , Protein Precursors/blood , Randomized Controlled Trials as Topic , Respiratory Tract Infections/diagnosis , Respiratory Tract Infections/drug therapy , Respiratory Tract Infections/metabolism , Sepsis/diagnosis , Sepsis/drug therapy , Sepsis/metabolismABSTRACT
The paper contains data on specific features of cardiac involvement in primary and secondary hemochromatosis (symptomatology, echocardiographic signs, etc.) as well as on pathogenesis of hereditary hemochromatosis. Algorithm of diagnosis of hereditary hemochromatosis is also presented.
Subject(s)
Cardiomyopathies/etiology , Hemochromatosis/complications , Diagnosis, Differential , Hemochromatosis/diagnosis , Hemochromatosis/genetics , HumansABSTRACT
AIM: To elucidate relationship between hereditary and environmental factors in development of target organ damage in hypertension. MATERIAL AND METHODS: The state of myocardium, central nervous system, blood vessels (including funduscopic examination) was assessed in 64 pairs of mono- and dizygous hypertensive twins (mean age 57.2+/-3.2 years) and clinical and genetic analysis of qualitative and quantitative signs was carried out. RESULTS: Hypertensive twins had similar qualitative features of target organs involvement irrespective of duration of hypertension. Concordance of signs of target organ damage in homozygous twins was more than twice higher than that of same signs in dizygous twin pairs. Left ventricular myocardial mass and intima-media thickness were mainly determined by hereditary factors. Their contribution into overall phenotypic variability of a sign exceeded 70%.
Subject(s)
Diseases in Twins , Hypertension/genetics , Blood Pressure Monitoring, Ambulatory , Blood Vessels/diagnostic imaging , Blood Vessels/pathology , Carotid Artery, Common/diagnostic imaging , Carotid Artery, Common/pathology , Central Nervous System Diseases/complications , Diseases in Twins/diagnosis , Echocardiography , Environment , Female , Humans , Hypertension/complications , Hypertension/diagnosis , Hypertension/etiology , Hypertension/pathology , Hypertrophy, Left Ventricular/diagnosis , Hypertrophy, Left Ventricular/diagnostic imaging , Hypertrophy, Left Ventricular/genetics , Male , Middle Aged , Phenotype , Time Factors , Twins, Dizygotic , Twins, MonozygoticABSTRACT
Twenty four hour blood pressure monitoring was carried out in 64 sex concordant pairs of monozygotic and dizygotic hypertensive twins (mean age 52.7-/+3.2 years). Clinico-genetic analysis of quantitative parameters showed that during day awake time systolic, diastolic, and mean blood pressures were mainly determined by environmental factors while pulse pressure and heart rate were predominantly affected by genetic factors. Formation of parameters of variability of blood pressure and its biphasic rhythm were under the influence of random (intrafamily) environmental factors.
Subject(s)
Circadian Rhythm , Environment , Hypertension/epidemiology , Hypertension/genetics , Twins/genetics , Adult , Humans , Male , Severity of Illness IndexABSTRACT
The bicycle ergometric test was used to examine exercise tolerance in 73 patients with coronary heart disease following a single remedial plasmapheresis session, which removed an average of 1562.2 ml plasma. A rapid increase in exercise tolerance was significantly revealed in patients with Functional Class IV exertional angina.
Subject(s)
Angina Pectoris/therapy , Physical Exertion , Plasmapheresis , Adult , Aged , Angina Pectoris/physiopathology , Electrocardiography , Exercise Test , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
In order to reveal changes in the myocardium at the preclinical stage of heart failure, 34 patients with hereditary hemochromatosis (HHC) underwent echocardiography in the M-mode. There were 26 men and 8 women aged 24 to 59 years. The control group was made up of 20 healthy persons. The HHC patients over 35 years of age (49.5 years on the average) manifested enlargement of the left ventricular cavity, an increase of the thickness of the interventricular septum and of the posterior heart wall, and reduction of pump function of the left ventricle.
Subject(s)
Echocardiography , Heart/physiopathology , Hemochromatosis/physiopathology , Adult , Female , Heart Failure/diagnostic imaging , Heart Failure/etiology , Heart Failure/physiopathology , Hemochromatosis/complications , Hemochromatosis/diagnostic imaging , Hemochromatosis/genetics , Hemodynamics/physiology , Humans , Male , Middle AgedABSTRACT
The authors have used gravitation plasmapheresis in the treatment of 26 patients with diabetic angiopathies of lower extremities. It was established that continuous gravitation plasmapheresis facilitated the immediate correction of most of the altered biochemical and coagulation parameters of blood, in patients with diabetes mellitus. The use of rheopolyglucinum is followed by stable central hemodynamics and stabilization of the general state of the patients during continuous plasmapheresis which allows to recommend rheopolyglucinum as the main plasma-substituting solution for fractionation of blood in patients with diabetic angiopathies. The gravitation plasmapheresis used in the treatment of critical degrees of ischemia in patients with diabetic angiopathies of lower extremities is thought by the authors to allow to preserve the extremity or to make the level of its amputation lower in most patients.
Subject(s)
Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/therapy , Ischemia/therapy , Leg/blood supply , Plasmapheresis , Aged , Blood Coagulation , Combined Modality Therapy , Critical Care , Diabetic Angiopathies/physiopathology , Female , Hemodynamics , Humans , Ischemia/etiology , Male , Middle Aged , Plasma Substitutes/therapeutic useABSTRACT
A significant decrease of work fitness was revealed in 23 patients with verified diagnosis of hereditary hemochromatosis exposed to graded physical exercise. It is assumed that the decrease of exercise tolerance in these patients may be most possibly accounted for by the lowering of myocardial contractility as a result of its injury due to iron overload. It is not excluded, however, that nonspecific dystrophic processes determined by diabetes mellitus, liver damage and coronary atherosclerosis in some cases may develop.
