Dilated cardiomyopathy laboratory findings: Difference between revisions
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{{Dilated cardiomyopathy}} | {{Dilated cardiomyopathy}} | ||
{{CMG}}; {{AE}} {{AIA}} | |||
Most of the laboratory workup for dilated cardiomyopathy is usually targeted towards detecting the cause.<ref name="pmid27339497">{{cite journal| author=Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK| title=The Diagnosis and Evaluation of Dilated Cardiomyopathy. | journal=J Am Coll Cardiol | year= 2016 | volume= 67 | issue= 25 | pages= 2996-3010 | pmid=27339497 | doi=10.1016/j.jacc.2016.03.590 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27339497 }}</ref> | ==Overview== | ||
The majority of [[dilated cardiomyopathy]] laboratory workup is targeted towards detecting the cause (such as [[thyroid function tests]], [[Toxicology screen (patient information)|toxicology screen]]<nowiki/>ing, and [[Genetic counseling|genetic counselling]]) or assessing the cardiac [[Complication (medicine)|complications]] of the condition. Other biomarkers that are under investigation include serum [[uric acid]], Ca-125, soluble ST2, and Growth and differentiation factor-15. | |||
==Laboratory Findings == | |||
Most of the laboratory workup for [[dilated cardiomyopathy]] is usually targeted towards detecting the cause.<ref name="pmid27339497">{{cite journal| author=Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK| title=The Diagnosis and Evaluation of Dilated Cardiomyopathy. | journal=J Am Coll Cardiol | year= 2016 | volume= 67 | issue= 25 | pages= 2996-3010 | pmid=27339497 | doi=10.1016/j.jacc.2016.03.590 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27339497 }}</ref> | |||
* [[Thyroid function tests]] | * [[Thyroid function tests]] | ||
* Comprehensive metabolic panel | *[[Comprehensive metabolic panel]] | ||
* Workup for [[anemia]] ([[Complete blood count|CBC]] and iron studies) | * Workup for [[anemia]] ([[Complete blood count|CBC]] and [[iron]] studies) | ||
* Urine toxicology screening | * Urine toxicology screening | ||
** Some drugs as [[cocaine]] and [[amphetamine]] increase the risk of [[dilated cardiomyopathy]] | ** Some drugs as [[cocaine]] and [[amphetamine]] increase the risk of [[dilated cardiomyopathy]] | ||
* [[Genetic testing|Genetic screening]] | * [[Genetic testing|Genetic screening]] | ||
** Usually reserved as the last step. | ** Usually reserved as the last step. | ||
** May identify genetic/inherited causes of dilated cardiomyopathy. | ** May identify [[Genetics|genetic]]/inherited causes of [[dilated cardiomyopathy]]. | ||
Other laboratory investigations may target the severity of the condition or its effect on the cardiac function. | Other laboratory investigations may target the severity of the condition or its effect on the cardiac function. | ||
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* Pro-inflammatory [[Cytokine|cytokines]] (as [[Tumour necrosis factor|tumor necrosis factor]]-α and [[Interleukin 6|interleukin-6]])<ref name="pmid18698552">{{cite journal| author=Bielecka-Dabrowa A, Wierzbicka M, Dabrowa M, Goch A| title=New methods in laboratory diagnostics of dilated cardiomyopathy. | journal=Cardiol J | year= 2008 | volume= 15 | issue= 4 | pages= 388-95 | pmid=18698552 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18698552 }}</ref> | * Pro-inflammatory [[Cytokine|cytokines]] (as [[Tumour necrosis factor|tumor necrosis factor]]-α and [[Interleukin 6|interleukin-6]])<ref name="pmid18698552">{{cite journal| author=Bielecka-Dabrowa A, Wierzbicka M, Dabrowa M, Goch A| title=New methods in laboratory diagnostics of dilated cardiomyopathy. | journal=Cardiol J | year= 2008 | volume= 15 | issue= 4 | pages= 388-95 | pmid=18698552 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18698552 }}</ref> | ||
*Soluble ST2 (sST2): A cytokine released by cardiac [[Fibroblast|fibroblasts]] and vascular [[Endothelium|endothelial cells]] upon biomechanical stress | *Soluble ST2 (sST2): A cytokine released by cardiac [[Fibroblast|fibroblasts]] and vascular [[Endothelium|endothelial cells]] upon biomechanical stress | ||
