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An investigation into the utility of cardiac biomarkers for risk stratification in familial cardiomyopathies in a high risk screening population

An investigation into the utility of cardiac biomarkers for risk stratification in familial cardiomyopathies in a high risk screening population

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An essay for the 2012 Undergraduate Awards Competition by Sarah Lyster. Originally submitted for Biomedical, Health and Life Sciences at None, with lecturer Prof. William Watson in the category of Life Sciences
An essay for the 2012 Undergraduate Awards Competition by Sarah Lyster. Originally submitted for Biomedical, Health and Life Sciences at None, with lecturer Prof. William Watson in the category of Life Sciences

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Published by: Undergraduate Awards on Aug 30, 2012
Copyright:Attribution Non-commercial

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10/27/2013

 
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A
n investigation into the utility of cardiacbiomarkers for risk stratification in familialcardiomyopathies in a high risk screeningpopulation
Abstract
 
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Early detection is of paramount importance in both hypertrophic cardiomyopathy (HCM) anddilated cardiomyopathy (DCM). Preclinical screening allows the initiation of prophylacticmeasures to reduce or slow progression to disease. Changing protein levels in the blood havelong been associated with disease pathology and increasing interest is growing in using thesechanging levels as biomarkers or predictors of disease. This study aimed to investigate whetherlevels of certain biomarkers could be correlated to cardiomyopathy screening results stratified onclinical echocardiograph measurements.Of a cohort of 185 voluntary screenees presenting between January 2010 and September 2011,110 were screened for HCM and 75 for DCM. 107 of the HCM screenees were included in thestudy with 24 (22.43%) diagnosed as borderline and 18 (16.82%) diagnosed as definite diseasepatients. Of the 75 patients screened for DCM, 74 were included in the study with 7 (9.46%)presenting as abnormal. Sample analysis of BNP, TnI, HSTnI and CK revealed a significantdifference in the levels of TnI (p=0.0041) and HSTnI (p=0.0021) across the HCM stratifiedgroups. The use of hsTnI as a predictor of echocardiograph abnormality measured 0.7 under areceiver-operator curve.In conclusion, preliminary investigations suggest a possible link between TnI or hsTnI levels andpresence of hypertrophic cardiomyopathy. This result merits further study in larger cohorts toevaluate the potential use of TnI or hsTnI as a future biomarker for use in early risk screening forHCM.
Contents
 
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Section 1: Introduction
1-8
Hypertrophic Cardiomyopathy
2
Dilated Cardiomyopathy
3
Screening
4
Biomarkers
5
Troponin I and high-sensitivity Troponin I
6
B-Type Natriuretic Peptide
7
Creatine Kinase
8
Aims
9
Section 2: Materials and Methods
10-16
Study Population
11
Echocardiographic Study
11
Sample Collection
12
Patient Stratification
13
Serum Analysis
14
Ethical Approval
15
Statistical Analysis
15
Section 3: Results
17-38
Demographics and Clinical Characteristics
18
Echocardiograph and Doppler characteristics
23
Biomarker Analysis
27
Associations between Biomarkers and Clinical Measurements
31
Associations between the Biomarkers
36
Receiver-Operator Curves and Area Under Curve
37

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