BACKGROUND: Transjugular intrahepatic portosystemic shunts (TIPS) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess glycogen phosphorylase BB (GPBB) concentration in relation to echocardiographic and haemodynamic parameters in patients before and after TIPS insertion. METHODS: The study population consisted of 55 patients (38 men and 17 women, age 55.6±8.9 years, range 37-74 years) with liver cirrhosis treated with transjugular portosystemic shunting. GPBB, echocardiographic, and haemodynamic parameters were measured before TIPS insertion and 24 h after the procedure. GPBB concentrations were assessed using the Cardiac Array for Evidence Investigator protein biochip. Correlation between parameters was assessed using the Spearman's coefficient. RESULTS: Serum post-procedural GPBB concentrations were increased in comparison with baseline (5.58 vs. 2.67 μg/L, P<0.001). GPBB concentration after TIPS significantly correlated with baseline systemic vascular resistence (r=0.330; P=0.017) and cardiac index (r=0.313; P=0.025). CONCLUSION: GPBB concentration measurement may be a useful tool for monitoring myocardial ischemia during a TIPS procedure.
- MeSH
- biologické markery krev MeSH
- dospělí MeSH
- glykogenfosforylasa krev MeSH
- hemodynamika fyziologie MeSH
- jaterní cirhóza komplikace enzymologie patofyziologie MeSH
- katetrizace centrálních vén MeSH
- lidé středního věku MeSH
- lidé MeSH
- portální hypertenze enzymologie etiologie chirurgie MeSH
- senioři MeSH
- stupeň závažnosti nemoci MeSH
- transjugulární intrahepatální portosystémový zkrat * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Transjugular intrahepatic portosystemic shunts (TIPSs) have become a widely accepted tool in the treatment of patients with symptomatic portal hypertension. The aim of our study was to assess the value of cardiac markers before and after TIPS insertion for the prediction of one-year mortality in cirrhotic patients. METHODS: The study population consisted of 55 patients (38 men and 17 women, aged 55.6 ± 8.9 y, range 37-74) with liver cirrhosis treated with transjugular portosystemic shunting. Biochemical markers were measured before and 24 h after TIPS. High-sensitivity cardiac troponin T (hs-cTnT) was tested by high-sensitivity immunoassay for Elecsys analyser (Roche Diagnostics). Concentrations of creatine kinase MB isoenzyme, myoglobin (MYO), glycogenphosphorylase BB isoenzyme (GPBB) and heart type of fatty acid binding protein (FABP) were measured by the Evidence Investigator protein biochip system (Randox Laboratories). RESULTS: In patients before TIPS insertion, hs-cTnT was increased above the cut-off (0.014 μg/L) in 39.2% of patients. Higher hs-cTnT and FABP concentrations were associated with poor survival in patients before TIPS (hs-cTnT: P = 0.018; FABP: P = 0.016). Twenty-four hours after the TIPS procedure, we found a significant elevation in serum GPBB in comparison with preprocedural values (P < 0.001). There was an association between postprocedural concentrations of cardiac markers (MYO, hs-cTnT, FABP) and overall survival. CONCLUSIONS: Measurement of cardiac markers, mainly hs-cTnT and FABP, may be useful for mortality prediction in cirrhotic patients after TIPS. Cardiac markers are better mortality predictors than other risk factors such as age, gender or Child-Pugh score.
- MeSH
- biologické markery krev metabolismus MeSH
- dospělí MeSH
- jaterní cirhóza krev diagnóza metabolismus mortalita chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- multivariační analýza MeSH
- myokard metabolismus MeSH
- prognóza MeSH
- ROC křivka MeSH
- senioři MeSH
- transjugulární intrahepatální portosystémový zkrat * MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Biochemical markers of myocardial injury play an important role in the diagnosis of cardiovascular diseases. Measurement of cardiac biomarkers is one of the most important diagnostic tests in acute myocardial infarction (AMI), heart failure, and other cardiovascular disorders. Recently, the European Society of Cardiology, the American College of Cardiology Foundation, the American Heart Association, and the World Heart Federation have published a consensus definition of AMI that includes a detailed guideline for the assessment of biochemical markers in suspected disease. The cardiac troponins (cTI and cTnT) were recommended as preferred markers of myocardial necrosis in this setting. Herein, we review cardiac troponin biochemistry, the performance characteristics of cTnT assays, and optimal utilization of troponin in patients with proven or possible cardiovascular disease. We also discuss the use of troponin tests, with emphasis on cTnT, in different clinical situations in which its levels may be elevated.
