Biomarkers of Cardiovascular diseases. By Dr. Gouse Mohiddin Shaik
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1 Biomarkers of Cardiovascular diseases By Dr. Gouse Mohiddin Shaik
2 In this section we will discuss Introduction Types of CVD CVD biomarkers Future CVD biomarkers
3 Introduction CVD is the one of the leading causes of deaths worldwide Almost 30% of global deaths account Increasing rate every year Can be addressed by identifying behavioral risk factors in high risk groups Helpful if detected early Biomarkers aid in detection and management
4 Types of CVD As the name implies it is coronary (heart) and vascular (blood vessel) disease Coronary heart disease Cerebrovascular disease Types of CVD Diseases of the blood vessels supplying blood to the heart Diseases of the blood vessels supplying blood to the brain Peripheral arterial disease Diseases of the blood vessels supplying blood to arms and legs Rheumatic heart disease Congenital heart disease Streptococcal infection damage to heart muscle and valves from rheumatic fever Malformation of heart during fetus development
5 Coronary heart diseases Mainly due to plaque build up inside the coronary arteries (atherosclerosis) which leads to Ischemic heart disease & myocardial infraction Congestive heart failure
6 Atherosclerosis Characterized by deposition of fatty (mainly cholesterol) plaques in the inner walls of blood vessels leading to hardening and narrowing
7 BMs of Atherosclerosis Ghrelin : Hunger hormone regulates appetite Empty stomach releases more hormone stomach hormone observed to be increased in atherosclerotic conditions Positive correlation between ghrelin concentration and atherosclerosis are established in males
8 BMs of Atherosclerosis Lp-PLA2 : Lipoprotein associated phospholipase A2 Member of phospholipase super family Hydrolyze phospholipids Can be predictive biomarker
9 BMs of Atherosclerosis NO (nitric oxide) impairment NO involved in many pathways Important function as antioxidant Reduces oxidation of LDL cholesterol With age NO production decreases Difficult to measure but good BM
10 BMs of Atherosclerosis Other BMs Proteomic profiles Inflammatory markers Lipid modified proteins Free radicals.
11 BMs of ischemic heart disease and myocardial infraction Only two categories are approved so far Troponins Natriuretic peptide
12 BMs of ischemic heart disease and myocardial infraction Troponins Heart is a muscle Contractile unit of muscle fiber has thick and thin filaments Thick filaments myosin Thin filaments actin, tropomyosin, troponin
13 BMs of ischemic heart disease and myocardial infraction Troponins Heart tissue damage leads to increased circulating troponins Creatine kinase muscle brain (CK-MB) is also elevated
14 BMs of ischemic heart disease and myocardial infraction Natriuretic peptide Primarily an endocrine system that maintains fluid and pressure homeostasis Special peptides responsible for discharge of sodium through urine High NP levels can serve as warning system to help identify patients at high risk Troponin-NP complement tests are useful
15 BMs of ischemic heart disease and myocardial infraction Natriuretic peptide
16 BMs of ischemic heart disease and myocardial infraction Fatty acid binding protein (H-FABP) Low molecular weight protein involved in myocardial fatty acid metabolism Fast (30-45 min) elevation during early stages of infraction Incombination with troponin and CK-MB can serve as excellent biomarker of diagnosis and prognosis
17 BMs of ischemic heart disease and myocardial infraction Other BMs Cripto -1 also expressed in stem cells. Helpful in assessing tissue regeneration Myoglobin along with troponins Plasma fetuin-a produced by liver and induces insulin resistance. Increased levels directly correlated with risk of MI
18 BMs of congestive heart failure (CHF) CHF occurs when infracted heart muscle can not pump blood efficiently Resulting in organs receiving depleted blood supply Organs like kidneys try to hold more water and salt, leading to edema of ankles, hands, legs and lungs - congestion Diagnosis of CHF is difficult
19 BMs of congestive heart failure (CHF) Beta-2a protein Calcium plays key role in heart function Votage dependentca++ (VDCC) channels are regulated by beta-2a Beta-2a is elevated in many cases of heart failure Can offer therapeutic possibilities
20 BMs of congestive heart failure (CHF) Galectin-3 An inflammatory protein shown to be elevated in failing heart Can be a prognosis marker in acute CHF Indicates the role of inflammation in CHF Also offers a therapeutic target
21 BMs of congestive heart failure (CHF) KIF6 gene Kinesin family member 6 Carriers of this gene are at high risk Especially KIF6 719Arg allele carriers are 34% higher risk of MI and 24% higher risk of CHF Can serve as predisposition marker to identify risk group More research needed
22 Future CVD biomarkers Instead of relying on one biomarker combination of biomarkers can be useful Employment of Bionanochips toa analyze saliva
23 Next class Next class.. Biomarkers of neurological diseases
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