Cardiac biomarkers

Plasma or serum biomarkers can be measured to assess

myocardial dysfunction and ischaemia.

Brain natriuretic peptide-

This is a 32-amino acid peptide and is secreted by the

LV along with an inactive 76-amino acid N-terminal

fragment (NT-proBNP). The latter is diagnostically more

useful, as it has a longer half-life. It is elevated principally

in conditions associated with left ventricular systolic

dysfunction, and may aid the diagnosis and assess

prognosis and response to therapy in patients with heart

.failure 

Cardiac troponins-

Troponin I and troponin T are structural cardiac muscle

proteins  that are released during

myocyte damage and necrosis, and represent the cornerstone

of the diagnosis of acute myocardial infarction

 However, modern assays are extremely sensitive

and some have a normal reference range and can

detect very low levels of myocardial damage, so that

elevated plasma troponin concentrations are seen in

other acute conditions, such as pulmonary embolus,

septic shock and acute pulmonary oedema. The diagnosis

of MI therefore relies on the patient’s clinical presentation