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The aim of the study was to evaluate the ability of technetium-99m-fucoidan ([99mTc]fucoidan), a molecular imaging agent specific for selectins, in the assessment of early localized immunity in a rat model of experimental autoimmune myocarditis (EAM). EAM was induced in Lewis rats and troponin T; brain natriuretic peptide (BNP) and anti-myosin antibodies were measured in plasma. Separately, [99mTc]fucoidan single-photon emission computed tomography (SPECT)/x-ray computed tomography (CT) was performed in the very early phase of myocarditis at 10, 15, and 21 days after immunization. Then, hearts were collected and used for autoradiography, well counting, histology, and flow cytometry analysis. The EAM acute phase is characterized by extensive myocardial necrosis, release of troponin and BNP, and pericardial effusion. [99mTc]Fucoidan uptake was significantly increased in EAM compared with controls starting from D15. There was a close relationship between uptake of the tracer and myocardial content in CD45+, CD8+, CD11b+, and CD31+ cells. [99mTc]Fucoidan SPECT/CT accurately diagnosed the autoimmune attack in the early steps of EAM and could be used to monitor disease evolution and therapy efficiency.

International audience; PurposeThe growth phases of medically treated abdominal aortic aneurysms (AAA) are frequently associated with an 18F–fluorodesoxyglucose positron emission tomography (FDG-PET) pattern involving low baseline and subsequent higher FDG uptake. However, the FDG-PET patterns associated with the endovascular aneurysm repair (EVAR) of larger AAA are presently unknown. This study aimed to investigate the relationship between serial AAA FDG uptake measurements, obtained before EVAR and 1 and 6 months post-intervention and subsequent sac shrinkage at 6 months, a well-recognized indicator of successful repair.MethodsThirty-three AAA patients referred for EVAR (maximal diameter: 55.4 ± 6.0 mm, total volume: 205.7 ± 63.0 mL) underwent FDG-PET/computed tomography (CT) before EVAR and at 1 and 6 months thereafter, with the monitoring of AAA volume and of a maximal standardized FDG uptake [SUVmax] averaged between the axial slices encompassing the AAA.ResultsSac shrinkage was highly variable and could be stratified into three terciles: a first tercile in which shrinkage was absent or very limited (0–29 mL) and a third tercile with pronounced shrinkage (56–165 mL). SUVmax values were relatively low at baseline in the 1st tercile (SUVmax: 1.69 ± 0.33), but markedly increased at 6 months (2.42 ± 0.69, p = 0.02 vs. baseline). These SUV max values were by contrast much higher at baseline in the 3rd tercile (SUVmax: 2.53 ± 0.83 p = 0.009 vs. 1st tercile) and stable at 6 months (2.49 ± 0.80), while intermediate results were documented in the 2nd tercile. Lastly, the amount of sac shrinkage, expressed in absolute values or in percentages of baseline AAA volumes, was positively correlated with baseline SUVmax (p = 0.001 for both).ConclusionA low pre-EVAR FDG uptake and increased AAA FDG uptake at 6 months are associated with reduced sac shrinkage. This sequential FDG-PET pattern is similar to that already shown to accompany growth phases of medically treated AAA.

A new tabulated chemistry approach for representing turbulent combustion in industrial furnaces is presented. This model is based on the tabulation of two dimensional diffusion flamelets to account for ternary mixtures between fuel, oxidant and burned gases which are integrated over probability density functions. To avoid excessive CPU time for the table generation, the calculation of the two dimensional flamelets is performed using the method proposed in the ADF-PCM (Approximated Diffusion Flame - Presumed Conditional Moment) approach: only the equation for the progress variable is solved, instead of the equations for all species. The progress variable reaction rate is given by a table of homogeneous reactors using the DHR model (Diluted Homogeneous Reactor) proposed by Locci et al. These approximated diffusion flames are first compared to exact diffusion flames computed using the flamelet equations and the chemistry for all species. The resulting model, called A2DF (Approximate 2 Dimensional Flamelet) is then applied to the RANS (Reynolds Averaged Navier-Stokes) simulations of Sandia Flames D and F, showing a good agreement with experimental measurements. Finally, this model is applied to the flameless and conventional combustion cases of the burner of Verissimo et al., showing a correct agreement for temperature and species predictions.

