European Journal of Clinical InvestigationVolume 37, Issue 1 p. 83-84 Use of midregional proadrenomedullin in the detection of myocardial ischaemia D. Staub, D. Staub Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this authorM. Futterer, M. Futterer Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this authorN. G. Morgenthaler, N. G. Morgenthaler Brahms AG, Berlin, Germany,Search for more papers by this authorC. Nusbaumer, C. Nusbaumer Department of Laboratory Medicine andSearch for more papers by this authorM. J. Zellweger, M. J. Zellweger Division of Cardiology, University Hospital Basel, SwitzerlandSearch for more papers by this authorC. Mueller, C. Mueller Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this author D. Staub, D. Staub Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this authorM. Futterer, M. Futterer Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this authorN. G. Morgenthaler, N. G. Morgenthaler Brahms AG, Berlin, Germany,Search for more papers by this authorC. Nusbaumer, C. Nusbaumer Department of Laboratory Medicine andSearch for more papers by this authorM. J. Zellweger, M. J. Zellweger Division of Cardiology, University Hospital Basel, SwitzerlandSearch for more papers by this authorC. Mueller, C. Mueller Department of Internal Medicine, University Hospital Basel, Switzerland,Search for more papers by this author First published: 06 December 2006 https://doi.org/10.1111/j.1365-2362.2007.01754.xCitations: 1 Dr med. Daniel Staub, Department of Internal Medicine, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland. Tel.: +41-61-2652525; Fax: +41-61-2655356; e-mail: staubd@uhbs.ch Department of Internal Medicine, University Hospital Basel, Switzerland (D. Staub, M. Futterer, C. Mueller), Brahms AG, Berlin, Germany (N. G. Morgenthaler), Department of Laboratory Medicine (C. Nusbaumer), Division of Cardiology, University Hospital Basel, Switzerland (M. J. Zellweger). M. Futterer and D. Staub have contributed equally and should be considered first author. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume37, Issue1January 2007Pages 83-84 RelatedInformation

Background. B-type natriuretic peptide (BNP) levels are reliably elevated in patients with congestive heart failure (CHF) and therefore helpful in its diagnosis. However, kidney disease results in elevated BNP levels independently of CHF. Accordingly, the impact of kidney disease on the benefit of BNP testing needs to be scrutinized.Methods. This study evaluated patients with and without kidney disease [glomerular filtration rate (GFR) less than 60 mL/min/1.73m(2)) presenting with acute dyspnea. A total of 452 consecutive patients (240 with kidney disease and 212 without kidney disease) were randomly assigned to a diagnostic strategy with (BNP group) or without (control group) the use of BNP levels provided by a rapid bedside assay.Results. Patients with kidney disease were older, more often had CHF as the cause of acute dyspnea, and more often died in-hospital or within 30 days as compared to patients without kidney disease. In patients without kidney disease, BNP testing significantly reduced median time to discharge (from 9.5 days to 2.5 days) (P = 0.003) and total cost of treatment (from $7184 to $4151) (P = 0.004). In contrast, in patients with kidney disease, time to discharge and total cost of treatment were similar in both groups.Conclusion. When applying BNP cut-off values without adjustment for the presence of kidney disease, the use of BNP levels does significantly improve the management of patients without kidney disease, but not of those with kidney disease.

BACKGROUND:Because of its unique storage and release mechanisms allowing a very rapid response to haemodynamic changes, pro-atrial natriuretic peptide (proANP) may be a helpful cardiac marker in the detection of myocardial ischaemia.MATERIALS AND METHODS:A total of 260 consecutive patients with suspected myocardial ischaemia referred for rest/ergometry myocardial perfusion single-photon emission computed tomography (SPECT) were enrolled. Levels of plasma proANP were determined before and 1 min after maximal exercise.RESULTS:Baseline proANP and peak exercise proANP were significantly higher in patients with myocardial ischaemia as compared to those without ischaemia (median, 82 [IQR, 57-112] vs. 67 [IQR, 50-106] pmol L(-1), P = 0.007; and 89 [IQR, 65-121] vs. 78 [IQR, 57-116] pmol L(-1), P = 0.033). The area under the ROC curve for baseline proANP was 0.597 (95% CI, 0.527-0.667), as compared to 0.577 (95% CI, 0.507-0.648) for peak exercise proANP. Exercise-induced changes in proANP were similar in patients with and without myocardial ischaemia, and showed no correlation with the extent of myocardial ischaemia.CONCLUSIONS:Baseline proANP and peak exercise proANP are significantly higher in patients with myocardial ischaemia. However, because of considerable overlap in proANP levels between patients with and without myocardial ischaemia, neither measurement seems helpful in the detection of myocardial ischaemia in clinical practice.

Electron transfer kinetics between the blue copper proteins spinach plastocyanin or wt-azurin and optically active Fe-II or Co-II complexes have been measured as a function of temperature and pH. From the observed stereoselectivity, the analysis of the reaction products, and the influence of site directed mutagenesis it is concluded, that low molecular weight electron transfer reagents can react at different sites of a narrow area of the protein surface and that considerable selection of the reactive sites can occur between enantiomeric reagents.