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14 pages, 971 KiB  
Article
High Voltage and Train-Surfing Injuries: A 30-Year Retrospective Analysis of High-Voltage Trauma and Its Impact on Cardiac Biomarkers
by Viktoria Koenig, Maximilian Monai, Alexandra Christ, Marita Windpassinger, Gerald C. Ihra, Alexandra Fochtmann-Frana and Julian Joestl
J. Clin. Med. 2025, 14(14), 4969; https://doi.org/10.3390/jcm14144969 - 14 Jul 2025
Viewed by 286
Abstract
Background: High-voltage electrical injuries (HVEIs) represent a complex and life-threatening entity, frequently involving multi-organ damage. While traditionally linked to occupational hazards, train surfing—riding on moving trains—and train climbing—scaling stationary carriages—have emerged as increasingly common causes among adolescents. Popularized via social media, these [...] Read more.
Background: High-voltage electrical injuries (HVEIs) represent a complex and life-threatening entity, frequently involving multi-organ damage. While traditionally linked to occupational hazards, train surfing—riding on moving trains—and train climbing—scaling stationary carriages—have emerged as increasingly common causes among adolescents. Popularized via social media, these behaviors expose individuals to the invisible danger of electric arcs from 15,000-volt railway lines, often resulting in extensive burns, cardiac complications, and severe trauma. This study presents a 30-year retrospective analysis comparing cardiac biomarkers and clinical outcomes in train-surfing injuries versus work-related HVEIs. Methods: All patients with confirmed high-voltage injury (≥1000 volts) admitted to a Level 1 burn center between 1994 and 2024 were retrospectively analyzed. Exclusion criteria comprised low-voltage trauma, suicide, incomplete records, and external treatment. Clinical and laboratory parameters—including total body surface area (TBSA), Abbreviated Burn Severity Index (ABSI), electrocardiogram (ECG) findings, intensive care unit (ICU) and hospital stay, mortality, and cardiac biomarkers (creatine kinase [CK], CK-MB, lactate dehydrogenase [LDH], aspartate transaminase [AST], troponin, and myoglobin)—were compared between the two cohorts. Results: Of 81 patients, 24 sustained train-surfing injuries and 57 were injured in occupational settings. Train surfers were significantly younger (mean 16.7 vs. 35.2 years, p = 0.008), presented with greater TBSA (49.9% vs. 17.9%, p = 0.008), higher ABSI scores (7.3 vs. 5.1, p = 0.008), longer ICU stays (53 vs. 17 days, p = 0.008), and higher mortality (20.8% vs. 3.5%). ECG abnormalities were observed in 51% of all cases, without significant group differences. However, all cardiac biomarkers were significantly elevated in train-surfing injuries at both 72 h and 10 days post-injury (p < 0.05), suggesting more pronounced cardiac and muscular damage. Conclusions: Train-surfing-related high-voltage injuries are associated with markedly more severe systemic and cardiac complications than occupational HVEIs. The significant biomarker elevation and critical care demands highlight the urgent need for targeted prevention, public awareness, and early cardiac monitoring in this high-risk adolescent population. Full article
(This article belongs to the Section Cardiovascular Medicine)
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22 pages, 2244 KiB  
Article
Revolutionizing Cardiac Risk Assessment: AI-Powered Patient Segmentation Using Advanced Machine Learning Techniques
by Joan D. Gonzalez-Franco, Alejandro Galaviz-Mosqueda, Salvador Villarreal-Reyes, Jose E. Lozano-Rizk, Raul Rivera-Rodriguez, Jose E. Gonzalez-Trejo, Alexei-Fedorovish Licea-Navarro, Jorge Lozoya-Arandia and Edgar A. Ibarra-Flores
Mach. Learn. Knowl. Extr. 2025, 7(2), 46; https://doi.org/10.3390/make7020046 - 22 May 2025
Viewed by 1570
Abstract
Cardiovascular diseases stand as the leading cause of mortality worldwide, underscoring the urgent need for effective tools that enable early detection and monitoring of at-risk patients. This study combines Artificial Intelligence (AI) techniques—specifically the k-means clustering algorithm—alongside dimensionality reduction methods like Principal Component [...] Read more.
Cardiovascular diseases stand as the leading cause of mortality worldwide, underscoring the urgent need for effective tools that enable early detection and monitoring of at-risk patients. This study combines Artificial Intelligence (AI) techniques—specifically the k-means clustering algorithm—alongside dimensionality reduction methods like Principal Component Analysis (PCA) and Uniform Manifold Approximation and Projection (UMAP) to identify patient groups with varying levels of heart attack risk. We used a publicly available clinical dataset with 1319 patient records, which included variables such as age, gender, blood pressure, glucose levels, CK-MB Creatine Kinase MB (KCM), and troponin levels. We normalized and prepared the data, then we employed PCA and UMAP to reduce dimensionality and facilitate visualization. Using the k-means algorithm, we segmented the patients into distinct groups based on their clinical features. Our analysis revealed two distinct patient groups. Group 2 exhibited significantly higher levels of troponin (mean 0.4761 ng/mL), KCM (18.65 ng/mL), and glucose (mean 148.19 mg/dL) and was predominantly composed of men (97%). These factors indicate an increased risk of cardiac events compared to Group 1, which had lower levels of these biomarkers and a slightly higher average age. Interestingly, no significant differences in blood pressure were observed between the groups. This study demonstrates the effectiveness of combining Machine Learning (ML) techniques with dimensionality reduction methods to enhance risk stratification accuracy in cardiology. By enabling more targeted interventions for high-risk patients, our unsupervised segmentation approach focuses on intrinsic data patterns rather than predefined diagnostic labels, serves as a powerful complement to traditional risk assessment tools. Full article
(This article belongs to the Special Issue Sustainable Applications for Machine Learning)
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16 pages, 2064 KiB  
Article
Effect of Metabolic Stress to High-Load Exercise on Muscle Damage, Inflammatory and Hormonal Responses
by Séverine Stragier, Jacques Duchateau, Frédéric Cotton, Julie Smet, Fleur Wolff, Jérémy Tresnie and Alain Carpentier
Sports 2025, 13(4), 111; https://doi.org/10.3390/sports13040111 - 9 Apr 2025
Viewed by 2791
Abstract
To assess the impact of metabolic stress on blood lactate, muscle damage, inflammatory and hormonal responses following a high-load (70% maximum) strength training session, we compared two methods with a similar number of repetitions but that differed by their metabolic demand: the 3/7 [...] Read more.