An abdominal aortic aneurysm (AAA) is a localized dilatation of the infrarenal aorta. AAA is a multifactorial disease, and genetic and environmental factors play a part; smoking, male sex and a positive family history are the most important risk factors, and AAA is most common in men >65 years of age. AAA results from changes in the aortic wall structure, including thinning of the media and adventitia due to the loss of vascular smooth muscle cells and degradation of the extracellular matrix. If the mechanical stress of the blood pressure acting on the wall exceeds the wall strength, the AAA ruptures, causing life-threatening intra-abdominal haemorrhage — the mortality for patients with ruptured AAA is 65–85%. Although AAAs of any size can rupture, the risk of rupture increases with diameter. Intact AAAs are typically asymptomatic, and in settings where screening programmes with ultrasonography are not implemented, most cases are diagnosed incidentally. Modern functional imaging techniques (PET, CT and MRI) may help to assess rupture risk. Elective repair of AAA with open surgery or endovascular aortic repair (EVAR) should be considered to prevent AAA rupture, although the morbidity and mortality associated with both techniques remain non-negligible. An abdominal aortic aneurysm (AAA) is an enlargement of the abdominal aorta. As the AAA grows, the aortic wall becomes progressively thin, and the risk of rupture increases; AAA rupture causes severe intra-abdominal haemorrhage and has a very high mortality.

A new model for Flameless Combustion (FC) based on the tabulation of diluted homogeneous reactors (DHR) is presented. This model is developed within the Large Eddy Simulations (LES) approach because LES has a good potential for correctly predicting the ternary mixing of FC. In DHR, a ternary mixture of fuel, air and burnt gases at equilibrium is considered as an initial condition for the reactor calculations. The auto-ignition of this mixture is then tabulated as a function of the input parameters which are mixture fraction, fresh gases temperature, dilution fraction, progress variable and enthalpy loss. The enthalpy loss is introduced by decreasing the temperature of the diluting burnt gases. The DHR model is first evaluated over the partially premixed Sandia Flame D. Correct results are obtained for this flame, although CO is overestimated by the model. This discrepancy is attributed to the usage of homogeneous reactors which impedes to account for the influence of scalar dissipation. Secondly, the flameless configuration of Verissimo et al., characterized by a strong enthalpy loss due to wall heat losses, is used to assess the performance of the model. Combustion results are found in correct agreement for temperature and major species. The largest discrepancies are found for CO again, although the axial shape for this species is correctly predicted.

Coiling is the gold standard for the treatment of intracranial aneurysms. However, some issues associated with endovascular treatment limit its long-term efficiency. Recanalization with coil compaction is certainly the most important. New approaches may be considered to promote thrombus colonization by mesenchymal cells and aneurysm healing. In the present study, we have percutaneously delivered autologous bone marrow mesenchymal stem cells (BMSCs) to an elastase-induced rabbit carotid aneurysm model in vivo.Autologous mesenchymatous stem cells were obtained after femoral puncture and bone marrow aspiration. After 2 weeks of in vitro cell culture, five million BMSCs were grafted in the carotid aneurysm using an endovascular approach.We demonstrated the feasibility of in vivo percutaneous seeding of autologous BMSCs in the aneurysm by positive Hoechst fluorostaining. Two weeks later, conventional angiography showed an increase in median aneurysmal surface in the sham group, whereas this surface was decreased in the group treated with BMSCs, +28.4 versus -26.4 %, respectively (p = 0.01). BMSC seeding resulted in intimal hyperplasia with cell colonization and disappearance of the thrombus.In conclusion, percutaneous seeding of BMSCs may colonize and heal the arterial wall thus limiting aneurysm expansion.

Selectins are cell adhesion molecules mainly involved in regulation of leukocyte trafficking [1]. Leukocyte extravasation is involved in a wide range of pathophysiological processes such as neurodegenerative diseases, rheumatoid arthritis, graft rejection, etc. In the cardiovascular field, selectins expression has been evidenced in early steps of atherosclerosis as in most degenerative cardiovascular diseases. Platelet expression of P-selectin links platelet aggregates to leukocyte retention, mainly neutrophils. L-selectin is expressed on all circulating leukocytes and directly involved in their trafficking between blood and tissue. Endothelial expression of P-selectins and E-selectins is also provoked by ischemia, and may be a relevant target in the setting of retrospective identification of transient ischemia (ischemic memory). This article briefly reviews agents currently under development to achieve molecular imaging of selectins in endothelial activation, and deals with main issues to be addressed before clinical translation.

