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Study of some Cardiac Biomarkers and Oxidative Stress markers in Patients with Acute coronary syndromes

Authors: Kismat M .Turki --- Ala’a G. Hussein --- Mohammed O. Hamzah
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2011 Volume: 4 no 2 Issue: 10 Pages: 1102-1108
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Acute Coronary Syndromes (ACS) represents a pathological, diagnostic, and risk continuum from unstable angina through myocardial infarction (MI) with or without ST-segment elevation. These three conditions share a very similar pathology, although treatment differs. Elevated markers of inflammation, in particular hs-CRP, are associated with an increased risk of future cardiovascular events in healthy subjects, Increased oxidative stress and the generation of the free oxygen radicals can result in modification of LDL to oxidized LDL that could lead to atherosclerotic lesions, Elevated levels of CK-MB have been regarded as biochemical markers of myocyte necrosis.Objective: The aim of this study was to investigate the predictive value of CK-MB and oxidative stress (MDA) in acute coronary syndromes.Patients and Methods: One hundred one (101) cardiac patients were admitted to the coronary care unit, Ibn alnafees Hospital and Al kindy Hospital over the period July 2009 and March 2010 with the clinical diagnosis of acute coronary syndrome their ages range was (24-84) years, the number of male was (65) (64.36%) and female was (37) (36.63%).39 healthy control (age, sex, matched) were enrolled in this study. All cardiac patients have routine ECG, cardiac biomarkers measurements especially(CK-MB), serelogical markers (hs-C-RP),lipid profile test and oxidative stress markers(MDA).10 ml of blood needed for assessment of the above makers.Results: Oxidative Stress and Cardiac Biomarkers in Patients with Acute Coronary Syndromes (ACS) 101 were found significantly high in patients with ACS as compared to healthy subjects but significantly decreased in HDL-cholesterol in ACS patients as compared to healthy controls. ACS is associated with greater than normal lipid peroxidation.Conclusion: Our study shows a significantly increase in lipid peroxidation and cardiac biomarkers in the circulation of patients with ACS. A significant decrease level of HDL-C were observes only in ACS patients. These finding suggest these biomarkers may be useful diagnosis of patients with ACS.


Article
Echocardiographic Estimation of Infarct Size By Using Cardiac Biomarkers (Troponin I,CK And CK-MB) And Some Hematological Changes in Patients With STEMI

Authors: Muhammad O. Al-Muhammadi --- Muneam M. AL-Shawk --- Hassan Y. Ali
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2014 Volume: 11 Issue: 3 Pages: 528-538
Publisher: Babylon University جامعة بابل

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Abstract

Background: Severity of infarction in ST segment elevation MI (STEMI) is clinically important so early determination of infarct size by using non- invasive ,non-coasty imaging modalities is a key to assessing the future risk of patients and instructive for optimization of therapeutic strategies. Aims of the study: 1-To evaluate the efficacy of echocardiographic examination in estimation of extension and severity of infarction in ST segment elevation MI (STEMI) and its relationship with cardiac biomarkers and some heamatological changes.2-To find out the relationship between these biomarkers and post STEMI complications .Materials & Methods: The study lasted from 23th ∕ October/2012 to 28th ∕ May / 2013 in AL-Zahraa teaching hospital in Kerbala city There are 92 (56± 13 years old) patients and 86 (50 ± 12 years old) healthy controls are taken in this study. ECG and echocardiographic study of wall motion abnormality had been done for each one as well as serum cardiac biomarkers as cardiac troponin I (cTRI) , Creatine kinase (CK) and creatine kinase myocardial band (CKMB) also hematological ayalysis (WBC,ESR & platelet count) . The patients are classified into 3 groups (G1,G2 &G3) according to wall motion score index (WMSI): G1 WMSI (>2) MI ; G2 WMSI (1.7-2) and G3 WMSI (<1.7) to estimate the extension of myocardial injury .Results: Cardiac biomarkers study , serum cTRI ; CK and CK-MB showed that there was high significant increment in relation to severity of infarction (p<0.01) assessed by WMSI . Our result revealed that there was strong relationship between both serum cTRI and CK-MB concentration and acute complications developed in ST-elevation MI ,statistically reaching (P<0.01) and (p<0.05) respectively. Hematological showed highly significant (p<0.01) increase in the levels of platelet count according to the severity of infarction (G 1,G2 and G 3) while the total white blood cells (WBC)count and erythrocyte sedimentation rate (ESR) showed significant (p<0.01) increment in group 1 and group 3 only.Conclusion: In patients with STEMI echocardiographic examination of left ventricle wall motion abnormalities and calculate WMSI reveal good estimation of severity and extension of infarction which is assessed by increment of cardiac biomarkers .presence of acute complications as arrhythmias which is associated with increase in serum biomarker concentration give us a clue about adverse prognosis of MI.

