Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.000316
Jornal Vascular Brasileiro
Review

Biomarcadores de função endotelial em doenças cardiovasculares: hipertensão

Biomarkers of endothelial function in cardiovascular diseases: hypertension

Josynaria Araújo Neves, Josyanne Araújo Neves, Rita de Cássia Meneses Oliveira

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Resumo

A incidência de hipertensão arterial sistêmica está aumentando mundialmente. Sua prevenção baseia-se na identificação dos hipertensos. Atualmente, biomarcadores são utilizados com fins de diagnosticar, estratificar e prognosticar doenças. Neste estudo, objetivou-se revisar artigos dos últimos cinco anos relacionados a biomarcadores nas doenças cardiovasculares. Pesquisaram-se dados de PubMed, SciELO, Science Direct e MEDLINE, mediante as palavras-chave: hipertensão arterial, biomarcadores cardiovasculares, óxido nítrico, função endotelial e dimetilarginina assimétrica. Os estudos levantados mostram que as doenças cardiovasculares possuem uma etiologia complexa. Neste artigo, evidenciaram-se interações entre o óxido nítrico e a dimetilarginina assimétrica na regulação, no metabolismo e na determinação dos níveis intracelulares, e reviram-se outros biomarcadores relacionados à hipertensão. Alguns estudos indicam os biomarcadores como uma ferramenta útil na predição de eventos cardíacos, e outros reportam que eles contribuem pouco para a avaliação. A seleção e combinação desses pode ser uma alternativa para validar o uso dos biomarcadores devido à pouca especificidade existente para diagnosticar a hipertensão.

Palavras-chave

biomarcadores; hipertensão; função endotelial; ADMA.

Abstract

The incidence of systemic arterial hypertension is increasing worldwide. The foundation of prevention is identification of people with hypertension. Nowadays, biomarkers are used to diagnose and stratify diseases and estimates prognosis. The objective of this study was to review articles published over the last 5 years on the subject of biomarkers of cardiovascular diseases. The PubMed, SciELO, Science Direct and MEDLINE databases were searched using the keywords: arterial hypertension, cardiovascular biomarkers, nitric oxide, endothelial function and asymmetric dimethylarginine. The studies reviewed show that cardiovascular diseases have complex etiologies. This article describes evidence demonstrating interactions between nitric oxide and asymmetric dimethylarginine that are involved in regulation, in metabolism, and in determination of intracellular levels, and also discusses other biomarkers related to hypertension. Some studies indicate that biomarkers are useful tools for prediction of cardiac events, whereas others state that they have little to contribute to assessments. Careful selection of tests and combinations of tests may be the key to validating use of biomarkers, in view of their low specificity for diagnosing hypertension.

Keywords

biomarkers; hypertension; endothelial function; ADMA.

References

1. Gama H, Damasceno A, Silva-Matos C, Diogo D, Azevedo A, Lunet N. Low prevalence of hypertension with pharmacological treatments and associated factors. Rev Saude Publica. 2013;47(2):301-8. PMid:24037357. http://dx.doi.org/10.1590/S0034-910.2013047004328.

2. Simão AF, Précoma DB, Andrade JP, et al. I Diretriz Brasileira de prevenção cardiovascular. Arq Bras Cardiol. 2013;101(6, Supl. 2):1-63. PMid:24554026. http://dx.doi.org/10.5935/abc.2013S012.

3. Georgiopoulou VV, Kalogeropoulos AP, Butler J. Heart failure in hypertension: prevention and treatment. Drugs. 2012;72(10):1373-98. PMid:22747449. http://dx.doi.org/10.2165/11631100-000000000-00000.

4. Durand ML, Gutterman DD. Diversity in mechanisms of endotheliumdependent vasodilation in health and disease. Microcirculação. 2013;20(3):239-47. PMid:23311975. http://dx.doi.org/10.1111/micc.12040.

5. Dharmashankar K, Widlansky ME. Vascular endothelial function and hypertension: insights and directions. Curr Hypertens Rep. 2010;12(6):448-55. PMid:20857237. http://dx.doi.org/10.1007/s11906-010-0150-2.

