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1.
J Cell Mol Med ; 26(2): 274-286, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34894069

RESUMO

Based on the recent reports, cardiovascular events encompass a large portion of the mortality caused by the COVID-19 pandemic, which drawn cardiologists into the management of the admitted ill patients. Given that common laboratory values may provide key insights into the illness caused by the life-threatening SARS-CoV-2 virus, it would be more helpful for screening, clinical management and on-time therapeutic strategies. Commensurate with these issues, this review article aimed to discuss the dynamic changes of the common laboratory parameters during COVID-19 and their association with cardiovascular diseases. Besides, the values that changed in the early stage of the disease were considered and monitored during the recovery process. The time required for returning biomarkers to basal levels was also discussed. Finally, of particular interest, we tended to abridge the latest updates regarding the cardiovascular biomarkers as prognostic and diagnostic criteria to determine the severity of COVID-19.


Assuntos
COVID-19/sangue , Doenças Cardiovasculares/sangue , Sistema Cardiovascular/metabolismo , SARS-CoV-2/patogenicidade , Biomarcadores/sangue , COVID-19/complicações , COVID-19/diagnóstico , COVID-19/imunologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/imunologia , Sistema Cardiovascular/patologia , Sistema Cardiovascular/virologia , Quimiocina CCL2/sangue , Creatina Quinase Forma MB/sangue , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Homocisteína/sangue , Humanos , Interferon gama/sangue , Interleucina-6/sangue , L-Lactato Desidrogenase/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Prognóstico , SARS-CoV-2/crescimento & desenvolvimento , SARS-CoV-2/imunologia , Troponina I/sangue , Troponina T/sangue , Fator de Necrose Tumoral alfa/sangue
2.
Pak J Pharm Sci ; 34(5(Special)): 2035-2040, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34862870

RESUMO

This study aimed to investigate the effect of the therapy of amiodarone combined with atorvastatin on cardiac function of patients with acute myocardial infarction after percutaneous coronary intervention (PCI). A total of 90 patients with acute myocardial infarction who underwent PCI in the tertiary care hospital from January 2019 to January 2020 were selected as the subjects and randomly assigned into the control group and the study group, with 45 cases in each group. All the subjects had undergone PCI. The control group received amiodarone while those the study group received atorvastatin additionally. Comparison was done on the clinical efficacy, cardiac function, myocardial injury indicator and inflammatory factor between the two groups. The overall response rate (ORR) in the study group was significantly higher than that in the control group (P<0.05); patients in the study group had markedly better cardiac function compared with those in the control group (P<0.001); patients in the study group had considerably lower creatine kinase (CK) index, creatine kinase-MB (CK-MB) index, tumor necrosis factor (TNF-α) and interleukin-6 (IL-6) as opposed to those in the control group (P<0.001). It was observed that the therapy of amiodarone combined with atorvastatin could effectively improve the clinical indicators and cardiac function of patients with acute myocardial infarction after PCI. It is effective and worthy of wide promotion and application.


Assuntos
Amiodarona/uso terapêutico , Atorvastatina/uso terapêutico , Fármacos Cardiovasculares/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Intervenção Coronária Percutânea , Amiodarona/efeitos adversos , Atorvastatina/efeitos adversos , Fármacos Cardiovasculares/efeitos adversos , Estudos de Casos e Controles , China , Creatina Quinase Forma MB/sangue , Quimioterapia Combinada , Feminino , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Mediadores da Inflamação/sangue , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , Intervenção Coronária Percutânea/efeitos adversos , Distribuição Aleatória , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangue
3.
Eur Rev Med Pharmacol Sci ; 25(23): 7409-7417, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34919243

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effect of dexmedetomidine administration on myocardial ischemia/reperfusion (I/R) injury in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). MATERIALS AND METHODS: Online databases including PubMed, the Cochrane Library, Web of Science, Medline, and EMBASE were searched for clinical trials that investigated the application of dexmedetomidine in CPB patients prior to May 2021. A total of 17 studies involving 866 patients were included in this study. RESULTS: The result of the meta-analysis showed that there was a significant difference in serum creatinine-kinase-MB (CK-MB) between the dexmedetomidine group and the control group at the end of the operation and 24 h after the operation. Compared to the control group, cardiac troponin I (cTn-I) concentration in the dexmedetomidine group was significantly decreased at the end of the operation, 24 h after the operation, and 48 h after the operation. There was also a significant difference between the dexmedetomidine group and the control group in the length of a patient's ICU stay. CONCLUSIONS: Dexmedetomidine can reduce CK-MB and cTn-I concentrations and shorten the length of ICU stays for patients undergoing cardiac surgery with CPB. It can also provide myocardial protection from I/R injury.


