by Jeffrey Graf

Created on: July 05, 2011   Last Updated: July 06, 2011

Diagnosing heart failure candidates presents a challenge for cardiologists because heart disease may be progressing while the heart is apparently pumping normally. Direct observation of the coronary arteries, those that supply the heart itself, is invasive or requires interpretation of indirect measurements through medical imaging. For this reason, cardiologists seek quick blood tests that may give information about condition and risk to the coronary arteries. Perhaps the most well known is the cholesterol test.

The medical community seeks to find ever more accurate and meaningful tests to diagnose atherosclerosis and heart disease risk and progression. Hardening of the arteries is an immune response initiated by unhealthy, or abnormal cholesterol ratio. Because the progression of disease is an immune response, physicians have focused upon inflammation products circulating in the blood, and searched for correlations between specific immune response markers and heart disease.

The first of these was known as C reactive Protein. [1] . As such, cardiologists and physicians now use measures of CRP to enhance evaluation of risks and prognosis associated with circulatory disorders. The medical industry and pharmaceutical industry have joined to create a medical industry around CRP.

C Reactive Protein is a nonspecific immunological marker made by the liver. More recently, Researchers have been able to focus on markers that are more specific to coronary disease. In particular, Pentraxin 3 shows much promise.[2].

A traditional technique for identifying cardiological myopathy (muscle dysfunction) is to evaluate the ejection fraction (EJ) of the left ventricle during exercise.[3] This is done using echocardiography, or a sonogram of the heart. The ejection fraction is defined as the volume of blood in the ventricle during diastole (fully distended) minus the volume during systole (fully contracted) divided by the volume during diastole.

This functional evaluation of the heart is not absolutely indicative of heart health. The title of the Matsubara reference [2] indicates that even if the ejection fraction indicates normal coronary health, on an immunological evaluation, heart disease may be progressing. It is hoped that a Pentraxin 3 test will provide a more reliable evaluation of heart health or condition than echocardiogram, CRP, and cholesterol evaluations alone.

[1]Paul M. Ridker, MD; Robert J. Glynn, ScD; ; Charles H. Hennekens, MD

C-Reactive Protein Adds to the Predictive Value of Total and HDL Cholesterol in Determining Risk of First Myocardial Infarction

Circulation. 1998;97:2007-2011 [here]

[2] Junichi Matsubara, MD et. al.

Pentraxin 3 Is a New Inflammatory Marker Correlated With Left Ventricular Diastolic Dysfunction and Heart Failure With Normal Ejection Fraction

Journal Am. College of Cardiology, 2011, 57: 861 – 869 [here]

[3] DePace NL, Iskandrian AS, Hakki AH, Kane SA, Segal BL.

Value of left ventricular ejection fraction during exercise in predicting the extent of coronary artery disease.

Journal Am Coll Cardiol. 1983 Apr;1(4):1002-10. [Abstract]

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