RESUMEN
OBJECTIVE: The extent of severity and complexity of coronary artery disease (CAD) in patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and possible correlations between serum 25-hydroxyvitamin D (25(OH)D) have not yet been adequately studied. We evaluated the relationship between 25(OH)D levels and the burden of CAD as assessed by the SYNTAX score (SXscore) in patients with acute coronary syndrome (ACS) including STEMI and NSTEMI. METHODS: After exclusion, a total of 113 patients who were admitted to our hospital due to ACS and who were referred for undergoing coronary angiography were prospectively included. Their mean age was 63.3±18.5 years, and 80.5% of them were men. In total, 44.2% of the patients had NSTEMI and the remaining had STEMI. Blood samples were drawn at admission to evaluate serum 25(OH)D levels. CAD severity was assessed using the SXscore. Patients were classified as having low (SXscore ≤22) or high (SXscore >22) SXscores. Pearson's and Spearman's correlation coefficients were used to examine the relationship between serum 25(OH)D levels and the SXscore. RESULTS: 25(OH)D levels were significantly lower in the group with a high SXscore than in the group with a low SXscore (21.0±8.0 vs. 16.7±6.8, p=0.005). Correlation analysis showed a significant correlation between 25(OH)D levels and the SXscore. Multiple linear regression (MLR) analysis was used to determine the significance of the relationship between the SXscore and 25(OH)D, parathyroid hormone, and C-reactive protein levels and eGFR. MLR analysis revealed that only 25(OH)D levels (coefficient beta, -0.217, p=0.029) was significantly associated with the severity of CAD. CONCLUSION: The present study showed that serum 25(OH)D levels were significantly lower in patients with STEMI/NSTEMI and that low serum 25(OH)D levels were significantly correlated with CAD severity and extent.
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Síndrome Coronario Agudo/diagnóstico por imagen , Biomarcadores/sangre , Infarto del Miocardio con Elevación del ST , Índice de Severidad de la Enfermedad , Vitamina D/análogos & derivados , Síndrome Coronario Agudo/sangre , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Medición de Riesgo , Factores de Riesgo , Vitamina D/sangreRESUMEN
OBJECTIVE: In this study we aimed to investigate heart rate recovery (HRR) in patients with inflammatory bowel disease (IBD). SUBJECTS AND METHODS: A total of 40 patients with IBD and 30 healthy controls were included in this study. A treadmill stress test was performed in all the patients to calculate the HRR index based on the age-specific maximum heart rate. The HRR indices were calculated as follows: HRR1, 2, 3, 4, 5 = heart rate at peak exercise - heart rate at 1, 2, 3, 4, and 5 min. The independent samples t test was used to compare HRR indices between the patient and control groups. The Pearson correlation coefficient was used to examine the association between the duration of IBD and the HRR indices. Multivariate regression analysis was carried out to identify predictors of impaired HRR in patients with IBD. RESULTS: HRR indices at various time intervals were significantly lower in the patients with IBD than in the controls: HRR1 (1.18 ± 8 vs. 31 ± 7, p < 0.001), HRR2 (36 ± 12 vs. 51 ± 8, p < 0.001), HRR3 (46 ± 12 vs. 62 ± 11, p < 0.001), HRR4 (54 ± 7 vs. 65 ± 8, p < 0.001), and HRR5 (55 ± 13 vs. 71 ± 15, p < 0.001). Mean duration of IBD was 7.8 ± 3.6 years. In addition, there was a significant negative correlation between disease duration and HRR at the first minute (r = -0.704, p < 0.001). Multivariate logistic regression analysis showed that symptom duration (OR: 1.742, 95% CI: 1.148-2.636, p = 0.009) was an independent predictor of impaired HRR in patients with IBD. CONCLUSION: In this study, the data showed that the HRR was impaired in patients with IBDs. Hence, given the prognostic value of the test, patients with IBD should be monitored for future cardiovascular events.