Assuntos
Ponte Cardiopulmonar/métodos , Dexmedetomidina/uso terapêutico , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Procedimentos Cirúrgicos Cardíacos/métodos , Creatina Quinase Forma MB/sangue , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação , Traumatismo por Reperfusão Miocárdica/fisiopatologia
4.
J Biochem Mol Toxicol ; 35(12): e22907, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34816538

RESUMO

We planned to appraise the effects of ß-caryophyllene on Fas- receptor and caspase-mediated apoptosis signaling pathway and endothelial dysfunction in rats infarcted with isoproterenol. Rats were induced myocardial infarction by using isoproterenol (100 mg/kg body weight [b.w]). Serum creatine kinase-MB, serum cardiac troponin-T, heart weight, heart rate, and heart lipid peroxidation were greatly (p < 0.05) augmented, while heart enzymatic antioxidants and plasma nonenzymatic antioxidants were greatly (p < 0.05) lessened in isoproterenol-treated rats. Reverse transcription-polymerase chain reaction study revealed augmented expressions of Fas-receptor and caspases 8, 9, and 3 genes in myocardial infarcted rats. Furthermore, iNOS protein expression was amplified and eNOS protein was lessened in the myocardial infarcted heart. Three weeks pre- and cotreatment with ß-caryophyllene (20 mg/kg b.w) greatly (p < 0.05) protected isoproterenol-treated rats against these altered structural, biochemical, molecular, and immunohistochemical parameters, by its anti-cardiac hypertrophic, anti-tachycardial, antioxidant, anti-apoptotic, and anti-endothelial dysfunction effects. In conclusion, these findings projected the use of ß-caryophyllene for the therapy of human myocardial infarction after clinical trials.


Assuntos
Apoptose/efeitos dos fármacos , Inibidores de Caspase/farmacologia , Caspases/metabolismo , Endotélio Vascular/efeitos dos fármacos , Infarto do Miocárdio/metabolismo , Sesquiterpenos Policíclicos/farmacologia , Transdução de Sinais/efeitos dos fármacos , Receptor fas/antagonistas & inibidores , Animais , Antioxidantes/metabolismo , Biomarcadores/sangue , Creatina Quinase Forma MB/sangue , Relação Dose-Resposta a Droga , Endotélio Vascular/fisiopatologia , Frequência Cardíaca/efeitos dos fármacos , Masculino , Miocárdio/enzimologia , Miocárdio/metabolismo , Óxido Nítrico Sintase Tipo II/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Tamanho do Órgão/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Sesquiterpenos Policíclicos/administração & dosagem , Ratos , Ratos Wistar , Receptor fas/metabolismo
5.
J Clin Lab Anal ; 35(12): e24088, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34741347

RESUMO

BACKGROUND: At present, SARS-CoV-2 epidemic in the world rapidly spread. It is a serious global public health emergency. METHODS: In this study, we described the clinical characteristics of 11 COVID-19 patients hospitalized in the Meizhou People's Hospital, and viral genome sequences of SARS-CoV-2 from these patients were analyzed. RESULTS: Of the 11 patients, six cases developed fever, 9 cases developed a cough, and two cases developed headache and chills. Four patients (36.4%) had underlying diseases. Pneumonia is the most common complication. The laboratory test results showed that there were no adult patients with increased lymphocyte/lymphocyte percentage (LYM/LYM%). Most patients had normal total protein (TP) and albumin (ALB), but only two patients had decreased. Most patients had increased or normal levels of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), activated partial thromboplastin time (APTT), fibrinogen (FIB), creatine kinase isoenzymes (CK-MB), and lactate dehydrogenase (LDH). Neutrophil (NEU) (r = 0.664, p = 0.026), CK-MB (r = 0.655, p = 0.029) and blood urea nitrogen (BUN) (r = 0.682, p = 0.021) were significantly associated with SARS-CoV-2 virus cycle threshold (Ct) value. Multiple sequence alignment (MSA) shows that two different SNPs were identified at positions 8781 and 28144, and have a complete linkage genetic form of 8781C-28144T and 8781T-28144C. CONCLUSIONS: The reports of the 11 COVID-19 patients in our hospital will provide useful information for the diagnosis, treatment, and drug development of SARS-CoV-2.


Assuntos
COVID-19/etiologia , COVID-19/virologia , SARS-CoV-2/genética , Corticosteroides/uso terapêutico , Adulto , Sedimentação Sanguínea , Proteína C-Reativa/análise , COVID-19/sangue , COVID-19/tratamento farmacológico , Teste de Ácido Nucleico para COVID-19 , China , Creatina Quinase Forma MB/sangue , Feminino , Genoma Viral , Hospitalização , Humanos , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Neutrófilos , Polimorfismo de Nucleotídeo Único , Reação em Cadeia da Polimerase em Tempo Real , SARS-CoV-2/patogenicidade , Carga Viral , Proteínas Virais/genética
6.
Dis Markers ; 2021: 3440714, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34725560

RESUMO

BACKGROUND: It has been observed that COVID-19 may cause myocardial damage, but there are few detailed reports on myocardial enzyme abnormalities. METHODS: In this retrospective study, we analyzed data from 157 consecutive laboratory-confirmed and hospitalized COVID-19 patients from Wuhan. We collected information on demographic and clinical characteristics, laboratory findings, and clinical outcomes. Logistic regression analysis was used to explore the risk factors associated with the severity of COVID-19. The association between myocardial enzyme abnormalities and the mortality was also investigated. RESULTS: The mortality in abnormal myocardial enzyme group was obviously higher than the normal group (P < 0.001). The majority of patients (n = 72, 97.3%) with normal cardiac enzyme group were of the common novel coronavirus pneumonia (NCP) type, whereas half of the patients with cardiac enzyme abnormalities (n = 40, 48.2%) developed critical and severe NCP type. The multivariable logistic regression analysis indicated that COVID-19 patients with increasing age (P = 0.035), higher levels of CRP (P = 0.038), and TNI (P = 0.036) were associated with increased death than other patients. CONCLUSIONS: Myocardial enzyme abnormality and myocardial injury were associated with the severity and fatal outcomes of COVID-19. Clinicians should pay attention to the markers of myocardial injury in COVID-19 patients, especially those with older age, comorbidities, and inflammation.