To assess the impact of metabolic stress on blood lactate, muscle damage, inflammatory and hormonal responses following a high-load (70% maximum) strength training session, we compared two methods with a similar number of repetitions but that differed by their metabolic demand: the 3/7 method consisting in two series of five sets of an increasing number of repetitions (3 to 7) with a short inter-set interval (15 s) and the 8 × 6 method that comprises eight sets of six repetitions with a longer inter-set interval (2.5 min). Blood concentrations in lactate, creatine kinase (CK), myoglobin (MB), interleukine-6 (IL-6), leukocytes, growth hormone (GH), insulin-like growth factor-1 (IGF-1) and cortisol were determined before and after each session. Lactate concentration increased more (11.9 vs. 3.1 mmol/L; p < 0.001) for the 3/7 method whereas CK and MB concentrations were augmented similarly (p > 0.05) for both methods. Inflammatory markers (leukocytes and IL-6) increased (p < 0.01) more after the 3/7 method. GH and cortisol concentrations also increased more (p < 0.001) after the 3/7 method with no difference in IGF-1 concentrations between methods. Positive associations were found between the change in lactate and changes in IL-6 (r2 = 0.47; p < 0.01), GH (r2 = 0.58; p < 0.001) and cortisol (r2 = 0.61; p < 0.001) concentrations. In conclusion, the greater lactate accumulation induced by short inter-set intervals during a high-load training session is associated with enhanced inflammatory and hormonal responses, suggesting that metabolic stress might contribute to the greater adaptative response previously observed with this method. Full article
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17 pages, 1937 KiB  
Article
Effect of Continuous Lipopolysaccharide Induction on Oxidative Stress and Heart Injury in Weaned Piglets
by Jinyan Li, Guotong Zhao, Jin Liu, Xiaofen Hu, Wanting Yu, Jue Wang, Shengwei Zhong, Wenlu Zhu, Tingyu Yang, Yunxiao Zhou, Yijie Jiang, Lingna Bai, Mengyan Tu, Quan Yang and Yong Li
Vet. Sci. 2025, 12(4), 330; https://doi.org/10.3390/vetsci12040330 - 3 Apr 2025
Viewed by 781
Abstract
After weaning, piglets no longer consume breast milk, and their immune system is not yet fully developed. At this time, if weaned piglets are infected with E. coli, their subsequent growth will be seriously affected. In the present study, 48 healthy 28-day-old [...] Read more.
After weaning, piglets no longer consume breast milk, and their immune system is not yet fully developed. At this time, if weaned piglets are infected with E. coli, their subsequent growth will be seriously affected. In the present study, 48 healthy 28-day-old weaned piglets (6.65 ± 1.19 kg, Duroc × Landrace × Large White) were randomly divided into an LPS group and control group. Piglets in the LPS group were intraperitoneally injected with an LPS solution (LPS was dissolved in sterile saline to form a solution of 100 μg/mL and injected at a dose of 1 mL per kilogram of body weight) for 13 consecutive days. Piglets in the control group were injected with the same volume of sterile saline. On days 1, 5, 9, and 13 of the experiment, six piglets from each group were randomly selected for dissection, the blood and heart samples were collected, and then cardiac function-related indicators were detected. A portion of the heart tissue was fixed in 4% paraformaldehyde and further used to make paraffin sections; then, hematoxylin–eosin (H&E) staining was performed. Masson staining was used to detect the changes in collagen fibers in the hearts. The other parts of the heart tissues were frozen in liquid nitrogen and stored in a refrigerator at −80 °C for the detection of tissue antioxidant indices. The mRNA expression levels of the toll-like receptor 4 (TLR4) signaling pathway, transforming growth factor-β (TGF-β) signaling pathway, and inflammatory cytokines in heart tissues were detected by real-time PCR. The results showed that catalase (CAT) and superoxide dismutase (SOD) contents in the heart tissue homogenates increased significantly on days 1 and 5 in LPS-induced piglets (p < 0.01, p < 0.05), while total antioxidant capacity (T-AOC) and glutathione peroxidase (GSH-Px) contents decreased significantly on day 5 (p < 0.05). On day 5, the contents of serum cardiac function indicators lactate dehydrogenase (LDH), creatine kinase isoenzymes (CK-MB), and cardiac troponin I (cTn-I) were significantly increased in LPS-induced piglets (p < 0.01). On the 1st and 5th days, the heart tissue showed obvious pathological damage, which was manifested as the disordered arrangement of myocardial fibers, depression of myocardial cells, infiltration of inflammatory factors, congestion of capillaries, and significant increase in cardiac collagen fibers. On the 1st day, the mRNA expression levels of tumor necrosis factor-alpha (TNF-α) and interleukin 6 (IL-6) were significantly increased in LPS-induced piglets with heart injury (p < 0.01). On the 5th day, the mRNA expression levels of the TLR4 signaling pathway [TLR4, myeloid differentiation primary response gene 88 (MyD88), nuclear factor kappa-B (NF-κB)], TNF-α, and interleukin 10 (IL-10) were also significantly increased in LPS-induced piglets with heart injury (p < 0.01, p < 0.05). The mRNA expression levels of the TGF-β signaling pathway (TGF-β, Smad2, and Smad4) in cardiac fibrosis-related genes were significantly increased on days 5 and 9 (p < 0.01, p < 0.05). The mRNA expression levels of Smad3 and Smad7 in cardiac fibrosis-related genes were also significantly increased on day 9 (p < 0.01). These results indicate that oxidative stress occurs in the heart tissue of LPS-induced piglets on the 1st and 5th days, leading to cardiac tissue damage. However, on the 9th and 13th days, the degree of heart damage in the piglets was less than that on the 1st and 5th days, which may be due to the tolerance of piglets’ tissues and organs because of multiple same-dose LPS stimulations. Full article
