Biochemical Markers of Cardiac Injury in Normal, Surviving Septic, or Nonsurviving Septic Neonatal Foals

Abstract

The cardiac biomarkers cardiac troponin T (cTnT) and I (cTnI) and the cardiac isoenzyme of creatine kinase (CKMB) are used extensively in human medicine to diagnose and provide valuable prognostic information in patients with ischemic, traumatic, and septic myocardial injury. We designed a study to establish normal values for these markers in healthy, neonatal foals and to compare them with values obtained from septic neonates in a referral hospital population. The 25th, 50th, 75th, and 95th percentiles for cTnI and CKMB in the healthy-foal population were 0.08, 0.14, 0.25, 0.49 ng/mL and 1.4, 2.3, 4.0, 7.4 ng/mL, respectively. The values obtained for cTnT were frequently (43/52 foals; 83%) below the lower limit of detection of the assay (0.009 ng/mL), but the median and range were 0.009 and 0.009-0.041 ng/mL, respectively. In the septic foal population, the 25th, 50th, 75th, and 95th percentile values for cTnI and CKMB were 0.05, 0.12, 0.22, and 1.10 ng/mL and 2.0, 4.4, 7.8, and 24 ng/mL, respectively. The values obtained for cTnT were less frequently below the lower limit of detection (23/38 foals; 60%) compared with the healthy foal population, and the median and range were 0.009 and 0.009-0.20 ng/mL, respectively. Significantly higher values were observed for cTnT and CKMB in septic foals compared with the healthy neonatal foal population, but there were no differences among septic foals in survivors compared with nonsurvivors. These findings suggest that myocardial injury occurs during septicemia in neonatal foals but that the injury is not associated with survival among septic foals.

Estudo da isoenzima creatina quinase CKMB sérica em equinos de enduro após exercício físico prolongado

“…Os valores medianos da isoenzima CKMB observados para os grupos controle (2,25 ng/mL), grupo 1 (2,95 ng/mL), grupo 2 (1,95 ng/mL) e grupo 3 (2,40 ng/mL) (Tabela 1 e Figura 1A) são semelhantes aos relatados para potros hígidos com mediana 2,3 ng/mL e 1 o e 3 o quartis, respectivamente 1,3 e 4,0 ng/mL observados por Slack et al 12 , mas maiores que aqueles observados em dois cavalos hígidos (<0,7 ng/mL) por Cornelisse et al 11 . Esta disparidade de valores pode ser devida às diferentes metodologias: enquanto os autores citados 11 utilizaram kit de imunoensaio enzimático (ELISA), empregou-se neste estudo a técnica de imunoquimioluminescência.…”

Marcadores cardíacos na medicina veterinária

“…O aumento de seus níveis foi descrito em cães com cardiomiopatia dilatada (OYAMA & SISSON, 2004), trauma cardíaco (SCHOBER et al, 1999;DINIZ et al, 2007), infarto (RICCHIUTI et al, 1998) (LOBETTI et al, 2002). Em gatos, níveis elevados de cTnI foram descritos em casos de cardiomiopatia hipertrófica (HERNDON et al, 2002) e em equinos, em lesão por ruptura da válvula aórtica (CORNELISSE et al, 2000), taquicardia ventricular e necrose miocárdica (SCHWARZWALD et al, 2003), sepse neonatal (SLACK et al, 2005), babesiose (DIANA et al, 2007), intoxicação por monensina e cardiopatia (PEEK et al, 2004).…”

Supportive care for the critically ill neonatal foal

“…Cardiac contractility may also be reduced in compromised neonates, additionally decreasing CO. There is some evidence that myocardial injury occurs in septic foals, based on increased serum cardiac troponin T (cTNT) and the cardiac isoenzyme of creatine kinase (CKMB) concentrations found in septic foals (Slack et al 2005). Although no measures of cardiac function were reported in this study, it is conceivable that cardiac performance is negatively affected in these animals.…”