China ; Female ; Heart Failure ; diagnosis ; drug therapy ; metabolism ; Humans ; Male ; Natriuretic Peptide, Brain ; analysis ; Peptide Fragments ; analysis

BACKGROUNDN-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) are excellent biomarkers for detecting heart failure and subclinical myocardial injury. However, it remains unclear whether subclinical myocardial injury is associated with NT-proBNP elevation in a community based population.

METHODSIn a community based study, levels of hs-cTnT and of NT-proBNP were determined in 1 497 participants older than 45 years. The lower detection limit of the hs-cTnT assay used in the present study was 0.003 ng/ml. The association of hs-cTnT levels and NT-proBNP levels was analyzed.

RESULTSWhen the subjects with undetectable (<0.003 ng/ml), intermediate (0.003-0.014 ng/ml), and elevated (≥0.014 ng/ml) levels of hs-cTnT were compared (r = 0.175, P < 0.001), a strong association between the hs-cTnT levels and NT-proBNP levels was observed (β = -0.206, P < 0.001; β = -0.118, P < 0.001, respectively). In multivariable analyses, older age and hs-cTnT were positively and independently associated with NT-proBNP levels (β = 0.341, P < 0.001; β = 0.143, P < 0.001, respectively), and male gender and the levels of eGFR were inversely and independently associated with NT-proBNP levels. When the subjects with normal or elevated NT-proBNP were analyzed separately, the hs-cTnT level was not an independent predictor for the NT-proBNP level in the normal NT-proBNP group, whereas the hs-cTnT level was the only independent predictor for NT-proBNP level in the elevated NT-proBNP group (β = 0.399, P < 0.01).

CONCLUSIONSIn this community based population, NT-proBNP elevation was common. In addition to female gender and older age, subclinical myocardial injury indicated by the hs-cTnT level was another important factor in NT-proBNP elevation.

Biomarkers ; analysis ; Female ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Troponin T ; blood

OBJECTIVEDynamic changes of quality and growth of Whitmania pigra were investigated to provide theoretical basis for quality control and determination of optimal harvest time.

METHODThe contents of moisture, ethanol-soluble extractive, total ash, and acid-insoluble ash, as well as antithrombin activity were determined according to Chinese pharmacopoeia (2005 edition).

RESULTQualities of W. pigra collected from different growth stages met the standards of Chinese pharmacopoeia (2005 edition). The highest amount of ethanol-soluble extract was found in 9-month-old, W. pigra, followed by 6-month-aged ones. And there was significant difference between 9-month-old and 4-month-old, 7 month-old and 11 month-old (P < 0.05). The highest antithrombin activity was detected in 6 month-old W. pigra, followed by 10 month-old. Significant differences of antithrombin activity were found between 6-month-old and 4 month-old ones, and 5 month-old (P < 0.05), however, there were no significant difference between 6 month-old ones with other samples. Eleven-month-old W. pigra got the most dry weight, and there were significant difference between 11 month-old ones with other samples (P < 0.05).

CONCLUSIONNovember, namely for 6 month old artificial cultivated W. pigra was the best harvest time in Jiangsu and Zhejiang provinces.

Animals ; Antithrombin III ; Antithrombins ; analysis ; China ; Leeches ; chemistry ; growth & development ; Medicine, Chinese Traditional ; Peptide Fragments

Effective biomarkers for clinical usage of osteoarthritis are still limited. It was confirmed that C-terminal crosslinking telopeptide of type I collagen (CTX- II) was a specific marker reflecting degradation of articular cartilage. Detection of CTX- II could promptly reflect level of cartilage injury and degradation ,diagnose OA,predict its progress,monitor effects of drug treatment, thus, reflect the condition of osteoarthritis patient indirectly. Application of CTX- II focused mainly on in the early stage of OA and need together to detect with other biomarkers,in order to more accurately reflection of the pathological changes of OA,but the specific clinical significance of CTX- II results still need to improve further.
Biomarkers ; analysis ; Cartilage, Articular ; pathology ; Collagen Type II ; analysis ; Early Diagnosis ; Humans ; Osteoarthritis ; diagnosis ; Peptide Fragments ; analysis

OBJECTIVETo evaluate the diagnostic value of NT-proBNP in aortic stenosis (AS) patients with heart failure.

