Cleveland Heartlab



Understanding Inflammation Testing
As featured at TEDMED 2012

Cleveland HeartLab has established a profile of biomarkers that measure both oxidation and inflammation levels in order to help better define individuals at risk and also to determine where they are on a spectrum of risk. In short, this profile of biomarkers enables physicians to determine who is at risk and why they are at risk.

Using five simple, non-invasive tests, physicians can determine if an individual:
    • Is early in the disease process and may someday have disease
    • Has disease, but it’s not actively progressing
    • Has disease that is actively progressing putting them at risk for a heart attack or stroke
 
 

Myeloperoxidase (MPO)

MPO is a white blood cell-derived inflammatory enzyme that is used by the immune system to fight infection. Interestingly, white blood cells also release MPO when responding to damaged arteries in an attempt to mend the body. In these instances, white blood cells may respond to vulnerable plaque, erosions or a tear in the artery wall and release MPO into the bloodstream. Thus, MPO levels in the bloodstream are a specific marker of white blood cell activity in response to vulnerable plaque or erosions, and can determine your risk for heart attack.

Lp-PLA2 (The PLAC® Test)

Lp-PLA2 is a vascular-specific inflammatory enzyme that is predominantly attached LDL (low-density lipoprotein; “bad” cholesterol). When the artery wall is damaged due to high blood pressure or smoking, the Lp-PLA2-LDL complex enters the artery wall. Here, Lp-PLA2 modifies the LDL releasing byproducts which cause inflammation, and ultimately lead to plaque accumulation in the artery wall. Thus, Lp-PLA2 levels can be used to measures the amount of vulnerable plaque, and determine risk for heart attack or stroke.

High-Sensitivity CRP (hsCRP)

C-reactive protein (CRP) is an acute phase protein released by the liver during systemic inflammation. The high-sensitivity CRP test is a sensitive way to measure small amounts of CRP.  Because inflammation underlies the atherosclerotic process, CRP can be used as an indirect measure of heart disease and identify risk for heart attack and stroke.

Microalbumin

Microalbumin detects small amounts of albumin, a serum protein, in the urine that is below the detection limit of a standard dipstick test. Because albumin is not normally present in the urine, but retained in the bloodstream by the kidneys, microalbumin can be used to measure microvascular integrity and endothelial dysfunction as early indicators of heart disease.

F2-Isoprostanes

F2-Isoprostanes are potent inflammatory mediators and markers of oxidative stress formed from the peroxidation of essential fatty acids.  F2-Isoprostanes are considered lifestyle markers that are indicative of diet and exercise patterns that may contribute to the premature development of disease.