CARDIAC ENZYMES AND PROTEINS الفريق الطبي األكاديمي. Done By :- Obadah Abubaker & Yousef Qandeel
|
|
- Giles Berry
- 5 years ago
- Views:
Transcription
1 CARDIAC ENZYMES AND PROTEINS الفريق الطبي األكاديمي Done By :- Obadah Abubaker & Yousef Qandeel لكية الطب البرشي البلقاء التطبيقية / املركز /
2 Cardiac enzymes and cardiac proteins In this lecture, we are going to talk about different types of cardiac biomarkers and how these biomarkers are used for diagnosis and. ف يال طالعة prognosis of myocardial infarction (0-4:40min) Sometimes myocardial infarction cannot be detected by ECG so it is important to do enzymatic test in order to confirm the diagnoses or to follow up the diagnosis of myocardial infarction. It is very important that the biomarker must be sensitive and specific. Sensitive: the biomarker must be found in large amount in order to be measured and to avoid false positives or false negatives of that biomarker. Specific: it is found in a specific tissue and not found in other tissues. Page 1
3 So these two parameters (sensitive and specific) are very important for a biomarker to be used. It is very important to take different samples at different times to follow up the myocardial infarction, the time course of that biomarker if it is increased or decreased and that will tell you about the condition of infarction. ببساطة بقلك مهم جدا نوخذ عينات متعددة بأوقات متتابعة بحيث نالحظ ونتابع حالة ال.biomarker من خالل تركيز ال myocardial infarction (4:40-5:54min) The ideal marker for myocardial infarction must satisfy in addition to specificity and sensitivity it must help in early diagnosis (that mean you have to look for some biomarkers that will appear in the blood at the onset of the infarction not after one or two days because in that case it will be missed so the marker must appear in the circulation as soon as the infarction happened. Page 2
4 The biomarker is used for prognosis to follow up the infarction and it also must be selected in order to test if re-infarction is happened or not. (5:54-9:50min) The most two biomarkers that are used nowadays and if you go to hospitals and see those patients who are suspected of myocardial infarction or who have myocardial infarction blood tests are taken to assay or to determine two important things : troponin and CK, sometimes myoglobin is determined and we will tell you why. الفقرة السابقة بس بتقلك عن اهم ال biomarkers اللي لو راح حدى عالمستشفى وكان مشكوك او معه myocardial infarction رح يفحصوا دمه بحيث يشوفوا تراكيز ال cardiac biomarkers واهم شيئين همه ال troponin and CK ولقدام سيتم التفصيل اما هذه فكرة عامة عن الموضوع. So we have two important things which are the CK and it is isoenzyme and the second thing is troponin. Page 3
5 CK: creatine kinase that will phosphorylate creatine to creatine phosphate. Troponin: it is a protein found in cardiac muscle as well as skeletal muscle it is associated with actin and myosin in the muscle and there we are are 3 types of troponin (troponin I, troponin T, troponin C), interested here for myocardial infarction in troponin I. الزبدة انه النوع اللي بهمنا من ال troponin بموضوع ال myocardial infarction هو ال. troponin I CK-MB: is an isoenzyme of the CK and we will explain this in moments. Myoglobin: it is a protein which is found not only in cardiac muscle but in all types of muscles and because of this myoglobin is not specific for cardiac muscle but the advantage of myoglobin : it appears early after the onset of the infarction. - CK is not much specific as troponin but it helps - The CK-MB is more specific than the total CK as you will see Page 4
6 (10:05-15:15min) Page 5
7 Creatine kinase is an enzyme that is found in muscles including cardiac muscle, it is a dimer (it is composed of 2 subunit one subunit is called M and the second subunit is called B) because it is composed of 2 subunits there must be 3 isoenzymes (three forms of creatine kinase enzyme) for this enzyme : One form is composed of two B subunits (BB),one form is composed of two M subunits (MM) and one form is a heterodimer which is composed of one M subunit and one B subunit(mb),, and what concerns us is MB, because the MB isoenzyme is specific for cardiac muscle (found mainly in cardiac muscle). BB mostly in brain, MM mostly in muscles other than cardiac muscles. النوع اللي بهمنا أكثر شيء في ال myocardial infarction هو ال CK-MB So if you want to diagnose myocardial infarction you must ask to analyze blood sample from the patient and determine the total CK, then determine how much of this total is CK-MB, then determine the RI which means how much you have of CK-MB out of the total CK multiply by hundred, if the ratio that percentage of the RI is less than 3 then there is no infarction, if it is above 3 then there is an infarction. MB is the isoenzyme that is found mainly in cardiac tissue, so after ischemia, there is no more oxygen for the heart demand and anaerobic glycolysis will take place, pyruvate will convert to lactate after that we will have acidosis, lysozymes will be activated and that will lead to necrosis of the cardiac tissue, after this process CK total will leak to the blood circulation including the CK- MB, so you take blood sample and analyze for total CK and for the CK-MB and compare it to the normal physiological values. الفقرة السابقة مشروحة في هذه الفترة لمن لم تتضح له الفكرة كما يجب (14:04-15:05min) Page 6