METHODWe measured the whole venous blood of NT-proBNP with enzyme linked immuno sorbent assay (Biomedica, Vienna, Austria) in 40 AS patients with heart failure and 76 normal subjects and assessed the diagnostic value of NT-proBNP for heart failure.

RESULTSNT-proBNP levels were significantly higher in AS patients with heart failure compared to controls (P < 0.01). The level of NT-proBNP increased in proportion to the increase of NYHA functional classes (all P < 0.01). The level of NT-proBNP was similar between compensated heart failure group and control group (P > 0.05) and significantly (8 times) increased in decompensated heart failure group (P < 0.01 vs. control group). NT-proBNP level was also significantly higher in LVEDD > 50 mm group than that in LVEDD ≤ 50 mm group (P < 0.05) and in LVEF ≤ 60% group than that in LVEF > 60% group (P < 0.01). Patients with atrial fibrillation also had higher NT-proBNP levels compared to those with sinus rhythm (P < 0.05). The NT-proBNP value of 1360 ng/L was determined as the best cutoff value for the diagnosis of AS patients with heart failure (AUC = 0.762, P < 0.01) and decompensated heart failure (AUC = 0.997, P < 0.01), the sensitivity, specificity and accuracy were 67.50% and 100.00%, 96.05% and 96.05% and 86.21% and 95.83%, respectively. Log (NT-proBNP) was positively related with NYHA functional class and negatively related with LVEF in univariate analysis and multiple regression analyses (P < 0.05). NT-proBNP was independent correlative with NYHA functional class and LVEF.

CONCLUSIONSNT-proBNP has a fairly good diagnostic potential for the identification of AS patients with heart failure. The accuracy is 86.21% for the diagnosis of AS patients with heart failure and 95.83% for decompensated heart failure with the diagnostic cutoff value of 1360 ng/L.

Adult ; Aged ; Aortic Valve Stenosis ; diagnosis ; Case-Control Studies ; Female ; Heart Failure ; diagnosis ; Humans ; Middle Aged ; Natriuretic Peptide, Brain ; analysis ; Peptide Fragments ; analysis

OBJECTIVETo examine the protective effect of ecdysterone (ECR) against beta-amyloid peptide fragment(25-35) (Abeta(25-35))-induced PC12 cells cytotoxicity, and to further explore its mechanism.

METHODSExperimental PC12 cells were divided into the Abeta group (treated by Abeta(25-35) 100 micromol/L), the blank group (untreated), the positive control group (treated by Vit E 100 micromol/L after induction) and the ECR treated groups (treated by ECR with different concentrations of 1, 50 and 100 micromol/L). The damaged and survival condition of PC12 cells in various groups was monitored by lactate dehydrogenase (LDH) release and MTT assay. The content of malondialdehyde (MDA) was measured by fluorometric assay to indicate the lipid peroxidation. And the antioxidant enzymes activities in PC12 cells, including superoxide dismutases (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px), were detected respectively.

RESULTSAfter PC12 cells were treated with Abeta(25-35) (100 micromol/L) for 24 hrs, they revealed a great decrease in MTT absorbance and activity of antioxidant enzymes, including SOD, CAT and GSH-Px as well as a significant increase of LDH activity and MDA content in PC12 cells (P < 0.01). When the cells was pretreated with 1-100 micromol/L ECR for 24 hrs before Abeta(25-35) treatment, the above-mentioned cytotoxic effect of Abeta(25-35) could be significantly attenuated dose-dependently, for ECR 50 micromol/L, P < 0.05 and for ECR 100 micromol/L, P < 0.01. Moreover, ECR also showed significant inhibition on the Abeta(25-35) induced decrease of SOD and GSH-Px activity, but not on that of CAT.

