The role of biomarkers of stress in heart failure

According to the literature, there are numerous stress biomarkers. However, for the first time, this review article summarizes the role of major physiological stress biomarkers in heart failure collectively which include chromogranin A, catecholamines, copeptin, cortisol, liver-type fatty acid-binding protein (L-FABP), superoxide dismutase (SOD) and catalase, fibrinogen, malondialdehyde, heat shock proteins. Chromogranin A (CgA) serum levels are increased in patients with chronic heart failure and are a predictive factor for mortality. A novel mechanistic insight for elevated catecholamine levels in plasma commonly seen in chronic heart failure (HF) conditions, suggests that increased trans-synaptic activation of the chromaffin cells within the adrenal medulla may increase catecholamines in the circulation and, in turn, contribute to the enhanced neurohumoral drive. Elevated copeptin plasma concentrations seen in HF patients were linked to an increased risk of all-cause death suggesting that copeptin may function as an HF outcome predictor. Since cortisol is a general stress indicator, serum cortisol levels in congestive heart failure (CHF) may reflect worse hemodynamic parameters and systemic sympathetic nerve activity. In individuals with acute heart failure, an elevated urine L-FABP level before therapy may indicate worsening renal function. Compared to children without heart failure, children with heart failure have decreased levels of SOD. In contrast to children without heart disease, children with heart failure had greater catalase (CAT) levels. In children with left-to-right shunt congenital heart disease (CHD), oxidative stress was the primary factor contributing to the development of heart failure. The individuals with acute aggravation of chronic heart failure who have high fibrinogen levels ( >  284 mg/dL) were independently predicted to die. Malondialdehyde is a sign of lipid peroxidation which was detected in the plasma of congestive heart failure patients with varied levels of clinical symptoms and in healthy individuals. HSPs can reduce heart dysfunction in HF and carry out a variety of additional functions, including regulating apoptosis and possessing anti-oxidant and anti-inflammatory properties

The role of inflammatory biomarkers in the arterial hypertension

Studies on both humans and animals have found evidence of a link between inflammation and hypertension (HTN). A lower serum calprotectin level was found to be independently related to HTN. The elevated ferritin–HTN link could be mediated by fatty liver disease and insulin resistance (IR). Similarly, fibrinogen was engaged in several processes that may increase the risk of HTN which including hemostasis, coagulation, and the proliferation of smooth muscle cells in the artery wall, and others. Procalcitonin monitoring could be a useful biomarker in inflammation related to atherosclerosis and early-stage HTN. Plasminogen activator 1 (PAI-1) was not just a result of HTN but also contributes to its development. Also, the positive correlation between monocyte chemoattractant protein 1 (MCP-1) levels with blood pressure were found among smokers. The high level of pentraxin 3 (PTX3) was one of the factors of increased blood pressure. Galectin 3 (Gal-3) may contribute to the onset and progression of diastolic dysfunction-complicated HTN. Increased intercellular adhesion molecules (ICAM)/vascular cell adhesion molecule 1 (VCAM-1) ligand expression, along with a drop in soluble cell adhesion molecules (sCAMs) and endocan, points to endothelium deactivation with lower blood pressure, which reduces the adherence of circulatory leukocytes to endothelium and, as a result, lowers the probability of atherosclerosis developing. The circulating levels of soluble VCAM-1 were substantially connected with left ventricular mass indexes (LVMIs) and were higher in uncomplicated essential hypertension (EH) patients with left ventricle (LV) hypertrophy than in those without LV hypertrophy.

Biomarkers of Metabolic Syndrome in Cardiomyopathy: A Leading Cause of Heart Failure

Cardiomyopathy is a disease of the heart muscle, which makes the muscles harder to pump blood to the rest of the body leading to heart failure. The main types of cardiomyopathies include dilated cardiomyopathy, hypertrophic cardiomyopathy, ischemic cardiomyopathy, arrhythmogenic right ventricular dysplasia, restrictive cardiomyopathy, and Takotsubo cardiomyopathy. On the other hand, Metabolic syndrome (MetS) is the clustering of different medical conditions, which requires at least three of the five following diseases. These diseases are high blood sugar, high blood pressure, high serum triglycerides, low serum high-density lipoprotein, and central obesity. The risk of developing type 2 diabetes and cardiovascular disease associated with metabolic syndrome. In MetS, many different biomarkers are used in the early detection and risk stratification of MetS patients. It includes adiponectin, leptin, interleukin 6, tumor necrosis factor-alpha, uric acid, interleukin 10, ghrelin, adiponectin, paraoxonase, oxidized low-density lipoprotein, and plasminogen activator inhibitor-1. This chapter provides an overview and focuses on the basic role of major biomarkers of metabolic syndrome in the pathogenesis of different types of cardiomyopathies, which mainly highlights recent pathophysiological aspects in the development and progress of cardiomyopathy which is the leading cause of heart failure. In conclusion, biomarkers of metabolic syndrome play a significant role in the development and progress of cardiomyopathy which is the leading cause of heart failure

Pathogenesis of hematological parameters in hypertension

Hypertension, which is a significant risk factor for cardiovascular disease, is often assessed in clinical settings using reference ranges for various haematological and immunological parameters. Research has indicated that specific haematological parameters, such as red blood cells, red cell distribution width, mean cellular/corpuscular haemoglobin, mean cellular/corpuscular haemoglobin concentration, haemoglobin, hematocrit, mean cellular/corpuscular volume, platelet count, white blood cells, basophils, lymphocytes, neutrophils, monocytes, eosinophils, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, have a role to play in the development of hypertension. This review article focuses explicitly on the pathophysiological aspects of haematological parameters in the pathogenesis of hypertension