6. Collier P, Watson CJ, Voon V, et al. Can emerging biomarkers of myocardial remodelling identify asymptomatic hypertensive patients at risk for diastolic dysfunction and diastolic heart failure? Eur J Heart Fail. 2011;13(10):1087-95. PMid:21719449. http://dx.doi.org/10.1093/eurjhf/hfr079.

7. Krebs C, Fraune C, Schmidt-Haupt R, et al. CCR5 deficiency does not reduce hypertensive end-organ damage in mice. Am J Hypertens. 2012;25(4):479-86. PMid:22258337. http://dx.doi.org/10.1038/ajh.2011.243.

8. Franceschini N, Reiner AP, Heiss G. Recent findings in the genetics of blood pressure and hypertension traits. Am J Hypertens. 2011;24(4):392-400. PMid:20948529. http://dx.doi.org/10.1038/ajh.2010.218.

9. Nascimento LR, Molina MCB, Faria CP, et al. Reproducibility of arterial pressure measured in the ELSA-Brasil with 24-hour pressure monitoring. Rev Saude Publica. 2013;47(Suppl 2):113-21. PMid:24346728. http://dx.doi.org/10.1590/S0034-8910.2013047003825.

10. Mamas M, Dunn WB, Neyses L, Goodacre R. The role of metabolites and metabolomics in clinically applicable biomarkers of disease. Arch Toxicol. 2011;85(1):5-17. PMid:20953584. http://dx.doi.org/10.1007/s00204-010-0609-6.

11. Lopez B, Gonzalez A, Lindner D, et al. Osteopontin-mediated myocardial fibrosis in heart failure: a role for lysyl oxidase? Cardiovasc Res. 2013;99(1):111-20. PMid:23619422. http://dx.doi.org/10.1093/cvr/cvt100.

12. World Health Organization. Global atlas on cardiovascular disease prevention and control. Geneva: WHO; 2011.

13. Sociedade Brasileira de Hipertensão. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol. 2010 [citado em 2016 mar 02];95(1):1-41. http://publicacoes.cardiol.br/consenso/2010/Diretriz_hipertensao_associados.pdf

14. Sociedade Brasileira de Cardiologia; Sociedade Brasileira de Hipertensão; Sociedade Brasileira de Nefrologia. VI Diretrizes Brasileiras de hipertensão. Arq Bras Cardiol. 2010;5(Supl.1):1-51.

15. World Health Organization. A global brief on hypertension: silent killer, global public health crisis. Geneva: WHO; 2013.

16. Martins LC, Figueiredo VN, Quinaglia T, et al. Characteristics of resistant hypertension: ageing, body mass index, hyperaldosteronism, cardiac hypertrophy and vascular stiffness. J Hum Hypertens. 2011;25(9):532-8. PMid:20927128. http://dx.doi.org/10.1038/jhh.2010.95.

17. Lima FAT, Araújo TL, Lopes MVO, Silva LF, Monteiros ARM, Oliveira SKP. Fatores de risco da doença coronariana em pacientes que realizaram revascularização miocárdica. Rev Rene. 2012 [citado em 2016 mar 02];13:853-60. http://www.revistarene.ufc.br/revista/index.php/revista/article/viewFile/1080/pdf

18. Anyaegbu EI, Dharnidharka VR. Hypertension in the Teenager. Pediatr Clin North Am. 2014;61(1):131-51. PMid:24267462. http://dx.doi.org/10.1016/j.pcl.2013.09.011.

19. Nobre F, Coelho EB, Lopes PC, Geleilete TJM. Hipertensão arterial sistêmica primária. Medicina. 2013 [citado em 2016 mar 02];46:256-272. http://revista.fmrp.usp.br/2013/vol46n3/rev_Hipertens%E3o%20arterial%20sist%EAmica%20prim%E1ria. pdf

20. Grassi G. Sympathetic neural activity in hypertension and related diseases. Am J Hypertens. 2010;23(10):1052-60. PMid:20651696. http://dx.doi.org/10.1038/ajh.2010.154.

21. Prati C, Demougeot C, Guillot X, Godfrin-Valnet M, Wendling D. Endothelial dysfunction in joint disease. Joint Bone Spine. 2014;81(5):386-91. PMid:24565889. http://dx.doi.org/10.1016/j.jbspin.2014.01.014.