8 (15:18-19:18min) Now we want to see the time course of this enzyme (CK) and its isoenzyme (CK- MB) with the onset of the infarction, now the y axis represent the values of each of the parameter that we are going to talk about, and the x axis represent time, how many hours from the onset of infarction, now we will concentrate on two curves (Total CK curve, CK-MB curve) As you see,total CK start to rise 4 hours to 8 hours from the onset of the infarction as well as the CK-MB, after 20 to24 hours both curves will peak, in 48 to 72 hours it will go back to the normal value, if any re infarction happened after this time, that will be in 4 hours and in another 24 hours it will reach the peak, it is not much specific as you will see but relatively specific specially CK-MB, from these values, knowing the total CK and CK-MB you could calculate RI (ratio) RI : how much CK-MB is found per total CK multiply by 100 If RI > (3-5) -positive or infarction- Page 7
9 Troponin I (19:30-24:00) Troponin is a protein that is associated with actin and myosin and as we said it has 3 types of troponin (T & I & C) it was found that troponin I is the most specific type that will be detected in MI Troponin I is the subunit of the troponin complex that binds actin and inhibits actomyosin ATPase activity in the absence of calcium Three isoforms of troponin I have been described, one cardiac (ctni), and two skeletal muscle (slow twitch, stni, and fast twitch, ftni). Each of the three TnI isoforms is encoded by different genes located on different chromosomes. If we look at the figure above we can see that troponin I like CK- MB can be detected after 4-8 hours after MI symptoms onset and it will reach its peak after hours which will stay for 5-7 days until it go back to normal Now unlike CK-MB in a healthy people we can t detect any ctni so once we detect it that indicates that there is an infarction. Page 8
10 ctni has been shown to be a very sensitive and specific marker for acute MI. But in case of reinfarction after 24 hours CK-MB level will rise CK-MB important in case of reinfarction (because ctni level stays elevated for long time so we can t detect reinfarction depending on it) ctni very sensitive and important marker to confirm the diagnosis of MI Nowadays a test is done routinely for people who are suspected for MI by taking a blood sample, add it on a strip and detecting ctni if it s exist or not (appears as fragments on the strip) and it s done in 1 minute, but it s important to determine the absolute value of the ctni because it will tell you the size of the infarction. Due to long duration of increase of ctni following onset of chest pain, it could replace LD-2 isoenzyme for the detection of late presenting AMI patients. Additionally, recent studies demonstrate that ctni is more sensitive than the LD1/LD2 ratio. ctni has proved to be a diagnostic and prognostic marker for myocardial damage with high diagnostic sensitivity and specificity. So it s the most important biomarker for MI Myoglobin (24:00-24:35) One of earliest markers, which is very sensitive but, lacks specificity. Its diagnostic value is primarily due to its early appearance. Page 9
11 Case (24:35-29:15) This table shows multiple tests for a patient to know if he has MI or not and we usually make many tests to follow up with the situation and know the size of the infarction. After few days from the treatment we take blood sample to know if the treatment worked or not ( if the biomarkers values stays high that mean that there was no response to the treatment) Old biomarkers (29:15-34:00) These biomarkers were used in about 20 years ago and they are not used anymore Aspartate aminotransferase : which is a transaminase enzyme it s found in many tissues not only the heart but it s level increase in MI Lactate dehydrogenase : this enzyme as we know will be very active in case of ischemia which will convert pyruvate to lactate and increase acidity LDH is composed of 2 types of subunits (4 subunits in total) LDH as we ll see in the next table has 5 isoenzymes and the important ones are LDH1 and LDH2 Nowadays we use more specific biomarkers than these ones Page 10
12 CARDIAC ENZYMES AND PROTEINS Lactate dehydrogenaserises in 12 to 24 hours following MI, Peaks in 2 to 3 days Gradually disappearing in 5 to 14 days Tissue distribution of LDH Page 11
13 This is the electrophoresis of LDH enzyme. Normally LD1 is less than LD2 but in case of MI LD1 level becomes more than LD2 so the ratio between LD1 and LD2 will help to diagnose and to see if there is reinfarction or not Page 12
Biomarkers of myocardial infarction. Dr. Mamoun Ahram Cardiovascular system, 2013
Biomarkers of myocardial infarction Dr. Mamoun Ahram Cardiovascular system, 2013 References This lecture Hand-outs Acute Myocardial Infarction A rapid development of myocardial necrosis caused by prolonged
More informationBIOCHEMICAL EXAMINATION OF ACUTE MYOCARDIAL INFARCTION. Written by Lenka Fialová, translated by Jan Pláteník
BIOCHEMICAL EXAMINATION OF ACUTE MYOCARDIAL INFARCTION 1 Structure of heart muscle Written by Lenka Fialová, translated by Jan Pláteník Heart muscle (myocardium) is a particular form of striated muscle,
More informationBIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS. As. MARUSHCHAK M.I.
