Biomarkers of myocardial fibrosis, myocardial necrosis, hemodynamic stress and inflammation in patients undergoing coronary artery bypass grafting : doctoral dissertation

[N. B. Mladenović]

[11], 116 listova

Biografija autora: list 113 Bibliografija: list. 98-109

Internal medicine, cardiology

Coronary heart disease is one of the most widespread diseases of the cardiovascular system. As a result, ischemic cardiomyopathy, myocardial infarction, myocardial fibrosis and valvular diseases develop. Treatment of coronary artery disease can be conservative and invasive. Invasive therapeutic approaches are percutaneous coronary interventions and surgical revascularization of the myocardium, which have greatly contributed to prolonging life and improving the quality of life. Myocardial fibrosis is, among other things, a consequence of coronary disease, which is directly related to quality of life and survival. One of the newer biomarkers that can be used to assess myocardial fibrosis is galectin-3, although it is not yet in routine use. Myocardial fibrosis is also influenced by hemodynamic stress, which can be directly observed through the biomarker NT-proBNP, and markers of inflammation and necrosis of the myocardium also have a significant impact. In this study, galectin-3 was investigated and compared with the values of NTproBNP, C-reactive protein (CRP) and creatine kinase MB (CK-MB) in coronary disease treated by surgical myocardial revascularization. 110 patients participated, whose biomarker values were monitored preoperatively and on two occasions postoperatively. The laboratory processing of the markers was carried out using the Elisa method. The mutual relationship of the mentioned biomarkers was monitored, as well as the movement in relation to the complications recorded during the postoperative period in terms of heart rhythm disorders, perioperative myocardial infarction, central vascular ischemia, as well as the influence of spironolactone on their movement and overall connection. The results obtained are significant in the direction of the level of galectin-3 as a marker whose early postoperative decrease is associated with heart rhythm disturbances in the form of atrial fibrillation with absolute ventricular response. It is also registered that patients who preoperatively used spironolactone in their therapy had a statistically significantly lower incidence of cardiac arrhythmia. No significant correlations were found between galectin-3 levels and other biomarkers.

Hirurška revaskularizacja miokarda, galektin-3, NT-proBNP, CRP, CK-MB, fibroza miokarda, atrijalna fibrilacija

Surgical myocardial revascularization, galectin-3, NT-proBNP, CRP, CK-MB, myocardial fibrosis, atrial fibrillation

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