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Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Enfermedades Inflamatorias del Intestino/fisiopatología , Adulto , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Factores de TiempoRESUMEN
In this study we aimed to investigate whether there is an association between the neutrophil to lymphocyte ratio (NLR) and severity of coronary artery disease (CAD) in patients with non-ST segment elevation myocardial infarction (NSTEMI) using the SYNTAX score (SXscore). A total of 414 patients with NSTEMI who underwent coronary angiography were enrolled in the study. NLR was measured for all patients at presentation. The study population was then divided into 3 tertiles based on the SYNTAX trial results.(1)) The low syntax group (n = 329) was defined as those with an SXscore ≤ 22, the intermediate syntax group (n = 58) was defined as an SXscore ≥ 23 and < 33, and the high syntax group (n = 27) as those with an SXscore ≥ 33. NLR was significantly lower in patients with a low SXscore compared to patients with an intermediate SXscore or high SXscore (3.7 ± 4 to 4.6 ± 2 and 7.9 ± 4, P < 0.001). Linear regression analysis revealed that NLR (coefficientß = 0.380, 95%CI: 1.165-1.917, P < 0.001) was significantly associated with the SXscore in patients with NSTEMI. Our results indicate that NLR is independently associated with the severity of CAD in patients with NSTEMI.
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Enfermedad de la Arteria Coronaria , Inflamación/sangre , Linfocitos , Infarto del Miocardio , Neutrófilos , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico , Vasos Coronarios/patología , Estudios Transversales , Electrocardiografía , Femenino , Humanos , Recuento de Leucocitos/métodos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/etiología , Pronóstico , Proyectos de Investigación , Índice de Severidad de la Enfermedad , Estadística como Asunto , TurquíaRESUMEN
OBJECTIVES: Spontaneous echo contrast (SEC) is the presence of smoke-like echoes with a characteristic swirling motion of the blood in echocardiography. Previous clinical studies have shown that SEC is a risk factor for left atrial thrombus formation and a predictor of potential systemic embolism originating from the heart. There is an association between uric acid and prothrombotic state. Therefore, we aimed to investigate the role of uric acid in SEC in patients with mitral stenosis (MS). METHODS: A total of 85 consecutive patients with MS were enrolled in the study. Patients were divided into two groups according to whether SEC was present in the left atrium. RESULTS: There were 41 patients (mean age 46.4 ± 11.4 and 68% female) in the SEC(-) group and 44 patients (mean age 45.7 ± 7.2 and 64% female) in the SEC(+) group. High sensitive C-reactive protein (hs-CRP) levels were significantly higher in the SEC(+) group than in the SEC(-) group (9.5 ± 4.2 vs. 4.7 ± 2.2 mg/L, P < 0.001). Uric acid was also significantly higher in the SEC (+) group (6.3 ± 1.4 vs. 4.5 ± 1.3 mg/dL, P < 0.001). In receiver operating characteristics curve analysis, uric acid >5.2 mg/dL had a 73% sensitivity and 76% specificity in predicting SEC in patients with MS. At multivariate analysis, uric acid (OR 3.919, 95% CI 1.911-8.035; P < 0.002) was an independent risk factor for SEC in patients with MS. CONCLUSION: Uric acid is independently associated with SEC in patients with MS. Our findings suggest that this inexpensive, universally available marker may be a useful biomarker for the stratification of risk in patients with MS.
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Ecocardiografía , Estenosis de la Válvula Mitral/sangre , Estenosis de la Válvula Mitral/diagnóstico por imagen , Ácido Úrico/sangre , Biomarcadores/sangre , Proteína C-Reactiva/metabolismo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
OBJECTIVES: The aim of this study was to evaluate the association of the levels of red blood cell distribution width (RDW) with the severity of atherosclerosis and to determine whether or not the RDW level on admission is an independent predictor of all-cause mortality in patients with non-ST elevation myocardial infarction (NSTEMI). MATERIALS AND METHODS: A total of 335 consecutive patients with NSTEMI were enrolled in this study. The patients were divided into high (n = 105) and low (n = 230) SYNTAX groups. The high SYNTAX group was defined as patients with a value in the third tertile (SYNTAX score, SXscore ≥12), while the low SYNTAX group was defined as those with a value in the lower 2 tertiles (SXscore <12). The high RDW group (n = 152) was defined as patients with RDW >14.25% and the low RDW group (n = 183) as those with RDW ≤14.25%. All-cause mortality was followed up to 38 months. RESULTS: The mean follow-up period was 18 ± 11 months. The RDW levels of patients were significantly higher in the high SYNTAX group than in the low SYNTAX group (15.2 ± 1.8 vs. 14.2 ± 1.2, p < 0.001). Pearson's coefficients were used to determine the degree of association between RDW levels and SXscore and also between RDW levels and high-sensitivity C-reactive protein. There was a significant correlation between RDW levels and SXscore (r = 0.460, p < 0.001). Also, there was a significant correlation between RDW levels and high-sensitivity C-reactive protein (r = 0.180, p = 0.001). All-cause mortality rate was not significantly different between the high and low RDW groups (log-rank, p = 0.621). CONCLUSION: RDW levels were independently associated with high SXscore but were not associated with long-term mortality in NSTEMI patients.