Assuntos
COVID-19/enzimologia , COVID-19/mortalidade , Enzimas/sangue , Miocárdio/enzimologia , Adulto , Alanina Transaminase/sangue , COVID-19/sangue , Creatina Quinase Forma MB/sangue , Feminino , Humanos , L-Lactato Desidrogenase/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Troponina I/sangue
7.
Ann Clin Lab Sci ; 51(5): 721-725, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34686516

RESUMO

OBJECTIVE: To investigate the value of high-sensitivity C-reactive protein (hs-CRP) in evaluating the myocardial damage and prognosis in children with mycoplasmal pneumonia. MATERIALS: A total of 150 children with mycoplasmal pneumonia were selected. According to their serum creatine kinase isoenzyme (CK-MB) level, they were divided into 72 cases of the myocardial damage group and 78 cases of the non-myocardial damage group. Eighty healthy children undergoing physical examination were selected as the control group. The electrocardiography results and serum CK-MB and hs-CRP levels were compared among the subjects. The correlations among the above indexes were analyzed. RESULTS: The levels of hs-CRP and CK-MB in the myocardial damage group were significantly higher than those in the nonmyocardial damage group and control group, respectively (P<0.05). The rates of abnormal hs-CRP and abnormal electrocardiogram in the myocardial damage group were significantly higher than those in the non-myocardial damage group, respectively (P<0.05). In the 150 children with mycoplasmal pneumonia, the serum hs-CRP and CK-MB levels were positively correlated (P<0.001), and the abnormal hs-CRP rate was positively correlated with the abnormal electrocardiogram rate (P<0.001). In the myocardial damage group, the serum levels of hs-CRP and CK-MB after treatment were significantly lower than those before treatment, respectively (P<0.05). After treatment, each index in the myocardial damage group had no significant difference with those in the control group (P>0.05). CONCLUSION: hs-CRP may be an important index for evaluating the myocardial damage and prognosis in children with mycoplasmal pneumonia. The combination of hs-CRP and CK-MB detection has obvious guiding significance for the monitoring and treatment of mycoplasmal pneumonia complicated by myocardial damage.


Assuntos
Proteína C-Reativa/análise , Miocárdio/patologia , Pneumonia por Mycoplasma/fisiopatologia , Antibacterianos/uso terapêutico , Biomarcadores/análise , Estudos de Casos e Controles , Criança , Pré-Escolar , Creatina Quinase Forma MB/sangue , Eletrocardiografia , Eritromicina/uso terapêutico , Feminino , Humanos , Masculino , Pneumonia por Mycoplasma/sangue , Pneumonia por Mycoplasma/tratamento farmacológico , Prognóstico , Sensibilidade e Especificidade
8.
Medicine (Baltimore) ; 100(36): e27046, 2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34516494

RESUMO

ABSTRACT: To investigate how high-intensity exercise influences an athlete's myocardial resilience and the correlation between myocardial resilience and markers of myocardial ischemic injury.Fifteen swimmers participated in high-intensity exercises. Cardiac ultrasound was performed before and after exercise on each subject. Left ventricular general strain, systolic general strain rate, and the differences (▴general strain and ▴ general strain rate, respectively), before and after exercise were analyzed. Blood was collected at the morning of the exercise day and 6 hours after exercise to measure cardiac enzyme indicators.The correlation between myocardial resilience and markers of myocardial injury were evaluated. Most cardiac enzymes concentrations increased after exercise (P < .05). Cardiac troponin I, creatine kinase MB, and cardiac troponin T were all correlated with the degree of ▴ peak strain (differential value of posterior wall basal segment before and after exercise) and ▴ peak strain rate (differential value before and after exercise) (P < .05).After high-intensity exercise, the concentrations of creatine kinase MB and cardiac troponin T in the blood are positively correlated with two-dimensional ultrasound deformation indices, proving the fact that the seindices can be used as a diagnostic basis for myocardial injury, and are more sensitive than general strain. The two-dimensional strain echocardiogram is non-invasive and easily accepted by the patient. It can make up for the shortage of myocardial enzymes in the injury areas, including weak timeliness and the inability to locate injury.