22. Pereira AC, Paulo M, Araújo AV, Rodrigues GJ, Bendhack LM. Nitric oxide synthesis and biological functions of nitric oxide released from ruthenium compounds. Braz J Med Biol Res. 2011;44(9):947-57. PMid:21755266. http://dx.doi.org/10.1590/S0100-879X2011007500084.

23. Dias RG, Negrão CE, Krieger MH. Óxido nítrico y sistema cardiovascular: activación celular, reactividad vascular y variante genética. Arq Bras Cardiol. 2011 [citado em 2016 mar 02];96(1):68-75. http://www.scielo.br/pdf/abc/v96n1/es_v96n1a12 PMid:21308339.

24. Ando J, Yamamoto K. Effects of shear stress and stretch on endothelial function. Antioxid Redox Signal. 2011;15(5):1389-403. PMid:20854012. http://dx.doi.org/10.1089/ars.2010.3361.

25. Ferreira LB, Albuquerque AAS, Celotto AC. Fator hiperpolarizante derivado do endotélio e doenças cardiovasculares. Rev Soc Cardiol. 2011;21:40-5.

26. Melo JB, Figueiredo JAF No, Campos RCA, Meireles MF, Costa ECC, Leal MCM. Estudo da função endotelial no Brasil: prevenção de doenças cardiovasculares. Rev Bras Cardiol. 2014;27:616-23.

27. Menezes IAC, Santos MRV, Cunha CLP. O índice de perfusão da oximetria de pulso na avaliação da função endotelial na aterosclerose. Arq Bras Cardiol. 2014;102:237-44. PMid:24676228.

28. Dillenburg DR, Mostarda C, Moraes-Silva IC, et al. Resveratrol and grape juice differentially ameliorate cardiovascular autonomic modulation in L-NAME-tread rats. Auton Neurosci. 2013;179(1-2):17. PMid:23810687. http://dx.doi.org/10.1016/j.autneu.2013.06.002.

29. Nakmareong S, Kukongviriyapan U, Pakdeechote P, et al. Tetrahydrocurcumin alleviates hypertension, aortic stiffening and oxidative stress in rats with nitric oxide deficiency. Hypertens Res. 2012;35(4):418-25. PMid:22072109. http://dx.doi.org/10.1038/hr.2011.180.

30. Lee S, Park Y, Zuidema MY, Hannink M, Zhang C. Effects of interventions on oxidative stress and inflammation of cardiovascular diseases. World J Cardiol. 2011;26(1):18-24. PMid:21286214. http://dx.doi.org/10.4330/wjc.v3.i1.18.

31. Forstermann U, Sessa WC. Nitric synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. PMid:21890489. http://dx.doi.org/10.1093/eurheartj/ehr304.

32. Aroor AR, Demarco VG, Jia G, et al. The role of tissue ReninAngiotensin-Aldosterone system in the devolopment of endothelial dysfunction and arteial stiffenes. Front Endocrinol. 2013;4:161. PMid:24194732. http://dx.doi.org/10.3389/fendo.2013.00161.

33. Petrella E, Pignatti L, Neri I, Facchinetti F. The L-arginine/nitric oxide pathway is impaired in overweight/obese pregnant women. Pregnancy Hypertens. 2014;4(2):150-5. PMid:26104420. http://dx.doi.org/10.1016/j.preghy.2014.01.001.

34. Zhang X, Lynch AI, Davis BR, et al. Pharmacogenetic association of NOS3 variants with cardiovascular disease in patients with hypertension: the genhat study. PLoS One. 2012;7(3):e34217. PMid:22470539. http://dx.doi.org/10.1371/journal.pone.0034217.

35. Teixeira BCA, Lopes AL, Macedo RCO, et al. Marcadores inflamatórios, função endotelial e riscos cardiovasculares. J Vasc Bras. 2014;13:2. http://dx.doi.org/10.1590/jvb.2014.054.

36. Bressler J, Pankow JS, Coresh J, Boerwinkle E. Interaction between the NOS3 Gene and obesity as a determinant of risk of type 2 diabetes: the atheros clerosis risk in communities study. PLoS One. 2013;8(11):e79466. PMid:24278136. http://dx.doi.org/10.1371/journal.pone.0079466.

37. Ghasemi A, Zahediasl S, Azizi F. Reference values for serum nitric oxide metabolites in an adult population. Clin Biochem. 2010;43(1-2):89-94. PMid:19782059. http://dx.doi.org/10.1016/j.clinbiochem.2009.09.011.