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Enfermedad de la Arteria Coronaria/sangre , Eritrocitos/metabolismo , Adulto , Anciano , Angiografía , Aterosclerosis , Causas de Muerte , Electrocardiografía , Servicio de Urgencia en Hospital , Índices de Eritrocitos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/complicaciones , Curva ROC , Medición de Riesgo , Factores de Riesgo , Índice de Severidad de la Enfermedad , Turquía/epidemiologíaRESUMEN
OBJECTIVE: Nonalcoholic steatohepatitis (NASH) is a part of histological spectrum of nonalcoholic fatty liver disease (NAFLD). Higher incidence of cardiovascular mortality has been reported in studies including patients with NAFLD. Impaired myocardial function can be detected by a novel echocardiographic method called speckle tracking echocardiography (STE) when conventional methods were normal. METHODS: Twenty-eight biopsy-proven NASH patients (mean age 41.6 ± 9.8, 16 male) without hypertension and diabetes mellitus were included in study. All patients underwent transthoracic echocardiography. Offline analyses of images was performed and strain (S), strain rate (SR) parameters compared between NASH patients and controls. Statistical analysis were done by independent samples t test between groups and a multiple linear regression model was used to identify the statistical significance of relationships between selected variables. RESULTS: R(SR-S) values were similar but R(S), R(SR-E), R(SR-E/A) values were significantly lower and R(SR-A) was higher in the NASH patients. There were no significant differences in CS, C(SR-S), C(SR-E), C(SR-A) and C(SR-E/A) values among the two groups. The most impressive results were obtained from longitudinal strain and strain rate parameters. LS, L(SR-S), L(SR-E), L(SR-A), values were significantly lower in NASH group when compared with healty controls. Linear regression analysis showed that RS and LS was not associated with diastolic blood pressure, total cholesterol and LDL cholesterol. CONCLUSION: The LV longitudinal and radial systolic functions may be deteriorated in patients with NASH even in the absence of apparent decrease in the LV ejection fraction. STE may be useful in detecting preclinical LV impairment in patients with NASH.
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Enfermedad del Hígado Graso no Alcohólico/complicaciones , Disfunción Ventricular Izquierda/diagnóstico por imagen , Adulto , Ecocardiografía/métodos , Femenino , Humanos , Masculino , Disfunción Ventricular Izquierda/complicacionesRESUMEN
We evaluated the acute effect of intracoronary administration of tirofiban on no-reflow phenomenon in patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention. Consecutive patients (n = 162) were randomized into 2 groups based on whether intracoronary tirofiban was administered. After the administration of intracoronary tirofiban, thrombolysis in myocardial infarction (TIMI) flow grade significantly increased (P < .001) and successful reperfusion was achieved in 26 (32%) patients. In the placebo group, however, after the administration of intracoronary placebo the TIMI flow grade did not change (P = .070), and successful reperfusion was achieved only in 8 (10%) patients. In-hospital major adverse cardiac events (MACE) were significantly lower in the tirofiban group (36% vs 19%, P = .013). Intracoronary administration of tirofiban significantly improves TIMI flow grade and is associated with a lower in-hospital rate of MACE.