Assuntos
Atletas , Creatina Quinase Forma MB/sangue , Exercício Físico , Miocárdio , Natação , Troponina T/sangue , Função Ventricular Esquerda/fisiologia , Adolescente , Biomarcadores/sangue , Ecocardiografia , Feminino , Humanos , Masculino
9.
Med Sci Monit ; 27: e929949, 2021 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-34341325

RESUMO

BACKGROUND This study aimed to clarify the protective role of dexmedetomidine in thoracoscopic-assisted thoracic surgery (TATS), including control of the intraoperative heart rate, blood pressure, and myocardial injury markers. MATERIAL AND METHODS The patients who underwent TATS were divided into 2 equal groups: the dexmedetomidine group (dexmedetomidine pumped at 0.5 µg/kg for >10 min before the administration of anesthesia and at 0.5 µg/kg in the maintenance period) and the control group (pumped normal saline for >10 min before the administration of anesthesia). The data recorded for each patient were heart rate (preoperative, maximum intraoperative, and minimum intraoperative), systolic and diastolic blood pressure, intraoperative hemodynamic data, and intraoperative cardiovascular drugs administered. An enzyme-linked immunosorbent assay was performed to assess the postoperative levels of cardiac troponin I (cTnI), creatine kinase isoenzyme, myoglobin, and N-terminal pro-B-type natriuretic peptide (NT-proBNP). RESULTS There were no significant differences in the age, sex, body height, body weight, American Society of Anesthesiologists classification grade, resection mode, operation time, ejection fraction, basal heart rate, and systolic and diastolic blood pressure of the 2 groups. In the dexmedetomidine group, the patients' maximum intraoperative heart rate and diastolic pressure decreased, and the postoperative hospital stay period was shorter. The postoperative peripheral blood test for the dexmedetomidine group showed higher NT-proBNP levels and lower cTnI levels. CONCLUSIONS Preoperative administration of dexmedetomidine can benefit hemodynamic stability, protect the cardiovascular system in the intraoperative and postoperative periods, and shorten postoperative hospitalization.


Assuntos
Determinação da Pressão Arterial , Dexmedetomidina/administração & dosagem , Frequência Cardíaca , Monitorização Intraoperatória/métodos , Infarto do Miocárdio , Dor Pós-Operatória/prevenção & controle , Cuidados Pré-Operatórios/métodos , Cirurgia Torácica Vídeoassistida , Idoso , Analgésicos não Narcóticos/administração & dosagem , Determinação da Pressão Arterial/métodos , Determinação da Pressão Arterial/estatística & dados numéricos , Cardiotônicos/administração & dosagem , Creatina Quinase Forma MB/sangue , Feminino , Hemodinâmica/efeitos dos fármacos , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/prevenção & controle , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Cirurgia Torácica Vídeoassistida/efeitos adversos , Cirurgia Torácica Vídeoassistida/métodos , Resultado do Tratamento , Troponina I/sangue
10.
Mol Med Rep ; 24(4)2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34396450

RESUMO

Numerous studies have demonstrated that metformin can reduce the incidence of myocardial infarction and improve the prognosis of patients. However, its specific mechanism has not been determined. Using a rat model of myocardial ischemia­reperfusion injury (MIRI), it was observed that metformin significantly reduced infarct size, and decreased the levels of plasma lactate dehydrogenase and creatine kinase­MB form. A TTC­Evans blue staining was used to detect the infarct size and MTT assay was used to evaluate the cell viability. TUNEL assay was performed to evaluate apoptosis. Furthermore, 4­hydroxynonenal was detected by immunohistochemical staining. mRNA expression levels were detected by reverse transcription­quantitative PCR; protein expression levels were detected by immunoblotting. When treated with metformin, the number of TUNEL­positive cells was significantly decreased. Reduced 4HNE immunoreactivity was observed in metformin­treated rats as determined via immunohistochemistry. Furthermore, NADPH oxidase 4 (NOX4) was downregulated by metformin at both the mRNA and protein levels, and adenosine 5'­monophosphate­activated protein kinase (AMPK) phosphorylation was increased by metformin. In a primary myocardial hypoxia­reoxygenation cell model, metformin increased the viability of cardiomyocytes and reduced the content of malondialdehyde. It was also found that metformin upregulated the phosphorylation of AMPK and decreased the expression of NOX4. Furthermore, pre­treatment with AMPK inhibitor compound­C could block the effect of metformin, indicated by increased NOX4 compared with metformin treatment alone. These results suggested that metformin was capable of reducing the oxidative stress injury induced by MIRI. In conclusion, the present study indicated that metformin activated AMPK to inhibit the expression of NOX4, leading to a decrease in myocardial oxidative damage and apoptosis, thus alleviating reperfusion injury.


Assuntos
Proteínas Quinases Ativadas por AMP/metabolismo , Metformina/farmacologia , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , NADPH Oxidase 4/metabolismo , Animais , Apoptose/efeitos dos fármacos , Hipóxia Celular , Sobrevivência Celular/efeitos dos fármacos , Creatina Quinase Forma MB/sangue , Masculino , Infarto do Miocárdio/metabolismo , Traumatismo por Reperfusão Miocárdica/patologia , Miocárdio/metabolismo , Miócitos Cardíacos/metabolismo , Miócitos Cardíacos/patologia , NADPH Oxidase 4/genética , Estresse Oxidativo , Fosforilação/efeitos dos fármacos , RNA Interferente Pequeno , Ratos , Ratos Sprague-Dawley
11.
Adv Med Sci ; 66(2): 304-314, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34256241