38. Rajendran P, Rengarajan T, Thangavel J, et al. The vascular endothelium and human diseases. Int J Biol Sci. 2013;9(10):1057-69. PMid:24250251. http://dx.doi.org/10.7150/ijbs.7502.

39. Celik M, Iyisoy A, Celik T, Yilmaz MI, Yuksel UC, Yaman H. The relationship between L-arginine/ADMA ratio and coronary collateral development in patients with low glomerular filtration rate. Cardiol J. 2012;19(1):29-35. PMid:22298165. http://dx.doi.org/10.5603/CJ.2012.0006.

40. Sharma V, Ten-Have GA, Ytrebo L, et al. Nitric oxide and L-arginine metabolism in a devascularized porcine model of acute liver failure. Am J Physiol Gastrointest Liver Physiol. 2012;303(3):G435-41. PMid:22421619. http://dx.doi.org/10.1152/ajpgi.00268.2011.

41. Veresh Z, Debreczeni B, Hamar J, Kaminski PM, Wolin MS, Koller A. Asymmetric dimethylarginine reduces nitric oxide donor-mediated dilation of arterioles by activating the vascular renin-angiotensin system and reactive oxygen species. J Vasc Res. 2012;49(4):363-72. PMid:22652896. http://dx.doi.org/10.1159/000337485.

42. Nishiyama Y, Ueda M, Katsura KI, et al. Asymmetric dimethylarginine (ADMA) as a possible risk marker for ischemic stroke. J Neurol Sci. 2010;290(1-2):12-5. PMid:20060545. http://dx.doi.org/10.1016/j.jns.2009.12.020.

43. Hirooka Y, Kishi T, Sakai K, Takeshita U, Sunagawa K. Imbalance of central nitric oxide and reactive oxygen species in the regulation of sympathetic activity and neural mechanisms of hypertension. Am J Physiol Regul Integr Comp Physiol. 2011;300(4):R818-26. PMid:21289238. http://dx.doi.org/10.1152/ajpregu.00426.2010.

44. Rocha MS, Teerlink T, Janssen MCH, et al. Asymmetric dimethylarginine in adults with cystathionine β-synthase deficiency. Atheroscler. 2012;222(2):509-11. PMid:22484094. http://dx.doi.org/10.1016/j.atherosclerosis.2012.03.009.

45. Nemeth Z, Cziraki A, Szabados S, Biri B, Keki S, Koller A. Elevated levels of Asymmetric Dimethylarginine (ADMA) in the pericardial fluid of cardiac patients correlate with cardiac hypertrophy. PLoS One. 2015;10(8):e0135498. PMid:26313940. http://dx.doi.org/10.1371/journal.pone.0135498.

46. Hu X, Atzler D, Xu X, et al. Dimethylarginine dimethylaminohydrolase-1 is the critical enzyme for degrading the cardiovascular risk factor asymmetrical dimethylarginine. Arterioscler Thromb Vasc Biol. 2011;31(7):1540-6. PMid:21493890. http://dx.doi.org/10.1161/ATVBAHA.110.222638.

47. Liu X, Fassett J, Wei Y, Chen Y. Regulation of DDAH1 as a potential therapeutic target for treating cardiovascular diseases. Evid Based Complement Alternat Med. 2013;2013:619207. PMid:23878601.

48. Caplin B, Wang Z, Slaviero A, et al. Alanine-glyoxylate aminotransferase-2 metabolizes endogenous methylarginines, regulates NO, and controls blood pressure. Arterioscler Thromb Vasc Biol. 2012;32(12):2892-900. PMid:23023372. http://dx.doi.org/10.1161/ATVBAHA.112.254078.

49. Caplin B, Leiper J. Endogenous nitric oxide synthase inhibitors in the biology of disease: markers, mediators, and regulators? Arterioscler Thromb Vasc Biol. 2012;32(6):1343-53. PMid:22460557. http://dx.doi.org/10.1161/ATVBAHA.112.247726.

50. Davids M, van Hell AJ, Visser M, Nijveldt RJ, van Leeuwen PA, Teerlink T. Role of the human erythrocyte in generation and storage of asymmetric dimethylarginine. Am J Physiol Heart Circ Physiol. 2012;302(8):1762-70. PMid:22367507. http://dx.doi.org/10.1152/ajpheart.01205.2011.

