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Suzuki et al Biomarkers of Acute Diseases.pdf (1.6 MB)

Editor’s choice-Biomarkers of acute cardiovascular and pulmonary diseases

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posted on 2018-06-05, 09:07 authored by Toru Suzuki, Alexander Lyon, Rajeev Saggar, Liam HeaneyLiam Heaney, Kenichi Aizawa, Antonio Cittadini, Ciro Mauro, Rodolfo Citro, Giuseppe Limongelli, Francesco Ferrara, Olga Vriz, Andrew Morley-Smith, Paolo Calabro, Eduardo Bossone
Acute cardiothoracic and respiratory diseases frequently remain a challenge to diagnose and differentiate in the emergency setting. The main diseases that manifest with chest pain include ischaemic heart disease, myocarditis, acute pericarditis, aortic dissection/rupture and pulmonary embolism (PE). Diseases that primarily present with dyspnoea include heart failure (HF), acute respiratory distress syndrome (ARDS), pneumonia, asthma exacerbations and chronic obstructive pulmonary disease. Pre-test probabilities of clinical findings play a vital part in diagnostic decisions, and the use of a Bayesian approach to these greatly improves the ability to stratify patients more accurately. However, blood tests (biomarkers) are increasingly used to assist in rapid decision-making in the emergency setting in combination with imaging methods such as chest radiograph, ultrasound and increasingly computed tomography, as well as physiological tests such as the electrocardiogram in addition to physical examination. Specific tests for ischaemic heart disease and myocarditis (cardiac troponins), HF (B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP)), aortic dissection (smooth muscle markers) and PE (D-dimer) have been developed. Surfactant protein-D and interleukin-8 have been developed for ARDS. Additionally, circulating microRNAs have emerged as promising biomarker candidates in cardiovascular disease. With this increasing array of biochemical markers to aid in the diagnosis of chest diseases presenting with chest pain and dyspnoea, we herein review the clinical usefulness of these markers, in particular in differentiating cardiac from pulmonary diseases. A symptom-oriented assessment as necessary for use in the critical setting is described in addition to discussion of individual biomarkers.

History

School

  • Sport, Exercise and Health Sciences

Published in

European Heart Journal: Acute Cardiovascular Care

Volume

5

Issue

5

Pages

416 - 433

Citation

SUZUKI, T. ...et al., 2016. Editor’s choice-Biomarkers of acute cardiovascular and pulmonary diseases. European Heart Journal: Acute Cardiovascular Care, 5(5), pp. 416-433.

Publisher

© The European Society of Cardiology. Published by Sage

Version

  • AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/

Publication date

2016

Notes

This paper was accepted for publication in the journal European Heart Journal: Acute Cardiovascular Care and the definitive published version is available at https://doi.org/10.1177/2048872616652309

ISSN

2048-8726

eISSN

2048-8734

Language

  • en

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