BIOCHEMICAL INVESTIGATIONS IN THE DIAGNOSTICS OF CARDIOVASCULAR DISORDERS As. MARUSHCHAK M.I. Heart attack symptoms Acute MI Measurement of cardiac enzyme levels Measure cardiac enzyme levels at regular
More informationMetabolic Energy Part 2 الفريق الطبي األكاديمي
Metabolic Energy Part 2 الفريق الطبي األكاديمي Done By :- Shady Soghayr Corrected By :- Rasha Rakan لكية الطب البرشي البلقاء التطبيقية / املركز 2022 2016/ Metabolic Energy Page 1 Metabolic energy For aa
More informationMohammad Alfarra. Faisal Al Nemri. Hala Al Suqi
25 Mohammad Alfarra Faisal Al Nemri Hala Al Suqi Review: - Modes of regulation:- Feed-back regulation is when an enzyme present early in a biochemical pathway is regulated by a late product of the pathway.
More informationlipoproteins and cholesterol الفريق الطبي األكاديمي Done By :- Obadah Abubaker & Yousef Qandeel
lipoproteins and cholesterol الفريق الطبي األكاديمي Done By :- Obadah Abubaker & Yousef Qandeel لكية الطب البرشي البلقاء التطبيقية / املركز 6166 6102/ Lipoproteins and cholesterol In this lecture we are
More informationPharmacologyonline 2: (2010) Newsletter Kakadiya and Shah
ROLE OF CREATINE KINASE MB AND LACTATE DEHYDROGENASE IN CARDIAC FUNCTION A REVIEW Jagdish Kakadiya*, Nehal Shah Department of Pharmacology, Dharmaj Degree Pharmacy College, Petlad- Khambhat Road, Dharmaj,
More informationHigh Sensitivity Troponins. IT S TIME TO SAVE LIVES. Updates from the ESC 2015 Guidelines November 17th 2016 OPL CONGRESS Dr.
High Sensitivity Troponins. IT S TIME TO SAVE LIVES. Updates from the ESC 2015 Guidelines November 17th 2016 OPL CONGRESS Dr. Marcel El Achkar Chairperson of Laboratory department Nini Hospital Lecturer
More informationConversion of amino acids الفريق الطبي األكاديمي
الفريق الطبي األكاديمي لكية الطب البرشي البلقاء التطبيقية / املركز 2022 2016/ -the ones with * are the essential amino acids- - Histidine decarboxylation -> histamine Page 1 - Glutamine is a nitrogen carrier
More informationAcute coronary syndromes
Acute coronary syndromes 1 Acute coronary syndromes Acute coronary syndromes results primarily from diminished myocardial blood flow secondary to an occlusive or partially occlusive coronary artery thrombus.
More informationBiochemistry of carbohydrates/ pentose phosphate pathway الفريق الطبي األكاديمي
Biochemistry of carbohydrates/ pentose الفريق الطبي األكاديمي Done By: - Khansaa Mahmoud - Renad Aburumman لكية الطب البرشي البلقاء التطبيقية / املركز 6166 6102/ Biochemistry of carbohydrates/ pentose
More informationLec: 21 Biochemistry Dr. Anwar J Almzaiel. Clinical enzymology. Very efficient can increase reaction rates at the order of x 10
Clinical enzymology Enzymes Biological catalysis Very efficient can increase reaction rates at the order of x 10 All are proteins- so liable to denaturation Specific to substrates Partly specific to tissues
More informationIschemic Heart Disease
Ischemic Heart Disease Dr Rodney Itaki Lecturer Division of Pathology University of Papua New Guinea School of Medicine & Health Sciences Division of Pathology General Consideration Results from partial
More informationCardiac Troponin Testing and Chest Pain Patients: Exploring the Shades of Gray
Cardiac Troponin Testing and Chest Pain Patients: Exploring the Shades of Gray Nichole Korpi-Steiner, PhD, DABCC, FACB University of North Carolina Chapel Hill, NC Learning Objectives Describe the acute
More informationPPP_glycogen_metabolism Part 2 الفريق الطبي األكاديمي. Done By: - Shady Soghayr
PPP_glycogen_metabolism Part 2 الفريق الطبي األكاديمي Done By: - Shady Soghayr لكية الطب البرشي البلقاء التطبيقية / املركز 6166 6102/ **How we get glucose-1-phosphate from glucose (source of glucose-1-
More informationAn update in Cardiac Biomarkers
An update in Cardiac Biomarkers By / Abdelrafi Rigbah Hago MSc, clinical chemistry Karary university Eglal Osman Hussein MSc, clinical chemistry khartoum teaching hospital Objectives by the end of this
More informationAbout OMICS International
About OMICS International OMICS International through its Open Access Initiative is committed to make genuine and reliable contributions to the scientific community. OMICS International hosts over 700
More informationPost Operative Troponin Leak: David Smyth Christchurch New Zealand
Post Operative Troponin Leak: Does It Really Matter? David Smyth Christchurch New Zealand Life Was Simple Once Transmural Infarction Subendocardial Infarction But the Blood Tests Were n t Perfect Creatine
More informationChallenging Issues in Cardiac Biomarker interpretation. F. Nikaeen. MD interventional Cardiologist
Challenging Issues in Cardiac Biomarker interpretation F. Nikaeen. MD interventional Cardiologist Biomarkers Types of Troponin Troponin C Binds calcium Troponin I Binds actin Troponin T Binds tropomyosin
More informationBiochemistry of carbohydrates
Biochemistry of carbohydrates الفريق الطبي األكاديمي Done By: - Hanan Jamal لكية الطب البرشي البلقاء التطبيقية / املركز 6166 6102/ In the last lecture we talked about Pyruvate, pyruvate is a central intermediate;
