Dilated cardiomyopathy laboratory findings: Difference between revisions
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* Serum carbohydrate antigen-125 (Ca-125)<ref name="pmid22587744">{{cite journal| author=Karaca O, Guler GB, Guler E, Gunes HM, Alizade E, Agus HZ et al.| title=Serum carbohydrate antigen 125 levels in nonischemic dilated cardiomyopathy: a useful biomarker for prognosis and functional mitral regurgitation. | journal=Congest Heart Fail | year= 2012 | volume= 18 | issue= 3 | pages= 144-50 | pmid=22587744 | doi=10.1111/j.1751-7133.2011.00260.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22587744 }}</ref> | * Serum carbohydrate antigen-125 (Ca-125)<ref name="pmid22587744">{{cite journal| author=Karaca O, Guler GB, Guler E, Gunes HM, Alizade E, Agus HZ et al.| title=Serum carbohydrate antigen 125 levels in nonischemic dilated cardiomyopathy: a useful biomarker for prognosis and functional mitral regurgitation. | journal=Congest Heart Fail | year= 2012 | volume= 18 | issue= 3 | pages= 144-50 | pmid=22587744 | doi=10.1111/j.1751-7133.2011.00260.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22587744 }}</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> | * 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 fibroblasts and vascular endothelial cells upon biomechanical stress<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> | *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> | |||
* Growth and differentiation factor-15<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> | * 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> | |||
* Serum immunoglobulin free light chain (FLC) κ and λ | * Serum immunoglobulin free light chain (FLC) κ and λ | ||
** Associated with the risk of heart failure and mortality in dilated cardiomyopathy patients. | ** 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== | ||
Revision as of 16:53, 2 December 2019
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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.