Bacterial pathogens evolve during the infection of their human host(1-8), but separating adaptive and neutral mutations remains challenging(9-11). Here we identify bacterial genes under adaptive evolution by tracking recurrent patterns of mutations in the same pathogenic strain during the infection of multiple individuals. We conducted a retrospective study of a Burkholderia dolosa outbreak among subjects with cystic fibrosis, sequencing the genomes of 112 isolates collected from 14 individuals over 16 years. We find that 17 bacterial genes acquired nonsynonymous mutations in multiple individuals, which indicates parallel adaptive evolution. Mutations in these genes affect important pathogenic phenotypes, including antibiotic resistance and bacterial membrane composition and implicate oxygen-dependent regulation as paramount in lung infections. Several genes have not previously been implicated in pathogenesis and may represent new therapeutic targets. The identification of parallel molecular evolution as a pathogen spreads among multiple individuals points to the key selection forces it experiences within human hosts.

Cytomegalovirus (CMV) is associated with atherosclerosis and transplant vascular sclerosis. The aim of this study was to explore the hypothesis that active CMV infection in the vessel wall could be associated with abdominal aortic aneurysm (AAA). We examined the prevalence of CMV in AAA specimens from 22 patients undergoing surgery and, in five cases, characterized the function of smooth muscle cells (SMCs) from the aneurysm in vitro. Twenty-one (95%) of the 22 AAA specimens were CMV positive by a polymerase chain reaction assay, in situ hybridization, or a highly sensitive immunohistochemical staining technique. No positive cells were found in aortas from three CMV-seronegative organ donor cadavers. CMV immediate-early and late antigens were expressed in SMCs in the lesions and were associated with 5-lipoxygenase (5-LO) expression. CMV-positive intimal SMCs migrated 6.6 +/- 1.5 times more efficiently than CMV-negative medial SMCs (p < 0.05). In vitro CMV infection of medial SMCs resulted in a 3.2 +/- 1.2 times increase in migration (p < 0.05). The intimal migration was significantly inhibited by antibodies against basic fibroblast growth factor (bFGF; p < 0.05) in a dose-dependent fashion. Antibodies against platelet-derived growth factor (PDGF)-AB, insulin-like growth factor 1, vascular endothelial growth factor (VEGF), RANTES, monocyte chemoattractant protein 1 (MCP-1), macrophage inflammatory protein (MIP)-1alpha, or interleukin-1beta did not significantly affect intimal SMC migration. However, intimal and medial SMCs secreted similar amounts of bFGF, MCP-1, MIP-1alpha, RANTES, PDGF-AB, PDGF-BB, epidermal growth factor, and VEGF. CMV infection in vitro of intimal and medial cells did not result in significant changes of bFGF or MCP-1 secretion. Since CMV infection can affect several functional parameters in SMCs, including several key factors in infected SMCs, our findings provide support for the hypothesis that CMV contributes to the pathogenesis of abdominal aortic aneurysm.

Different combustion models such as PCM (Presumed Conditional Moments) or ADF-PCM (Approximated Diffusion Flames Presumed Conditional Moments) can be used for RANS simulations of non premixed or partially premixed turbulent flames. In this paper, the auto-ignition experiment performed by Mastorakos and co-workers at Cambridge University is used as a validation case for comparing these two approaches. Furthermore, the first order PCM model is introduced to analyze the effects of the progress variable segregation and an improved version of ADF-PCM is developed with a pdf of the scalar dissipation rate. Compared to ADF-PCM models, the first and second order PCM models predict very sharp temperature and progress variable increase after ignition for all simulated cases. The segregation factors of the progress variable reach important values during the ignition for ADF-PCM models whereas for PCM, high values are reached at the beginning of the ignition.

