Coroides y lágrimas, dos biomarcadores que predicen cardiopatía isquémica

Choroids and tears, two biomarkers that predict ischemic heart disease

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Mario Gutiérrez Bedmar, Manuel Francisco Jiménez Navarro and José Lorenzo Romero Trevejo, the three researchers of the study.

The eye can be the mirror in which the health of the heart is reflected. This is confirmed by a study that indicates that two ophthalmic biomarkersthe thickness of the membrane choroid and granulocyte colony-stimulating factor levels in tears, could contribute to improving the detection of ischemic heart disease. This research, led by the Ciber Cardiovascular Diseases area (cybercv), the Virgen de la Victoria Hospital in Malaga and the Malaga Biomedical Research Institute (Ibima), has just been published in the journal Cardiovascular Diabetology.

The cardiovascular diseases continue to be the leading cause of death worldwidebeing the ischemic heart disease (or coronary artery disease) the most relevant. The progressive aging of the populationcoupled with the increased prevalence of risk factors such as hypertensionthe hypercholesterolemiathe diabetes wave obesitymake it necessary to develop new methods that allow detect early to people at risk of suffering from this pathology that causes a narrowing of the arteries, which would allow both an improvement in the care of these patients and an optimization in the use of available health resources.

Early detection of ischemic heart disease

“Currently, screening for ischemic heart disease continues to be controversial, since the available techniques are invasive and have a high cost for health systems”, he points out. Manuel Francisco Jimenez Navarro, a researcher at Cibercv, the Virgen de la Victoria Hospital and Ibima who has coordinated this work. “The eye, due to its particular structure, function and accessibility, is presented as a candidate organ for obtaining parameters for this diagnostic purpose, also taking into account its more than demonstrated involvement in other pathologies at the systemic level. In this sense, cardiovascular changes have also been related to signs that are visible in the eye, turning this organ into a window that provides quick access to the cardiovascular system”, he explains.

From this starting point, the objective of this new work focused on evaluate the usefulness of routine ophthalmological findings and possible biomarkers in tears as predictors for the detection of this coronary artery disease. To do this, the data of a total of 96 patients from the Hospital Virgen de la Victoria in Malaga with suspected acute coronary heart disease. These patients underwent a complete ophthalmological examination, and samples of their tear fluid were also analyzed for cytokines (small proteins that are crucial for controlling the growth and activity of other cells of the immune system) and other inflammatory mediators.

The analysis of all these data allowed us to differentiate two biomarkers that, used in combination with classic risk markers (hypertension, hypercholesterolemia, diabetes, obesity, smoking, alcohol consumptionetc.), help to define a risk predictive model that could improve screening systems and early detection of ischemic heart disease. Specifically, these are choroidal thickness and levels of granulocyte-colony-stimulating factor (a type of white blood cell) in tears.

Characteristics of the two ophthalmological biomarkers

The choroid It is a membrane formed by a multitude of blood vessels that is located between the sclera (or white part of the eye) and the retina, which allows to provide oxygen and other nutrients to the eye. The results of this investigation allowed us to conclude that the increased choroidal thickness is associated with the presence of coronary lesions.

The second biomarker was obtained from the analysis of tear samples. Specifically, this team was able to detect that higher levels of G-CSF, a growth factor involved in the formation of colonies of granulocytes (a type of white blood cell) in tears, could be a protective factor against coronary pathology. In fact, the growth factor G-CSF intervenes in the process of generating the cells that make up the blood, and also induces the differentiation of bone marrow stem cells into heart muscle cells when they come into contact with damaged areas of the heart. myocardium “This is the first time that an investigation associates the levels of G-CSF in tears with the presence of coronary heart diseaseshowing that an increase in its levels can constitute a protective factor”, explains Jiménez Navarro.

In summary, the results of the study have shown that the choroidal thickness and the tear granulocyte colony-stimulating factor improve the predictive model for coronary ischemic disease when added to age, sex, hypertension, hypercholesterolemia, diabetes, smoking and obesity”, details the researcher. Now, “need further studies to assess the validity of this model in other groups of patients with different clinical characteristics”, he concludes.

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