51. Davids M, Teerlink T. Plasma concentrations of arginine and asymmetric dimethylarginine do not reflect their intracellular concentrations in peripheral blood mononuclear cells. Metabolism. 2013;62(10):1455-61. PMid:23890667. http://dx.doi.org/10.1016/j.metabol.2013.05.017.

52. Sibal L, Agarwal SC, Home PD, Boger RH. The Role of Asymmetric Dimethylarginine (ADMA) in Endothelial Dysfunction and Cardiovascular Disease. Curr Cardiol Rev. 2010;6(2):82-90. PMid:21532773. http://dx.doi.org/10.2174/15734031079116265

9.

53. Malyszko J, Koc-Zorawska E, Matuszkiewicz-Rowinska J, Malyszko J. FGF23 and Klotho in relation to markers of endothelial dysfunction in kidney transplant recipients. Transplant Proc. 2014;46(8):2647-50. PMid:25380886. http://dx.doi.org/10.1016/j.transproceed.2014.09.015.

54. Tripepi G, Kollerits B, Leonardis D, et al. Competitive interaction between fibroblast growth factor 23 and asymmetric dimethylarginine in patients with CKD. J Am Soc Nephrol. 2015;26(4):935-44. PMid:25150156. http://dx.doi.org/10.1681/ASN.2013121355.

55. Reriani MK, Lerman LO, Lerman A. Endothelial function as a functional expression of cardiovascular risk factors. Biomark Med. 2010;4(3):351-60. PMid:20550469. http://dx.doi.org/10.2217/bmm.10.61.

56. Hirata Y, Nagata D, Suzuki E, Nishimatsu H, Suzuki J, Nagai R. Diagnosis and treatment of endothelial dysfunction in cardiovascular disease. Int Heart J. 2010;51(1):1-6. PMid:20145343. http://dx.doi.org/10.1536/ihj.51.1.

57. Sen S, Mcdonald SP, Coates PT, Bonder CS. Endothelial progenitor cells: novel biomarker and promising cell therapy for cardiovascular disease. Clin Sci (Lond). 2011;120(7):263-83. PMid:21143202. http://dx.doi.org/10.1042/CS20100429.

58. Lee PS, Poh KK. Endothelial progenitor cells in cardiovascular diseases. World J Stem Cells. 2014;26(3):355-66. PMid:25126384.

59. McEvoy JW, Chen Y, Nambi V, et al. High-sensitivity cardiac troponin T and risk of hypertension. Circulation. 2015;132(9):825-33. PMid:26152706. http://dx.doi.org/10.1161/CIRCULATIONAHA.114.014364.

60. Bugnicourt JM, Rogez V, Guillaumont MP, Rogez JC, Canaple S, Godefroy O. Troponin levels help predict new-onset atrial fibrillation in ischaemic stroke patients: a retrospective study. Eur Neurol. 2010;63(1):24-8. PMid:19923841. http://dx.doi.org/10.1159/000258679.

61. Tu HT, Campbell BC, Churilov L, et al. Frequent early cardiac complications contribute to worse stroke outcome in atrial fibrillation. Cerebrovasc Dis. 2011;32(5):454-60. PMid:22005390. http://dx.doi.org/10.1159/000332028.

62. Lackland DT, Elkind MS, D’Agostino R Sr, et al. Inclusion of stroke in cardiovascular risk prediction instruments: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2012;43(7):1998-2027. PMid:22627990. http://dx.doi.org/10.1161/STR.0b013e31825bcdac.

63. Brondum-Jacobsen P, Benn M, Jensen GB, Nordestgaard BG. 25-hydroxyvitamin D levels and risk of ischemic heart disease, myocardial infarction, and early death: population-based study and meta-analyses of 18 and 17 studies. Arterioscler Thromb Vasc Biol. 2012;32(11):2794-802. PMid:22936341. http://dx.doi.org/10.1161/ATVBAHA.112.248039.

64. Grandi NC, Breitling LP, Brenner H. Vitamin D and cardiovascular disease: systematic review and meta-analysis of prospective studies. Prev Med. 2010;51(3-4):228-33. PMid:20600257. http://dx.doi.org/10.1016/j.ypmed.2010.06.013.

