High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Troponin is a widely used biomarker in patients with cardiac disease. The use of troponin is well established in patients with suspected acute myocardial infarction (AMI), but troponin measurement is also used in other acute and nonacute settings. In patients with suspected AMI, early decision-making is crucial to allow rapid treatment and further diagnostic evaluation. Current guidelines recommend serial measurements of troponin with a cut-off concentration at the 99th percentile to triage patients in the emergency department.

Newer, high-sensitivity assays for troponin enable the detection of distinctly lower concentrations. Using these assays and very low cut-off concentrations, several rapid diagnostic strategies have been reported to improve diagnosis in acute cardiac care. Furthermore, noncoronary and non-acute applications of troponin assays — for example as a biomarker in patients with heart failure, pulmonary embolism, or stable coronary artery disease — are on the horizon and might improve individual risk stratification.

In this Review, we provide an overview on the development of high-sensitivity assays for troponin, and their application in patients with cardiac disease.

Pathophysiological background of troponin and troponin release

in different settings. A schematic overview of myocardial structure

related to troponin (inset), as well as the plasma troponin concentrations 

in different clinical settings (young and healthy, elderly or chronic diseases,

myocardial injury, and myocardial infarction).

Read more: High-Sensitivity Assays for Troponin in Patients with Cardiac Disease !

Source: NatureReviewsCadiology

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Serum Level Measurements Improve Disease Risk Prediction.

Results obtained by using a commercially available uromodulin ELISA kit to analyze serum samples from individuals at risk for heart and circulatory system diseases indicated that this kidney-specific protein is a biomarker not only for kidney disease but also for cardiovascular diseases.

The glycoprotein uromodulin, also known as Tamm-Horsfall protein (THP), is synthesized exclusively in the kidneys and subsequently secreted. Low uromodulin concentrations in serum are a sensitive indicator for a loss of kidney function and thus play a role in the diagnosis of various renal diseases (nephropathies). When renal function is impaired, the uromodulin concentration in the serum sinks rapidly. Therefore, renal functional disorders can be identified at a very early stage of kidney damage, even in cases with few symptoms.

Uromodulin -a biomarker not only for kidney disease but also for cardiovascular diseases.

Read more: Serum Level Measurements Improve Disease Risk Prediction.

Source: LabMedica

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The Best Medicine Against Cholesterol And High Blood Pressure

Cholesterol is a waxy substance that comes from two sources: your body and food. Excess cholesterol can form plaque between layers of artery walls, making it harder for your heart to circulate blood.

Plaque can break open and cause blood clots. If a clot blocks an artery that feeds the brain, it causes a stroke. If it blocks an artery that feeds the heart, it causes a heart attack.

Heart disease, stroke and other cardiovascular diseases are among the leading cause of death and now kill more than 800,000 adults in the US each year. Two main reasons people have heart disease or stroke are high blood pressure and cholesterol.

Read more: The Best Medicine Against Cholesterol And High Blood Pressure

Source: herb-cookbook

Anatomy of the Heart

The heart sits in the middle of the chest behind the sternum, and extends towards the left side. It is a strong muscular pump, about the size of its owner’s clenched fist. It has four chambers:

• two atria, which receive blood to pump to the ventricles
• two ventricles, one that pumps blood to the lungs (right), and another that pumps blood to the body (left)

In the average adult, the heart beats around 60 – 100 times per minute, sending about six litres of blood through well over 1,000 complete circuits of the body each day.

During a lifetime of 70 years, the heart will beat more than 2.5 billion times. The only rest it gets or needs is a split-second pause between beats.

Read more: Anatomy of the Heart

Source: learncpronline

Organ regeneration with skin cells turning Into brain and heart cells

In a breakthrough study, researchers were able to chemically change skin cells to heart and brain cells.

When a person’s own body fails them, there are plenty of roadblocks to getting it running again. Adult hearts have a very limited ability to regenerate, so oftentimes the only way to help a person with a failing heart is to get them a new one. This is risky, though, since the patient’s body may reject even a perfectly matched organ. Scientists have been making strides in overcoming that problem by using a patient’s own stem cells to regenerate tissue, and researchers from the Gladstone Institutes have made a major breakthrough in the area — they successfully used a combination of chemicals to transform skin cells into heart and brain cells.

The feat is unprecedented, since all previous attempts to reprogram cells required scientists to add outside genes. Published in Science and Stem Cell, the research gives scientists a foundation for one day being able to regenerate lost or damaged cells with pharmaceuticals. The system is both more reliable and efficient than previous processes, and avoids medical concerns surrounding genetic engineering.

“This method brings us closer to being able to generate new cells at the site of injury in patients,” Dr. Sheng Ding, a Gladstone senior investigator, said in a press release. “Our hope is to one day treat diseases like heart failure or Parkinson’s disease with drugs that help the heart and brain regenerate damaged areas from their own existing tissue cells. This process is much closer to the natural regeneration that happens in animals like newts and salamanders, which has long fascinated us.”

Read more: Organ regeneration with skin cells turning Into brain and heart cells 

Brain cells are hard to fake, but it may now be possible.

Source: Pixabay

High troponin levels may account for mental stress ischemia in cardiac patients.

Some people with heart disease experience a restriction of blood flow to the heart in response to psychological stress. Usually silent (not painful), the temporary restriction in blood flow, called ischemia, is an indicator of greater mortality risk.

Cardiologists at Emory University School of Medicine have discovered that people in this group tend to have higher levels of troponin -- a protein whose presence in the blood that is a sign of recent damage to the heart muscle-- all the time, independently of whether they are experiencing stress or chest pain at that moment.

The results are scheduled for presentation by cardiology research fellow Muhammad Hammadah, MD at the American College of Cardiology meeting in Chicago on April 3, as part of the Young Investigator Awards competition. Hammadah works with Arshed Quyyumi, MD, and Viola Vaccarino, MD, PhD, and colleagues at the Emory Clinical Cardiovascular Research Institute.

"Elevated troponin levels in patients with coronary artery disease may be a sign that they are experiencing repeated ischemic events in everyday life, with either psychological or physical triggers," Hammadah says.

Video source: High troponin levels may account for mental stress ischemia in cardiac patients.

Sourse: newsmedia.tasnimnews

Human Myocardium is Bioengineered on Native Heart ‘Scaffold’.

Heart cells have been successfully grown in a human heart stripped of all cellular components by scientists at the Massachusetts General Hospital.

Using detergent, scientists removed all cells and human leukocyte antigens from 73 human hearts. The ‘matrix’ of the heart was then repopulated with pluripotent stem cells induced to differentiate into cardiac muscle. The scientists behind the work hope to create cardiac muscle to repair damaged tissue.

Professor Jacques Guyette, from the Massachusetts General Hospital (MGH) and lead author of this study, said: “Regenerating a whole heart is most certainly a long-term goal that is several years away, so we are currently working on engineering a functional myocardial patch that could replace cardiac tissue damaged due a heart attack or heart failure.”

In 2008, Dr Harold Ott, also from the MGH, developed a procedure to strip all cells from organs, leaving just the ‘scaffolding’ behind. To date, his technique has been used on hearts, lungs, livers, pancreases and kidneys.

MicroRNA molecules were used to reprogramme adult skin cells to created induced pluripotent stem cells (iPSC). It is hoped this method, as well as being more efficient, will be less likely to encounter regulatory issues.

Read more: Human Myocardium is Bioengineered on Native Heart ‘Scaffold’.

Source: labnews; thedailybeast