• 제목/요약/키워드: Cardiac marker

검색결과 64건 처리시간 0.037초

외상 환자에서의 cardiac troponin I 상승군에서의 기초 조사 (Primary Survey of Cardiac Troponin I Elevated Groups in Trauma Patients)

  • 손유동;임경수;안지윤;박정근;조규종;오범진;김원
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.81-86
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    • 2005
  • Background: Cardiac troponin I (cTnI) is a sensitive cardiac marker of myocardial injury. In normal coronary angiogram, positive cTnI values may be detected in various events such as sepsis, stroke, trauma and so on. To investigate characteristics of cTnI positive group in trauma patients, we designed this study between cTnI positive group and cTnI negative group. Method: Trauma patients who visited emergency room within 24 hours after accidents were included. Patients who had renal failure, acute coronary syndrome, sepsis, spontaneous SAH were excluded. Retrospective study of 97 trauma patients was done. We investgated ISS (injury severity score), positive cTnI, EKG abnormality, shock class, ICU admission rate and mortality. Result: In comparing with non chest trauma group, chest trauma group, whose chest AIS (Abbreviated Injury Score) is more than 3 point, had significant values in ISS, positive cTnI, EKG abnormality, shock class and ICU admission rate. Also, in non chest trauma group, we found several patients whose cTnI level was positive. When non chest trauma group was divided into two subgroups, the mortality and shock class of positive cTnI group were higher than that of negative cTnI group. When all trauma patients were divided into two groups, a positive cTnI group had higher values in ISS, shock class, ICU admission rate and mortality than that in a negative cTnI group. Conclusion: We found that cTnI were positive in patients of cardiac contusion but also in various trauma cases. In non chest trauma patients, we assumed that hypotension caused cTnI elevating. The cTnI could play a role in predicting prognosis in trauma patients.

강아지에서 컨벡스스캐너를 이용한 정상적인 심장구조물의 초음파상 (Ultrasound Imaging of Normal Cardiac Structures with Convex Scanner in Puppies)

  • 정순욱;박희명;한숙희;윤정희;한홍율
    • 한국임상수의학회지
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    • 제11권2호
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    • pp.529-537
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    • 1994
  • Sector scanner which has a conical end is used to image through the intercostal space because heart is protected by the ribs. Cardiac data published all around the world were also obtained by sector scanner. Although scanners being used in every small animal practice and animal hospital at college in Korea include convex ape and linear type, linear type is not appropriate f3r cardiac scan because of a wide contact surface. The purpose of this study is to establish ultrasonographic images of normal cardiac structures by measuring shape, size of reflectable cardiac structure according to restraint position in scanning normal heart of the puppies with 6.5 MHz convex scanner(SonoAce 4500, Medison, Korea) used in our veterinary teaching hospital, Seoul national university. Seventeen male and female puppies considered having healthy hear by X-ray and clinical examination are used feom April to July 1994. Scanning point selection of probe head and the distinction of imaged cardiac structures were accomplished by necropsy and cardiac scanning performed through thoracotomy under general anesthesia. At 10 o'clock position of transducer(at an angle of 30$^{\circ}$ between imaginary line from elbow joint to 3rd sternum and probe head, 60$^{\circ}$ from body surface, 4th intercostal space of right thorax) with the marker of scanner toward the head of dogs right atrium, left atrium and left ventricle were observed in 2, 3, 4, 5 intercostal space(2cm from the sternum) of experimental dog positioned ventrodorsally under general anesthesia. Under these conditions, the numerical values of imaged diastolic hear are as follows : the distance from skin to apex(mean$\pm$S.D) 47.53$\pm$6.94mm, thickness of left ventricular wall 6.00$\pm$1.60mm, length of left ventricle 16.27$\pm$5.31mm, width of left ventricle 15,33$\pm$4.25mm, length of left atrium 12.33$\pm$3.82mm, width of left atrium 11. 33$\pm$3.94mm, length of right atrium 1.00$\pm$2.41mm, width of right atrium 11.21$\pm$2.76mm and the area of left ventricle 270.92$\pm$109.81mm$^2$, area of left atrium 98.00$\pm$41.08mm$^2$, area of right atrium 62.75$\pm$21.04mm$^2$.

