Tag Archives: biomarkers

MicroRNAs as Biomarkers and Therapeutic Targets in Heart Failure

DOI: 10.2478/amma-2019-0016

Heart failure still represents a real challenge both in everyday practice and research, due to the complex issues related to its pathogenesis and management. Humoral biomarkers have emerged in the last decades as useful tools in the diagnosis, risk stratification and guiding the treatment of heart failure. These molecules are related to different pathological and adaptive processes, like myocardial injury, neurohormonal activation and cardiac remodeling, their most widespread representatives being the natriuretic peptides (e.g. NT-proBNP). The role of altered gene expression and transcription as the basis of myocardial structural and functional changes in heart failure is largely recognized. MicroRNAs (miRNAs) are non-coding RNAs which have a major role in post-transcriptional gene expression by interfering with messenger RNA molecules. Our short review summarizes the molecular biology of miRNAs and their possible role as biomarkers in the diagnosis and prognosis of heart failure. Furthermore, the therapeutical perspectives conferred by these molecules are also presented.
Keywords: miRNA, biomarkers, heart failure

Full text: PDF

The Value of a Simplified Lung Ultrasound Protocol in the Pre-Discharge Evaluation of Patients Hospitalized with Acute Heart Failure

DOI: 10.1515/amma-2016-0039

Optimal timing of hospital discharge in patient with acute heart failure (AHF) is an important factor of preventing rehospitalizations.
Aim. To evaluate the value of a simplified lung ultrasound (LUS) protocol in assessing pre-discharge status of patients with AHF, correlating the US findings with the values of NT-proBNP levels.
Methods. 24 patients (18 men, 6 women, mean age 68,2 years) hospitalized with acute heart failure underwent LUS examination in the afternoon of the day before hospital discharge, applying a simplified LUS protocol, using three basal examination areas on the right side (anterior, lateral and posterior) and two basal examination areas on the left side (lateral and posterior). The LUS score was represented by the sum of B lines. In the next morning the value of NT-proBNP was also determined. The correlation between LUS findings and NT-proBNP values was analyzed using Fisher`s exact test (significant if alpha<0,05).
Results. 6 patients had <15 B lines, 16 patients had >15 B lines and 2 patients had pleural effusion on LUS, while 16 patients had the value of NT-proBNP >1000pg/ml at discharge. The results of LUS examination correlated significantly (p=0.0013) with the NT-proBNP values – only one patient not having increased NT-proBNP in the group with >15 B lines.
Conclusions. Despite a relatively good clinical status, the majority of patients had high NT-proBNP values at the time of hospital discharge. LUS proved to be a useful tool in identifying patients with subclinical congestion reflected also by the high NT-proBNP levels. These patients may need a prolongation of hospitalization and/or a more careful follow-up to prevent early readmission.

Full text: PDF

TNF-α and MMP-8 as Biomarkers for Diagnosing Knee Cartilage Lesions — Preliminary Results

Objective: To analyse the correlations between the levels of Tumor Necrosis Factor α, Matrix Metalloproteinase 8, Interleukin 6 and the presence of cartilage lesions in the knee.
Methods: We studied 79 individuals divided in three groups – a group with cartilage lesions, a group with meniscal lesions and a control group. All patients underwent arthroscopic surgical interventions – either diagnostic or therapeutic. Venous blood samples and synovial fluid samples were obtained and we determined the levels of TNF-α, MMP-8 and IL-6 respectively. All study participants filled out the International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Score questionnaire, based on which the IKDC score was calculated.
Results: we found higher levels of MMP-8 in both serum and synovial fluid for groups 1 and 2 compared to the control group, but no correlation between the serum and synovial fluid levels of MMP-8. The serum MMP-8 levels showed a significant negative correlation with the highest level of activity without pain and significant giving way. The synovial MMP-8 could be correlated to the IKDC score. Serum levels and synovial levels of TNF-α were in strong correlation. We found no association between serum and/or synovial TNF-α and MMP-8 levels.
Conclusions: We found that synovial MMP-8 concentrations showed a reverse correlation with the IKDC scores (an activity-based score) – thus MMP-8 might be a diagnostic and prognostic marker in knee osteoarthritis.

Full text: PDF