Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat producti...Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat production and dissipation in the human body results in excessive body heat storage in cases.It occurs frequently in the military population because of work characteristics such as the requirements to perform essential duties under prolonged heat stress,the need to achieve mission objectives during deployment operations,or the opportunities for training and selection for elite units[2].The pathophysiology of EHS is complex,which often results in thermoregulation failure,hemodynamic disturbance,and endotoxin release,and further causes multiple organ failure,probably increasing myocardial enzymes and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Rhabdomyolysis caused by EHS often results from mechanical and metabolic injury to the striated muscle fibers accompanied with the release of muscle contents into the circulation[3].Liu et al.展开更多
AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV)...AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls. RESULTS: Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as thepatients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.展开更多
Objective:Carbohydrate antigen 125(CA125),which is traditionally used in ovarian cancer diagnostics,is increasingly recognized as a marker of congestion and inflammation in heart failure(HF).This study compared the an...Objective:Carbohydrate antigen 125(CA125),which is traditionally used in ovarian cancer diagnostics,is increasingly recognized as a marker of congestion and inflammation in heart failure(HF).This study compared the analytical performance of N-(4-aminobutyl)-N-ethylisoluminol(ABEI)-based CA125 and N-terminal pro-Btype natriuretic peptide(NT-proBNP)assays on the Maglumi®X6 analyzer with that of the Roche Cobas e602 system and explored the relationship of CA125 with biomarkers of adverse remodeling in HF with reduced ejection fraction(HFrEF).-Methods:Imprecision testing and method comparison were performed on matched serum samples from 108 HFrEF patients.CA125 concentrations were evaluated in relation to the New York Heart Association(NYHA)class,left ventricular ejection fraction(LVEF),galectin-3,and soluble suppression of tumorigenicity 2(sST2)levels.Prognostic value was assessed by Kaplan-Meier survival analysis using the 35 U/mL threshold.Results:The ABEI based CA125 assay showed low imprecision[coefficient of variation(CV)≤4.5%]and strong agreement with the Cobas e602 assay(R=0.97,slope=1.06,P<0.001).CA125 levels increased progressively with NYHA class(P=0.02),correlated negatively with LVEF(R=-0.38,P<0.001)and positively with galectin-3(R=0.21,P=0.03)and sST2(R=0.57,P<0.001).Elevated CA125 levels(≥35 U/mL)were associated with significantly increased cardiovascular mortality(P<0.001).Conclusions:ABEI-based CA125 measurement provides an analytical performance comparable to that of Cobas e602.In HFrEF,CA125 is correlated with clinical severity,fibrosis/inflammation biomarkers,and prognosis.Its integration into multimarker strategies,particularly alongside NT-proBNP and sST2,may enhance risk stratification and therapeutic monitoring,including the response to sodium-glucose cotransporter-2(SGLT2)inhibitor therapy.展开更多
基金supported by the Natural Science Foundation of Hainan Province(821QN389,821MS112,822MS198,820MS126,820QN383)the Military Medical Science and Technology Youth Incubation Program(20QNPY110,19QNP060)+6 种基金the Excellent Youth Incubation Program of Chinese PLA General Hospital(2020-YQPY-007)the Heatstroke Treatment and Research Center of Chinese PLA(413EGZ1D10)the Simulation Training for Treatment of Heatstroke,the Major Science and Technology Programme of Hainan Province(ZDKJ2019012)the National Key Research and Development Program of China(2018YFC2000400)the National S&T Resource Sharing Service Platform Project of China(YCZYPT[2018]07)the Specific Research Fund of Innovation Platform for Academicians of Hainan Province(YSPTZX202216)the Medical Big Data Research and Development Project of Chinese PLA General Hospital(MBD2018030).