CONCLUSIONECR could protect PC12 cells from cytotoxicity of Abeta(25-35), and the protective mechanism might be related to the increase of SOD and GSH-Px activities and the decrease of MDA resulting from the ECR-pretreatment.

Amyloid beta-Peptides ; toxicity ; Animals ; Catalase ; analysis ; Ecdysterone ; pharmacology ; Glutathione Peroxidase ; analysis ; L-Lactate Dehydrogenase ; analysis ; Malondialdehyde ; analysis ; PC12 Cells ; Peptide Fragments ; toxicity ; Rats

BACKGROUND: Cardiovascular complications are major causes of morbidity and mortality following non-cardiac thoracic operations. Recent studies have demonstrated that elevation of N-Terminal Pro-B-type natriuretic peptide (NT-proBNP) levels can predict cardiac complications following non-cardiac major surgery as well as cardiac surgery. However, there is little information on the correlation between lung resection surgery and NT-proBNP levels. We evaluated the role of NT-proBNP as a potential marker for the risk stratification of cardiac complications following lung resection surgery. MATERIAL AND METHODS: Prospectively collected data of 98 patients, who underwent elective lung resection from August 2007 to February 2008, were analyzed. Postoperative adverse cardiac events were categorized as myocardial injury, ECG evidence of ischemia or arrhythmia, heart failure, or cardiac death. RESULTS: Postoperative cardiac complications were documented in 9 patients (9/98, 9.2%): Atrial fibrillation in 3, ECG-evidenced ischemia in 2 and heart failure in 4. Preoperative median NT-proBNP levels was significantly higher in patients who developed postoperative cardiac complications than in the rest (200.2 ng/L versus 45.0 ng/L, p=0.009). NT-proBNP levels predicted adverse cardiac events with an area under the receiver operating characteristic curve of 0.76 [95% confidence interval (CI) 0.545~0.988, p=0.01]. A preoperative NT-proBNP value of 160 ng/L was found to be the best cut-off value for detecting postoperative cardiac complication with a positive predictive value of 0.857 and a negative predictive value of 0.978. Other factors related to cardiac complications by univariate analysis were a higher American Society of Anesthesiologists grade, a higher NYHA functional class and a history of hypertension. In multivariate analysis, however, high preoperative NT-proBNP level (>160 ng/L) only remained significant. CONCLUSION: An elevated preoperative NT-proBNP level is identified as an independent predictor of cardiac complications following lung resection surgery.
Arrhythmias, Cardiac ; Atrial Fibrillation ; Electrocardiography ; Heart Failure ; Humans ; Hypertension ; Ischemia ; Lung ; Multivariate Analysis ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Prospective Studies ; ROC Curve ; Thoracic Surgery