More informationUse of enzymes as diagnostic markers. Evaluation of lactate dehydrogenase (LDH) isoenzymes by agarose gel electrophoresis
Use of enzymes as diagnostic markers Evaluation of lactate dehydrogenase (LDH) isoenzymes by agarose gel electrophoresis Lactate dehydrogenase LDH tetramer M (gene LDHA, ch.11) H (gene LDHB, ch.12) LDH
More informationInternationally indexed journal
www.ijpbs.net Internationally indexed journal Indexed in Chemical Abstract Services (USA), Index coppernicus, Ulrichs Directory of Periodicals, Google scholar, CABI,DOAJ, PSOAR, EBSCO, Open J gate, Proquest,
More informationCollin County Community College BIOL Muscle Physiology. Muscle Length-Tension Relationship
Collin County Community College BIOL 2401 Muscle Physiology 1 Muscle Length-Tension Relationship The Length-Tension Relationship Another way that muscle cells can alter their force capability, is determined
More informationMario Plebani University-Hospital of Padova, Italy
Mario Plebani University-Hospital of Padova, Italy CK-MB mass assay CHF guidelines use BNP for rule out AST in AMI CK in AMI INH for CK-MB electrophoresis for CK and LD isoenzymes RIA for myoglobin WHO
More informationLipid Metabolism الفريق الطبي األكاديمي. Done By: - Yousef Qandeel & Shady Soghayr
Lipid Metabolism الفريق الطبي األكاديمي Done By: - Yousef Qandeel & Shady Soghayr لكية الطب البرشي البلقاء التطبيقية / املركز 2022 2016/ From the last lecture *even number of fatty acids will produce acetyl
More informationClinical enzymology. University of Babylon College of pharmacy Second semester - biochemistry 3 rd class By Dr. Abdulhussien M. K.
Clinical enzymology University of Babylon College of pharmacy Second semester - biochemistry 3 rd class 2014 2015 By Dr. Abdulhussien M. K. Aljebory Enzyme activity Enzyme assays usually depend on the
More informationAcute coronary syndrome. Dr LM Murray Chemical Pathology Block SA
Acute coronary syndrome Dr LM Murray Chemical Pathology Block SA13-2014 Acute myocardial infarction (MI) MI is still the leading cause of death in many countries It is characterized by severe chest pain,
More informationClassification of lab tests useful in cardiac disease Biochemical markers in Acute Coronary Syndromes (ACS) Redefinition of Myocardial Infarction (MI)
Biochemical Markers in Cardiac Injury Dr Sami Saeed Assistant Professor/Consultant Chemical Pathologist Foundation University Medical College Fauji Foundation Hospital Rawalpindi Email: drsami@comsats.net.pk
More informationHuman Troponin I ELISA Kit
Human Troponin I ELISA Kit Cat. No.:DEIA2358 Pkg.Size:96T Intended use This kit is intended for the quantitative determination of cardiac troponin I in human serum. Measurement of troponin I values are
More informationرمضان كريم. 1Page كالشمس للدنيا
Slide # 17 ( michaelis- menten approach) : Most enzymes adopt a certain behavior that involves first order + zero order in their reactions When the German scientist studied the enzyme kinetics, he put
More informationMyocardial Infarction
Myocardial Infarction MI = heart attack Defined as necrosis of heart muscle resulting from ischemia. A very significant cause of death worldwide. of these deaths, 33% -50% die before they can reach the
More informationBiomarkers in Acute Cardiac Disease Samir Arnaout, M.D.FESC Associate Professor of Medicine Internal Medicine i & Cardiology American University of Beirut Time course of the appearance of various markers
More informationClinical Cardiology Frontiers
750 Clinical Cardiology Frontiers Biochemical Markers of Myocardial Injury Is MB Creatine Kinase the Choice for the 1990s? Jesse E. Adams III, MD; Dana R. Abendschein, PhD; Allan S. Jaffe, MD M odern medical
More informationUse of Biomarkers for Detection of Acute Myocardial Infarction
Use of Biomarkers for Detection of Acute Myocardial Infarction Allan S. Jaffe, MD.* Consultant - Cardiology & Laboratory Medicine Professor of Medicine Chair, CCLS Division, Department of Laboratory Medicine
More informationHigh-Sensitive Troponin in the Evaluation of patients with Acute Coronary Syndrome (High-STEACS): a stepped-wedge cluster-randomised controlled trial
EUROPEAN SOCIETY OF CARDIOLOGY CONGRESS 2018 High-Sensitive Troponin in the Evaluation of patients with Acute Coronary Syndrome (High-STEACS): a stepped-wedge cluster-randomised controlled trial Professor
More informationProduct Information. Instruction for Use. Troponin I ELISA kit Catalog Number: EA Storage Temperature: 2 8 C
9620 Medical Center Dr., Suite 200, Rockville, MD 20850 Phone: 1.888.267.4436 Fax: 301-340-9254 Email: techsupport@origene.com Web: www.origene.com Product Information Troponin I ELISA kit Catalog Number:
More informationBiochem. q1) the amount of cholesterol lost per day is: +a.1g/day b.10g/week c.15g/day d.5g/day
Biochem q1) the amount of cholesterol lost per day is: +a.1g/day b.10g/week c.15g/day d.5g/day q2) which of the following carry cholestrol to peripheral tissue : a.hdl b.ldl c.vldl d.chylomicrons q3) esterification
More informationChapter 10! Chapter 10, Part 2 Muscle. Muscle Tissue - Part 2! Pages !