RESUMO

OBJECTIVES: We conducted a systematic review and meta-analysis with meta-regression of creatine kinase-MB (CK-MB), a biomarker of myocardial injury, in COVID-19 patients. METHODS: We searched PubMed, Web of Science and Scopus, for studies published between January 2020 and January 2021 that reported CK-MB, COVID-19 severity and mortality (PROSPERO registration number: CRD42021239657). RESULTS: Fifty-five studies in 11,791 COVID-19 patients were included in the meta-analysis. The pooled results showed that CK-MB concentrations were significantly higher in patients with high disease severity or non-survivor status than patients with low severity or survivor status (standardized mean difference, SMD, 0.81, 95% CI 0.61 to 1.01, p<0.001). The rate of patients with CK-MB values above the normal range was also significantly higher in the former than the latter (60/350 vs 98/1,780; RR â€‹= â€‹2.84, 95%CI 1.89 to 4.27, p<0.001; I2 â€‹= â€‹19.9, p â€‹= â€‹0.254). Extreme between-study heterogeneity was observed (I2 â€‹= â€‹93.4%, p<0.001). Sensitivity analysis, performed by sequentially removing each study and re-assessing the pooled estimates, showed that the magnitude and direction of the effect size was not modified (effect size range, 0.77 to 0.84). Begg's (p â€‹= â€‹0.50) and Egger's (p â€‹= â€‹0.86) t-tests did not show publication bias. In meta-regression analysis, the SMD was significantly and positively associated with the white blood count, aspartate aminotransferase, myoglobin, troponin, brain natriuretic peptide, lactate dehydrogenase, and D-dimer. CONCLUSIONS: Higher CK-MB concentrations were significantly associated with severe disease and mortality in COVID-19 patients. This biomarker of myocardial injury might be useful for risk stratification in this group.


Assuntos
COVID-19 , Creatina Quinase Forma MB/sangue , Mortalidade , Índice de Gravidade de Doença , Biomarcadores/sangue , COVID-19/sangue , COVID-19/diagnóstico , COVID-19/mortalidade , Humanos , SARS-CoV-2/patogenicidade
12.
BMC Cardiovasc Disord ; 21(1): 337, 2021 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-34256723

RESUMO

BACKGROUND: Predictive value of creatine kinase MB (CK-MB) for contrast-induced acute kidney injury (CI-AKI) among myocardial infarction (MI) patients has rarely been reported. We aim to evaluate the predictive value of CK-MB for CI-AKI among MI patients. METHODS: Totally, 1131 MI patients were included from the REduction of rIsk for Contrast-Induced Nephropathy (REICIN) study. The peak CK-MB before coronary angiography (CAG) was chosen. The study population was divided into two groups by log-transformed CK-MB cut-off point. The association between CK-MB and CI-AKI was tested by multivariable logistic regression. CK-MB was integrated with Age, creatinine and ejection fraction (ACEF) score and Mehran risk score (MRS) to evaluate the additive value of CK-MB. The integrated models were validated internally by the bootstrap method and externally by the PREdictive Value of COntrast voluMe to creatinine Clearance Ratio (PRECOMIN) study data set. RESULTS: Overall, 62(5.48%) patients developed CI-AKI, patients with CK-MB point > 4.7 displayed a higher incidence of CI-AKI than those without (11.9% vs. 4.0%, p < 0.001). CK-MB point > 4.7 was independently associated with CI-AKI (adjusted OR: 3.40, 95% CI: 1.93-5.98, p < 0.001). The additions of CK-MB to ACEF score, Mehran score A and Mehran score B resulted in increases in C-statistics, which ranged from 0.680 to 0.733 (p = 0.046), 0.694 to 0.727 (p = 0.091), 0.704 to 0.734 (p = 0.102), respectively. Internal validation also showed increases in C-statistics, and external validation performed well in discrimination and calibration. CONCLUSIONS: Preprocedural peak CK-MB was a predictor of CI-AKI among MI patients.


Assuntos
Injúria Renal Aguda/induzido quimicamente , Meios de Contraste/efeitos adversos , Angiografia Coronária/efeitos adversos , Creatina Quinase Forma MB/sangue , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea/efeitos adversos , Injúria Renal Aguda/diagnóstico , Injúria Renal Aguda/epidemiologia , Idoso , Biomarcadores/sangue , China/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/epidemiologia , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Resultado do Tratamento
13.
Am J Emerg Med ; 48: 307-311, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34246919

