Heart Health

Pulmonary Arterial Hypertension (PAH) is a heterogenic group of devastating disorders that characterizes higher rates of mortality and morbidity worldwide. Recent clinical studies have shown that clinical features, hemodynamic parameters, echocardiography patter, multi-spiral computer tomography findings, exercise capacity, and anti-nuclear antibody profiles could be used as predictors of clinical severity and outcomes in PAH patients. However, the reliability, sensitivity, specificity and predictive value are derived from PAH patients with different comorbidities and specific complications associated with CTD,  congenital heart disease and respiratory disease might be unacceptable. The aim of the review: to summarize the knowledge regarding predictive value of several biomarkers in PAH individuals. The review is argued the perspective to utilize single sample and serial measurements of biomarkers as a regulatory peptide contributed in PAH pathogenesis aimed to improve prediction of PAH development and progression. 

Cardiotoxicity due to tumoricidal drug use is defined as an asymptomatic reduction in Left Ventricular (LV) Ejection Fraction (EF) of ≥10% to <55% or as a reduction of the LVEF of ≥5% to <55% with symptoms of Heart Failure (HF). The implementation in routine practices the highly tumoricidal anthracycline drugs, taxanes, and trastuzumab cause progressive LV dysfunction and symptomatic HF in dose-dependent manner. Despite there is potent reversibility of tumoricidal drug-induced cardiotoxicity, this adverse effect frequently consists continuously and might lead to limited response to medical treatment and worse survival sufficiently. The aim of the mini review is consideration the clinical evidence that supports the use of cardiac biomarkers for early detection of cardiotoxicity. The review is reported that the identification of cancer patient with increased risk of early cardiotoxicity would allow not only prevention and diagnosis of chemotherapy related cardiotoxicity but also administration of optimal dose and duration of chemotherapy. The predictive role of brain natriuretic peptides, cardiac troponins and inflammatory biomarkers (C-reactive protein) is discussed. 

Kawasaki disease is a systemic vasculitis of unknown etiology. It usually affects small and medium-sized vessels. The complication of coronary artery is aneurysm, which may lead to myocardial ischemia and infarction due to stenosis or thrombosis. We reported a case of patient with giant coronary artery aneurysm presenting myocardial infarction in Kawasaki disease.  

Development of Heart Failure (HF) associates with endothelial dysfunction that considered a key cause for tissue injury, and target organ damage. Endothelial Microparticles (EMPs) are small membrane vesicles that originate from activated or apoptotic endothelial cells and play a pivotal role in cell-to-cell communication, cellular fusion, and transport of biological active molecules. EMPs contribute in different types of biological effects depending on their origin. EMPs derived from activated endothelial cells may mediate tissue and vascular repair; induce angiogenesis, neovascularization, and cell differentiation. EMPs originated from apoptotic particles support inflammation, oxidative injury, reprogramming, intercellular communication of the target cells. Balance between both phenotypes of microparticles in circulation is frequently mediated by HF stage, aging, as well as comorbidity states. The review is depicted the role of several phenotypes of EMPs in realize of comorbidity state effects on endothelial function among HF patients.