تعتبر خطورة احتشاء عضلة القلب نوع( ستيمي) ذات اهمية سريرية عالية لذلك يكون الكشف المبكر لحجم الاحتشاء باستخدام الوسائل الغير مخترقة والغير مكلفة هي المفتاح لتقييم الخطورة المستقبلية لهولاء المرضى والوصف لستراتيجيات الشفاء و تهدف هذه الدراسة الى تقييم فعالية فحص القلب بالأمواج فوق الصوتية (الإيكو) في استنتاج امتداد و شدة احتشاء عضلة القلب و علاقتها مع الكيموحيويات القلبيه وكذلك مع بعض التغيرات الدموية.استغرقت مدة الدراسة من بداية شهر تشرين الاول 2012 ولغاية نهاية ايار 2013و إشتملت على 92 مريضآ باحتشاء عضلة القلب و 86 ممن هم اصحاء كمجموعة سيطرة. وقد اجريت الدراسة على المرضى الذين راجعوا مستشفى الزهراء التعليمي في مدينة كربلاء المقدسة وادخلوا الى وحدة الانعاش .وقد خضع المرضى لفحص تخطيط القلب الكهربائي(ECG) و فحص القلب بالأمواج فوق الصوتية (الإيكو) لكل مريض بالإضافة الى المتغيرات الكيموحيوية القلبية كتحليل التروبونين اي(cTRI) و الكرياتين كينيز(CK )وكذلك تحليل و الكرياتين كينيز نوع الرابط القلبي (CKMB ).بعض التحاليل لمباحث الدم . تم تصنيف مرضى هذه الدراسة الى ثلاث مجاميع وذلك حسب مؤشر الحركة الشاذة لجدار البطين الايسر :المجموعة الاولى (اكثر من 2) والمجموعة الثانية (من1.7 الى 2) والمجموعة الثالثة (اقل من 1.7). أظهرت نتائج تحليل المؤشرات الكيموحيوية القلبية ل (cTRI) , (CK ), (CKMB) في مصل دم المرضى زيادة معنوية عالية (P<0.01) لكل منهم مقارنة بحجم الاحتشاء لدى المرضى المصابين بالجلطة القلبية و كذلك بالمقارنة مع المجموعة القياسية .نتائج اخرى لهذه الدراسه اثبتت بان هنالك علاقة معنوية عاليه بين تركيز كلا من (cTRI) و ((CK-MB و تطور المضاعفات الجانبية لمرضى الجلطه القلبية نوع STEMI)) . بالنسبة لبعض فحوصات معايير الدم للمرضى أظهرت الدراسة زيادة معنوية عالية في مستوى الصفيحات الدمويه (P<0.01) في الدم بالمقارنة مع حجم الاحتشاء بين المجموعة الاولى و الثانيه و الثالثة و كذلك مع مجموعة السيطرة .بينما كان لمستوى كريات الدم البيضاء و معدل ترسيب الكريات الحمراء زيادة معنوية عالية فقط بين المجموعة الاولى و الثالثة.

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