65. Sokol SI, Tsang P, Aggarwal V, Melamed ML, Srinivas VS. Vitamin d status and risk of cardiovascular events: lessons learned via systematic review and meta-analysis. Cardiol Rev. 2011;19(4):192-201. PMid:21646873. http://dx.doi.org/10.1097/CRD.0b013e31821da9a5.

66. Wang L, Song Y, Manson JE, et al. Circulating 25-hydroxy-vitamin D and risk of cardiovascular disease: a meta-analysis of prospective studies. Circ Cardiovasc Qual Outcomes. 2012;5(6):819-29. PMid:23149428. http://dx.doi.org/10.1161/CIRCOUTCOMES.112.967604.

67. Lou YR, Molnár F, Peräkylä M, et al. 25-Hydroxyvitamin D(3) is an agonistic vitamin D receptor ligand. J Steroid Biochem Mol Biol. 2010;118(3):162-70. PMid:19944755. http://dx.doi.org/10.1016/j.jsbmb.2009.11.011.

68. Roger VL, Go AS, Lloyd-Jones DM, et al. Heart disease and stroke statistics-2012 update: a report from the American Heart Association. Circulation. 2012;125(1):e2-220. PMid:22179539. http://dx.doi.org/10.1161/CIR.0b013e31823ac046.

69. Yanik M, Feig DI. Serum urate: a biomarker or treatment target in pediatric hypertension? Curr Opin Cardiol. 2013;28(4):433-8. PMid:23736817.

70. Grassi D, Ferri L, Desideri G, et al. Chronic hyperuricemia, uric acid deposit andcardiovascular Risk. Curr Pharm Des. 2013;19(13):2432-8. PMid:23173592. http://dx.doi.org/10.2174/1381612811319130

011.

71. Kaufman M, Guglin M. Uric acid in heart failure: a biomarker or therapeutic target? Heart Fail Rev. 2013;18(2):177-86. PMid:22584465. http://dx.doi.org/10.1007/s10741-012-9322-2.

72. Mamas M, Dunn WB, Neyses L, Goodacre R. The role of metabolites and metabolomics in clinically applicable biomarkers of disease. Arch Toxicol. 2011;85(1):5-17. PMid:20953584. http://dx.doi.org/10.1007/s00204-010-0609-6.

73. Zhao Y-Y, Cheng X-L, Vaziri ND, Liu S, Lin R-C. UPLC-based metabonomic applications for discovering biomarkers of diseases in clinical chemistry. Clin Biochem. 2014;47(15):16-26. PMid:25087975. http://dx.doi.org/10.1016/j.clinbiochem.2014.07.019.

74. Kessler T, Erdmann J, Dichgans M, Schunkert H. Shared genetic aetiology of coronary artery disease and atherosclerotic stroke-2015. Curr Atheroscler Rep. 2015;17(4):498. PMid:25690589. http://dx.doi.org/10.1007/s11883-015-0498-5.

75. O’Donnell CJ, Nabel EG. Genomics of cardiovascular disease. N Engl J Med. 2011;365(22):2098-109. PMid:22129254. http://dx.doi.org/10.1056/NEJMra1105239.

76. Zhao YY, Cheng XL, Vaziri ND, Liu S, Lin RC. UPLC-based metabonomic applications for discovering biomarkers of diseases in clinical chemistry. Clin Biochem. 2015;47(15):16-26. PMid:25087975. http://dx.doi.org/10.1016/j.clinbiochem.2014.07.019.

77. Giannakoulas G, Dimopoulos K, Bolger AP, et al. Usefulness of natriuretic Peptide levels to predict mortality in adults with congenital heart disease. Am J Cardiol. 2010;105(6):869-73. PMid:20211335. http://dx.doi.org/10.1016/j.amjcard.2009.11.041.

78. Goff DC Jr, Lloyd-Jones DM, Bennett G, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Circulation. 2014;129(25, Suppl2):S49-73. PMid:24222018. http://dx.doi.org/10.1161/01.cir.0000437741.48606.98.

79. Mokra D, Kosutova P. Biomarkers in acute lung injury. Respir Physiol Neurobiol. 2014;209:52-8. PMid:25466727.

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