RESUMO

BACKGROUND AND AIM: Occasionally, children with COVID-19 may develop arrhythmia, myocarditis, and cardiogenic shock involving multisystemic inflammatory syndrome in children (MIS-C). This study aimed to identify the laboratory parameters that may predict early cardiovascular involvement in these patients. MATERIALS AND METHODS: Data of 320 pediatric patients, aged 0-18 years (average age, 10.46 ± 5.77 years; 156 female), with positive COVID-19 reverse transcription-polymerase chain reaction test and with cardiac biomarkers at the time of admission to the pediatric emergency department were retrospectively scanned. The age, sex, COVID-19-associated symptoms, pro-brain natriuretic peptide (proBNP), CK-MB, and troponin I levels of the patients were recorded. RESULTS: Fever was noted in 58.1% of the patients, cough in 29.7%, diarrhea in 7.8%, headache in 14.7%, sore throat in 17.8%, weakness in 17.8%, abdominal pain in 5%, loss of taste in 4.1%, loss of smell in 5.3%, nausea in 3.4%, vomiting in 3.8%, nasal discharge in 4.4%, muscle pain in 5%, and loss of appetite in 3.1%. The proBNP value ≥282 ng/L predicted the development of MIS-C with 100% sensitivity and 93% specificity [AUC: 0.985 (0.959-1), P < 0.001]; CK-MB value ≥2.95 with 80% sensitivity and 77.6% specificity [AUC: 0.792 (0.581-1), P = 0.026]; and troponin I value ≥0.03 with 60% sensitivity and 99.2% specificity [AUC: 0.794 (0.524-1)]. CONCLUSIONS: Cardiac markers (proBNP and troponin I), especially proBNP, could be used to detect early diagnosis of cardiac involvement and/or MIS-C in pediatric patients with COVID-19 and to predict related morbidity and mortality.


Assuntos
COVID-19/sangue , COVID-19/complicações , Creatina Quinase Forma MB/sangue , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Síndrome de Resposta Inflamatória Sistêmica/sangue , Troponina I/sangue , Adolescente , COVID-19/etiologia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Valor Preditivo dos Testes , Prognóstico , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica/etiologia
14.
J Cardiovasc Surg (Torino) ; 62(5): 502-509, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34105925

RESUMO

BACKGROUND: The evidence regarding the impact of patient's age and gender on del Nido cardioplegia cadio-protection capability in adults is strongly limited. METHODS: A group of 75 patients undergoing aortic valve replacement (AVR) with del Nido cardioplegia was divided into Group 1 (male) and Group 2 (female). Creatine kinase (CK-MB isoenzyme) and high sensitivity troponin T (hs-TnT) values at 24 hours and 48 hours, occurrence of cardiac activity during crossclamp and ventricular fibrillation (VF) during reperfusion were compared. The impact of age on hs-TnT,CK-MB, VF during reperfusion and cardiac activity during crossclamp was investigated using regression models. RESULTS: No difference between the groups was reported in 24-hour CK-MB (median 15.57 ng/mL; IQR 12.13-22.82 ng/mL vs. 13.97; 12.09-17.147 ng/mL; P=0.168), 48-hour CK-MB (6.19; 4.22-7.71 ng/mL vs. 6.07;4.56-7.06 ng/mL; P=0.707), 24-hour hs-TnT (259.2; 172.0-376.9 pg/mL vs. 193.0; 167.8-351 pg/mL.1; P=0.339), 48-hour hs-TnT (169.1; 124.9-293.0 pg/mL vs. 159.2; 123.12-211.77 pg/mL; P=0.673), VF during reperfusion (25% vs. 18,5%; P=0.774) and cardiac activity during arrest (39.6% vs. 37.1%; p= 1.0). Values of CK-MB at 24 hours, hs-TnT at 24 hours and hs-TnT at 48 hours were not dependent on age. The CK-MB at 48 hours was dependent on age (P=0.039). Probit regression failed to reveal the impact of patients' age on postclamp VF occurrence (P=0.11) or electrical activity during arrest (P=0.57). CONCLUSIONS: Considering our study results, it can be hypothesized that the del Nido cardioplegia provides adequate myocardial protection in AVR patients regardless of age and gender.


Assuntos
Insuficiência da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Soluções Cardioplégicas/uso terapêutico , Eletrólitos/uso terapêutico , Parada Cardíaca Induzida , Cardiopatias/prevenção & controle , Implante de Prótese de Valva Cardíaca , Lidocaína/uso terapêutico , Sulfato de Magnésio/uso terapêutico , Manitol/uso terapêutico , Cloreto de Potássio/uso terapêutico , Bicarbonato de Sódio/uso terapêutico , Soluções/uso terapêutico , Fatores Etários , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/fisiopatologia , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/fisiopatologia , Biomarcadores/sangue , Soluções Cardioplégicas/efeitos adversos , Creatina Quinase Forma MB/sangue , Eletrólitos/efeitos adversos , Feminino , Parada Cardíaca Induzida/efeitos adversos , Cardiopatias/sangue , Cardiopatias/diagnóstico , Cardiopatias/etiologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Humanos , Lidocaína/efeitos adversos , Sulfato de Magnésio/efeitos adversos , Masculino , Manitol/efeitos adversos , Cloreto de Potássio/efeitos adversos , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores Sexuais , Bicarbonato de Sódio/efeitos adversos , Soluções/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Troponina T/sangue
15.
J Cardiovasc Pharmacol ; 78(4): 572-580, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34166304

RESUMO

ABSTRACT: This study aimed to explore the correlation between QTc dispersion (QTcd) and soluble growth-stimulating gene 2 protein (sST2) after heart rate correction in patients with acute carbon monoxide poisoning heart disease. Among the 150 patients, 35 cases had severe toxic heart disease. The concentrations of sST2, cardiac troponin I, and creatine kinase-MB in the severe group began to increase from admission, 24 hours, and 2 days, respectively, and their detected values were all higher than those in the nonsevere group and the normal control group. There were statistically significant differences in sST2 and QTcd between the poisoning, nonsevere, and normal control groups before the treatment. There was a statistically significant difference between the indexes of the poisoning groups at different degrees 2 and 3 days after poisoning. Receiver operating characteristic curve analysis confirmed the sensitivity and specificity of sST2 and QTcd. The correlation analysis showed that sST2 and QTcd levels were positively correlated with the incidence of severe heart disease at admission. Generally, the combined observation of sST2 and QTcd improved the prediction sensitivity and were early predictor indexes of toxic heart disease.


