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

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Title: Editor’s Choice-Biomarkers of acute cardiovascular and pulmonary diseases
Author(s): Suzuki, T
Lyon, A
Saggar, R
Heaney, LM
Aizawa, K
Cittadini, A
Mauro, C
Citro, R
Limongelli, G
Ferrara, F
Vriz, O
Morley-Smith, A
Calabro, P
Bossone, E
Item Type: Journal Article
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 ischemic heart disease, myocarditis, acute pericarditis, aortic dissection/rupture and pulmonary embolism (PE). Diseases that primarily present with dyspnea 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 ischemic heart disease and myocarditis (cardiac troponins), HF (B-type natriuretic peptide [BNP] and NTproBNP), 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 dyspnea, 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.
Publication Date: 7-Sep-2016
Date of Acceptance: 1-Apr-2016
URI: http://hdl.handle.net/10044/1/32400
DOI: https://dx.doi.org/10.1177/2048872616652309
ISSN: 2048-8734
Publisher: SAGE Publications
Start Page: 416
End Page: 433
Journal / Book Title: European Heart Journal: Acute Cardiovascular Care
Volume: 5
Issue: 5
Copyright Statement: © Sage 2016. The final publication is available via Sage at http://dx.doi.org/10.1177/2048872616652309
Sponsor/Funder: British Heart Foundation
Funder's Grant Number: FS/13/34/30173
Keywords: Biomarkers
chest disease
critical care
Publication Status: Published
Appears in Collections:National Heart and Lung Institute
Faculty of Medicine

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