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Circulación Coronaria/efectos de los fármacos , Infarto del Miocardio/terapia , Fenómeno de no Reflujo/prevención & control , Intervención Coronaria Percutánea , Inhibidores de Agregación Plaquetaria/administración & dosificación , Tirosina/análogos & derivados , Anciano , Trombosis Coronaria/etiología , Trombosis Coronaria/prevención & control , Femenino , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/mortalidad , Infarto del Miocardio/fisiopatología , Fenómeno de no Reflujo/diagnóstico , Fenómeno de no Reflujo/etiología , Fenómeno de no Reflujo/mortalidad , Fenómeno de no Reflujo/fisiopatología , Intervención Coronaria Percutánea/efectos adversos , Intervención Coronaria Percutánea/instrumentación , Intervención Coronaria Percutánea/mortalidad , Recurrencia , Factores de Riesgo , Stents , Factores de Tiempo , Tirofibán , Resultado del Tratamiento , Turquía , Tirosina/administración & dosificaciónRESUMEN
OBJECTIVE: In this study, we aimed to investigate atrial electromechanical delay (EMD) in patients with psoriasis. SUBJECTS AND METHODS: A total of 43 patients with psoriasis (26 mild-moderate, 17 severe) and 17 healthy control subjects were enrolled. Patients with psoriasis were divided into two groups: the mild-moderate group and the severe group according to their psoriasis area severity index (PASI) scores. Atrial EMD was measured from the lateral mitral annulus and called 'PA lateral', from the septal mitral annulus, called 'PA septal', and from the right ventricle tricuspid annulus, called 'PA tricuspid'. Atrial EMD was defined as the time interval from the onset of atrial electrical activity (P wave on surface ECG) to the beginning of mechanical atrial contraction (late diastolic A wave). All three groups were compared with each other, and correlation analysis was performed to investigate the relationship between the PASI score and interatrial EMD. RESULTS: PA lateral was significantly higher in both the mild-moderate psoriasis group and the severe psoriasis group compared to controls (69 ± 12 and 78 ± 13 vs. 60 ± 6 ms; p = 0.001). Also, PA septal (63 ± 11 vs. 53 ± 6 ms; p = 0.005, post hoc analysis) and PA tricuspid (49 ± 7 vs. 41 ± 5 ms; p = 0.009, post hoc analysis) were significantly higher in the severe psoriasis group than in the control group. Correlation analysis revealed that the PASI score was well correlated with PA lateral (r = 0.520, p < 0.001), PA septum (r = 0.460, p = 0.002), interatrial EMD (r = 0.371, p = 0.014) and intra-atrial EMD (r = 0.393, p = 0.009). CONCLUSION: Atrial EMD was prolonged in patients with psoriasis. The measurement of atrial EMD might be used to determine the risk of development of AF in patients with psoriasis.
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Atrios Cardíacos/fisiopatología , Psoriasis/complicaciones , Adolescente , Adulto , Anciano , Análisis de Varianza , Fibrilación Atrial/complicaciones , Estudios de Casos y Controles , Ecocardiografía Doppler , Electrocardiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Índice de Severidad de la Enfermedad , Factores de Tiempo , Adulto JovenRESUMEN
BACKGROUND AND AIM: Vitamin D deficiency is common and may contribute to cardiovascular diseases. We hypothesized that serum 25-hydroxyvitamin D [25(OH)D] levels would be inversely associated with inflammation and with diastolic dysfunction. We therefore investigated the link between serum vitamin D levels (i) echocardiographic measures and (ii) inflammatory parameters. METHODS: The cross-sectional study included 281 patients who were referred to coronary angiography for stable angina pectoris. Patients were recruited between December 2010 and November 2011. Patients with established congestive heart failure, gout, chronic kidney disease (estimated glomeruler filtration rate <60 mL/min per 1.73 m), and acute infection were not included. We measured serum 25(OH)D levels, C-reactive protein and fibrinogen levels. A radioimmunoassay procedure was used to measure 25(OH)D (DiaSorin, Stillwater, MN). We also performed standardized left ventricular (LV) echocardiograms, and echocardiographic data were used for classification of systolic and diastolic dysfunction. We analyzed the relation between serum levels of 25(OH)D and inflammatory markers and echocardiographic measures of LV mass and diastolic dysfunction. RESULTS: At baseline, subjects had a mean age of 59.5 ± 10 years, and 43.4% were women. Left ventricular mass index, left atrial diameter, isovolumic relaxation time, and E/E' ratio were significantly higher in patients with lower 25(OH)D levels. In ordinal logistic regression analysis, higher 25(OH)D was negatively associated only with LV mass index (odds ratio [OR], 0.965; 95% confidence interval [95% CI], 0.939-0.992; P = 0.015), isovolumic relaxation time (OR, 0.962; 95% CI, 0.939-0.985; P = 0.001), E/E' ratio (OR, 0.874; 95% CI, 0.811-0.942; P = 0.008), and C-reactive protein (OR, 0.802; 95% CI, 0.668-0.962; P = 0.021). CONCLUSIONS: Serum levels of 25(OH)D are significantly associated with LV diastolic dysfunction and LV mass index, although the effect size is rather small. Longitudinal studies in larger populations are needed to establish firmly or refute a causal relationship between vitamin D levels and diastolic dysfunction and LV mass index.