Assuntos
Potenciais de Ação , Intoxicação por Monóxido de Carbono/complicações , Eletrocardiografia , Sistema de Condução Cardíaco/fisiopatologia , Cardiopatias/diagnóstico , Frequência Cardíaca , Proteína 1 Semelhante a Receptor de Interleucina-1/sangue , Adulto , Biomarcadores/sangue , Creatina Quinase Forma MB/sangue , Feminino , Cardiopatias/sangue , Cardiopatias/etiologia , Cardiopatias/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Troponina I/sangue , Regulação para Cima
16.
Sci Rep ; 11(1): 13365, 2021 06 28.
Artigo em Inglês | MEDLINE | ID: mdl-34183728

RESUMO

There is a large amount of evidence that selective serotonin reuptake inhibitors (SSRIs) are related to cardiovascular toxicity, which has aroused concern regarding their safety. However, few studies have evaluated the effects of SSRIs on cardiac injury biomarkers, such as creatine kinase (CK) and creatine kinase isoenzyme (CK-MB). The purpose of our study was to determine whether SSRIs elevated CK and CK-MB levels of prior medicated depressive patients (PMDP) compared to first-episode drug-naïve depressive patients (FDDPs). We performed an observational and retrospective study involving 128 patients with major depressive disorder. Patients who had never used any type of antidepressant were designated FDDP; patients who had used only one type of SSRI but were not treated after a recent relapse were designated PMDP. Serum CK and CK-MB levels were measured before and after using SSRIs for a period of time. The duration of current treatment in the FDDP and PMDP groups was 16.200 ± 16.726 weeks and 15.618 ± 16.902 weeks, respectively. After SSRI treatment, levels of serum CK in the PMDP group were significantly higher than in the FDDP group. Univariate ANCOVA results revealed that PMDP was 22.313 times more likely to elevate CK (OR 22.313, 95% CI 9.605-35.022) and 2.615 times more likely to elevate CK-MB (OR 2.615, 95% CI 1.287-3.943) than FDDP. Multivariate ANCOVA revealed an interaction between the group and sex of CK and CK-MB. Further pairwise analysis of the interaction results showed that in female patients, the mean difference (MD) of CK and CK-MB in PMDP was significantly greater than that in FDDP (MD = 33.410, P = 0.000, 95% CI 15.935-50.886; MD = 4.613, P = 0.000, 95% CI 2.846-6.381). Our findings suggest that patients, especially females, who had previously used SSRI antidepressants were more likely to have elevated CK and CK-MB, indicators of myocardial muscle injury. Use of SSRIs should not be assumed to be completely safe and without any cardiovascular risks.


Assuntos
Antidepressivos/uso terapêutico , Creatina Quinase Forma MB/sangue , Creatina Quinase/sangue , Transtorno Depressivo Maior/sangue , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/metabolismo , Inibidores de Captação de Serotonina/uso terapêutico , Adulto , Biomarcadores/metabolismo , Depressão/sangue , Depressão/tratamento farmacológico , Depressão/metabolismo , Feminino , Traumatismos Cardíacos/sangue , Traumatismos Cardíacos/tratamento farmacológico , Traumatismos Cardíacos/metabolismo , Humanos , Masculino , Miocárdio/metabolismo , Estudos Retrospectivos
17.
Can J Cardiol ; 37(10): 1665-1667, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34118375

RESUMO

Vaccination plays an important role in the fight against SARS-CoV-2 to minimie the spread of coronavirus disease 2019 (COVID-19) and its life-threatening complications. Myocarditis has been reported as a possible and rare adverse consequence of different vaccines, and its clinical presentation can range from influenza-like symptoms to acute heart failure. We report a case of a 30-year-old man who presented progressive dyspnea and constrictive retrosternal pain after receiving SARS-CoV-2 vaccine. Cardiac magnetic resonance and laboratory data revealed typical findings of acute myopericarditis.


Assuntos
Aspirina/administração & dosagem , Bisoprolol/administração & dosagem , COVID-19 , Miocardite , Prednisolona/administração & dosagem , Antagonistas de Receptores Adrenérgicos beta 1/administração & dosagem , Adulto , Anti-Inflamatórios/administração & dosagem , /efeitos adversos , COVID-19/diagnóstico , COVID-19/prevenção & controle , Creatina Quinase Forma MB/sangue , Eletrocardiografia/métodos , Humanos , Imagem Cinética por Ressonância Magnética/métodos , Masculino , Miocardite/sangue , Miocardite/etiologia , Miocardite/fisiopatologia , Miocardite/terapia , SARS-CoV-2 , Resultado do Tratamento , Troponina I/sangue
18.
J Int Soc Sports Nutr ; 18(1): 47, 2021 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-34126996

