Cardiovascular Disease
Atherosclerosis
What is the pathology behind heart failure?
Typically caused by left ventricular function, fluid leaks and accumulates into the lungs, as the heart fails to supply blood throughout body.
The ideal marker of cardiac would
be sensitive and specific: is released rapidly, perisists in circulation, and would not detectable in the serum of healthy individuals
Markers of cardiac damage
AST, LD, CK-MB, troponin, and myoglobin
What 3 additional markers are utilized to assess the risk of heart disease (increased cardiac risk)?
Homocysteine
Lp(a)
hs-CRP
Atherosclerosis becomes pathogenic with...
the development of atherosclerotic plaques (atheroma), predisposing vasculature to thrombosis, which leads to organ ischemia and infarction
The most common cause of heart failure is
coronary heart disease (CHD)
The most sensitive and specific marker is known as
Troponin
The isoenzyme of CK of interest in Mi is
CK-MB
Which marker is elevated with increased risk of premature coronary heart disease and stroke?
Lipoprotein a (Lp(a))
The major types are classidied on the location for which it occurs...
Cardiovascular disease
(1) coronary heart disease
(2) cerebrovascular disease
(3) peripheral arterial disease
(4) aortic athersclerotic disease
Which cardiac marker is increased in fluid overload disease? (renal failure and CHF)
BNP
The role of Troponin is
to regulate muscle contraction through calcium binding
The first cardiac marker to rise in the event of MI
is known as creatinine kinase
Which marker is a strong predictor of future coronary heart disease and increases with inflammation?
high sensitivity CRP
Ischemic events ranging from angina (no cell death) to acute myocardial infarction (cell death) are classified as
Acute coronary syndrome
What cells secrete CHF marker?
Ventricular muscle cells
The role of Myoglobin is
a heme containing protein which carries oxygen
The isoforms of troponin of clinical interest with MI are
are the cardiac troponins: cTnI and cTnT
Name the risk groups of future CHD according to the AHA and CDC?
hsCRP
Low risk <1.0 mg/L
Average risk: 1.0 - 3.0 mg/L
High risk: > 3.0 mg/L
Risk factors for atherscleorsis include
advanced age, gender, diabetes, and previous history of MI.
What other cardiac enzymes are indicative of heart failure and of prognostic value?
cTnT and cTnI
What may cause elevations of CK-MB other than AMI?
Chronic muscle disease, strenous exercise, and ESRD
Myocarditis, or acute ischemic syndrome, may be detected by plasma...
troponin
Which two plasma biomarkers of cardiac disease are also important in the management of patients at risk for CHD and MI?
CRP and homocysteine
both markers of inflammation - which elevate risks of CHD and MI