(99m)Tc-annexin V (ANX) allows scintigraphic detection of apoptotic cells via specific binding to exposed phosphatidylserine. In myocardial infarction, apoptosis of myocytes is variable and depends especially on the presence or absence of coronary reperfusion. In this study, ANX uptake in non-reperfused experimental myocardial infarcts was compared with uptake of a marker of myocyte necrosis ((111)In-antimyosin antibodies, AM) and an immunohistochemical marker of apoptosis (Apostain).The left anterior coronary artery was ligated in 47 Wistar rats, which were then injected with ANX (n=20), AM (n=21) or both (n=6). Myocardial uptake of ANX and AM was determined at 2 h (n=14), 4 h (n=14) and 24 h (n=19) after coronary ligation (CL), by quantitative autoradiography with (n=23) or without (n=24) gamma imaging. Heart-to-lung ratios (HLRs) and infarct-to-remote myocardium activity ratios (INRs) were calculated on the scintigrams and autoradiograms respectively. Cardiac sections were stained with haematoxylin-eosin and Apostain. The above studies were repeated in 12 normal rats.All rats with CL showed increased ANX and AM uptake in cardiac areas on scintigrams 24 h after CL, with HLRs higher than in controls: 3.1+/-0.6 versus 1.5+/-0.3 (p=0.001) for ANX and 1.99+/-0.44 versus 1.01+/-0.05 (p0.0005) for AM. Autoradiography showed intense ANX and AM uptake in infarcts, with comparable topography and INRs at 2 h, 4 h and 24 h after CL (4.6+/-0.9 versus 5.0+/-1.8 at 24 h), while Apostain staining was very low (0.06+/-0.06% of cells).In this model of persistent CL, we observed increased ANX uptake in injured myocardium, comparable in intensity, topography and kinetics to that of AM. There was only minimal Apostain staining in the same areas.

Interleukin (IL)-10 is an anti-inflammatory cytokine that may play a protective role in atherosclerosis. The aim of this study was to assess the effect of IL-10 deficiency in the apolipoprotein E knockout mouse. Apolipoprotein E deficient (E−/−) and IL-10 deficient (−/−) mice were crossed to generate E−/− × IL-10−/− double knockout mice. By 16 wk, cholesterol and triglycerides were similar in double and single knockouts but the lack of IL-10 led to increased low-density lipoprotein cholesterol whereas very-low-density lipoprotein was reduced. In parallel, T-helper 1 responses and lesion size were dramatically increased in double knockout compared with E−/− controls. At 48 wk, matrix metalloproteinases and tissue factor activities were increased in lesions of double-knockout mice. Furthermore, markers of systemic coagulation were increased, and vascular thrombosis in response to i.v. thrombin occurred more frequently in E−/− × IL-10−/− than in E−/− mice. Our findings suggest that IL-10 deficiency plays a deleterious role in atherosclerosis. The early phase of lesion development was increased, and the proteolytic and procoagulant activity was elevated in advanced lesions. These data show that IL-10 may reduce atherogenesis and improve the stability of plaques.

The conversion of angiotensin I (AT-I) to angiotensin II (AT-II) by angiotensin I-converting enzyme (ACE) is a key step in the action of angiotensins. ACE is constitutively expressed in endothelial cells, but can also be detected at low levels in smooth muscle cells (SMC). Furthermore, in rats the ACE activity can be induced in SMC in vivo by experimental hypertension or vascular injury and in vivo by corticoid treatment. This study was therefore undertaken to evaluate the conversion of AT-I and its subsequent effects in SMC in basal conditions and after stimulation by dexamethasone. Using rat and human SMC, showed that dexamethasone induced ACE expression and that this enzyme was functional, leading to AT-II-dependent intracellular signaling. A fourfold increase in phospholipase C activity in response to AT-I was observed in dexamethasone-activated SMC compared with quiescent SMC. This effect of dexamethasone on signal transduction is dependent on ACE activity, whereas AT-II receptor parameters remain unchanged. The action of AT-I was blocked by an AT1 receptor antagonist, suggesting that it was mediated by AT-II. Similarly, dexamethasone-induced ACE expression was present in human SMC, and calcium signaling was mobilized in response to AT-I in activated human cells. Experiments performed with cocultures of endothelial cells and SMC in a Transwell system showed that the response to AT-I was limited to the compartment where AT-I was localized, suggesting that AT-I does not pass through the endothelial cell barrier to interact with underlying SMC. Our data suggest that in rat, as in human SMC, the conversion of AT-I into AT-II and the signal transduction in response to AT-I are ACE expression-dependent. In addition, the present findings show that this SMC response to AT-I is endothelium-independent, supporting the idea of a local generation of AT-II in the vascular wall.