! Chapter 10, Part 2 Muscle Chapter 10! Muscle Tissue - Part 2! Pages 308-324! SECTION 10-5! Sarcomere shortening and muscle fiber stimulation produce tension! 2! Tension Production - Muscle FIBER! All-or-none
More informationChemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-25 U/L 10-35 U/L 10-30 U/L 10-25 U/L 10-30 U/L 10-35 U/L 10-25 U/L 10-35 U/L 10-25 U/L 10-20 U/L 10-35 U/L Albumin 0-6
More informationChemistry Reference Ranges and Critical Values
Alanine Aminotransferase (ALT, SGPT) 3-9 years 9-18 years 1-9 years 9-18 years 10-30 U/L 10-30 U/L 10-20 U/L Albumin 0-6 days 6 days - 37 months 37 months - 7 years 7-20 years 2.6-3.6 g/dl 3.4-4.2 g/dl
More informationPyruvate + NADH + H + ==== Lactate + NAD +
1 UNIVERSITY OF PAPUA NEW GUINEA SCHOOL OF MEDICINE AND HEALTH SCIENCES DIVISION OF BASIC MEDICAL SCIENCES DISCIPLINE OF BIOCHEMISTRY AND MOLECULAR BIOLOGY PBL SEMINAR ANAEROBIC METABOLISM - An Overview
More informationLaboratory diagnosis of heart diseases: Cardiometabolic risk AMI Heart failure
Laboratory diagnosis of heart diseases: 2017 Cardiometabolic risk AMI Heart failure 2 Suggested Risk Factors for CVD LDL Oxidation LDL-C Anti-OxLDL OxLDL LDL Oxid. Lag Time Negative LDL HDL-C Paraoxonase
More informationCardiac Bio-Marker Testing in Acute Coronary Syndromes
Cardiac Bio-Marker Testing in Acute Coronary Syndromes Dr. Zohair Alaseri, MD FRCPc, Emergency Medicine FRCPc, Critical Care Medicine Intensivest and Emergency Medicine Consultant Chairman, Department
More informationDiagnosis and Management of Acute Myocardial Infarction
Diagnosis and Management of Acute Myocardial Infarction Acute Myocardial Infarction (AMI) occurs as a result of prolonged myocardial ischemia Atherosclerosis leads to endothelial rupture or erosion that
More informationMedical Biochemistry and Molecular Biology department
Medical Biochemistry and Molecular Biology department Cardiac Fuels [Sources of energy for the Cardiac muscle] Intended learning outcomes of the lecture: By the end of this lecture you would be able to:-
More informationCardiovascular Disorders Lecture 3 Coronar Artery Diseases
Cardiovascular Disorders Lecture 3 Coronar Artery Diseases By Prof. El Sayed Abdel Fattah Eid Lecturer of Internal Medicine Delta University Coronary Heart Diseases It is the leading cause of death in
More informationProcedures: LifeSign MI Myoglobin/CK-MB/Troponin I Test. Prepared by Date Adopted Supersedes Procedure # Review Date Revision Date Signature
Procedures: LifeSign MI Myoglobin/CK-MB/Troponin I Test Prepared by Date Adopted Supersedes Procedure # Review Date Revision Date Signature Distributed to # of Copies Distributed to # of Copies PRINCIPLE:
More informationBIL 256 Cell and Molecular Biology Lab Spring, Tissue-Specific Isoenzymes
BIL 256 Cell and Molecular Biology Lab Spring, 2007 Background Information Tissue-Specific Isoenzymes A. BIOCHEMISTRY The basic pattern of glucose oxidation is outlined in Figure 3-1. Glucose is split
More informationWhat are enzyme markers?
What are enzyme markers? Enzymes are highly specialized complex proteins that aid chemical changes in every part of the body. For example, they help break down food so your body can use it effectively.
More informationAnatomy & Physiology Muscular System Worksheet
Anatomy & Physiology Muscular System Worksheet 1. What are the three categories of muscle tissue? a) b) c) 2. The smallest functional unit of a muscle fiber is called a. 3. What are the four characteristics
More informationACUTE MYOCARDIAL INFARCTION: DEFINITION, DIAGNOSIS, AND THE EVOLUTION OF CARDIAC MARKERS
ACUTE MYOCARDIAL INFARCTION: DEFINITION, DIAGNOSIS, AND THE EVOLUTION OF CARDIAC MARKERS d Copyright 2018 by. LEARNING OBJECTIVES: 1. Define MI and the challenges in MI diagnosis 2. Define the current
More informationOriginal Article ABSTRACT. Kiumars Ahmadi 1 PhD, Fahimeh Dadgari 1 MS, Mohammad Reza Safarinejad 2 MD
Original Article The most sensitive double-marker method of cardiac isoenzymes of creatinine kinase, troponin I, and myoglobin in different time periods for diagnosing acute myocardial infarction Kiumars
More informationATP RELEASE ENERGY THROUGH THE CONVERSION OF ATP INTO ADP AND THE RELEASE OF A PHOSPHATE.