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심장수술시 심폐기 충전액에 첨가된 저용량 aprotinin의 효과 (Effect of Low Dose Administration of Aprotinin in Pump Priming Solution on Cardiac Surgery)

  • 문성민;최석철
    • 생명과학회지
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    • 제17권4호
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    • pp.515-521
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    • 2007
  • Serine protease 억제약물인 aprotinin은 체외순환을 동반한 심장수술 후 필연적으로 발생하는 혈액성분 손상을 포함한 유해한 합병증을 감소시키기 위해 사용한다. 그러나 이 약물의 용량이나 사용법에 대해 여전히 논란의 여지가 있다. 본 연구자들은 심장수술 동안 심폐기 충전액에 저 용량의 aprotinin을 투여하여 그 효과를 연구하였다. 30명의 성인 심장수술 환자들을 대상으로 aprotinin 투여군(n=15)과 대조군(n=15)으로 나눈 뒤 수술 전, 동안, 후의 시기에 혈액학적 및 생화학적 변수들, 사이토카인 및 심장 표지자, 수술 후 각종 임상결과들을 비교분석 하였다. 혈소판수와 activated partial thromboplastin time은 수술 후 24시간 때 아프로티닌군이 대조군 보다 유의하게 높았다. Troponin-I 농도와 수술 후 출혈량은 아프로티닌군이 대조군보다 유의하게 낮았다. 이러한 결과들을 볼 때 심장수술시 저 용량의 aprotinin을 심폐기 충전액에 첨가하는 방법은 혈소판의 파괴를 줄여줘 수술 후 출혈량의 감소를 제공해주며 심근보호 효과가 있는 것으로 판단된다. 향후 더 많은 성인 환자군과 소아환자에 대한 다양한 연구가 더 많이 수행되어야 할 것으로 사료된다.

Identification of Marker Genes Related to Cardiovascular Toxicity of Doxorubicin and Daunorubicin in Human Umbilical Vein Endothelial Cells (HUVECs)

  • Kim, Youn-Jung;Lee, Ha-Eun;Ryu, Jae-Chun
    • Molecular & Cellular Toxicology
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    • 제3권4호
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    • pp.246-253
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    • 2007
  • Doxorubicin and daunorubicin are excellent chemotherapeutic agents utilized for several types of cancer but the irreversible cardiac damage is the major limitation for its use. The biochemical mechanisms of doxorubicin- and daunorubicin- induced cardiotoxicity remain unclear. There are many reports on toxicity of doxorubicin and doxorubicin in cardiomyocytes, but effects in cardiovascular system by these drugs are almost not reported. In this study, we investigated gene expression profiles in human umbilical vein endothelial cells (HUVECs) to better understand the causes of doxorubicin and doxorubicininduced cardiovascular toxicity and to identify differentially expressed genes (DEGs). Through the clustering analysis of gene expression profiles, we identified 124 up-regulated common genes and 298 down-regulated common genes changed by more than 1.5-fold by all two cardiac toxicants. HUVECs responded to doxorubicin and doxorubicin damage by increasing levels of apoptosis, oxidative stress, EGF and lipid metabolism related genes. By clustering analysis, we identified some genes as potential markers on apoptosis effects of doxorubicin and doxorubicin. Six genes of these, BBC3, APLP1, FAS, TP53INP, BIRC5 and DAPK were the most significantly affected by doxorubicin and doxorubicin. Thus, this study suggests that these differentially expressed genes may play an important role in the cardiovascular toxic effects and have significant potential as novel biomarkers to doxorubicin and doxorubicin exposure.

관상동맥질환자에 있어 수술 전 brain natriuretic peptide 농도, 심장표지자, 수술전후기 변수들 간의 상관관계와 임상적 유용성 (Relationship and Clinical Usefulness between Preoperative Levels of Brain Natriuretic Peptide, Other Cardiac Markers and Perioperative Parameters in Patients with Coronary Artery Disease)