- MeSH
- biologické markery analýza chemie metabolismus MeSH
- diagnostické techniky kardiovaskulární * MeSH
- kardiovaskulární nemoci diagnóza MeSH
- lidé MeSH
- myokard metabolismus patologie MeSH
- protein - isoformy chemie diagnostické užití metabolismus MeSH
- troponin T analýza chemie metabolismus MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
BACKGROUND: The aim of our study was to monitor radiofrequency catheter ablation-induced myocardial damage by measuring high-sensitivity cardiac troponin T (hs-cTnT). METHODS: Serum concentrations of hs-cTnT (Elecsys 2010 system, Roche) were measured in 73 healthy blood donors and serially in 27 patients who had samples taken both before and 24 h after radiofrequency ablation (RFA) for atrioventricular nodal re-entry tachycardia (AVNRT), atrial fibrillation (AF) or right atrial flutter (AFL). RESULTS: Significant increases of hs-cTnT were seen in patients after RFA (AVNRT: P = 0.0115, AF: P = 0.0011, AFL: P = 0.0009). Postprocedural serum hs-cTnT correlated with the number of radiofrequency applications and with the duration of RFA procedure. Spearman's coefficient of rank correlation (r) were as follows: hs-cTnT versus RFA duration: r = 0.771 (P < 0.001); hs-cTnT versus number of pulses: r = 0.708 (P < 0.001). Patients with the diagnosis of AVNRT had lower serum hs-cTnT concentration after RFA compared with AFL (P < 0.0001) and AF (P < 0.0001) patients. CONCLUSIONS: Our data indicate that RFA causes a significant increase of serum hs-cTnT concentration that could be used to monitor myocardial injury.
- MeSH
- atrioventrikulární nodální reentry tachykardie terapie MeSH
- biologické markery krev MeSH
- fibrilace síní terapie MeSH
- flutter síní terapie MeSH
- katetrizační ablace škodlivé účinky MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování fyziologických funkcí metody MeSH
- myokard MeSH
- pilotní projekty MeSH
- poranění srdce krev diagnóza MeSH
- troponin T krev MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Sdělení podává informace o novém přístupu k biochemickým analýzám. Dále shrnuje principy, použití, možné výhody či nevýhody nových multiplexních technologií. Většina prezentovaných metod je v současné době buď ve fázi vývoje, nebo je již používána v rámci výzkumných projektů. Pouze některé technologie postupně pronikají do laboratoří klinické biochemie.
The publication reports recent approach to biochemical analyses. There are summarized data about principles, usages, advantages or disadvantages of new multiplex technologies. Although, in the meantime, the most of presented methods are in development or they are used in research projects some technologies already expand to clinical biochemistry laboratories.
Cíl sdělení: Monitorovat analytickou a klinickou vhodnost použití nové high-senzitivní metody pro stanovení troponinu T (hs-cTnT). Metoda: Sérová koncentrace troponinu T byla testována high-senzitivní metodou pro analyzátor Elecsys 2010 (Roche). Kardiální troponin T (cTnT) byl měřen v skupinách: 73 krevních dárců (BD), 41 akutních infarktů myokardu (AIM), 34 nestabilních angin pectoris (UAP), 38 stabilních angin pectoris (SAP), 22 hypertrofických kardiomyopatií (HKM) a 27 různých typů arytmií (AR). Výsledky: Koncentrace hs-cTnT byla zvýšená nad 99. percentil kontrolní populace (BD) u 100 % AIM, 63,6 % UAP, 15,8 % SAP, 18,5 % AR a13,6 % HKM. Závěry: High-senzitivní metoda má adekvátní analytické vlastnosti. Naše data ukazují, že zvýšení hs-cTnT může monitorovat malé poškození myokardu u pacientů s AKS nebo s jinou chronickou srdeční chorobou. Byly nalezeny signifikantní rozdíly ve výsledcích mezi BD, SAP a UAP skupinami, což může být využito pro stratifikaci rizika. Výsledky nízkých koncentrací cTnT (< 0,03μg/l) mohou být užitečné pro klinickou interpretaci, ale je třeba přesně stanovit referenční limity.
Background: The aim of our study was to monitor analytical and clinical performance of new high-sensitivity troponin T method (hs-cTnT). Methods: Elecsys 2010 system (Roche) was used to assess the serum levels of hs-cTnT. Cardiac troponin T (cTnT) was measured in populations: 73 healthy blood donors (BD), 41 acute myocardial infarction (AIM), 34 unstable angina pectoris (UAP), 38 stable angina pectoris (SAP), 22 hypertrophic cardiomyopathy (HKM) and 27 different types of arrhythmia (AR). Results: Concentration hs-cTnT was elevated above 99th percentile of reference population (BD) in 100 % AIM, 63.6 % UAP, 15.8 % SAP, 18.5 % AR and 13.6 % HKM. Conclusions: High-sensitivity method has adequate analytical performance. Our data indicate increase of hs-cTnT that can be monitoring of minor myocardial injury in AKS patients or chronic cardiac diseases. It is significant differences between BD, SAP and UAP results. This fact can be used for risk stratification. Results of low cTnT concentration (< 0.03μg/l) can be useful for clinical classification but it is necessary to establish reference limits.
