Usefulness of Heart-Type Fatty Acid-Binding Protein and Myocardial Performance Index for Early Detection of 5-Fluorouracil Cardiotoxicity

Turhan, Turan; Ağaç, Mustafa Tarık; Aykan, Ahmet Çağrı; Kul, Selim; Akyüz, Ali Rıza; Gökdeniz, Tayyar; Gül, İlker; Cengiz, Ercüment; Boyacı, Faruk; Erkan, Hakan; Akdemir, Ramazan; Çelık, Şükrü

doi:10.1177/0003319716637516

Cited by 22 publications

(18 citation statements)

References 16 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In clinical patients, angiographic examinations of the coronary arteries have shown that CAS particularly occurs in cases of variant or unstable angina [ 4 , 6 , 7 ]. Heart-type fatty acid-binding protein (h-FABP) and myocardial performance index (Tei index) have recently been proposed to be useful for early detection of ischemia coronary vasospasm induced by 5- Fluorouracil [ 8 ]. At forensic autopsies, the pathological diagnosis of antemortem CAS is difficult due to limitation of specific markers.…”

Section: Introductionmentioning

confidence: 99%

Phosphorylated Myosin Light Chain 2 (p-MLC2) as a Molecular Marker of Antemortem Coronary Artery Spasm

Lin

et al. 2016

Med Sci Monit

View full text Add to dashboard Cite

BackgroundIt is not uncommon that only mild coronary artery stenosis is grossly revealed after a system autopsy. While coronary artery spasm (CAS) is the suspected mechanism of these deaths, no specific biomarker has been identified to suggest antemortem CAS.Material/MethodsTo evaluate the potential of using phosphorylated myosin light chain 2 (p-MLC2) as a diagnostic marker of antemortem CAS, human vascular smooth muscle cells (VSMCs) were cultured and treated with common vasoconstrictors, including prostaglandins F2α (PGF2α), acetylcholine (ACh), and 5-hydroxy tryptamine (5-HT). The p-MLC2 level was examined in the cultured cells using Western blot analysis and in a rat model of spasm provocation tests using immunohistochemistry (IHC). Effects of increased p-MLC2 level on VSMCs contractile activities were assessed in vitro using confocal immunofluorescence assay. Four fatal cases with known antemortem CAS were collected and subject to p-MLC2 detection.ResultsThe p-MLC2 was significantly increased in VSMCs after treatments with vasoconstrictors and in the spasm provocation tests. Myofilament was well-organized and densely stained in VSMCs with high p-MLC2 level, but disarrayed in VSMCs with low p-MLC2 level. Three of the 4 autopsied cases showed strongly positive staining of p-MLC2 at the stenosed coronary segment and the adjacent interstitial small arteries. The fourth case was autopsied at the 6th day after death and showed negative-to-mild positive staining of p-MLC2.Conclusionsp-MLC2 might be a useful marker for diagnosis of antemortem CAS. Autopsy should be performed as soon as possible to collect coronary arteries for detection of p-MLC2.

show abstract

Section: Introductionmentioning

confidence: 99%

Phosphorylated Myosin Light Chain 2 (p-MLC2) as a Molecular Marker of Antemortem Coronary Artery Spasm

Lin

et al. 2016

Med Sci Monit

View full text Add to dashboard Cite

show abstract

“…This might be due to lack of power but may also suggest that myocyte injury is uncommon and only occurs in severe cases of cardiotoxicity. Prior studies of troponin levels during 5-FU treatment have shown comparable findings, with no change in troponin during treatment [17][18][19][20][21]. However, the number of patients included in the individual studies of troponin levels during 5-FU treatment was small (n = 22-59).…”

Section: Discussionmentioning

confidence: 90%

Myocardial Ischemia Induced by 5-Fluorouracil: A Prospective Electrocardiographic and Cardiac Biomarker Study

et al. 2020

View full text Add to dashboard Cite

Background. Cardiotoxicity induced by 5-fluorouracil (5-FU) is well known but poorly understood. In this study, we undertook ECG recording (Holter) and analyses of the biomarkers troponin and copeptin in patients receiving 5-FU to increase our understanding of the cardiotoxicity. Subjects, Materials, and Methods. Patients with colorectal or anal cancer that received first-time treatment with 5-FUbased chemotherapy were prospectively included. Holter recording, clinical evaluation, 12-lead electrocardiogram, and assessment of plasma concentrations of troponin I and copeptin were performed before (control) and during 5-FU treatment (intervention). Results. A total of 108 patients were included, 82 with colorectal and 26 with anal cancer. The proportion of patients with myocardial ischemia on Holter recording was significantly higher during the first 5-FU infusion (14.1%) than before (3.7%; p = .001). The ischemic burden per day (p = .001), the number of ST depression episodes per day (p = .003), and the total duration of ischemic episodes per day (p = .003) were higher during the first 5-FU infusion than before, as was plasma copeptin (p < .001), whereas plasma troponin I was similar (p > 0.999). Six patients (5.6%) developed acute coronary syndromes and two (1.8%) developed symptomatic arrhythmias during 5-FU treatment. Conclusion. 5-FU infusion is associated with an increase in the number of patients with myocardial ischemia on Holter recording. According to biomarker analyses, 5-FU is associated with an increase in copeptin, but rarely with increases in cardiac troponin I. However, 5%-6% of the patients developed acute coronary syndromes during treatment with 5-FU.