(This article belongs to the Section Anatomy, Histology and Pathology)
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16 pages, 4960 KiB  
Article
Protective Effect of Probiotics on Cardiac Damage in Experimental Sepsis Model Induced by Lipopolysaccharide in Rats
by Necip Gökhan Taş, Osman Aktaş, Hakan Gökalp Taş, Selim Zırh, Nezahat Kurt and Hakan Uslu
Medicina 2025, 61(4), 589; https://doi.org/10.3390/medicina61040589 - 25 Mar 2025
Viewed by 979
Abstract
Background and Objective: Probiotics have been shown to be effective in controlling various adverse health conditions such as antibiotic-associated diarrhea, inflammatory bowel disease, obesity, and neurological diseases. However, to our knowledge, there is no research on the preventive effect of probiotics on [...] Read more.
Background and Objective: Probiotics have been shown to be effective in controlling various adverse health conditions such as antibiotic-associated diarrhea, inflammatory bowel disease, obesity, and neurological diseases. However, to our knowledge, there is no research on the preventive effect of probiotics on heart damage caused by infections. This study examined the preventive benefits of probiotics against sepsis-related heart injury using a rat model caused by lipopolysaccharide (LPS). Materials and Methods: Four groups of twenty-four male Wistar albino rats, each with six rats, were set up. For 14 days, Group 1 (Sham Group) was given oral normal saline, intraperitoneal Escherichia coli O111-B4 lipopolysaccharide (LPS Group) was given to Group 2, and oral probiotics were given to Group 3 (Probiotic Group). Escherichia coli O111-B4 lipopolysaccharide was injected intraperitoneally after Group 4 (Probiotic + LPS) received oral probiotics containing Lactobacillus rhamnosus GG and Bifidobacterium animalis subsp. lactis BB-12 (109 CFU/day). Blood samples were taken twenty-four hours following the administration of LPS. The animals were then euthanized by cervical dislocation, and samples of cardiac tissue were taken in order to assess any damage to the heart. The following serum values were measured: C-reactive protein (CRP), creatine kinase-myocardial band (CK-MB), cardiac troponin subunit I (cTn-I), tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and interleukin-6 (IL-6). The TNF-α, IL-1β, IL-6, glutathione (GSH), malondialdehyde (MDA), Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Oxidative Stress Index (OSI), CRP, CK-MB, and cTn-I levels were assessed in tissue samples. Additionally, staining techniques were used to analyze histopathological alterations in tissues. Results: With the exception of serum IL-6 (p = 0.111), tissue and serum cytokine levels were considerably greater in the sepsis group (Group 2) than in the other groups (p < 0.05 to <0.001). The TAS, GSH, and SOD levels were significantly lower (p < 0.05 to <0.001) in septic rats, although the tissue levels of TOS, OSI, and MDA were significantly higher. With the exception of serum CRP in Group 3 (p = 0.328), the CK-MB, CRP, and cTn-I levels were considerably higher in Group 2 than in the other groups (p < 0.01 to <0.001). When compared to the other groups, histopathological examination showed significant alterations in the LPS group. Conclusions: Probiotics showed positive effects on oxidative stress markers and dramatically decreased sepsis-induced cardiac damage in the LPS-induced sepsis model. These results imply that probiotics could be used as a therapeutic approach to lessen the cardiac damage brought on by sepsis. Full article
(This article belongs to the Special Issue Infection, Inflammation and Immunity in Health and Disease)
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15 pages, 1689 KiB  
Article
Effect of Combined Vitamin C and Thiamine Therapy on Myocardial and Inflammatory Markers in Cardiac Surgery: A Randomized Controlled Clinical Trial
by Mantana Saetang, Wirat Wasinwong, Maliwan Oofuvong, Jutarat Tanasansutthiporn, Laortip Rattanapittayaporn, Sutthasinee Petsakul, Pongsanae Duangpakdee, Puripong Rodneam, Parin Boonthum, Supphamongkhon Khunakanan, Chaitong Churuangsuk, Wilaiwan Sriwimol, Amphan Chantarokon, Kanjana Nuanjun and Dararat Yongsata
Nutrients 2025, 17(6), 1006; https://doi.org/10.3390/nu17061006 - 13 Mar 2025
Viewed by 1521
Abstract
Background: Oxidative stress and systemic inflammation during cardiac surgery can lead to postoperative complications. Although vitamin C and thiamine (vitamin B1) have individually demonstrated protective effects, their combined effects remain underexplored. This study aimed to evaluate the efficacy of combined vitamin C and [...] Read more.
