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Title: Advanced Blood Analysis May Speed Diagnosis of Heart Attacks
URL: http://www.pslgroup.com/dg/22B932.htm
Doctor's Guide
September 9, 2008

BOSTON -- September 9, 2008 -- A new technique that measures hundreds of molecular markers in the blood can identify those released when cardiac tissue is injured by a lack of oxygen, according to a study published early online and in the October issue of the Journal of Clinical Investigation.

Physicians may be able to use the blood test in the near future to confirm within minutes, instead of hours, if a patient is having a myocardial infarction, allowing more rapid treatment that could limit damage to heart muscle.

"Right now there are no blood markers for reversible myocardial injury in clinical use, and the only available markers are not detectable until hours after the onset of tissue damage," said senior author Robert Gerszten, MD, Division of Cardiology and Center for Immunology and Inflammatory Diseases, Massachusetts General Hospital, Boston, Massachusetts.

"Because our treatments for heart attacks are most effective in the first hours after symptoms occur, these newly identified markers could help us apply treatments sooner and help more patients."

The researchers took advantage of a procedure that is, in essence, a "planned" heart attack. They took blood samples before and after septal ablation in patients with hypertrophic cardiomyopathy, providing researchers with a unique window into metabolic changes that occur in response to the death of myocardial tissue and allowing study participants to act as their own controls.

The researchers then analysed blood samples from 36 patients taken before and at several time points after septal ablation. Using an advanced mass spectrometry system that can assess hundreds of metabolites in as little as 10 minutes, they were able to identify several that significantly changed right after the ablation process, a time period during which currently available markers remained unchanged.

The changes seen in the first 10 minutes persisted an hour later, and analysis of blood from veins in the coronary circulation confirmed that the heart was the source of the changes.

Comparing the results of these planned heart attacks with blood samples from patients with spontaneous coronary blockages found 4 metabolites that increased in response to ablation and also were elevated in patients with true heart attacks, confirming them as markers of myocardial damage.

SOURCE: Massachusetts General Hospital

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