show abstract

“…Relationship between a positive fluid balance when in intensive care unit and possible development of postoperative period complications (A) and atrial fibrillation (B) in patients after coronary artery bypass grafting on a beating heart фузионная программа при недооценке диастолической дисфункции ЛЖ сопровождается повышением гид-робаланса в раннем послеоперационном периоде, что приводит к осложненному течению послеоперацион-ного периода, в том числе пароксизмам фибрилляции предсердий. Индекс производительности миокарда изучается у пациентов с коронарной патологией и пороками сер-дца; он используется для оценки кардиотоксичности при химиотерапии [22], выявлении дисфункции мио-карда при сахарном диабете [23], а также полезен при трансплантации сердца как до операции, так и при диагностике отторжения трансплантата [24]. Нами об-наружена взаимосвязь Tei-индекса с vTIвтлж как сурро-гатным показателем ударного объема, иными словами, повышение производительности миокарда приводит к повышению ударного объема и, следовательно, сер-дечного выброса.…”

Section: Discussionunclassified

Predictors of complications when transferring postoperative cardiac patients from the intensive care unit

Paromov¹,

Kirov²

2017

PKiK

View full text Add to dashboard Cite

Aim. Emphasis in the study was placed on the evaluation of predictors of complications when transferring postoperative cardiac patients from the intensive care unit (ICU). Methods. 60 patients after cardiac surgery were included into this prospective observational study, with 41 of them undergoing off-pump coronary artery bypass grafting (CABG). Before the transfer from ICU, echocardiographical criteria of their systolic and diastolic dysfunction, parameters of oxygenation, hemodynamic and metabolism status, as well as postoperative complications and duration of hospitalization were evaluated. Results. Preoperatively, the patients had a moderate degree of heart failure and preserved ejection fraction. Those patients who had undergone valvular and combined procedures using cardiopulmonary bypass had higher Euroscore II values, more severe heart failure, prolonged duration of surgery, respiratory support and hospitalization in ICU and in hospital. The echocardiographical criteria of diastolic dysfunction before transfer from ICU were recorded in 14-77% patients. Despite a normal range of blood pressure, the systolic function of the left ventricle and preload (left atrial pressure), oxygenation and metabolic status, venous to arterial carbon dioxide difference (Pv-aCO2) and left ventricle performance index (Tei) exceeded the normal values before transfer from ICU. The correlation analysis revealed a relationship between duration of ICU and hospital stay and the criteria of heart failure severity (left atrial pressure [rho = 0.27, 95% CI 0.02–0.48, p = 0.04]) and left ventricle dysfunction (e’ [rho = 0.41, 95% CI 0.17–0.59, p<0.01]) before the transfer. The increase in fluid balance during ICU stay after off-pump coronary artery bypass surgery tended to result in a complicated postoperative period (AUC = 0.73, p = 0.02) and a higher risk of atrial fibrillation. Conclusion. The impairment of the left ventricle diastolic function before transferring from ICU correlates with the duration of hospitalization. A positive fluid balance during ICU period after off-pump surgery might bring about postoperative complications and atrial fibrillation, thus predicting their onset.Received 5 April 2017. Revised 10 August 2017. Accepted 15 August 2017.Funding: The study did not have sponsorship.Conflict of interest: The authors declare no conflict of interest.Acknowledgement The authors express their gratitude for patience and support during the study to the staff of Cardiac Surgery Department and Resuscitation Department.

show abstract

Usefulness of Heart-Type Fatty Acid-Binding Protein and Myocardial Performance Index for Early Detection of 5-Fluorouracil Cardiotoxicity

Cited by 22 publications

References 16 publications

Phosphorylated Myosin Light Chain 2 (p-MLC2) as a Molecular Marker of Antemortem Coronary Artery Spasm

Phosphorylated Myosin Light Chain 2 (p-MLC2) as a Molecular Marker of Antemortem Coronary Artery Spasm

Myocardial Ischemia Induced by 5-Fluorouracil: A Prospective Electrocardiographic and Cardiac Biomarker Study

Predictors of complications when transferring postoperative cardiac patients from the intensive care unit

Contact Info

Product

Resources

About