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Title: Biomarkers of acute cardiovascular and pulmonary diseases
Authors: Suzuki, Toru
Lyon, Alexander
Saggar, Rajeev
Heaney, Liam M.
Aizawa, Kenichi
Cittadini, Antonio
Mauro, Ciro
Citro, Rodolfo
Limongelli, Giuseppe
Ferrara, Francesco
Vriz, Olga
Morley-Smith, Andrew
Calabrò, Paolo
Bossone, Eduardo
First Published: 24-May-2016
Publisher: SAGE Publications on behalf of European Society of Cardiology, Acute Cardiac Care Working Group
Citation: European Heart Journal: Acute Cardiovascular Care, 2016, 5 (5), pp. 416-433
Abstract: 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.
DOI Link: 10.1177/2048872616652309
ISSN: 2048-8726
eISSN: 2048-8734
Version: Post-print
Status: Peer-reviewed
Type: Journal Article
Rights: Copyright © 2016, the author(s). Deposited with reference to the publisher’s archiving policy available on the SHERPA/RoMEO website.
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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