Non Enzyme MARKERS of Cardiac Function

Question 1

List the Non Enzyme MARKERS of Cardiac Function

Answer 1

Myoglobin
Troponin
Natriuretic Peptides
D-Dimers

Question 2

Discuss Myoglobin as a Non Enzyme Marker of Cardiac Function

Answer 2

Heme containing protein present in Muscles (both cardiac & Skeletal)

Released early in damages muscles (2-3)hrs of acute MI onset.

Hence useful for early diagnosis of an acute MI (much earlier than other MI markers). But myoglobin though sensitive is not specific. Because myoglobin is NOT RESTRICTED TO CARDIAC MUSCLE.

Question 3

Types of Troponin

Answer 3

Troponins
3-(C,I&T) types are available
Cardiac Troponin-C
Cardiac Troponin-I
Cardiac Troponin-T

Question 4

Which troponin has the same structure in or tissues?

Answer 4

Cardiac Troponin C in all tissue has same structure

Question 5

Which troponins have a different structure in organs and how can they be separated?

Answer 5

Troponins T & I have different structures in different organs and can be separated by electrophoresis

Question 6

Which marker is used for investigation (requested in Chronic Heart Failure) especially in primary & Care Centres where advanced radiological facilities are absent.

Answer 6

Natriuretic Peptides

Question 7

Types of Natriuretic Peptides

Answer 7

3-major types (ANP, BNP & CNP)

Atrial Natriuretic Peptide,
Brain Natriuretic Peptide &
C-type Natriuretic Peptide.

Question 8

Where is CNP present?

Answer 8

CNP is present in the Brain The kidneys and Vascular endothelial cells while the others indicate main sources

Question 9

What does D-Dimers indicate?

Answer 9

Releases into plasma in patients with Deep Vein Thrombosis. DVT can be fatal because it can result in massive pulmonary embolism.

Finding D- dimers is a Medical emergency. D-Dimers is elevated in Plasma of people with Deep Vein Thrombosis even when they look fine.

Question 10

Apart from D-Dimers which other proteins constitute serious Cardiovascular risk factors in Clinical Practice.

Answer 10

CRP and Homocystein

Question 11

What are some cardiovascular risk factors?

Answer 11

High Plasma Cholesterol
High Triglyceride
Low HDL
High blood pressure/Hypertension
Smoking
Diabetes Mellitus
Obesity and
Family history of Cardiovascular dx are the classic risk factors.
Patients with some these conditions are at higher risk paralysis/stroke and sudden death