RESUMO

BACKGROUND: Tart cherry supplementation has been shown to enhance recovery from strenuous exercise due to its antioxidant properties. The majority of these studies used tart cherry juice, with a significant calorie content. The primary purpose of this study was to assess whether powdered tart cherry extract with minimal calorie content reduces oxidative stress and enhances recovery following intense resistance exercise. METHODS: Thirteen men (mean age: 26.2 ± 5.3 years; height: 184.3 ± 8.2 cm; weight: 92.9 ± 15.6 kg) performed a demanding resistance exercise protocol consisting of 6 sets of 10 repetitions of barbell back squat with 80% 1RM. The protocol was performed once following 7 days of 500 mg of tart cherry extract and once following placebo. Serum protein carbonyl (PC) content, creatine kinase activity (CK) and creatine kinase myocardial band content (CK-MB) were used to assess oxidative stress, skeletal and cardiac muscle damage respectively. Muscle soreness was assessed by visual analog scale. Physical performance was measured by countermovement jump power and handgrip dynamometer strength. RESULTS: There was a significant increase in PC in the placebo (PL) condition when compared to the Tart Cherry (TC) condition at Immediate Post (IP) (PL: 0.4 ± 0.3 vs. TC: - 0.4 ± 0.2 nmol∙mg- 1; p < 0.001), 1 h (PL: 0.3 ± 0.3 vs. TC: - 0.7 ± 0.3 nmol∙mg- 1; p < 0.001) and 24 h (PL: 0.1 ± 0.4 vs. TC: - 0.3 ± 0.5 nmol∙mg- 1; p = 0.010). There was a significant increase in CK activity in PL when compared to the TC at IP (PL: 491.1 ± 280 vs. TC: 296.3 ± 178 U∙L- 1; p = 0.008) and 3 h (PL: - 87 ± 123 vs. TC: 43.1 ± 105.3 U∙L- 1; p = 0.006). There was a significant (p = 0.003) increase in CKMB concentration in PL when compared to the TC (PL: 21.6 ± 12.4 vs. TC: - 0.3 ± 11.8 ng∙ml- 1; p = 0.006) at 1 h post. There was a significant increase in handgrip strength in TC when compared to PL (PL: - 2 ± 5.1 vs. TC: 1.7 ± 3 kg; p = 0.017) at 24 h post. CONCLUSIONS: This study demonstrated that tart cherry extract reduced oxidative stress and markers of muscle and cardiac damage following intense resistance exercise. This occurred along with a prevention of the decrease in handgrip strength seen following the intense exercise protocol, indicating a potential reduction in central fatigue. These benefits were seen with minimal energy intake.


Assuntos
Suplementos Nutricionais , Músculo Esquelético/lesões , Mialgia/prevenção & controle , Extratos Vegetais/administração & dosagem , Polifenóis/administração & dosagem , Treinamento de Força/efeitos adversos , Adulto , Biomarcadores/sangue , Creatina Quinase/sangue , Creatina Quinase Forma MB/sangue , Estudos Cross-Over , Força da Mão , Humanos , Masculino , Fadiga Muscular/fisiologia , Músculo Esquelético/fisiologia , Estresse Oxidativo , Carbonilação Proteica , Prunus avium , Adulto Jovem
20.
J Toxicol Sci ; 46(5): 199-207, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33952797

RESUMO

Cardiovascular complications have been well documented as the downside to conventional cancer chemotherapy. As a notable side effect of cisplatin (CDDP), cardiotoxicity represents a major obstacle to the successful treatment of cancer. It has been reported that Salvianolic acid B (SalB) possesses cardioprotective quality. However, the effect of SalB on cardiac damage caused by conventional cancer chemotherapy remains unclear. In this study, we clarified the protective effect of SalB on cisplatin-induced heart injury. Furthermore, in H9c2 cells, SalB dramatically reduced cisplatin-induced apoptosis and oxidative stress by modulating the nuclear factor erythroid-2-related factor 2 (Nrf2) signaling pathway. In conclusion, SalB had great potential in mitigating cisplatin-induced cardiac injury. Furthermore, more attention should be placed on natural active compounds containing SalB with antioxidant effects for the treatment of cardiomyopathy.


Assuntos
Antineoplásicos , Antioxidantes/uso terapêutico , Benzofuranos/uso terapêutico , Cisplatino , Cardiopatias/tratamento farmacológico , Fator 2 Relacionado a NF-E2/metabolismo , Animais , Antioxidantes/farmacologia , Benzofuranos/farmacologia , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Creatina Quinase Forma MB/sangue , Coração/efeitos dos fármacos , Coração/fisiopatologia , Cardiopatias/induzido quimicamente , Cardiopatias/metabolismo , Cardiopatias/patologia , Heme Oxigenase-1/genética , L-Lactato Desidrogenase/sangue , Masculino , Camundongos Endogâmicos C57BL , Miocárdio/metabolismo , Miocárdio/patologia , NAD(P)H Desidrogenase (Quinona)/genética , Estresse Oxidativo/efeitos dos fármacos , Ratos , Transdução de Sinais/efeitos dos fármacos , Volume Sistólico/efeitos dos fármacos
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