Background: Oxidative stress and systemic inflammation during cardiac surgery can lead to postoperative complications. Although vitamin C and thiamine (vitamin B1) have individually demonstrated protective effects, their combined effects remain underexplored. This study aimed to evaluate the efficacy of combined vitamin C and B1 therapy versus that of vitamin C alone in reducing inflammatory and cardiac biomarkers and improving postoperative outcomes in patients undergoing cardiac surgery. Methods: In this prospective, double-blind, randomized controlled trial, 64 patients scheduled for elective cardiac surgery at a tertiary care center were randomized to receive either 1000 mg vitamin C or a combination of 1000 mg vitamin C and 100 mg vitamin B1 at four perioperative time points. Primary outcomes included changes in inflammatory biomarkers [C-reactive protein, interleukin-6 (IL-6), and white blood cells], and cardiac biomarkers [creatine kinase-MB, Troponin-I, and lactate dehydrogenase]. Secondary outcomes included hemodynamic parameters and left ventricular function. Results: Compared with vitamin C alone, combined vitamin B1 and vitamin C significantly reduced postoperative cardiac biomarker levels. IL-6 levels were significantly lower immediately in the combined group; however, this effect was not sustained at 24 h post-surgery. Up to 24 h after surgery, no significant differences in hemodynamic stability or left ventricular ejection were observed between the groups. Notably, the combined therapy group demonstrated a lower incidence of postoperative arrhythmias and shorter dobutamine duration within 24 postoperatively. Conclusions: Combined vitamin C and B1 therapy significantly reduced markers of myocardial injury and early inflammatory responses (IL-6) in patients undergoing cardiac surgery, suggesting its potential as a protective agent. Full article
(This article belongs to the Special Issue Effects of Nutrient Intake on Cardiovascular Disease)
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14 pages, 547 KiB  
Article
Evaluation of Thrombomodulin, Heart-Type Fatty-Acid-Binding Protein, Pentraxin-3 and Galectin-3 Levels in Patients with Myocardial Infarction, with and Without ST Segment Elevation
by Naile Fevziye Misirlioglu, Gulbahar Guler Orucoglu, Burcu Bıcakhan, Suat Hayri Kucuk, Solen Himmetoglu, Sena Baykara Sayili, Gulenay Defne Ozen and Hafize Uzun
J. Clin. Med. 2025, 14(3), 1015; https://doi.org/10.3390/jcm14031015 - 5 Feb 2025
Cited by 1 | Viewed by 1058
Abstract
Background: Medical history, ECG findings and cardiac markers are used in the diagnosis of myocardial infarction (MI). Biomarkers used especially for the diagnosis of MI include high-sensitivity troponins (hsTns), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), myoglobin, cardiac myosin-binding protein C and new cardiac [...] Read more.
Background: Medical history, ECG findings and cardiac markers are used in the diagnosis of myocardial infarction (MI). Biomarkers used especially for the diagnosis of MI include high-sensitivity troponins (hsTns), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), myoglobin, cardiac myosin-binding protein C and new cardiac biomarkers. This study evaluated the levels of serum thrombomodulin (TM), heart-type fatty-acid-binding protein (H-FABP), pentraxin-3 (PTX-3) and galectin-3 (Gal-3) to determine their utility in distinguishing between ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Methods: This study included a total of 180 patients (90 patients with acute STEMI and 90 patients with NSTEMI) who presented to the Gaziosmanpaşa Training and Research Hospital, Cardiovascular Surgery and Emergency Department, with ischemic chest pain lasting longer than 30 min. Ninety healthy volunteers were included as the control group. Results: Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), TM, H-FABP, PTX-3 and Gal-3 were significantly different across the STEMI, NSTEMI and control groups (p < 0.001). Strong positive correlations were observed between NT-proBNP and TM, H-FABP, PTX-3 and Gal-3 in the STEMI group. ROC analysis demonstrated excellent diagnostic accuracy for these biomarkers in distinguishing STEMI from NSTEMI and control groups. Conclusions: Vascular inflammation plays an important role in the pathophysiology of STEMI and NSTEMI. A comprehensive cardiac biomarker panel enhances diagnostic accuracy and risk stratification, particularly when distinguishing between STEMI and NSTEMI. The biomarkers hs-TnI, CK-MB, NT-proBNP, TM, H-FABP, PTX-3 and Gal-3 offer complementary information when used together as a panel. Further research and validation are essential to establish standardized protocols for their widespread use. Full article
(This article belongs to the Section Cardiovascular Medicine)
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12 pages, 944 KiB  
Article
Long-Term Clinical Relevance of Hyponatremia Identified During Acute Phase of Myocardial Infarction
by Karolina Eliasz, Konrad Stępień, Maja Wojtylak, Oliwia Andrasz, Katarzyna Majka, Gabriela Mazurek, Grzegorz Horosin, Jakub Plizga, Karol Nowak, Krzysztof Krawczyk, Mateusz Podolec, Jadwiga Nessler and Jarosław Zalewski
J. Clin. Med. 2025, 14(3), 962; https://doi.org/10.3390/jcm14030962 - 3 Feb 2025
Cited by 1 | Viewed by 954
Abstract
Background/Objectives: Hyponatremia is associated with increased mortality in the general hospital population. We sought to investigate whether hyponatremia affects the long-term survival of patients following a myocardial infarction (MI) in both ST-segment elevation (STEMI) and non-ST elevation (NSTEMI) presentations. Methods: In this [...] Read more.
