Biomarkers of Cardiac Diseases- CardioRush

Natriuretic peptidesWhat is an example of functional/stretch biomarkers in the heart?Troponins, natriuretic peptidesWhat are the most important biomarkers for cardiac disease?Cell death or loss of membrane integrityWhat causes release of leakage biomarkers?Volume/pressure overload, hypoxia/ischemia, toxins, Ca handing anomalies, inflammatory cytokinesWhat are leakage markers of cardiac disease released secondary to?False (a sensitive indicator)True or false: leakage markers are a poor indicator of active myocardial injuryCtnI, CTnT, CtnCWhat are the cardiac troponins that can be measured?CTnIWhat cardiac troponin is a highly sensitive and specific indicator of cardiomyocyte necrosis?CTnIWhat cardiac tropnonin is the gold standard for diagnosing myocardial infarction in people?3 structurally unique protein subunits (I, T, C)What is the troponin complex made of?False (Different isoforms allow identification of origin)True or false: troponin in the heart and the skeletal muscle has the same isoforms, so an increase in the blood levels cannot be attributed to either muscle typeTroponin IWhat troponin is specific to the heart?Troponin TWhat troponin has distinct skeletal and cardiac isoforms?Troponin CWhat troponin is non-specific and is therefore not used as a biomarker?Inhibits cardiomyocte contraction by preventing actin myosin interaction until Ca removedWhat is the function of Troponin I in myocytes?Bound and free pool, free pool releasedWhat are the 2 pools of troponins in the cardiac myocytes, and which is released with cell damage?Release from cardiomyocytes, degradation by serum proteases, clearanceWhat are circulating troponin levels affected by?Kidney, liver, reticuloendothelial systemWhat organs clear troponin in the blood?False (Human assays can be used, structure is preserved between species)True or false: structure of troponins is not closely preserved between human and animal species, so specific cTnI assays are required for each species you want to test inLack of standardization, many analyzers but no universal reference rangesWhat is the issue with measuring troponins with assays or analyzers?NoIs background cTnI usually detectable in healthy cats and dogs?TrueTrue or false: Both cTnI and cTnT are highly specific for myocardial damageDegree of cardiomyocte necrosisWhat does the degree of cTnI and cTnT increase correlate with?AcuteIn what type of injury as the levels of cTn highly correlated with degree of cardiomyocyte necrosis: acute or chronic?Minutes to hoursHow quickly do cTnI levels rise after myocardial damage?Days to weeksHow long do cTnI levels remain elevated after myocardial damage?False (Not great for diagnosis, mainly used for prognosis)True or false: cTnI is great both for specific diagnosis of CHF and as a prognostic indicatorNegativeWhat is the effect on prognosis of a dog in CHF if cTnI levels are elevated?Higher levels mean more severeWhat is the correlation between cTnI levels in cats and severity of disease of CHF?If troponin is high before you tap, there is more likely to be a malignant cause of PEWhat is the use of troponin levels in dogs with pericardial effusion?DoxorubicinWhat drug can cTnT levels be used to monitor for cardiotoxicity, which is the major side effect?Screening for early cardiotoxicityWhat is cTn level measurements in animals using doxorubicin used for?Diagnosis of acute myocardial injury, unexplained arrhythmias, pericardial effusion, suspected cardiotoxicity, possible CHF diagnosis in cats, prognostic indicator of disease in dogsWhat are some reasons you would measure cTnI?Myocarditis, infarction, trauma, toxin, GDVWhat are some causes of acute myocardial injury that would result in raised cTnI?CHF diagnosisWhat is the major use of natriuretic peptides as a biomarker?Atrial stretch, increased ventricular wall stressWhat are natriuretic peptides released in response to?Elevated cardiac filling pressures, myocardial dysfunctionWhat does an increase in natriuretic peptides indicate?Detect CHF, differentiation cardiac or noncardiac causes of dyspnea, screen for cardiomyopathy (some prognostic value and treatment guidance)What are the main uses of measuring natriuretic peptides?AtriaWhere is atrial natriuretic peptide produced?ProANP stored in atrial granules, cleaved to NT-proANP and C-ANPWhat is the pathway to produces ANP?C-ANPWhat is the active form of ANP?Cat, dog, humanWhat species all have ANP that is structurally and functionally similar to each other?TrueTrue or false: NT-proANP fragments are not cleared by the Natriuretic peptide Receptor-C, but undergo direct renal eliminationLonger half life, greater plasma concentration because don't bind C-ANP receptorsWhy are levels of NT-proANP higher than C-ANP?Diagnosis of CHF, assess cardiac disease severityWhat are the clinical uses of measuring NT-proANP?BNPWhich is more commonly measured: NT-proANP or BNP?VentriclesWhere is BNP released from?CHF, hypertrophyWhat can cause an increase in wall stress that leads to BNP release?Less BNP is stored, must be produced for releaseWhy is BNP less susceptible to rapid fluctuations than ANP?Pre Pro BNP, Pro-BNP, corin cleaves into N terminal pro-BNP and BNPWhat is the pathway for production of BNP?Natriuresis to increase lusitropy, vasodilation by decreased RAASWhat is the effect of active BNP?False (high variability between species)True or false: there is not much interspecies variation in BNP structure, so cross species assays can be usedA and BWhat natriuretic peptide receptors can respond to all natriuretic peptides?NPR-CWhat natriuretic peptide receptor doesn't cause an effect, but internalizes the peptide for clearance?A, B, CWhat are the natriuretic peptide receptor (NPR) subtypes?Receptor clearance, modulate NP availability, promote hydrolysisWhat is the purpose of NPR-C?Neutral endopeptidase (NEP)What enzyme actively eliminates circulating C-terminal NP?ANPWhat type of natriuretic peptide can use species universal assays?BNPWhat type of natriuretic peptide must use species specific peptides?CHF with elevated LV filling pressure, ventricular hypertrophyWhat conditions can cause natriuretic peptide elevations?Diagnose CHF, diagnose HCM or DCM, differentiate cardiac or resp causes of dyspnea and coughWhat are the clinical applications of monitoring natriuretic peptide levels?TrueTrue or false: there is a good direct relationship between vertebral heart score enlargement and NT-proBNP increasesFalse (It CAN)True or false: BNP can't reliably discriminate dyspnea or cough due to CHF or primary lung diseaseLarger left atrial size and diastolic dysfunction, CHF, heart diseaseWhat does an elevated NT-proBNP indicate in cats?False (it is a good screening test)True or false: NT-proBNP is a poor screening test for occult HCM in catsLong halflife, increased stability, better studiedWhat are the advantages of measuring NT-proBNP?Screen for occult heart disease, diagnose CHF, detect myocarditis, myocardial infarction, monitor cardiotoxic drug effects and therapeutic interventions, evaluate cardiac effects of systemic diseaseWhat are the specific uses of biomarkers for cardiac disease in vet med?