Module 6 review 1. Describe smooth, skeletal and cardiac muscle. Also tell where you would find these in the body. Smooth around internal organs (involuntary control) (one nucleus per cell) Skeletal pulls
More informationPhysiology sheet #2. The heart composed of 3 layers that line its lumen and cover it from out side, these layers are :
Physiology sheet #2 * We will talk in this lecture about cardiac muscle physiology, the mechanism and the energy sources of their contraction and intracellular calcium homeostasis. # Slide 4 : The heart
More informationEDUCATIONAL COMMENTARY UNDERSTANDING THE BENEFITS AND CHALLENGES OF HIGH- SENSITIVITY TROPONIN TESTING IN CLINICAL AND PATHOLOGY SETTINGS
SENSITIVITY TROPONIN TESTING IN CLINICAL AND PATHOLOGY SETTINGS Educational commentary is provided through our affiliation with the American Society for Clinical Pathology (ASCP). To obtain FREE CME/CMLE
More informationMetabolism of cardiac muscle. Dr. Mamoun Ahram Cardiovascular system, 2013
Metabolism of cardiac muscle Dr. Mamoun Ahram Cardiovascular system, 2013 References This lecture Mark s Basic Medical Biochemistry, 4 th ed., p. 890-891 Hand-out Why is this topic important? Heart failure
More informationMUSCLE METABOLISM. Honors Anatomy & Physiology
MUSCLE METABOLISM Honors Anatomy & Physiology ROLE OF ATP ATP binds to myosin heads and upon hydrolysis into ADP and Pi, transfers its energy to the cross bridge, energizing it. ATP is responsible for
More informationSkeletal Muscle and the Molecular Basis of Contraction. Lanny Shulman, O.D., Ph.D. University of Houston College of Optometry
Skeletal Muscle and the Molecular Basis of Contraction Lanny Shulman, O.D., Ph.D. University of Houston College of Optometry Like neurons, all muscle cells can be excited chemically, electrically, and
More information3 IN 1. Myoglobin/CK-MB/Troponin I. Manufactured by. Manufactured for: Princeton BioMeditech Corp U.S. Hwy 1 Monmouth Junction, NJ 08852
MI 3 IN 1 Myoglobin//Troponin I Point-of-care cardiac tests for the simultaneous qualitative detection of Myoglobin, and Troponin I in blood, plasma and serum for the rapid diagnosis of myocardial infarction
More informationUNIVERSITY OF BOLTON SPORT AND BIOLOGICAL SCIENCES SPORT AND EXERCISE SCIENCE PATHWAY SEMESTER TWO EXAMINATIONS 2016/2017
LH14 UNIVERSITY OF BOLTON SPORT AND BIOLOGICAL SCIENCES SPORT AND EXERCISE SCIENCE PATHWAY SEMESTER TWO EXAMINATIONS 2016/2017 INTRODUCTION TO SPORT AND EXERCISE PHYSIOLOGY MODULE NO: SPS4002 Date: Thursday
More informationComparative assessment of rapid test and routinmethods th to measurement of cardiac markers in patients with acute chest pain
Comparative assessment of rapid test and routinmethods th to measurement of cardiac markers in patients with acute chest pain *Reza Shahsavari I, Nastou Dehkourdi II and Saeid Yazdankha III I ) Assistant
More informationClinical Policy: Cardiac Biomarker Testing for Acute Myocardial Infarction Reference Number: CP.MP.156
Clinical Policy: Reference Number: CP.MP.156 Effective Date: 12/17 Last Review Date: 12/17 See Important Reminder at the end of this policy for important regulatory and legal information. Description The
More informationMuscular System. 3 types of muscle tissue. How skeletal muscles arrange CARDIAC SMOOTH SKELETAL
Muscular System Functions Support the body by allowing us to stay upright Allow for movement by attaching to the skeleton Help maintain a constant body temperature Assist in movement in the cardiovascular
More informationNATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice
NATIONAL INSTITUTE FOR HEALTH AND CLINICAL EXCELLENCE Centre for Clinical Practice Review consultation document Review of Clinical Guideline (CG95) Chest pain of recent onset: Assessment and diagnosis
More informationNerve Cell (aka neuron)
Nerve Cell (aka neuron) Neuromuscular Junction Nerve cell Muscle fiber (cell) The Nerve Stimulus and Action Potential The Nerve Stimulus and Action Potential Skeletal muscles must be stimulated by a motor
More informationCost-Effective Utilization of CK-MB Mass and Activity Assays
CHEMISTRY Lokinendi V. Rao, PhD, SC(ASCP) John R. Petersen, PhD, DABCC Amin A. Mohammad, PhD, DABCC Michael G. Bissell, MD, PhD, MPH Anthony. Okorodudu, PhD, MS(MCS), DABCC Cost-Effective Utilization of
More informationLecture #1. Done By : Rasha Rakan. Corrected by: Obadah Abubaker
Lecture #1 Done By : Rasha Rakan Corrected by: Obadah Abubaker مالحظة: المكتوب باللون األسود هو ما كتب ف السال دات وما كتب باللون األزرق فهو كالم الدكتور أثناء المحاضرة وللذ ن قومون بتصو ر الش ت جعلنا
More informationMuscle Metabolism Introduction ATP is necessary for muscle contraction single muscle cell form and break the rigor bonds of cross-bridges small
Muscle Metabolism Introduction 1. ATP is necessary for muscle contraction a. when a single muscle cell is contracting it can use up millions of ATP molecules per second to form and break the rigor bonds
More information2,3BPG & Smoking. When the carve is shifted to the right decreasing in O2 binging affinity b.c the change in the shape &function
Where do protons bind to Hemoglobin? It could bind in dissociated carboxyl group in Hb or in dissociate amino group ( NH+3, COOH ) Protons change Hb shape, How? Once proton bind to Hb it will produce +
More informationMWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient
MWLCEMS SYSTEM Continuing Education Packet Management of the Acute MI Patient In this CE we will discuss the patient presenting with an acute ST-Elevation Myocardial Infarction (STEMI) Definition: Myocardial
More informationSetting The setting was secondary care. The economic study was carried out in Hong Kong.
