Salivary biomarkers associated with myocardial necrosis: results from an alcohol septal ablation model

Abstract

Objective To determine if salivary biomarkers demonstrate utility for identifying aspects of myocardial necrosis. Methods Twenty-one patients undergoing alcohol septal ablation (ASA) for treatment of hypertrophic cardiomyopathy provided serum and unstimulated whole saliva at baseline and incremental time points post-ASA. Samples were analyzed for seven biomarkers related to myocardial damage, inflammation and tissue remodeling using immunosorbent assays. Levels were compared to baseline and levels observed in 97 healthy controls. Results Biomarkers of myocardial damage and inflammation (i.e., troponin I, creatine kinase-MB, myoglobin, C-reactive protein) rose in serum 2 to 812-fold after ASA (p<0.01). Significant elevations of 2 to 3.5-fold were observed with C-reactive protein and troponin I in saliva (p<0.02). Significant correlations between levels in serum and saliva were observed for C-reactive protein, matrix metalloproteinase-9, and myeloperoxidase (p < 0.001). Conclusions Select salivary biomarkers reflect changes that occur during, and subsequent to, myocardial necrosis caused by ASA.

Utility of Salivary Biomarkers for Demonstrating Acute Myocardial Infarction

“…Serum biomarkers of CHD are detectable in saliva (Floriano et al, 2009;Miller et al, 2010;Foley et al, 2012a), and recent reports indicate that concentrations of select salivary markers are elevated early post-AMI and after myocardial damage (Buduneli et al, 2011;Mirzaii-Dizgah and JafariSabet, 2011;Foley et al, 2012b;MirzaiiDizgah et al, 2012;Shen et al, 2012;Mirzaii-Dizgah and Riahi, 2013a;Toker et al, 2013). Despite a host of markers accumulating from these studies, the ability to discriminate which biomarkers would be best for facilitating a screening diagnosis of AMI, especially in cases of NSTEMI, has been lacking.…”

“…Saliva is rapidly, easily, and non-invasively procured and contains thousands of biomolecules that are derived from the local capillary bed (Hu et al, 2005;Xiao and Wong, 2011). Several biomarkers associated with CHD and AMI [i.e., TnI, TnT, CK-MB, active matrix metalloproteinase (MMP)-8, and C-reactive protein (CRP)] can be detected in saliva at concentrations distinct from those in healthy individuals and that correlate with serum concentrations (Floriano et al, 2009;Miller et al, 2010;Buduneli et al, 2011;MirzaiiDizgah and Jafari-Sabet, 2011;Foley et al, 2012b;Mirzaii-Dizgah et al, 2012;Mirzaii-Dizgah and Riahi, 2013a,b). However, the clinical utility of these biomarkers for AMI assessment, alone or as a multimarker panel, is not fully understood.…”

Diagnostic markers of acute myocardial infarction

“…Studies reveal that salivary soluble intracellular adhesion molecule 1 is significantly elevated in AMI patients; however, levels of salivary sCD40L were significantly lowered in AMI patients. In a study performed by Foley et al (66), salivary levels of troponin I and CRP correlated with the serum levels in patients with myocardial injury. Additionally, levels of MMP-9 and MPO in saliva correlated with its serum levels (67).…”

Salivary and plasma levels of matrix metalloproteinase-9 and myeloperoxidase at rest and after acute physical exercise in patients with coronary artery disease

“…Saliva has emerged as a non-invasive tool for assessing MMP-9 and MPO in cardiovascular disease [16, 17, 23]. If salivary levels reflect systemic levels, this might open up for a new and simple way to monitor inflammation, in particular stress-induced inflammation, in patients with CAD.…”

“…Only a few previous studies have compared salivary and systemic levels of MMP-9 and MPO, though with disparate results. Foley et al [23] performed serial measurements of MMP-9 and MPO in serum and unstimulated whole saliva after alcohol septal ablation in 21 patients with obstructive hypertrophic cardiomyopathy. They reported significant correlations between serum and salivary levels of MMP-9 and MPO at all time points.…”