Several in vitro studies have previously demonstrated that the addition of TGF-beta to aortic smooth muscle cells or skin fibroblasts stimulates elastin synthesis. It is not clear however whether, in vivo, TGF-beta participates in the regulation of elastin synthesis, especially in physiological conditions. The aim of our study was to explore the localization of elastin mRNA and TGF-beta1 in the rat thoracic aorta (an elastic artery) and caudal artery (a muscular artery). Elastin mRNA was localized by in situ hybridization and quantified using Northern blot analysis. TGF-beta1 was detected using immunohistochemistry. The study was carried out as a function of age (rats of 3, 10, 20, and 30 months). We observed that TGF-beta1 immunoreactivity is present predominantly, but not exclusively, at the sites of elastin synthesis as determined by elastin mRNA detection: in smooth muscle cells in the aorta and in endothelial cells in the caudal artery. The ability of exogenously added TGF-beta1 (0.001-10 ng/ml) to modulate the steady-state levels of elastin mRNA in primary cultures of endothelial cells, smooth muscle cells, and fibroblasts isolated from the thoracic aorta was also studied. At the highest concentration used, elastin mRNA levels increased 5-fold in endothelial cells and 11-fold in smooth muscle cells. The demonstration that TGF-beta1 immunoreactivity is present at the sites of elastin synthesis in the thoracic aorta and in the caudal artery and the observation that TGF-beta1 induces an increase in elastin mRNA levels in cultured endothelial cells and smooth muscle cells suggest that TGF-beta1 may be implicated, at least in part, in the physiological regulation of elastin gene expression.

A colony of 26 chimpanzees given a fruit and vegetable diet of very low Na and high K intake were maintained in long-standing, socially stable small groups for three years. Half of them had salt added progressively to their diet during 20 months. This addition of salt within the human dietetic range caused a highly significant rise in systolic, mean and diastolic blood pressure. The change reversed completely by six months after cessation of salt. The effect of salt differed between chimpanzees, some having a large blood pressure rise and others small or no rise. These results in the species phylogenetically closest to humans bear directly on causation of human hypertension, particularly in relation to migration of preliterate people, with low Na diet, to a Western urban lifestyle with increased salt intake. The hedonic liking for salt and avid ingestion was apt during human prehistory involving hunter-gatherer-scavenger existence in the interior of continents with a scarcity of salt, but is maladaptive in urban technological life with salt cheap and freely available.

A diglyceride derivative of a pentapeptide renin inhibitor, the 1,3-dipalmitoyl-[Iva-Phe-Nle-Sta-Ala-Sta-acetyl]-glycerol was synthesized and tested in vitro as a potential prodrug for oral administration. The ability of the diglyceride analog to inhibit the renin activity was equivalent to that of the parent peptide after predigestion with pancreatic lipase. Furthermore, the presence of the palmitoyl groups was found to induce, in vitro, an efficient protection of the peptide from gastric and intestinal hydrolysis. During incubation with intestinal and gastric fluids, and with alpha-chymotrypsin and pancreatic lipase, the glycerolipidic derivative was more stable than the peptide alone. These results support the use of glycerolipidic prodrug for oral administration of peptides.

Hypertension and ageing are associated with decreased arterial compliance, increased thickening of the arterial wall, hypertrophy of arterial smooth muscle cells and an increase in the collagen content of the arterial wall. Increased blood pressure has been implicated as a causative factor in such adaptive vascular alterations, however, other factors, including angiotensin II and epidermal growth factor also induce one or more of these adaptations. Long term use of the angiotensin-converting enzyme (ACE) inhibitor perindopril 1 mg/kg has been shown to reduce blood pressure in spontaneous and renovascular hypertensive rats. Associated with this antihypertensive effect, perindopril completely reversed aortic medial thickening, increased arterial compliance (by 42%) and decreased aortic smooth muscle cell nucleus density (by 13%), but had no significant effect on the elastin: collagen ratio of the arterial wall. In contrast, in spontaneously hypertensive animals, perindopril partially reversed aortic medial thickening and had no significant effect on arterial compliance, despite significantly increasing the arterial wall elastin: collagen ratio in this experimental group. The effect of ACE inhibition appears to directly reflect the role of angiotensin II in the pathogenesis of different hypertensive states.