Background/Objectives: Hyponatremia is associated with increased mortality in the general hospital population. We sought to investigate whether hyponatremia affects the long-term survival of patients following a myocardial infarction (MI) in both ST-segment elevation (STEMI) and non-ST elevation (NSTEMI) presentations. Methods: In this study, 862 MI patients who were hospitalized between 2012 and 2017 were retrospectively followed-up within the median time period of 41.9 [28.2–73.5] months. All participants were assigned to a hyponatremic or normonatremic group with hyponatremia defined as a sodium level of less than 135 mEq/L on admission. Results: In the acute phase of an MI, hyponatremia was diagnosed in 31 (3.6%) patients. The patients with hyponatremia were less often male (38.7 vs. 70.4%, p < 0.001), and less frequently had Killip class I (63.3 vs. 80%) but more often had Killip class IV on admission (16.7 vs. 4.2%, p = 0.024) and more often had a history of impaired renal function (32.3 vs. 15.5%, p = 0.013) than those with normonatremia. Hyponatremic patients had higher troponin T levels on admission by 75.1% (p = 0.003), a higher isoenzyme MB of creatine kinase level by 34.4% (p = 0.006), and lower hemoglobin (by 8.5%, p = 0.001) levels as compared to the normonatremia group. Long-term mortality was significantly higher in the patients with hyponatremia versus normonatremia (18 [58.1%] vs. 243 [29.2%], log-rank p < 0.001). This was driven by differences in the NSTEMI population (65 vs. 30.5%, p < 0.001). By a Cox proportional hazard regression analysis, hyponatremia was associated with a higher long-term mortality (hazard ratio [HR] of 2.222, a 95% confidence interval [CI] of 1.309–3.773, and p = 0.003). Conclusions: Hyponatremia rarely identified in acute phase of MI was associated with higher long-term mortality, particularly in the NSTEMI population. Full article
(This article belongs to the Section Cardiology)
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16 pages, 2741 KiB  
Article
Quantification of Myocardial Biomarkers in Sudden Cardiac Deaths Using a Rapid Immunofluorescence Method for Simultaneous Biomarker Analysis
by Matteo Antonio Sacco, Valerio Riccardo Aquila, Saverio Gualtieri, Roberto Raffaele, Maria Cristina Verrina, Lucia Tarda, Santo Gratteri and Isabella Aquila
Biomedicines 2025, 13(1), 193; https://doi.org/10.3390/biomedicines13010193 - 14 Jan 2025
Viewed by 1293
Abstract
Background/Objectives: Differential diagnosis of sudden cardiac death (SCD) remains challenging, particularly in cases lacking evident structural abnormalities. Cardiac markers have been proposed as useful tools for this differentiation in forensic contexts. However, key issues include the influence of postmortem interval (PMI) on marker [...] Read more.
Background/Objectives: Differential diagnosis of sudden cardiac death (SCD) remains challenging, particularly in cases lacking evident structural abnormalities. Cardiac markers have been proposed as useful tools for this differentiation in forensic contexts. However, key issues include the influence of postmortem interval (PMI) on marker stability and the limitations of traditional approaches that focus on pericardial fluid, which requires invasive sampling compared to peripheral blood. This study aimed to evaluate the potential of cardiac markers in peripheral blood for diagnosing SCD, addressing methodological concerns related to PMI, hemolysis, and sample handling. Methods: This study analyzed 5 cardiac markers (creatine kinase-MB [CK-MB], myoglobin, troponin I [TnI], BNP, and D-dimer) in peripheral blood samples from 42 autopsied cadavers, divided into an SCD group and a control group. Marker levels were quantified using immunofluorescence, with cases meticulously selected to exclude confounding factors such as chronic diseases, pulmonary thromboembolism, and drowning. The study also accounted for potential degradation due to PMI, and evaluated the accuracy of point-of-care testing (POCT) in forensic samples. Results: The study identified statistically significant differences in myoglobin and TnI levels between the SCD group and the control group, though myoglobin’s diagnostic reliability remains limited due to its lack of specificity for myocardial injury. TnI emerged as a more robust marker for SCD. Contrary to prior concerns, PMI showed no significant correlation with marker levels in samples handled without freeze–thaw cycles. Issues related to hemolysis were addressed, and no significant effects were observed from resuscitation maneuvers. Conclusions: This study supports the potential use of cardiac markers, particularly TnI, in peripheral blood for postmortem SCD diagnosis, emphasizing the importance of rapid and systematic analysis to minimize hemolysis-related variability. While further validation is needed to confirm these findings, this approach offers a less invasive, economical, and practical method for forensic investigations. Full article
(This article belongs to the Section Molecular Genetics and Genetic Diseases)
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17 pages, 4003 KiB  
Article
Cardiac Biomarkers in a Brazilian Indigenous Population Exposed to Arboviruses: A Cross-Sectional Study
by Jandir Mendonça Nicacio, Carlos Dornels Freire de Souza, Orlando Vieira Gomes, Beatriz Vasconcelos Souza, João Augusto Costa Lima, Rodrigo Feliciano do Carmo, Sávio Luiz Pereira Nunes, Vanessa Cardoso Pereira, Naiara de Souza Barros, Ana Luiza Santos de Melo, Lucca Gabriel Feitosa Lourencini, Jurandy Júnior Ferraz de Magalhães, Diego Guerra de Albuquerque Cabral, Ricardo Khouri, Manoel Barral-Netto and Anderson da Costa Armstrong
Viruses 2024, 16(12), 1902; https://doi.org/10.3390/v16121902 - 10 Dec 2024
Viewed by 1507
Abstract
Arthropod-borne viral diseases are acute febrile illnesses, sometimes with chronic effects, that can be debilitating and even fatal worldwide, affecting particularly vulnerable populations. Indigenous communities face not only the burden of these acute febrile illnesses, but also the cardiovascular complications that are worsened [...] Read more.
