Identification of patients with abnormal fractional shortening

a fractional shortening and patient technology, applied in the field of identification of patients with abnormal fractional shortening, can solve the problems of limited cost-benefit consideration for echocardiographic screening for abnormal mfs, often not tested or overlooked for abnormal midwall fractional shortening, and specialized imaging techniques. to achieve the effect of increasing risk

Inactive Publication Date: 2015-07-02
ROCHE DIAGNOSTICS OPERATIONS INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

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Benefits of technology

[0011]Mirzaa et al. 2009 (Mirzaa Atheroscleosis 207, 546-551) disclose an association between elevated serum FGF-23 levels and increased left ventricular mass, left ventricular hypertrophy and...

Problems solved by technology

However, abnormal midwall fractional shortening is frequently not tested or overlooked.
Assessment of fractional shortening using echocardiography requires expensive instrumentation, speciali...

Method used

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  • Identification of patients with abnormal fractional shortening
  • Identification of patients with abnormal fractional shortening
  • Identification of patients with abnormal fractional shortening

Examples

Experimental program
Comparison scheme
Effect test

example 1

Patient Cohort

[0372]The relationship between plasma levels of FGF-23 (ELISA, Immutopics), total 25-hydroxyvitamin D (ECLIA, Roche Diagnostics), IFGBP7, endostatin, mimecan and 2 cardiac markers (hs-cTnT and NT-proBNP, Roche Elecsys assays) and elevated LV mass / BSA (>95 g / m2 for women, >115 for men), subnormal midwall fractional shortening (MFS<15%) and mortality was examined in 2001 elderly people (mean age 73±5 years, 48% women), resident in central Italy (the PREDICTOR study). The subjects were divided into 4 categories according to normal values of LV mass index and MF. The markers were determined in plasma samples. Data on all-cause mortality were available for a subgroup of 1200 subjects after a median follow-up of 47 months (86 deaths).

[0373]Three markers (Endostatin, IGFBP7 Mimecan / Osteoglycin) were examined in 550 elderly subjects selected from the 2001 subjects aged 65-84 years of the epidemiological study PREDICTOR. This subcohort comprises 50 normal subjects, 150 subject ...

example 2

Assays

[0375]Troponin T was determined using Roche's electrochemiluminescence ELISA sandwich test Elecsys Troponin T hs (high sensitive) STAT (Short Turn Around Time) assay. The test employs two monoclonal antibodies specifically directed against human cardiac troponin T. The antibodies recognize two epitopes (amino acid position 125-131 and 136-147) located in the central part of the cardiac troponin T protein, which consists of 288 amino acids. The hs-TnT assay allows a measurement of troponin T levels in the range of 3 to 10000 pg / mL.

[0376]NT-proBNP was determined using Roche's electrochemiluminescence ELISA sandwich test Elecsys proBNP II STAT (Short Turn Around Time) assay. The test employs two monoclonal antibodies which recognize epitopes located in the N-terminal part (1-76) of proBNP (1-108).

[0377]Human FGF-23 was determined by used the (C-Term) ELISA Kit from Immutopics Inc., Cat. Number 60-6100, 2nd Generation Enzyme-Linked ImmunoSorbent Assay (ELISA) for the Determination...

example 3

Results

Subtle Alterations of LV Geometry—Midwall Fractional Shortening

[0381]The results are shown in table 1. Median concentrations of hs-cTnT, NT-proBNP, FGF-23 and vitamin D were on average low. Median concentrations of hs-cTnT, Nt-proBNP and FGF-23 / Vitamin D were higher in subjects with elevated LV mass and / or or subnormal MFS (for both, adjusted for sex and age). FGF-23 and vitamin D were significantly associated to LV mass independently of hs-cTnT.

TABLE 1Categories of LV mass index / MFSCategories of LV mass index / MFSNormal LVMINormal LVMIElevated LVMIElevated LVMINormal MFSAbnormal MFSNormal MFSAbnormal MFSP*N 918 (57.8) 275 (17.3) 189 (11.9)206 (13) Age (year)72.1 (4.8) 73.3 (5.2) 72.9 (4.9) 74.3 (5.1) Females 444 (48.4) 108 (39.3) 130 (68.8) 120 (58.3)0.0525LV81.1 (14.1)88.0 (13.8)116.0 (18.0) 125.7 (22.8) mass / BSA(g / m2)MFS (%)17.4 (1.6) 13.5 (1.2) 16.5 (1.3) 12.8 (2.0) PMarkersNT-proBNP7880124182Hs-cTnT4.35.95.488.5Vitamin D13.5313.719.8810.640.0021[ng / ml]FGF-2369.174.076.284...

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Abstract

The present invention relates to a method for assessing whether a subject shall be subjected to an imaging based diagnostic assessment. The method is based on the determination of the amount(s) of a cardiac Troponin and/or Fibroblast Growth Factor 23 (FGF-23) in a sample from the subject, and on the comparison of the, thus, determined amount(s) with a reference amount (reference amounts). The present invention also relates to a system for performing an assessment whether a subject shall be subjected to an imaging based diagnostic assessment and to reagents and kits used in performing the methods disclosed herein. Moreover, the present invention is directed to a method for predicting the risk of mortality and/or of a cardiovascular event. Also encompassed is a method for diagnosing an early stage of LVH in a subject having a preserved left ventricular ejection.

Description

CROSS REFERENCE TO RELATED APPLICATIONS[0001]This application is a continuation of International Patent Application PCT / EP2013 / 056706 filed Mar. 28, 2013, and claims priority to EP Patent Application No. 12184085.4 filed Sep. 12, 2012, the disclosures of which are hereby incorporated by reference in their entirety.SUMMARY OF THE INVENTION[0002]The present invention relates to a method for assessing whether a subject shall be subjected to an imaging based diagnostic assessment. The method is based on the determination of the amount(s) of a cardiac Troponin and / or Fibroblast Growth Factor 23 (FGF-23) in a sample from the subject, and on the comparison of the, thus, determined amount(s) with a reference amount (reference amounts). The present invention also relates to a system for performing an assessment whether a subject shall be subjected to an imaging based diagnostic assessment and to reagents and kits used in performing the methods disclosed herein. Moreover, the present inventio...

Claims

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Application Information

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IPC IPC(8): G01N33/68A61B5/055A61B8/08
CPCG01N33/6887A61B8/0883A61B5/055G01N2333/50G01N2800/329G01N2333/4703G01N2333/78G01N2333/4706G01N2333/4712G01N33/82G01N2800/32G01N2800/50
Inventor BLOCK, DIRKLATINI, ROBERTOMASSON, SERGEWIENHUES-THELEN, URSULA-HENRIKEZAUGG, CHRISTIAN
Owner ROCHE DIAGNOSTICS OPERATIONS INC
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