**A recent study found that sST2 can predict the risk of heart failure in dilated cardiomyopathy.<ref name="pmid28579310">{{cite journal| author=Lichtenauer M, Jirak P, Wernly B, Paar V, Rohm I, Jung C et al.| title=A comparative analysis of novel cardiovascular biomarkers in patients with chronic heart failure. | journal=Eur J Intern Med | year= 2017 | volume= 44 | issue= | pages= 31-38 | pmid=28579310 | doi=10.1016/j.ejim.2017.05.027 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28579310 }}</ref> | **A recent study found that sST2 can predict the risk of heart failure in [[dilated cardiomyopathy]].<ref name="pmid28579310">{{cite journal| author=Lichtenauer M, Jirak P, Wernly B, Paar V, Rohm I, Jung C et al.| title=A comparative analysis of novel cardiovascular biomarkers in patients with chronic heart failure. | journal=Eur J Intern Med | year= 2017 | volume= 44 | issue= | pages= 31-38 | pmid=28579310 | doi=10.1016/j.ejim.2017.05.027 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28579310 }}</ref> | ||
* Growth and differentiation factor-15 (GDF-15) | * Growth and differentiation factor-15 (GDF-15) | ||
**Showed a negative correlation with left ventricular [[ejection fraction]] and a positive correlation with [[New york heart association functional classification|NYHA]] heart failure class.<ref name="pmid29375722">{{cite journal| author=Nair N, Gongora E| title=Correlations of GDF-15 with sST2, MMPs, and worsening functional capacity in idiopathic dilated cardiomyopathy: Can we gain new insights into the pathophysiology? | journal=J Circ Biomark | year= 2018 | volume= 7 | issue= | pages= 1849454417751735 | pmid=29375722 | doi=10.1177/1849454417751735 | pmc=5777561 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29375722 }}</ref> | **Showed a negative correlation with left ventricular [[ejection fraction]] and a positive correlation with [[New york heart association functional classification|NYHA]] heart failure class.<ref name="pmid29375722">{{cite journal| author=Nair N, Gongora E| title=Correlations of GDF-15 with sST2, MMPs, and worsening functional capacity in idiopathic dilated cardiomyopathy: Can we gain new insights into the pathophysiology? | journal=J Circ Biomark | year= 2018 | volume= 7 | issue= | pages= 1849454417751735 | pmid=29375722 | doi=10.1177/1849454417751735 | pmc=5777561 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29375722 }}</ref> | ||
* Serum immunoglobulin free light chain (FLC) κ and λ | * Serum [[immunoglobulin]] free light chain (FLC) κ and λ | ||
** Associated with the risk of [[Congestive heart failure|heart failure]] and mortality in dilated cardiomyopathy patients.<ref name="pmid26251088">{{cite journal| author=Jackson CE, Haig C, Welsh P, Dalzell JR, Tsorlalis IK, McConnachie A et al.| title=Combined Free Light Chains Are Novel Predictors of Prognosis in Heart Failure. | journal=JACC Heart Fail | year= 2015 | volume= 3 | issue= 8 | pages= 618-25 | pmid=26251088 | doi=10.1016/j.jchf.2015.03.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26251088 }}</ref> | ** Associated with the risk of [[Congestive heart failure|heart failure]] and mortality in [[dilated cardiomyopathy]] patients.<ref name="pmid26251088">{{cite journal| author=Jackson CE, Haig C, Welsh P, Dalzell JR, Tsorlalis IK, McConnachie A et al.| title=Combined Free Light Chains Are Novel Predictors of Prognosis in Heart Failure. | journal=JACC Heart Fail | year= 2015 | volume= 3 | issue= 8 | pages= 618-25 | pmid=26251088 | doi=10.1016/j.jchf.2015.03.014 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26251088 }}</ref> | ||
==References== | ==References== | ||
Latest revision as of 18:15, 16 December 2019
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Dilated cardiomyopathy laboratory findings On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdelrahman Ibrahim Abushouk, MD[2]
Overview
The majority of dilated cardiomyopathy laboratory workup is targeted towards detecting the cause (such as thyroid function tests, toxicology screening, and genetic counselling) or assessing the cardiac complications of the condition. Other biomarkers that are under investigation include serum uric acid, Ca-125, soluble ST2, and Growth and differentiation factor-15.
