Neurohumoral,cardiac and inflammatory markers in the evaluation of heart failure severity and progression

Heart failure is common in adult population,accounting for substantial morbidity and mortality worldwide.The main risk factors for heart failure are coronary artery disease,hypertension,obesity,diabetes mellitus,chronic pulmonary diseases,family history of cardiovascular diseases,cardiotoxic therapy.The main factor associated with poor outcome of these patients is constant progression of heart failure.In the current review we present evidence on the role of established and candidate neurohumoral biomarkers for heart failure progression management and diagnostics.A growing number of biomarkers have been proposed as potentially useful in heart failure patients,but not one of them still resembles the characteristics of the"ideal biomarker."A single marker will hardly perform well for screening,diagnostic,prognostic,and therapeutic management purposes.Moreover,the pathophysiological and clinical significance of biomarkers may depend on the presentation,stage,and severity of the disease.The authors cover main classification of heart failure phenotypes,based on the measurement of left ventricular ejection fraction,including heart failure with preserved ejection fraction,heart failure with reduced ejection fraction,and the recently proposed category heart failure with mid-range ejection fraction.One could envisage specific sets of biomarker with different performances in heart failure progression with different left ventricular ejection fraction especially as concerns prediction of the future course of the disease and of left ventricular adverse/reverse remodeling.This article is intended to provide an overview of basic and additional mechanisms of heart failure progression will contribute to a more comprehensive knowledge of the disease pathogenesis.

Levels of Serum Procalcitonin and C-Reactive Protein for Evaluating Pulmonary Bacterial Infection in Patients with Lupus Erythematosus

The severity of systemic lupus erythematosus（SLE） patients with pulmonary bacterial infection varies widely. We investigated the significance of procalcitonin（PCT） and C-reactive protein（CRP） in evaluating the severity of pulmonary infection in SLE patients. This retrospective study contained a total of 117 patients（107 women and 10 men） with SLE from January 2010 to June 2011. Serum levels of PCT and CRP were measured by enzyme-linked immunosorbent assay. The severity of pulmonary bacterial infection（PBI） was evaluated using the pneumonia severity index（PSI）. SLE patients with PBI, particularly those with bacterial isolates, had significantly higher levels of serum PCT and CRP than those without PBI. Serum PCT and CRP were not associated with SLE disease activity, but positively with the values of PSI in active SLE patients with PBI. Serum levels of PCT and CRP may be additional biomarkers in evaluating the severity of PBI in lupus patients.

Evaluation of the scales assessing the severity of myasthenia gravis

Objective To evaluate the reliability and validity of the 4 myasthenia gravis(MG)scales widely used for assessing the grades of disease severity in Chinese MG patients.Methods Sixty MG patients were examined by a neurologist with the following four MG scales:Quantitative Myasthenia Gravis Score(QMGS),Myasthenia Gravis Composite(MGC),Myasthenic Muscle Scale(MMS),Absolute and Relative Score of MG(ARS-

A primary study on TRISS in a Chinese hospital

Objective: To investigate a revision of the Trauma and Injury Severity Score (TRISS) weight coefficients in order to overcome the inference from foreign coefficients on Chinese trauma scoring. Methods: The data of 1 297 Chinese trauma patients were studied for trauma scoring with the Revised Trauma Score Injury Severity Score TRISS (RTS ISS TRISS) system to get a serial of new weight coefficients through analyzing a multivariation logical regression between the outcome and the injury severity. Results: ISS was higher but the Age Score and probability of survival (Ps) of the death group were lower than those of the survival group. New values of RTS ISS Age coefficients differed from the Major Trauma Outcome Study (MTOS) ones, through which the constant b 0 decreased its negative value, and ISS weight b 2 increased its negative value, but RTS weight b 1 and age weight b 3 changed with the trauma types. MTOSs values and new values of weight coefficients were used on 1 297 patients for prognosis by calculating Ps. The accuracy of new values ( 90.13 %) was a little higher than that of MTOSs (89.5%), with a promotion in specialization but a loss in sensitivity. Conclusions: A revision of TRISSs weight coefficients is either necessary or feasible. To achieve this purpose, a Chinese trauma database with large capacity is recommended.