文摘Dear Editor,The most serious heat related injury is exertional heat stroke(EHS).EHS occurs when healthy individuals perform physical activity in a hot and humid environment[1].A disrupted balance between heat production and dissipation in the human body results in excessive body heat storage in cases.It occurs frequently in the military population because of work characteristics such as the requirements to perform essential duties under prolonged heat stress,the need to achieve mission objectives during deployment operations,or the opportunities for training and selection for elite units[2].The pathophysiology of EHS is complex,which often results in thermoregulation failure,hemodynamic disturbance,and endotoxin release,and further causes multiple organ failure,probably increasing myocardial enzymes and N-terminal pro-brain natriuretic peptide(NT-proBNP)levels.Rhabdomyolysis caused by EHS often results from mechanical and metabolic injury to the striated muscle fibers accompanied with the release of muscle contents into the circulation[3].Liu et al.
文摘AIM: To evaluate serum levels of N-terminal pro-brain natriuretic peptide (NTproBNP) and tumor necrosis factor α (TNF-α) in a large series of patients with hepatitis C associated with mixed cryoglobulinemia (MC+HCV).METHODS: Serum NTproBNP and TNF-α levels were assayed in 50 patients with MC+HCV, and in 50 sex- and age-matched controls. RESULTS: Cryoglobulinemic patients showed signifi cantly higher mean NTproBNP and TNF-α levels than controls (P < 0.001; Mann-Whitney U test). By defining high NTproBNP level as a value higher than 125 pg/mL (the single cut-off point for outpatients under 75 years of age), 30% of MC+HCV and 6% of controls had high NTproBNP (χ2, P < 0.01). With a cut-off point of 300 pg/mL (used to rule out heart failure (HF) in patients under 75 years of age), 8% of MC+HCV and 0 controls had high NTproBNP (χ2, P < 0.04). With a cut-off point of 900 pg/mL (used for ruling in HF in patients aged 50-75 years; such as thepatients of our study), 6% of MC+HCV and 0 controls had high NTproBNP (χ2, P = 0.08).CONCLUSION: The study demonstrates high levels of circulating NTproBNP and TNF-α in MC+HCV patients. The increase of NTproBNP may indicate the presence of a subclinical cardiac dysfunction.
文摘Objective:Carbohydrate antigen 125(CA125),which is traditionally used in ovarian cancer diagnostics,is increasingly recognized as a marker of congestion and inflammation in heart failure(HF).This study compared the analytical performance of N-(4-aminobutyl)-N-ethylisoluminol(ABEI)-based CA125 and N-terminal pro-Btype natriuretic peptide(NT-proBNP)assays on the Maglumi®X6 analyzer with that of the Roche Cobas e602 system and explored the relationship of CA125 with biomarkers of adverse remodeling in HF with reduced ejection fraction(HFrEF).-Methods:Imprecision testing and method comparison were performed on matched serum samples from 108 HFrEF patients.CA125 concentrations were evaluated in relation to the New York Heart Association(NYHA)class,left ventricular ejection fraction(LVEF),galectin-3,and soluble suppression of tumorigenicity 2(sST2)levels.Prognostic value was assessed by Kaplan-Meier survival analysis using the 35 U/mL threshold.Results:The ABEI based CA125 assay showed low imprecision[coefficient of variation(CV)≤4.5%]and strong agreement with the Cobas e602 assay(R=0.97,slope=1.06,P<0.001).CA125 levels increased progressively with NYHA class(P=0.02),correlated negatively with LVEF(R=-0.38,P<0.001)and positively with galectin-3(R=0.21,P=0.03)and sST2(R=0.57,P<0.001).Elevated CA125 levels(≥35 U/mL)were associated with significantly increased cardiovascular mortality(P<0.001).Conclusions:ABEI-based CA125 measurement provides an analytical performance comparable to that of Cobas e602.In HFrEF,CA125 is correlated with clinical severity,fibrosis/inflammation biomarkers,and prognosis.Its integration into multimarker strategies,particularly alongside NT-proBNP and sST2,may enhance risk stratification and therapeutic monitoring,including the response to sodium-glucose cotransporter-2(SGLT2)inhibitor therapy.