Arthropod-borne viral diseases are acute febrile illnesses, sometimes with chronic effects, that can be debilitating and even fatal worldwide, affecting particularly vulnerable populations. Indigenous communities face not only the burden of these acute febrile illnesses, but also the cardiovascular complications that are worsened by urbanization. A cross-sectional study was conducted in an Indigenous population in the Northeast Region of Brazil to explore the association between arboviral infections (dengue, chikungunya, and Zika) and cardiac biomarkers, including cardiotrophin 1, growth differentiation factor 15, lactate dehydrogenase B, fatty-acid-binding protein 3, myoglobin, N-terminal pro-B-type natriuretic peptide, cardiac troponin I, big endothelin 1, and creatine kinase-MB, along with clinical and anthropometric factors. The study included 174 individuals from the Fulni-ô community, with a median age of 47 years (interquartile range 39.0 to 56.0). High rates of previous exposure to dengue, chikungunya, and Zika were observed (92.5%, 78.2%, and 95.4% anti-IgG, respectively), while acute exposure (anti-IgM) remained low. The biomarkers were linked to age (especially in the elderly), obesity, chronic kidney disease, and previous or recent exposure to chikungunya. This study pioneers the use of Luminex xMAP technology to reveal the association between cardiac inflammatory biomarkers and exposure to classical arboviruses in an Indigenous population undergoing urbanization. Full article
(This article belongs to the Special Issue Zoonotic and Vector-Borne Viral Diseases)
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20 pages, 11828 KiB  
Article
Bacterial Cellulose Membrane Experimentally Implanted in the Peritoneum of Wistar Rats—Inflammatory Immunoreactivity and Oxidative Stress
by Karina Oliveira Santos, Rebecca Bertolo, Natasha Lien de Almeida Ibanez, Mônica Rodrigues Alves, Tatiana Pessoa Onuma, Gabriella Costa Ribeiro, Anna Julia de Souza Porto, Cláudio Gustavo Barbeito, Luciana Pinato, Angela Faustino Jozala, Denise Grotto and Alessandre Hataka
Curr. Issues Mol. Biol. 2024, 46(11), 11729-11748; https://doi.org/10.3390/cimb46110697 - 22 Oct 2024
Viewed by 1297
Abstract
Bacterial cellulose (BC) has been used for various applications; however, studies investigating the immunohistochemical characteristics of the inflammatory and scarring component in BC implanted in the peritoneum in vivo have not yet been fully described. This study aimed to evaluate the systemic and [...] Read more.
Bacterial cellulose (BC) has been used for various applications; however, studies investigating the immunohistochemical characteristics of the inflammatory and scarring component in BC implanted in the peritoneum in vivo have not yet been fully described. This study aimed to evaluate the systemic and organic safety of BC through oxidative stress, blood, and serum biochemical markers, as well as the late inflammatory response in rats, using histopathology and immunohistochemistry. Forty-three rats (26 males; 17 females) received BC in the peritoneal cavity (implanted group—IG), while twenty-seven rats (12 males; 15 females) served as the control (sham group—SG). Sixty days after surgery, oxidative stress in tissues, blood biochemical markers, and histopathological and immunohistochemical analyses for lymphocytes, macrophages, collagen, and vascular response around the BC were assessed. Only one oxidative stress marker, glutathione peroxidase, was elevated in the liver of IG rats. Creatine kinase MB and lactate dehydrogenase levels were significantly lower in IG animals. Histopathological analysis showed granulomatous inflammation in 93% of IG rats, with 74% of mild intensity. Immunohistochemistry revealed a significant macrophage presence (F4/80), with CD3, CD20, and F4/80 markers indicating differences favoring macrophages. In conclusion, BC implantation in the peritoneum induces a foreign body granulomatous response with prominent macrophage presence (F4/80). Type I and III collagen were observed around the membrane, and vascularization was intense 60 days post-implantation. From a biochemical and oxidative stress perspective, BC seems to be a safe material to be used in the peritoneal cavity. Full article
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13 pages, 3249 KiB  
Article
Machine Learning Diagnostic Model for Early Stage NSTEMI: Using hs-cTnI 1/2h Changes and Multiple Cardiovascular Biomarkers
by Junyi Wu, Yilin Ge, Ke Chen, Siyu Chen, Jiashu Yang and Hui Yuan
Diagnostics 2024, 14(20), 2322; https://doi.org/10.3390/diagnostics14202322 - 18 Oct 2024
Cited by 1 | Viewed by 1415
Abstract
Background: This study demonstrates differences in the distribution of multiple cardiovascular biomarkers between non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) patients. Diagnostic machine learning predictive models measured at the time of admission and 1/2 h post-admission, achieving competitive diagnostic predictive results. [...] Read more.
