Serological diagnostics of myocardium diseases based on multivariate analysis of cardiotrophic autoantibodies' profiles

ABSTRACT We analyzed profiles of IgG autoantibodies to 16 cardiac specific proteins and their main immunogenic region B-epitopes, in the groups of already verified cardiac pathology: acute and chronic lymphocytic myocarditis, ST elevation myocardial infarction, postinfarction remodeling of myocardium, dilated cardiomyopathy and in healthy controls along with patients, suffered from gastritis (to evaluate immune response against cross-reactive B-epitopes). AAB specific patterns allowed us to distinguish cases among themselves by means of multiparametrical canonical discriminant analysis in approximately 95% of cases. Positive predictive value in the group of MYO reached 95%, in the STEMI-89%, in the PIR-99%, in the DCM-99%, in the group of gastritis-88%. Principal component analysis of mentioned cardiac pathologies extended current clinical knowledge of their immunopathogenesis. Obtained data markedly proved a usability of serum AAB profiling for non invasive screening, differential diagnostics and working hypothesis composition

Simple Predictors for Cardiac Fibrosis in Patients with Type 2 Diabetes Mellitus: The Role of Circulating Biomarkers and Pulse Wave Velocity

Cardiac fibrosis is the basis of structural and functional disorders in patients with diabetes mellitus (T2DM). A wide range of laboratory and instrumental methods is used for its prediction. The study aimed to identify simple predictors of cardiac fibrosis in patients with T2DM based on the analysis of circulating fibrosis biomarkers and arterial stiffness. The study included patients with T2DM (n = 37) and cardiovascular risk factors (RF, n = 27) who underwent ECHO, cardiac magnetic resonance imaging (MRI), pulse wave analysis (PWV), reactive hyperemia (RH), peripheral arterial tonometry, carotid ultrasonography, and assessment of serum fibrosis biomarkers. As a control group, 15 healthy subjects were examined. Left ventricular concentric hypertrophy was accompanied by an increased serum galectin-3 level in T2DM patients. There was a relationship between the PICP and HbA1c levels in both main groups (R2 = 0.309; p = 0.014). A negative correlation between PICP level and the global longitudinal strain (GLS) was found (r = −0.467; p = 0.004). The RH index had a negative correlation with the duration of diabetes (r = −0.356; p = 0.03), the carotid-femoral PWV (r = −0.371; p = 0.024), and the carotid intima-media thickness (r = −0.622; p < 0.001). The late gadolinium-enhanced (LGE) cardiac MRI was detected in 22 (59.5%) T2DM and in 4 (14.85%) RF patients. Diabetes, its baseline treatment with metformin, HbA1c and serum TIMP-1 levels, and left ventricle hypertrophy had moderate positive correlations with LGE findings (p < 0.05). Using the multivariate regression analysis, increased TIMP-1 level was identified as an independent factor associated with cardiac fibrosis