The aim of this study was to perform a systematic review on the potential value of saliva biomarkers in the diagnosis, management and prognosis of heart failure (HF). The correlation between saliva and plasma values of these biomarkers was also studied. PubMed was searched to collect relevant literature, i.e., case-control, cross-sectional studies that either compared the values of salivary biomarkers among healthy subjects and HF patients, or investigated their role in risk stratification and prognosis in HF patients. No randomized control trials were included. The search ended on 31st of December 2020. A total of 15 studies met the inclusion criteria. 18 salivary biomarkers were analyzed and the levels of all biomarkers studied were found to be higher in HF patients compared to controls, except for amylase, sodium, and chloride that had smaller saliva concentrations in HF patients. Natriuretic peptides are the most commonly used plasma biomarkers in the management of HF. Their saliva levels show promising results, although the correlation of saliva to plasma values is weakened in higher plasma values. In most of the publications, differences in biomarker levels between HF patients and controls were found to be statistically significant. Due to the small number of patients included, larger studies need to be conducted in order to facilitate the use of saliva biomarkers in clinical practice.
Background
Pulmonary embolism (PE) is the third most common cause of cardiovascular death worldwide, after stroke and heart attack. Our purpose was to evaluate the patient's health-related quality of life (HR-QoL) after Acute Pulmonary Embolism (APE) and its association with biochemical and novel echocardiographic parameters of assessment of right ventricle (RV).
Material and methods
Successive patients with diagnosis of APE in a tertiary hospital were included in the study. RV evaluation and biochemical markers, (including Brain Natriuretic Peptide (BNP)) were recorded during hospitalization. HR-QoL was evaluated with the Greek version of the Pulmonary Embolism Quality of Life questionnaire (PEmb-Qol), at 1 and 3 months after the APE. Repeated measures analysis was used to assess changes in the PEmb-QoL dimensions and Pearson correlations to assess the relationships between RV global longitudinal strain (RV GLS) and the dimensions of Pemb-Qol.
Results and conclusions
One hundred consecutive patients were screened; 14 patients were excluded. The study sample consisted of 86 individuals (47 women) aged 69.7 ± 13.4 (mean ± SD) years. The differences between the two time points were statistically significant (P < 0.001) in all dimensions of HR-QoL. At 3 months, the dimensions of social limitations and intensity of complaints showed the highest rate of improvement. RV GLS values were correlated with quality of life in patient with APE (in 3 of the 6 dimensions of Pemb-Qol). While BNP, was related to the “intensity of complaints” dimension of Pemb-Qol,in patients with APE occurred during hospitalization for another reason (PE wasn't the cause of admission).
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