Integrin avb3 is expressed at high density in vascular smooth muscle cells (VSMCs). It functions as a receptor for adhesion proteins in VSMCs which phenotypic modulation plays a pivotal role in arteriosclerosis and atherosclerosis. The aim was to study the role of integrin avb3 in angiotensin II (Ang II)-induced arterial fibrosis in mice and in human samples of atherosclerotic arteries in situ. Transgenic mice conditionally inactivated for integrin av subunit in VSMCs (avSMKO) were treated with Ang II (1,5 mg/kg/day) for 4 weeks. Immunostained slices of atherosclerotic plaques at different stages of development and primary cultures of human aortic VSMCs were used. At baseline, blood pressure was lower in avSMKO compared to control (WT) mice. Isobaric carotid distensibility was increased and remained higher in avSMKO in response to Ang II. The increase in collagen content in response to Ang II was lower in avSMKO than in WT (15 vs 36%) for similar increase in blood pressure (20 mmHg) and arterial wall hypertrophy. The immunohistochemistry of aortic slices showed stronger staining for integrin avb3 in atherosclerotic plaques compared to healthy aortas. In VSMC cultures, the mRNA of av was decreased. In conclusion, these results show that avb3 is strongly expressed in neointimal proliferation and in fibrous plaques. The av integrin subunit seems to regulate arterial fibrosis in response to hypertension and plaque growth. Low RNA quantities of av subunit of VSMCs contrasted with strong protein staining in plaques suggesting the participation of inflammatory cells in the synthesis of this integrin.

In order to investigate the consequences of different types of cardiac hypertrophy on myocardial capillary and fibrosis density in rats we describe here, in the same hearts, the pattern of capillary bed density visualized by fluorescein isothiocyanate dextran (FITC-dextran) and the pattern of fibrosis density as determined by automated image analysis. Pressure overload was induced by clipping one renal artery in rats (one-clip, two-kidney Goldblatt hypertension, RHV). Volume overload was induced by creation of an arteriovenous shunt between the abdominal aorta and the vena cava (aorto-caval fistula model ACF). Animals were sacrified at 1, 3 and 6 months following surgical procedure. Immediately prior to sacrifice, FITC-dextran (MW 150,000) was injected with the animal under ether anesthesia. Five minutes later, cardiac diastolic arrest was induced by the i.v. injection of potassium chloride. The heart was rapidly excised and placed in a formaldehyde solution. The degree of cardiac hypertrophy was calculated after measurement of cardiac weight. Left ventricular wall thickness and cavity area were measured by microscopic methods. Capillary density and geometry were determined by morphometric methods, under ultraviolet light microscopy, using a graphic tablet connected to a microcomputer. The degree of myocardial fibrosis, visualized with Sirius Red, was estimated by the use of automated image analysis using light microscopy. In renovascular hypertension, cardiac hypertrophy was maximum at one month (36%) and persisted through the six months of the study. This increase in cardiac mass was concentric, due to a significant increase in ventricular wall thickness and was associated with a marked increase in fibrosis and a significant decrease in subendocardial capillary density. These effects existed already one month and did not change with time. In the aorto-caval fistula model, cardiac hypertrophy was also maximum at one month (+56%), but this eccentric increase in cardiac mass was associated with no significant change in left ventricular wall thickness, but rather with a significant increase in the surface area of the left ventricular cavity. This volume overload hypertrophy was associated with a decrease in subendocardial capillary density which was negatively correlated with time. In contrast to concentric hypertrophy there was no increase in the fibrosis density compared to the sham-operated groups. Despite the identical degrees of hypertrophy, pressure and volume cardiac overload differed in a significant manner in both left ventricular wall thickness and cavity surface area.(ABSTRACT TRUNCATED AT 400 WORDS)

Early diagnosis of acute mesenteric ischemia (AMI) remains a clinical challenge, and no biomarker has been consistently validated. We aimed to assess the accuracy of three promising circulating biomarkers for diagnosing AMI—citrulline, intestinal fatty acid-binding protein (I-FABP), and d-lactate. A cross-sectional diagnostic study enrolled AMI patients admitted to the intestinal stroke center and controls with acute abdominal pain of another origin. We included 129 patients—50 AMI and 79 controls. Plasma citrulline concentrations were significantly lower in AMI patients compared to the controls [15.3 μmol/L (12.0–26.0) vs. 23.3 μmol/L (18.3–29.8), p = 0.001]. However, the area under the receiver operating curves (AUROC) for the diagnosis of AMI by Citrulline was low: 0.68 (95% confidence interval = 0.58–0.78). No statistical difference was found in plasma I-FABP and plasma d-lactate concentrations between the AMI and control groups, with an AUROC of 0.44, and 0.40, respectively. In this large cross-sectional study, citrulline, I-FABP, and d-lactate failed to differentiate patients with AMI from patients with acute abdominal pain of another origin. Further research should focus on the discovery of new biomarkers.