Background: This study demonstrates differences in the distribution of multiple cardiovascular biomarkers between non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) patients. Diagnostic machine learning predictive models measured at the time of admission and 1/2 h post-admission, achieving competitive diagnostic predictive results. Objective: This study aims to explore the diagnostic value of changes in high-sensitivity cardiac troponin I (hs-cTnI) levels in patients with suspected NSTEMI. Methods: A total of 267 patients presented with chest pain, requiring confirmation of acute coronary syndrome (ACS) subtypes (NSTEMI vs. UA). Hs-cTnI and other cardiac markers, such as creatine kinase-MB (CK-MB) and Myoglobin (Myo), were analyzed. Machine learning techniques were employed to assess the application of hs-cTnI level changes in the clinical diagnosis of NSTEMI. Results: Levels of CK-MB, Myo, hs-cTnI measured at admission, hs-cTnI measured 1–2 h after admission, and NT-proBNP in NSTEMI patients were significantly higher than those in UA patients (p < 0.001). There was a positive correlation between hs-cTnI and CK-MB, as well as Myo (R = 0.72, R = 0.51, R = 0.60). The optimal diagnostic model, Hybiome_1/2h, demonstrated an F1-Score of 0.74, an AUROC of 0.96, and an AP of 0.89. Conclusions: This study confirms the significant value of hs-cTnI as a sensitive marker of myocardial injury in the diagnosis of NSTEMI. Continuous monitoring of hs-cTnI levels enhances the accuracy of distinguishing NSTEMI from UA. The models indicate that the Hybiome hs-cTnI assays perform comparably well to the Beckman assays in predicting NSTEMI. Moreover, incorporating hs-cTnI measurements taken 1–2 h post-admission significantly enhances the model’s effectiveness. Full article
(This article belongs to the Section Machine Learning and Artificial Intelligence in Diagnostics)
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21 pages, 6332 KiB  
Article
Unveiling the Potential of Silymarin, Spirulina platensis, and Chlorella vulgaris towards Cardiotoxicity via Modulating Antioxidant Activity, Inflammation, and Apoptosis in Rats
by Hanem F. El-Gendy, Hanem K. Khalifa, Ahmed Omran, Reda M. S. Korany, Shaimaa Selim, Eman Hussein, Rashed A. Alhotan, Anam Ayyoub and Shimaa R. Masoud
Life 2024, 14(10), 1289; https://doi.org/10.3390/life14101289 - 11 Oct 2024
Cited by 4 | Viewed by 2113
Abstract
This study assessed the possible pharmacological effects of Chlorella vulgaris (Cg), Spirulina platensis (St), and silymarin (Sl) against thioacetamide (TA)-induced cardiotoxicity in rats, with a focus on their antioxidant, cardioprotective, and anti-inflammatory properties. The following is the random grouping of sixty male rats [...] Read more.
This study assessed the possible pharmacological effects of Chlorella vulgaris (Cg), Spirulina platensis (St), and silymarin (Sl) against thioacetamide (TA)-induced cardiotoxicity in rats, with a focus on their antioxidant, cardioprotective, and anti-inflammatory properties. The following is the random grouping of sixty male rats into six groups of ten animals each: the control (negative control), TA-intoxicated group (positive control; 300 mg/kg body weight (BW)), Sl + TA group (100 mg Sl/kg BW + TA), St + TA group (400 mg St/kg BW + TA), Cg + TA (400 mg Cg/kg BW + TA), and St + Cg + TA group (400 St + 400 Cg mg/kg BW + TA) were all administered for 30 days. At the start of the study, groups 2 through 6 were administered TA intraperitoneally at a dosage of 300 mg/kg BW for two consecutive days, with a 24 h gap between each dose, to induce cardiac damage. Blood samples were obtained to measure hematological parameters and perform biochemical assays, including lipid profiles and cardiac enzymes. For histopathology and immunohistochemistry determination, tissue samples were acquired. The current findings showed that TA injection caused hematological alterations and cardiac injury, as evidenced by greater serum levels of troponin I, creatine kinase-MB, and total creatine kinase (p < 0.05), as well as significantly elevated serum malondialdehyde and decreased serum total antioxidant capacity (p < 0.05) concentrations. Moreover, an increase in blood low-density lipoprotein and total cholesterol concentration (p < 0.05) was recorded in the TA group. There were alterations in the heart tissue’s histological structure of the TA group compared to the control ones. These alterations were characterized by vacuolar degeneration of myocytes, loss of cross striation, coagulative necrosis, and fibrosis of interstitial tissue, which was ameliorated by the supplementation of SI, St, and Cg. The TA-intoxicated group showed weak expression of B-cell lymphoma protein 2 (p < 0.05) and strong immunoreactivity of tumor necrosis factor-α and B-cell lymphoma protein 2-associated X (p < 0.05). However, the groups receiving Sl, St, and Cg experienced the opposite. The administration of Sl, St, Cg, and St + Cg along with TA significantly improved and restored (p < 0.05) erythrogram indices, including RBCs, hemoglobin, total leukocytic count, lymphocytes, and monocyte, to the normal control values. The administration of Sl, St, and Cg alleviated the cardiotoxicity caused by TA via reducing oxidative stress, inflammatory markers, and apoptosis in heart tissue. In summary, the current findings suggest that the treatment with Sl, St, and Cg was beneficial in ameliorating and reducing the cardiotoxicity induced by TA in rats. Full article
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20 pages, 6800 KiB  
Article
Artemisia vulgaris Extract as a Novel Therapeutic Approach for Reversing Diabetic Cardiomyopathy in a Rat Model
by Liza, Ghulam Hussain, Abdul Malik, Suhail Akhtar and Haseeb Anwar
Pharmaceuticals 2024, 17(8), 1046; https://doi.org/10.3390/ph17081046 - 8 Aug 2024
Cited by 2 | Viewed by 2622
Abstract
Diabetic cardiomyopathy, a severe diabetic complication, impairs heart function, leading to heart failure. Treatment that effectively addresses this condition without causing side effects is urgently needed. Current anti-hyperglycemic therapies are expensive, has side effects and do not effectively prevent cardiac remodeling. Therefore, it [...] Read more.