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Proteína C-Reactiva/metabolismo , Enfermedad de la Arteria Coronaria/sangre , Hipertensión/sangre , Disfunción Ventricular Izquierda/sangre , Deficiencia de Vitamina D/sangre , Vitamina D/análogos & derivados , Anciano , Angina Estable/sangre , Angina Estable/diagnóstico , Enfermedad de la Arteria Coronaria/diagnóstico , Estudios Transversales , Diástole/fisiología , Femenino , Humanos , Hipertensión/diagnóstico , Masculino , Persona de Mediana Edad , Disfunción Ventricular Izquierda/diagnóstico , Vitamina D/sangre , Deficiencia de Vitamina D/diagnósticoRESUMEN
We investigated the association between coronary artery ectasia (CAE) and Neutrophil-to-lymphocyte ratio (NLR), an indicator of the inflammatory state. The study population included 434 patients (247 males, mean age 62 ± 10 years) including 230 patients with isolated CAE and 104 patients with coronary artery disease and 100 patientss with normal coronary arteries. The NLR was measured at admission and 30 days after coronary angiography in all the patients. The NLR was significantly higher in patients with CAE than those with normal coronary arteries (2.2 ± 0.6-1.3 ± 0.6, P < .001). Linear regression analyses revealed that NLR (coefficient ß = -.61, P < .001) was significantly associated with severity of CAE. The NLR is significantly higher in patients with CAE compared to controls with normal coronary arteries, and NLR is associated with severity of CAE.
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Vasos Coronarios/patología , Dilatación Patológica/patología , Recuento de Leucocitos , Anciano , Dilatación Patológica/fisiopatología , Femenino , Humanos , Recuento de Linfocitos , Masculino , Persona de Mediana Edad , NeutrófilosRESUMEN
We investigated the predictors of endothelial dysfunction in patients with rheumatoid arthritis (RA) by brachial artery flow-mediated vasodilatation (FMD). The study population included 50 patients with RA and 30 controls. Disease activity score (DAS28) was calculated for patients with RA. An FMD response <7% was accepted as impaired FMD. Brachial artery Doppler study revealed that in patients with RA, FMD% was significantly lower as compared with controls (6.6% ± 3.5% vs 9.7% ± 41%, P = .002). After multivariate logistic regression analysis, erythrocyte sedimentation rate (ESR; OR: 1.086, 95% confidence interval [CI]: 1.012-1.167, P = .023), duration of RA (OR: 1.392, 95% CI: 1.044-1.856, P = .024), and DAS28 (OR: 3.335, 95% CI: 1.067-10.42, P = .038) were independent predictors of impaired FMD in patients with RA. Endothelial function is impaired in patients with RA. Disease duration, DAS28, and ESR indicating active inflammation are independent predictors of impaired FMD in patients with RA.