BACKGROUND AND OBJECTIVES: Acute heart failure (AHF) is associated with a poor prognosis and it requires repeated hospitalizations. However, there are few studies on the characteristics, treatment and prognostic factors of AHF. The aims of this study were to describe the clinical characteristics, management and outcomes of the patients hospitalized for AHF in Korea. SUBJECTS AND METHODS: We analyzed the clinical data of 3,200 hospitalization episodes that were recorded between June 2004 and April 2009 from the Korean Heart Failure (KorHF) Registry database. The mean age was 67.6+/-14.3 years and 50% of the patients were female. RESULTS: Twenty-nine point six percent (29.6%) of the patients had a history of previous HF and 52.3% of the patients had ischemic heart disease. Left ventricular ejection fraction (LVEF) was reported for 89% of the patients. The mean LVEF was 38.5+/-15.7% and 26.1% of the patients had preserved systolic function (LVEF > or =50%), which was more prevalent in the females (34.0% vs. 18.4%, respectively, p<0.001). At discharge, 58.6% of the patients received beta-blockers (BB), 53.7% received either angiotensin converting enzyme-inhibitors or angiotensin receptor blockers (ACEi/ARB), and 58.4% received both BB and ACEi/ARB. The 1-, 2-, 3- and 4-year mortality rates were 15%, 21%, 26% and 30%, respectively. Multivariate analysis revealed that advanced age {hazard ratio: 1.023 (95% confidence interval: 1.004-1.042); p=0.020}, a previous history of heart failure {1.735 (1.150-2.618); p=0.009}, anemia {1.973 (1.271-3.063); p=0.002}, hyponatremia {1.861 (1.184-2.926); p=0.007}, a high level of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) {3.152 (1.450-6.849); p=0.004} and the use of BB at discharge {0.599 (0.360-0.997); p=0.490} were significantly associated with total death. CONCLUSION: We present here the characteristics and prognosis of an unselected population of AHF patients in Korea. The long-term mortality rate was comparable to that reported in other countries. The independent clinical risk factors included age, a previous history of heart failure, anemia, hyponatremia, a high NT-proBNP level and taking BB at discharge.
Anemia ; Angiotensin Receptor Antagonists ; Angiotensins ; Female ; Heart ; Heart Failure ; Hospitalization ; Humans ; Hyponatremia ; Korea ; Multivariate Analysis ; Myocardial Ischemia ; Natriuretic Peptide, Brain ; Peptide Fragments ; Prognosis ; Registries ; Risk Factors ; Stroke Volume

OBJECTIVETo establish the normal ranges for plasma N-terminal-pro-B-type natriuretic peptide (NT-proBNP) of middle-aged and elderly ( ≥ 40 years) healthy subjects in China.

METHODSA total of 5133 subjects (2170 men and 2963 women) from the cohort of Shanghai Heart Health Study (SHHS) were included in this study. Plasma NT-proBNP was measured by electrochemiluminescence immunoassay. The reference values (2.5th- 97.5th quartiles) were determined using both empiric and quantile regression methods.

RESULTSPlasma NT-proBNP values were higher in women than in men at all respective age groups (all P < 0.01) , and natural log-transformed NT-proBNP values increased in proportion with age for both genders and there was a lineal correlation between natural log-transformed NT-proBNP values and age (all P < 0.01) . Quantile regression derived normal reference values for NT-proBNP in male were 4.5-86.8 ng/L in the 40-44 years old group, 5.4-108.5 ng/L in the 45-49 years old group, 6.6-135.5 ng/L in the 50-54 years old group, 7.9-169.4 ng/L in the 55-59 years old group, 9.6-211.7 ng/L in the 60-64 years old group, 11.7-264.6 ng/L in the 65-69 years old group, 14.2-330.7 ng/L in the 70-74 years old group, and 18.1-429.2 ng/L in the ≥ 75 years old group. The reference values in female for NT-pro-BNP in respective age group were 8.5-141.8 ng/L, 10.4-166.6 ng/L, 12.8-195.7 ng/L, 15.7-229.9 ng/L, 19.3-270.1 ng/L, 23.7-317.3 ng/L, 29.1-372.8 ng/L, and 35.7-451.9 ng/L.

CONCLUSIONThis study preliminarily establishes the normal ranges of plasma NT-proBNP in middle-aged and elderly ( ≥ 40 years) Chinese.

Adult ; Aged ; Asian Continental Ancestry Group ; China ; Female ; Humans ; Male ; Middle Aged ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Reference Values ; Regression Analysis

Carcinoma, Hepatocellular ; chemistry ; Chromatography, High Pressure Liquid ; Female ; Hemoglobins ; analysis ; Humans ; Liver Neoplasms ; chemistry ; Male ; Mass Spectrometry ; Opioid Peptides ; analysis ; Peptide Fragments ; analysis