Diabetic cardiomyopathy, a severe diabetic complication, impairs heart function, leading to heart failure. Treatment that effectively addresses this condition without causing side effects is urgently needed. Current anti-hyperglycemic therapies are expensive, has side effects and do not effectively prevent cardiac remodeling. Therefore, it is important to explore natural products that may have the potential to reverse cardiac remodeling. That is why the aim of the current study was to determine the left ventricular remodeling potential of the methanolic extract of Artemisia vulgaris in a diabetic cardiomyopathy rat model. Following the initial comprehensive phytochemical evaluation of plant phenolic and flavonoid content, which showed strong anti-hyperglycemic and antioxidant activities, an extract of Artemisia vulgaris was administered in an in vivo experiment. Diabetic cardiomyopathy was induced in Wistar albino rats according to previously described protocols in the literature, and the effect of treatment was checked by serum and histopathological analysis after 45 days. Artemisia vulgaris treatment significantly (p ≤ 0.05) reduced fasting blood glucose (108.5 ± 1.75 mg/dL), glycated hemoglobin (4.03 ± 0.12 %), serum glucose (116.66 ± 3.28 mg/dL), insulin (15.66 ± 0.66 ng/mL), total oxidant status (54.66 ± 3.22 µmol H2O2Equiv.L−1), Malondialdehyde (0.20 ± 0.01 mmol/L), total cholesterol (91.16 ± 3.35 mg/dL), triglycerides (130.66 ± 3.15 mg/dL), low-density lipids (36.57 ± 1.02 mg/dL), sodium (140 ± 3.21 mmol/L), calcium (10.44 ± 0.24 mmol/L), creatine kinase MB (1227.5 ± 17.89 IU/L), lactate dehydrogenase (1300 ± 34.64 IU/L), C-reactive protein (30 ± 0.57 pg/mL), tumor necrosis factor-α (58.66 ± 1.76 pg/mL), atrial natriuretic peptide (2.53 ± 0.04 pg/mL), B-type natriuretic peptide (10.66 ± 0.44 pg/mL), aspartate aminotransferase (86.5 ± 4.99 U/L), Alanine Transaminase (55.33 ± 2.90 U/L), urea (25.33 ± 1.15 mg/dL) and creatinine (0.64 ± 0.02 mg/dL) but significantly increased (p ≤ 0.05) total antioxidant capacity (1.73 ± 0.07 mmol Trolox Equil./L), high-density lipids (40 ± 1.59 mg/dL) and potassium (3.82 ± 0.04 mmol/L) levels. ECG and histopathology confirmed the significant improvement in remodeling and the reversal of structural changes in the heart and pancreas. In conclusion, Artemisia vulgaris possesses significant left ventricular remodeling potential in course of diabetes-induced cardiomyopathy. Full article
(This article belongs to the Section Natural Products)
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17 pages, 5113 KiB  
Article
The Impact of Normobaric Hypoxia and Intermittent Hypoxic Training on Cardiac Biomarkers in Endurance Athletes: A Pilot Study
by Jakub Goliniewski, Miłosz Czuba, Kamila Płoszczyca, Małgorzata Chalimoniuk, Robert Gajda, Adam Niemaszyk, Katarzyna Kaczmarczyk and Józef Langfort
Int. J. Mol. Sci. 2024, 25(9), 4584; https://doi.org/10.3390/ijms25094584 - 23 Apr 2024
Viewed by 3187
Abstract
This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the [...] Read more.
This study explores the effects of normobaric hypoxia and intermittent hypoxic training (IHT) on the physiological condition of the cardiac muscle in swimmers. Hypoxia has been reported to elicit both beneficial and adverse changes in the cardiovascular system, but its impact on the myocardium during acute exercise and altitude/hypoxic training remains less understood. We aimed to determine how a single bout of intense interval exercise and a four-week period of high-intensity endurance training under normobaric hypoxia affect cardiac marker activity in swimmers. Sixteen young male swimmers were divided into two groups: one undergoing training in hypoxia and the other in normoxia. Cardiac markers, including troponin I and T (cTnI and cTnT), heart-type fatty acid-binding protein (H-FABP), creatine kinase-MB isoenzyme (CK-MB), and myoglobin (Mb), were analyzed to assess the myocardium’s response. We found no significant differences in the physiological response of the cardiac muscle to intense physical exertion between hypoxia and normoxia. Four weeks of IHT did not alter the resting levels of cTnT, cTnI, and H-FABP, but it resulted in a noteworthy decrease in the resting concentration of CK-MB, suggesting enhanced cardiac muscle adaptation to exercise. In contrast, a reduction in resting Mb levels was observed in the control group training in normoxia. These findings suggest that IHT at moderate altitudes does not adversely affect cardiac muscle condition and may support cardiac muscle adaptation, affirming the safety and efficacy of IHT as a training method for athletes. Full article
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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