The diagnostic value and cost-effectiveness of creatine kinase-mb, myoglobin and cardiac troponin-t for patients with chest pain in emergency department observation ward Choi Y F, Wong T W, Lau C C Record
More informationEnzymes. Enzymes : are protein catalysts that increase the rate of reactions without being changed in the overall process.
Enzymes Enzymes Enzymes : are protein catalysts that increase the rate of reactions without being changed in the overall process. All reactions in the body are mediated by enzymes A + B E C A, B: substrate
More informationTYPE II MI. KC ACDIS LOCAL CHAPTER March 8, 2016
TYPE II MI KC ACDIS LOCAL CHAPTER March 8, 2016 TYPE 2 MI DEFINITION: Acute coronary syndrome (ACS) encompasses a continuum of myocardial ischemia and infarction, which can make the diagnostic and coding
More informationg) Cellular Respiration Higher Human Biology
g) Cellular Respiration Higher Human Biology What can you remember about respiration? 1. What is respiration? 2. What are the raw materials? 3. What are the products? 4. Where does it occur? 5. Why does
More informationBIOH111. o Cell Module o Tissue Module o Integumentary system o Skeletal system o Muscle system o Nervous system o Endocrine system
BIOH111 o Cell Module o Tissue Module o Integumentary system o Skeletal system o Muscle system o Nervous system o Endocrine system Endeavour College of Natural Health endeavour.edu.au 1 Textbook and required/recommended
More information1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI).
1) Severe, crushing substernal chest pain 2) radiate to the neck, jaw, epigastrium, or left arm. 3- rapid and weak pulse 4- nausea (posterior MI). 5- cardiogenic shock (massive MIs >40% of the left ventricle)
More informationSkeletal Muscle. Skeletal Muscle
Skeletal Muscle Skeletal Muscle Types of muscle Skeletal muscle-moves the skeleton by pulling on the tendons that are connected to the bones Cardiac muscle-pumps blood through the heart and blood vessels
More informationTroponin: leaks, bumps and elevations : is it an MI or. question?.
Troponin: leaks, bumps and elevations : is it an MI or not an MI that is the question?. John E. Ellis MD Adjunct Professor University of Pennsylvania Anesthesiology and Critical Care www.vascularanesthesia.com
More informationPrinciples of Anatomy and Physiology
Principles of Anatomy and Physiology 14 th Edition CHAPTER 10 Muscular Tissue Introduction The purpose of the chapter is to: 1. Learn about the structure and function of the 3 types of muscular tissue
More informationTable of Contents # Date Title Page # /27/14 Ch 7: Skeletal System 01/29/14 Ch 8: Muscular System
Table of Contents # Date Title Page # 1. 1 2. 3. 4. 5. 01/27/14 Ch 7: Skeletal System 01/29/14 Ch 8: Muscular System 12 i 1 01/30/14 Ch 8: Muscular System 12 Objective: Students will be able to describe
More informationMuscle and Muscle Tissue
Muscle and Muscle Tissue Make up about half of total body mass Exerts force by converting chemical energy, ATP, to mechanical energy Muscle tissue is classified based on Shape Number and position of nuclei
More informationPractitioner Education Course
2015 Practitioner Education Course ST Elevation Myocardial Infarction 2 Pathology Concept of vulnerable plaque Mild Atheroma Diagnosis IVUS OCT 3 Diagnosis This is based on : Clinical History ECG Changes.
More informationOutline. Bio 105: Muscular System. Muscular System. Types of Muscles. Smooth Muscle. Cardiac Muscle 4/6/2016
Outline Bio 105: Muscular System Lecture 11 Chapter 6 Characteristics of muscles 3 types of muscles Functions of muscles Structure of skeletal muscles Mechanics of muscle contraction Energy sources for
More informationChapter 10! Muscle Tissue - Part 2! Pages ! SECTION 10-5! Sarcomere shortening and muscle fiber stimulation produce tension!
