Association of Adiponectin With Cardiovascular Risk

The experimental studies discussed above suggest an antiatherogenic role ofadiponectin and that hypoadiponectinemia therefore might be associated with increased risk of atherosclerotic disease. Indeed, several cross-sectional clinical studies have reported lower serum levels in patients with CHD (138-142) than in control subjects. Kumada et al. (138) studied 225 consecutive male patients with CHD and compared them with 225 voluntary blood donors. They found a twofold increased risk of CHD...

Potential for different fragments for different pathophysiological processes

Cytosolic vs Structural Pools Evidence for Existence of Two Cellular Pools Based on the bimodal release kinetics of cTnl, it is assumed that there are at least two pools oftroponin (26,27). They have been labeled cytosolic and structural, but the studies that have been conducted have usually made that distinction predicated on the ability to displace the troponin based on the buffer necessary rather than immunohistochemistry. Displacement with gentle buffers has been suggested to be associated...

Novel Candidate Markers Of Hemodynamic Stress

To discover novel pathways induced in the heart in response to hemodynamic overload in vivo, we used DNA microarray technology to characterize on a genomewide scale the acute and long-term response of the heart to pressure overload (95). We used the well-established transverse aortic constriction model of pressure overload hypertrophy in mice in which an occluding clip is surgically placed around the transverse aorta to create a hemodynamic overload on the left ventricle. LV RNA was harvested...

Definition of nonstelevation acute coronary syndrome

Although acute coronary syndrome (ACS) constitutes a continuum, it is usually divided into ST-elevation ACS (STEACS) and non-ST-elevation ACS (NSTEACS) according to the electrocardiogram (ECG) changes at presentation (Fig. 1). Patients presenting with symptoms of acute cardiac ischemia and ST-elevation on the ECG are referred to as having STEACS. Owing to the high specificity of ST-elevation, STEACS is, in practice, equivalent to ST-elevation myocardial infarction (STEMI). Patients presenting...

Inflammatory Biomarkers and Clinical Utility

Some have argued that assessment of inflammatory biomarkers is superfluous because of the lack of evidence-based interventions that would be predicated on them. Moreover, some oppose the measurement of inflammatory biomarkers on the grounds that if they revealed higher risk in patients already receiving maximal medical therapy, those results would not change management. A more optimistic position would argue that residual risk indicated by inflammatory biomarkers in an optimally managed patient...

References

B-type natriuetic peptide a biomarker for all seasons. N Engl J Med 2004 350 718-720. 3. Wang TJ, Larson MG, Levy D, et al. Plasma natriuretic peptide levels and the risk of cardiovascular events and death. N Engl J Med 2004 350 655-663. 4. Hunt SA, Baker DW, Chin MH, et al. ACC AHA guidelines for the evaluation and management of chronic heart failure in the adult executive summary a report of the American College of Cardiology American Heart Association Task Force on...

Natriuretic Peptides As Prognostic Tools In Ischemic Heart Disease

The prognostic utility of both ANPs and BNPs has been assessed in the setting of ACS. Whereas elevated plasma ANP levels are related to increased mortality risk after MI, they Nonischemic Factors Affecting BNP Levels Left ventricular systolic dysfunction Left ventricular diastolic dysfunction Pulmonary embolism Sepsis Valvular heart disease e.g., aortic stenosis do not appear to contribute additional prognostic information when added to other known predictors of increased mortality, such as...

Urotensin Expression in Hypertension and Heart Failure

A high density of urotensin receptors is found in the smooth muscle layer of coronary arteries and LV myocytes 69 . Urotensin is approx 50 times more potent than ET-1 in contracting human coronary, mammary, and radial arteries in responding tissue however, some samples fail to respond to urotensin but are reactive toward ET-1 69 . These results demonstrate binding of urotensin to the urotensin receptor in the human vasculature. Urotensin gene expression is abundant in the human kidney and...

Immunoinhibition Technique

Uln Troponin

Single value above 99th percentile of control reference population is surrogate of myocardial necrosis in setting of myocardial ischemia a Time of first increase for the markers was 1-3 h for myoglobin, 3-4 h for CK-MB mass, 3-4 h for cTnT, and 4-6 h for cTnl. b , modest cardiac specificity , high cardiac specificity , very high absolute cardiac specificity. LD2 isoenzymes predominated in serum after MI, frequently in an LD1 gt LD2 flipped pattern, whereas LD4 and LD5 predominated in patients...

Joseph B Muhlestein MD

Introduction Chlamydia pneumoniae Helicobacter pylori Mycoplasma pneumoniae Cytomegalovirus Other Herpesviruses Human Immunodeficiency Virus Influenza Virus Total Pathogen Burden as an Aggregate Serological Risk Factor Clinical Use of Infectious Markers for Risk Stratification Not Yet Ready for Prime Time Conclusion References Chronic infection has been found to be significantly associated with the development of atherosclerosis and the clinical complications of unstable angina, myocardial...

Cook Pj Honeyborne D Chlamydia Pneumoniae. Int J Syst Bacteriol 39 88-90 1989

Dyslipidemia and other risk factors for coronary artery disease. In Braunwald E, ed. Heart Disease A Textbook of Cardiovascular Medicine, 5th ed. WB Saunders, Philadelphia, 1997, pp. 1126-1160. 2. Wilson PW, D'Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart disease using risk factor categories. Circulation 1998 97 18 1837-1847. 3. Grayston IT, Kuo C-C, Campbell LA, Wang S-P. Chlamydia pneumoniae sp. Nov. for Chlamydia sp strain...

Clearance Of Natriuretic Peptides Mechanisms of Natriuretic Peptide Clearance

Clearance of natriuretic peptides from the circulation involves two main pathways 1 NPR-C-mediated endocytosis followed by lysosomal degradation and 2 enzymatic degradation independent of the clearance receptor by the enzyme neutral endopeptidase NEP 99,100 . NEP is a zinc metallopeptidase widely distributed on the surface of endothelial cells, vascular smooth muscle cells VSMCs , cardiac myocytes, and fibroblasts 101 . The lungs, liver, and kidneys are the most important organs for natriuretic...

Patterns Of Bnp Synthesis And Release In Cardiac Ischemia

Natriuretic peptide levels are elevated both in animal models and in patients with coronary ischemia. In rats that underwent coronary artery ligation, BNP concentration in the left ventricle increased twofold at 12 h and fivefold at 24 h postinfarction, whereas atrial natriuretic peptide ANP levels were unchanged 8 . Elevated levels of BNP were found in noninfarcted as well as in infarcted areas of the myocardium, suggesting that increased African-American race Female gender Comorbidities CHF...

Chlamydia Pneumoniae

Chlamydial Life Cycle

C. pneumoniae was isolated in 1986 3 . It was found to be responsible for a variety of respiratory illnesses including 10 of cases of community-acquired pneumonia. Like the more familiar Chlamydia trachomatis, C. pneumoniae is an obligate intracellular pathogen with a unique life cycle Fig. 1 4 . Generally, C. pneumoniae enters the body through a respiratory route and exists outside of cells in a spore form called the elementary body. Once inside the host cell it makes use ofthe cell's own...

HsCRP Metabolic Syndrome and Type 2 Diabetes Mellitus

Another reason for clinical interest in adding hsCRP to current risk algorithms derives from the fact that inflammation may play a key role in processes associated with metabolic syndrome, a condition that confers increased cardiovascular risk 72 . hsCRP levels are correlated positively with components of metabolic syndrome commonly measured in Fig. 8. Cardiovascular event-free survival according to baseline level of hsCRP among individuals with metabolic syndrome. Adapted from ref. 75. Fig. 8....