Association patterns of Atrial Fibrillation with symptoms of metabolic syndrome

Background: Atrial fibrillation (AF) is the common cardiac arrhythmia in which heart beats irregularly usually greater than 100 beats per minutes. AF is well-documented public health problem causing substantial mortality and morbidity. Metabolic syndrome (MS) is a collection of metabolic risk factors like diabetes, hypertension, dyslipidemia, obesity and impaired glucose level that exists in one person. The aim of the present study is to find the relation between AF and MS.Methods: 100 patients of AF were sampled from Punjab Institute of Cardiology, Lahore from December, 2014 to June 2015. These patients were divided into two AF groups, 50 without MS and 50 with MS. 25 healthy subjects were also included for the comparison. Lipid profile was assessed by chemistry analyzer and serum insulin was measured by ELISA.Results: In our population, there was significantly high levels of insulin resistance (IR) and obesity in AF groups (without MS and with MS) as compared with healthy subjects (P<0.05). Highly significant differences was observed in relation with other parameters e.g. hypertension, hypertriglyceridemia, HDL-C among the studied groups (P<0.05). Significant positive correlation was observed between insulin and lipid profile (TC, TG, LDL) while inverse with HDL.Conclusion: The indictors of metabolic syndrome were significantly correlated with AF in the studied subjects, while IR was found significantly higher in MS group.

Role of liver parameters in diabetes mellitus – a narrative review

Diabetes mellitus is characterized by hyperglycemia and abnormalities in insulin secretion and function. This review article focuses on various liver parameters, including albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), alpha fetoprotein (AFP), alpha 1 antitrypsin (AAT), ammonia, bilirubin, bile acid, gamma-glutamyl transferase (GGT), immunoglobulin, lactate dehydrogenase (LDH), and total protein. These parameters play significant roles in the development of different types of diabetes such as type 1 diabetes (T1DM), type 2 diabetes (T2DM) and gestational diabetes (GDM). The article highlights that low albumin levels may indicate inflammation, while increased ALT and AST levels are associated with liver inflammation or injury, particularly in non-alcoholic fatty liver disease (NAFLD). Elevated ALP levels can be influenced by liver inflammation, biliary dysfunction, or bone metabolism changes. High bilirubin levels are independently linked to albuminuria in T1DM and an increased risk of T2DM. Elevated GGT levels are proposed as markers of oxidative stress and liver dysfunction in T2DM. In GDM, decreased serum AFP levels may indicate impaired embryo growth. Decreased AFP levels in T2DM can hinder the detection of hepatocellular carcinoma. Hyperammonemia can cause encephalopathy in diabetic ketoacidosis, and children with T1DM and attention deficit hyperactivity disorder often exhibit higher ammonia levels. T2DM disrupts the regulation of nitrogen-related metabolites, leading to increased blood ammonia levels. Bile acids affect glucose regulation by activating receptors on cell surfaces and nuclei, and changes in bile acid metabolism are observed in T2DM. Increased LDH activity reflects metabolic disturbances in glucose utilization and lactate production, contributing to diabetic complications. Poor glycemic management may be associated with elevated levels of IgA and IgG serum antibodies, and increased immunoglobulin levels are also associated with T2DM

The Association between Coagulation and Atrial Fibrillation

The existing literature highlights the presence of numerous coagulation factors and markers. Elevated levels of coagulation factors are associated with both existing and newly diagnosed cases of atrial fibrillation (AF). However, this article summarizes the role of coagulation in the pathogenesis of AF, which includes fibrinogen and fibrin, prothrombin, thrombomodulin, soluble urokinase plasminogen activator receptor, von Willebrand factor, P-selectin, D-dimer, plasminogen activator inhibitor-1, and platelet activation. Coagulation irregularities play a significant role in the pathogenesis of AF

Association of adiponectin gene expression with atrial fibrillation in a Pakistani populace

Abstract Adiponectin, an adipocytokine produced and secreted by adipose tissue, has anti-diabetic, anti-atherogenic, and anti-inflammatory properties. This case-control study was aimed to assess the expression and serum levels of adiponectin in subject suffereing from atrial fibrillation (AF). The study's subjects (n = 690) were enrolled from the Punjab Institute of Cardiology, Lahore and were grouped into control, AF without Metabolic syndrome (MetS), and AF with MetS groups. Along with the collection of demographic data, an analysis of adiponectin and biochemical parameters were performed. A highly significant difference in serum levels of adiponectin was observed among the control, AF without MetS, and AF with MetS groups (61.61 ± 45.30 ng/ml, 37.20 ± 19.46 ng/ml, 63.78 ± 61.69 ng/ml). The expression analysis of adiponectin was decreased (n-fold = ̴ 0.30) in AF without MetS group as compared to control group (n-fold =  ~ 1.16) but increased in AF with MetS group (n-fold = ̴ 6.26). The correlation analysis revealed a highly significant positive relationship between the expression of the adiponectin gene with waist-to-hip ratio (WHR) in AF without MetS group. Whereas, serum adiponectin was negatively related to serum triglycerides (TG) in AF with MetS group. In multiple regression analysis using adiponectin expression as the dependent variable, WHR was a determinant in AF without MetS. Whereas, when serum adiponectin was used as the dependent variable, serum TG was the determinant in group AF with MetS. The present study implicates that decreased expression and serum levels of adiponectin were associated with the development of AF in which WHR and serum TG also contributed towards the onset of atrial fibrillation