Suzuki et al Biomarkers of Acute Diseases.pdf (1.6 MB)
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Biomarkers of acute cardiovascular and pulmonary diseases

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journal contribution
posted on 15.07.2016, 10:13 by Toru Suzuki, Alexander Lyon, Rajeev Saggar, Liam M. Heaney, Kenichi Aizawa, Antonio Cittadini, Ciro Mauro, Rodolfo Citro, Giuseppe Limongelli, Francesco Ferrara, Olga Vriz, Andrew Morley-Smith, Paolo Calabrò, Eduardo Bossone
Acute cardiothoracic and respiratory diseases frequently remain a challenge to diagnose and differentiate in the emergency setting. The main diseases that manifest with chest pain include ischaemic heart disease, myocarditis, acute pericarditis, aortic dissection/rupture and pulmonary embolism (PE). Diseases that primarily present with dyspnoea include heart failure (HF), acute respiratory distress syndrome (ARDS), pneumonia, asthma exacerbations and chronic obstructive pulmonary disease. Pre-test probabilities of clinical findings play a vital part in diagnostic decisions, and the use of a Bayesian approach to these greatly improves the ability to stratify patients more accurately. However, blood tests (biomarkers) are increasingly used to assist in rapid decision-making in the emergency setting in combination with imaging methods such as chest radiograph, ultrasound and increasingly computed tomography, as well as physiological tests such as the electrocardiogram in addition to physical examination. Specific tests for ischaemic heart disease and myocarditis (cardiac troponins), HF (B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP)), aortic dissection (smooth muscle markers) and PE (D-dimer) have been developed. Surfactant protein-D and interleukin-8 have been developed for ARDS. Additionally, circulating microRNAs have emerged as promising biomarker candidates in cardiovascular disease. With this increasing array of biochemical markers to aid in the diagnosis of chest diseases presenting with chest pain and dyspnoea, we herein review the clinical usefulness of these markers, in particular in differentiating cardiac from pulmonary diseases. A symptom-oriented assessment as necessary for use in the critical setting is described in addition to discussion of individual biomarkers.

History

Citation

European Heart Journal: Acute Cardiovascular Care, 2016, 5 (5), pp. 416-433

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

AM (Accepted Manuscript)

Published in

European Heart Journal: Acute Cardiovascular Care

Publisher

SAGE Publications on behalf of European Society of Cardiology, Acute Cardiac Care Working Group

issn

2048-8726

eissn

2048-8734

Acceptance date

10/05/2016

Copyright date

2016

Available date

24/05/2017

Publisher version

http://acc.sagepub.com/content/5/5/416

Language

en

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