Laboratory Findings
Most of the laboratory workup for dilated cardiomyopathy is usually targeted towards detecting the cause.[1]
- Thyroid function tests
- Comprehensive metabolic panel
- Workup for anemia (CBC and iron studies)
- Urine toxicology screening
- Some drugs as cocaine and amphetamine increase the risk of dilated cardiomyopathy
- Genetic screening
- Usually reserved as the last step.
- May identify genetic/inherited causes of dilated cardiomyopathy.
Other laboratory investigations may target the severity of the condition or its effect on the cardiac function.
- Cardiac biomarkers (troponin and CK-MB)
- Brain natriuretic peptide (BNP)
Other biomarkers currently under investigation include:
- Uric acid (persistently elevated)
- Osteopontin
- Serum carbohydrate antigen-125 (Ca-125)[2]
- Pro-inflammatory cytokines (as tumor necrosis factor-α and interleukin-6)[3]
- Soluble ST2 (sST2): A cytokine released by cardiac fibroblasts and vascular endothelial cells upon biomechanical stress
- A recent study found that sST2 can predict the risk of heart failure in dilated cardiomyopathy.[4]
- Growth and differentiation factor-15 (GDF-15)
- Showed a negative correlation with left ventricular ejection fraction and a positive correlation with NYHA heart failure class.[5]
- Serum immunoglobulin free light chain (FLC) κ and λ
- Associated with the risk of heart failure and mortality in dilated cardiomyopathy patients.[6]
References
- ↑ Japp AG, Gulati A, Cook SA, Cowie MR, Prasad SK (2016). "The Diagnosis and Evaluation of Dilated Cardiomyopathy". J Am Coll Cardiol. 67 (25): 2996–3010. doi:10.1016/j.jacc.2016.03.590. PMID 27339497.
- ↑ Karaca O, Guler GB, Guler E, Gunes HM, Alizade E, Agus HZ; et al. (2012). "Serum carbohydrate antigen 125 levels in nonischemic dilated cardiomyopathy: a useful biomarker for prognosis and functional mitral regurgitation". Congest Heart Fail. 18 (3): 144–50. doi:10.1111/j.1751-7133.2011.00260.x. PMID 22587744.
- ↑ Bielecka-Dabrowa A, Wierzbicka M, Dabrowa M, Goch A (2008). "New methods in laboratory diagnostics of dilated cardiomyopathy". Cardiol J. 15 (4): 388–95. PMID 18698552.
- ↑ Lichtenauer M, Jirak P, Wernly B, Paar V, Rohm I, Jung C; et al. (2017). "A comparative analysis of novel cardiovascular biomarkers in patients with chronic heart failure". Eur J Intern Med. 44: 31–38. doi:10.1016/j.ejim.2017.05.027. PMID 28579310.
- ↑ Nair N, Gongora E (2018). "Correlations of GDF-15 with sST2, MMPs, and worsening functional capacity in idiopathic dilated cardiomyopathy: Can we gain new insights into the pathophysiology?". J Circ Biomark. 7: 1849454417751735. doi:10.1177/1849454417751735. PMC 5777561. PMID 29375722.
- ↑ Jackson CE, Haig C, Welsh P, Dalzell JR, Tsorlalis IK, McConnachie A; et al. (2015). "Combined Free Light Chains Are Novel Predictors of Prognosis in Heart Failure". JACC Heart Fail. 3 (8): 618–25. doi:10.1016/j.jchf.2015.03.014. PMID 26251088.