Cardiovascular toxicology
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Cardiovascular toxicology · Jan 2001
ReviewOxidative stress and diabetic cardiomyopathy: a brief review.
Diabetes is a serious public health problem. Improvements in the treatment of noncardiac complications from diabetes have resulted in heart disease becoming a leading cause of death in diabetic patients. Several cardiovascular pathological consequences of diabetes such as hypertension affect the heart to varying degrees. ⋯ Oxidative stress, induced by reactive oxygen and nitrogen species derived from hyperglycemia, causes abnormal gene expression, altered signal transduction, and the activation of pathways leading to programmed myocardial cell deaths. The resulting myocardial cell loss thus plays a critical role in the development of diabetic cardiomyopathy. Advances in the application of various strategies for targeting the prevention of hyperglycemia-induced oxidative myocardial injury may be fruitful.
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Cardiovascular toxicology · Jan 2001
ReviewCardiac troponin assays: analytical issues and clinical reference range cutpoints.
A recently published consensus document from the European Society of Cardiology and American College of Cardiology emphasized the unique role cardiac troponin monitoring plays in redefining acute myocardial infarction. The cardiology community has now established criteria to define both the reference cutpoints and acceptable imprecision for troponin assays, which complement previous recommendations by the laboratory community. This article will review the analytical issues confronting laboratories, clinicians, and industry regarding troponin assay standardization, assay imprecision, and how clinical decision cutpoints should be established and implemented for clinical practice.
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Cardiovascular toxicology · Jan 2001
ReviewB-type natriuretic peptide levels: diagnostic and therapeutic potential.
A blood test that would aid in the diagnosis and management of patients with congestive heart failure would have a favorable impact on the staggering costs of the disease. B-type naturetic peptide (BNP) is synthesized in the cardiac ventricles and its release is directly proportional to ventricular volume expansion and pressure overload. Levels of BNP correlate with left ventricular pressure, amount of dyspnea, and the state of neurohumoral modulation. ⋯ A cut point of 100 pg/mL appears to discriminate patients with congestive heart failure from those without congestive heart failure. Measurement of BNP may also be an excellent screening tool for LV dysfunction. Key Words: Natriuretic peptides; neurohormonal; left-ventricular pressure;