  • 최석철;김양원;현경예;황수명;문성민
    • 생명과학회지
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    • 제20권9호
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    • pp.1299-1305
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    • 2010
  • 심혈관질환 진단을 위해 여러 가지 표지자들이 이용되고 있으며 그와 같은 표지자로 cardiac troponin-I (cTNI), creatine kinase-MB (CK-MB), C-reative protein (CRP)이 있다. 최근, 심장기능부전의 표지자로서 brain natriuretic peptide (BNP)에 대한 관심이 집중되고 있다. 이 연구는 심폐바이패스(cardiopulmonary bypass) 비적용 관상동맥우회수술을 시행한 74명의 성인환자를 대상으로 수술 전 BNP 농도와 다른 심장 표지자들 농도, 그리고 수술 전후 표지자들 간의 상관관계를 규명하기 위해 시행하였다. 수술 전 시기의 BNP, cTNI, CK-MB, CRP 각각의 농도는 수술 전 심초음파 변수와 양 또는 음의 상관성을 보였다. 수술 전 BNP 농도와 수술 전 cTNI, CK-MB, CRP 농도 각각과 높은 양의 상관관계가 있었다. 수술 전 BNP, cTNI, CK-MB, CRP 농도 각각은 수술 후 기계호흡보조시간, 중환자실치료기간과 유의한 양의 상관관계를 보였다. 이 연구의 결과들은 수술 전 BNP, cTNI, CK-MB, CR과 같은 심장 표지자들의 측정 및 병용은 심혈관질환자들의 진단, 환자들의 등급화, 수술 후 예후평가에 매우 유용한 방법임을 시사하고 있다.

체외순환을 동반한 심장판막 수술 시 혈청 사이토카인 농도와 수술 후 결과와의 상관관계 분석 (Analysis of the Correlations between the Serum Levels of Cytokines and Postoperative Outcomes in Valvular Heart Surgery with Cardiopulmonary Bypass)

  • 문성민;김정락;김윤태;최석철
    • 생명과학회지
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    • 제18권11호
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    • pp.1551-1560
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    • 2008
  • 본 연구자들은 체외순환을 적용한 심장판막 수술 시 혈청사이토카인들의 변화와 여러 장기 표지자들과의 상관관계규명을 위해 전향적 연구를 실시하였다. 체외순환은 수술 동안 또는 수술 후 시기에 걸쳐 염증성 사이토카인(TNF-$\alpha$ 및 IL-6) 및 항염증성 사이토카인(IL-10)의 혈청 농도의 증가를 가져왔고 염증성 사이토카인의 증가에 따라 항염증성 사이토카인의 길항적 상승이 뒤 따랐다. 또한 심장수술 후 간, 신장, 심장 등 장기의 기능표지자들 역시 기준치보다 증가되었고 사이토카인들은 이러한 장기기능 표지자와 다양한 시기에 걸쳐 유의한 상관성을 보였다. 본 연구의 결과들은 심장판막수술 시 필연적으로 적용하는 체외순환이 염증성 사이토카인을 활성화시키기도 하지만 이의 상쇄를 위한 항염증성 사이토카인의 방출 역시 자극하며 이러한 사이토카인들은 수술 후 여러 장기의 기능에 직간접적으로 관여하여 장기 손상 혹은 장기보호의 역할을 함이 시사되었다.

Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy

  • Na Young Kim;Dong Jin Im;Yoo Jin Hong;Byoung Wook Choi;Seok-Min Kang;Jong-Chan Youn;Hye-Jeong Lee
    • Korean Journal of Radiology
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    • 제25권6호
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    • pp.540-549
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    • 2024
  • Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

Cardioprotective effect of Argyreia speciosa (Burm. f) Boj. extracts against Isoproterenol- induced myocardial infarction in rats

  • Thakker, Shalin;Biradar, S.M.;Habbu, P.V.;Mahadevan, K.M.;Thippeswamy, B.S.;Veerapur, V.P.
    • Advances in Traditional Medicine
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    • 제10권4호
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    • pp.278-287
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    • 2010
  • The present study was undertaken to evaluate the protective effect of ethanol (EtAS), ethyl acetate (EAAS) and aqueous (AQAS) extracts of Argyreia speciosa (AS) roots against Isoproterenol (ISO)-induced myocardial infarction in rats. The animals were exposed to isoproterenol (200 mg/kg. s.c) twice at an interval of 24 hrs. Cardioprotective effect was assessed by observing ECG parameters, serum marker enzymes and histopathology of the heart. Pretreatment of EAAS, and EtAS (200 mg/kg) resulted in a significant (P < 0.001) increase in P wave, QRS complex and R-R interval, whereas heart rate, QT interval and cardiac cycle were maintained near to normal values. EtAS and EAAS showed significant (P < 0.05; P < 0.001) reduction in all the tested diagnostic markers compared to ISO treated group. Histological studies on the structural changes of heart tissue supported the protective activity of AS. The result suggest that treatment of AS prior to ISO has a significant role in protecting the animals from ISO induced myocardial infarction.

