Dilated cardiomyopathy laboratory findings: Difference between revisions

Jump to navigation Jump to search
No edit summary
 
(10 intermediate revisions by 4 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Dilated cardiomyopathy}}
{{Dilated cardiomyopathy}}
{{CMG}}; {{AE}} {{AIA}}


{{CMG}}; '''Associate Editor-in-Chief:''' Sachin Shah, M.D.
==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]]
*[[Comprehensive metabolic panel]]
* Workup for [[anemia]] ([[Complete blood count|CBC]] and [[iron]] studies)
* Urine toxicology screening
** Some drugs as [[cocaine]] and [[amphetamine]] increase the risk of [[dilated cardiomyopathy]]
* [[Genetic testing|Genetic screening]]
** Usually reserved as the last step.
** 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.
 
* Cardiac biomarkers ([[troponin]] and [[Creatine kinase|CK-MB]])
* [[Brain natriuretic peptide]] (BNP)


==Overview==
Other biomarkers currently under investigation include:


Endomyocardial [[biopsy]] has low sensitivy and the findings are also notoriously non-specificThe findings on biopsy usually involve findings of [[inflammation]] and specific [[pathogens]] are unlikely to be identifiedThere may be an increased yield to using MRI to target endomyocardial biopsyViral titiers (serologies) are often unhelpful and not routinely ordered in clinical practice.
* [[Uric acid]] (persistently elevated)
* [[Osteopontin]]
* 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>
*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 (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
** 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==
Line 15: Line 42:
[[Category:Cardiomyopathy]]
[[Category:Cardiomyopathy]]
[[Category:Cardiology]]
[[Category:Cardiology]]
 
[[Category:Up-To-Date cardiology]]
[[Category:Up-To-Date]]
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 18:15, 16 December 2019

Dilated cardiomyopathy Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Dilated cardiomyopathy from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Dilated cardiomyopathy laboratory findings On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Dilated cardiomyopathy laboratory findings

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Dilated cardiomyopathy laboratory findings

CDC on Dilated cardiomyopathy laboratory findings

Dilated cardiomyopathy laboratory findings in the news

Blogs on Dilated cardiomyopathy laboratory findings

Directions to Hospitals Treating Dilated cardiomyopathy

Risk calculators and risk factors for Dilated cardiomyopathy laboratory findings

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]

Other laboratory investigations may target the severity of the condition or its effect on the cardiac function.

Other biomarkers currently under investigation include:

References

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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.

Template:WH Template:WS