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Artritis Reumatoide/fisiopatología , Arteria Braquial/fisiopatología , Endotelio Vascular/fisiopatología , Vasodilatación , Adulto , Artritis Reumatoide/sangre , Artritis Reumatoide/diagnóstico , Biomarcadores/sangre , Sedimentación Sanguínea , Arteria Braquial/diagnóstico por imagen , Proteína C-Reactiva/análisis , Estudios de Casos y Controles , Endotelio Vascular/diagnóstico por imagen , Endotelio Vascular/metabolismo , Femenino , Humanos , Mediadores de Inflamación/sangre , Lípidos/sangre , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Valor Predictivo de las Pruebas , Factores de Riesgo , Índice de Severidad de la Enfermedad , Factores de Tiempo , Ultrasonografía DopplerRESUMEN
The relationship between extent, severity, and complexity of coronary artery disease (CAD) in patients with ST-segment elevation myocardial infarction (STEMI) and serum γ-glutamyl transferase (GGT) activity has not been adequately studied. We evaluated the relationship between GGT activity and the burden of CAD as assessed by SYNTAX score (SXscore) in patients with STEMI. A total of 243 patients (age 67.1 ± 8.6, 77.4% male) with STEMI were divided into 2 groups. Low- and high-SXscore groups were defined as SXscore <22 and ≥22, respectively. Admission GGT activities were similar between low- and high-SXscore groups (32 ± 17 vs 33 ± 18; P = .625), and there was no significant correlation between GGT activity and SXscore. Although there was an association between high SXscore and major adverse cardiovascular events, as expected, our results did not demonstrate any relationship between admission GGT activities and complexity and extent of the coronary lesions in patients with STEMI.
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Enfermedad de la Arteria Coronaria/complicaciones , Infarto del Miocardio/etiología , gamma-Glutamiltransferasa/sangre , Anciano , Biomarcadores/sangre , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/enzimología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/sangre , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/enzimología , Admisión del Paciente , Valor Predictivo de las Pruebas , Pronóstico , Factores de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVES: In this study, we aimed to investigate whether there is an association between mean platelet volume (MPV), gamma-glutamyltransferase (GGT) and uric acid and coronary artery ectasia (CAE) in a large patient population. STUDY DESIGN: A total of 406 patients (245 male, 161 female; mean age: 55±9 years) were selected retrospectively as the study population from among 3265 individuals who underwent coronary angiography between August 2011 and December 2012. Information regarding blood tests of the patients obtained during hospitalization was extracted from the institute electronic database. RESULTS: MPV, GGT and uric acid levels were significantly higher in subjects with stenotic coronary artery disease (CAD) and in subjects with both CAD and CAE compared with subjects with isolated CAE and subjects with normal coronary arteries (NCA). There were no significant differences between the isolated CAE and NCA groups in terms of MPV (8.6±1.2 fL vs. 8.6±1.1, respectively, p=0.993), serum GGT (33±15 U/L vs. 30±15 U/L, respectively, p=0.723) and uric acid levels (5.4±1.6 mg/dl vs. 5.2±1.7 mg/dl, respectively, p=0.845). CONCLUSION: Unlike previous studies, our study failed to demonstrate any association between CAE and MPV, uric acid and GGT levels.
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Enfermedad de la Arteria Coronaria/sangre , Ácido Úrico/sangre , gamma-Glutamiltransferasa/sangre , Enfermedad de la Arteria Coronaria/enzimología , Enfermedad de la Arteria Coronaria/patología , Dilatación Patológica/sangre , Dilatación Patológica/patología , Femenino , Humanos , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
OBJECTIVE: The aim of this study was to investigate the relationship between psoriasis and heart rate recovery (HRR) index. PATIENTS AND METHODS: A total of 50 patients with a diagnosis of psoriasis and 32 healthy volunteers were included in the study. In all patients, a stress test was performed to calculate the HRR index in a manner which aimed to reach the age-specific maximum heart rate. HRR indices were calculated in all patients and controls. RESULTS: HRR (beats/minute) indices after the 1st (HRR1, 26 ± 10 vs. 33 ± 8, p = 0.002), 2nd (44 ± 11 vs. 50 ± 6, p = 0.002), 3rd (51 ± 7 vs. 63 ± 8, p < 0.001), 4th (54 ± 7 vs. 65 ± 8, p < 0.001) and 5th (57 ± 8 vs. 70 ± 10, p < 0.001) minutes of the recovery period were significantly lower in the psoriasis group compared to healthy controls. In addition, HRR1 was significantly correlated with duration of psoriasis (r = 0.541, p < 0.001) and psoriasis area and severity index score (r = 0.511, p < 0.001). CONCLUSION: HRR was lower in patients with psoriasis. Given the prognostic value of this test, patients with psoriasis might be at risk for future cardiovascular events and cardiovascular mortality.