Ginsenoside-Re ameliorates ischemia and reperfusion injury in the heart: a hemodynamics approach

  • Lim, Kyu Hee;Lim, Dae-Jun;Kim, Jong-Hoon
    • Journal of Ginseng Research
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    • 제37권3호
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    • pp.283-292
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    • 2013
  • Ginsenosides are divided into two groups based on the types of the panaxadiol group (e.g., ginsenoside-Rb1 and -Rc) and the panaxatriol group (e.g., ginsenoside-Rg1 and -Re). Among them, ginsenoside-Re (G-Re) is one of the compounds with the highest content in Panax ginseng and is responsible for pharmacological effects. However, it is not yet well reported if G-Re increases the hemodynamics functions on ischemia (30 min)/reperfusion (120 min) (I/R) induction. Therefore, in the present study, we investigated whether treatment of G-Re facilitated the recovery of hemodynamic parameters (heart rate, perfusion pressure, aortic flow, coronary flow, and cardiac output) and left ventricular developed pressure (${\pm}dp/dt_{max}$). This research is designed to study the effects of G-Re by studying electrocardiographic changes such as QRS interval, QT interval and R-R interval, and inflammatory marker such as tissue necrosis factor-${\alpha}$ (TNF-${\alpha}$) in heart tissue in I/R-induced heart. From the results, I/R induction gave a significant increase in QRS interval, QT interval and R-R interval, but showed decrease in all hemodynamic parameters. I/R induction resulted in increased TNF-${\alpha}$ level. Treatment of G-Re at 30 and $100{\mu}M$ doses before I/R induction significantly prevented the decrease in hemodynamic parameters, ameliorated the electrocardiographic abnormality, and inhibited TNF-${\alpha}$ level. In this study, G-Re at $100{\mu}M$ dose exerted more beneficial effects on cardiac function and preservation of myocardium in I/R injury than $30{\mu}M$. Collectively, these results indicate that G-Re has distinct cardioprotectective effects in I/R induced rat heart.

Fuctional Relationship between Rate of Fatty Acid Oxidation and Carnitine Palmitoyl Transferase I Activity in Various Rat Tissues

  • Cho, Yu-Lee;Do, Kyung-Oh;Kwon, Tae-Dong;Jang, Eung-Chan;Lee, Keun-Mi;Lee, Suck-Kang;Kim, Jong-Yeon
    • The Korean Journal of Physiology and Pharmacology
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    • 제7권4호
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    • pp.207-210
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    • 2003
  • Lipids play many structural and metabolic roles, and dietary fat has great impact on metabolism and health. Fatty acid oxidation rate is dependent on tissue types. However there has been no report on the relationship between the rate of fatty acid oxidation and carnitine transport system in outer mitochondrial membrane of many tissues. In this study, the rate of fatty acid oxidation and carnitine palmitoyltransferase (CPT) I activity in the carnitine transport system were measured to understand the metabolic characteristics of fatty acid in various tissues. Palmitic acid oxidation rate and CPT I activity in various tissues were measured. Tissues were obtained from the white and red skeletal muscles, heart, liver, kidney and brain of rats. The highest lipid oxidation rate was demonstrated in the cardiac muscle, and the lowest oxidation rate was in brain. Red gastrocnemius muscle followed to the cardiac muscle. Lipid oxidation rates of kidney, white gastrocnemius muscle and liver were similar, ranging from 101 to 126 DPM/mg/hr. CPT I activity in the cardiac muscle was the highest, red gastrocnemius muscle followed by liver. Brain tissue showed the lowest CPT I activity as well as lipid oxidation rate, although the values were not significantly different from those of kidney and white gastrocnemius muscle. Therefore, lipid oxidation rate was highly (p<0.001) related to CPT I activity. Lipid oxidation rate is variable, depending on tissue types, and is highly (p<0.001) related to CPT I activity. CPT I activity may be a good marker to indicate lipid oxidation capacity in various tissues.