! Chapter 10, Part 2 Muscle Chapter 10! Muscle Tissue - Part 2! Pages 308-324! SECTION 10-5! Sarcomere shortening and muscle fiber stimulation produce tension! 2! 1 Tension Production - MUSCLE FIBER! All-or-none
More informationArabian Gulf University Kingdom of Bahrain Year 5 Internal Medicine Critical Appraisal of Medical Article (1) Critical Appraisal (Form A)
Arabian Gulf University Kingdom of Bahrain Year 5 Internal Medicine Critical Appraisal of Medical Article (1) Critical Appraisal (Form A) - What is Your Search question from the case history? Can we depend
More informationCHAPTER 7 10/16/2012. How cells release Chemical Energy
CHAPTER 7 10/16/2012 How cells release Chemical Energy 1 7.1 OVERVIEW OF CARBOHYDRATE BREAKDOWN PATHWAYS Organisms stay alive by taking in energy. Plants and all other photosynthetic autotrophs get energy
More information*Corresponding author - Dr. Uttam Kumar id - Received:14/05/2018 Revised:13/06/2018 Accepted:16/06/2018 ABSTRACT
International Journal of Medical Science and Education An official Publication of Association for Scientific and Medical Education (ASME) www.ijmse.com Original Research Article pissn- 2348 4438 eissn-2349-3208
More informationTopic. Updates on Definition of Myocardial Infarction
Topic Updates on Definition of Myocardial Infarction In the past, general consensus for MI? Definition of MI by WHO - Combination of 2 of 3 characteristics - 1. Typical Symptoms 2. Enzyme Rise 3. Typical
More informationSheet: Digestion of Lipids, Proteins,& Carbohydrates Done by: Obadah Abubaker & Yousef Qandeel
Sheet: Digestion of Lipids, Proteins,& Carbohydrates Done by: Obadah Abubaker & Yousef Qandeel In this lecture, we are going to talk about the biochemical aspects of digestion of carbohydrates, lipids
More informationSkeletal Muscle. Connective tissue: Binding, support and insulation. Blood vessels
Chapter 12 Muscle Physiology Outline o Skeletal Muscle Structure o The mechanism of Force Generation in Muscle o The mechanics of Skeletal Muscle Contraction o Skeletal Muscle Metabolism o Control of Skeletal
More informationMuscular System Module 3: Contraction and Relaxation *
OpenStax-CNX module: m48498 1 Muscular System Module 3: Contraction and Relaxation * Donna Browne Based on Muscle Fiber Contraction and Relaxation by OpenStax This work is produced by OpenStax-CNX and
More informationCurrent Utilities of Cardiac Biomarker Testing at POC. June 24, 2010 Joe Pezzuto, MT (ASCP) Carolyn Kite, RN
Current Utilities of Cardiac Biomarker Testing at POC June 24, 2010 Joe Pezzuto, MT (ASCP) Carolyn Kite, RN 1. Discuss challenges associated with diagnosing Acute Coronary Syndromes (ACS) and Heart Failure
More informationIntegration Of Metabolism
لكية الطب البرشي البلقاء التطبيقية / املركز أحياها 2016/2022 و من Integration Of Metabolism Metabolism Consist of Highly Interconnected Pathways The basic strategy of catabolic metabolism(in another words
More informationTroponin when is an assay high sensitive?
Troponin when is an assay high sensitive? Professor P. O. Collinson MA MB BChir FRCPath FRCP edin MD FACB EurClin Chem Consultant Chemical Pathologist and Professor of Cardiovascular Biomarkers, Departments
More informationGUIDELINES FOR TROPONIN TESTING: AN EVIDENCE-BASED APPROACH TO DIAGNOSIS AND TREATMENT OF THE ACS PATIENT
GUIDELINES FOR TROPONIN TESTING: AN EVIDENCE-BASED APPROACH TO DIAGNOSIS AND TREATMENT OF THE ACS PATIENT sponsored by TROPONIN OVERVIEW TROPONIN DETECTION IN NORMAL AND DISEASE STATES1 The detection of
More informationHigh Sensitivity Troponin Improves Management. But Not Yet
High Sensitivity Troponin Improves Management But Not Yet Allan S. Jaffe, MD.* Consultant - Cardiology & Laboratory Medicine Professor of Medicine Chair, CCLS Division, Department of Laboratory Medicine
More informationThe Clinical Laboratory Working with Physicians to Improve Patient Care
The Clinical Laboratory Working with Physicians to Improve Patient Care Michael A. Pesce, PhD Professor Emeritus Columbia University Medical Center Department of Pathology and Cell Biology Objectives Troponin
More informationMuscle Metabolism. Dr. Nabil Bashir
Muscle Metabolism Dr. Nabil Bashir Learning objectives Understand how skeletal muscles derive energy at rest, moderate exercise, and strong exercise. Recognize the difference between aerobic and anaerobic
More informationChest pain management. Ruvin Gabriel and Niels van Pelt August 2011
Chest pain management Ruvin Gabriel and Niels van Pelt August 2011 Introduction Initial assessment Case 1 Case 2 and 3 Comparison of various diagnostic techniques Summary 1-2 % of GP consultations are
More information