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Ejercicio Físico/fisiología , Frecuencia Cardíaca/fisiología , Psoriasis/fisiopatología , Adulto , Presión Sanguínea/fisiología , Estudios de Casos y Controles , Prueba de Esfuerzo , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PURPOSE: Cardiovascular diseases are the leading cause of death in patients with non-alcoholic steatohepatitis (NASH). We aimed to investigate the presence of endothelial dysfunction and whether serum concentrations of liver enzymes may reflect the severity of such an endothelial dysfunction in patients with NASH. METHODS: Fifty patients with NASH diagnosed by liver biopsies and 30 healthy controls were included. Blood samples after fasting were harvested for measurements of glucose, insulin, cholesterol, triglyceride, and liver enzymes. All patients underwent transthoracic echocardiography and brachial and carotid artery Doppler ultrasonography to evaluate flow-mediated dilatation (FMD) and carotid artery intima-media thickness (CIMT). RESULTS: Patients with NASH had impaired FMD (4.9 ± 2.8% to 9.3 ± 4.4%, P < 0.001) and higher CIMT (0.79 ± 0.16 mm to 0.64 ± 0.11 mm, P < 0.001) when compared with healthy controls. Linear regression analyses revealed that serum concentrations of gamma glutamyl transferase (GGT) and alanine transaminase (ALT) were associated with FMD and CIMT. CONCLUSIONS: Patients with NASH have impaired FMD and increased CIMT when compared with healthy controls. In patients with NASH, serum concentrations of GGT and ALT might have a predictive value for FMD and CIMT.
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Alanina Transaminasa/sangre , Endotelio Vascular/patología , Hígado Graso/sangre , Hígado Graso/patología , Hígado/enzimología , gamma-Glutamiltransferasa/sangre , Adulto , Biomarcadores/metabolismo , Biopsia , Glucemia/análisis , Arterias Carótidas/diagnóstico por imagen , Grosor Intima-Media Carotídeo , Estudios de Casos y Controles , Colesterol/sangre , Femenino , Humanos , Inflamación , Insulina/sangre , Masculino , Persona de Mediana Edad , Enfermedad del Hígado Graso no Alcohólico , Oxígeno/química , Valor Predictivo de las Pruebas , Análisis de Regresión , Triglicéridos/sangre , Ultrasonografía DopplerRESUMEN
OBJECTIVES: We evaluated the relationship between serum gamma-glutamyltransferase (GGT) levels and the burden of atherosclerosis in patients with acute coronary syndrome (ACS). STUDY DESIGN: This study involved 180 patients (139 male, 41 female; mean age 63±11 years) with the diagnosis of ACS (non-ST elevation myocardial infarction and unstable angina) who underwent coronary angiography on the first day after hospital admission. The burden of atherosclerosis was assessed by the number of involved vessels, and the Gensini and Syntax scores. Serum GGT levels were measured by enzymatic caloric test. RESULTS: Patients with high Syntax scores (>=33) were more frequently diabetic, hypertensive, and had higher GGT and creatinine levels compared to the patients with low Syntax scores (<=23). Similarly, patients with >=3 diseased vessels were more frequently diabetic, hypertensive, and smokers. In addition, these patients were older and had higher serum glucose, urea and GGT levels. Correlation analysis revealed that the level of GGT was significantly associated with Gensini and Syntax scores, number of diseased vessels, and the number of critical lesions (r=0.378 p<0.001, r=0.301 p<0.001, r=0.159 p=0.036, r=0.355 p<0.001, respectively). Multivariate linear regression analysis demonstrated that increased GGT level was an independent risk factor for high Gensini and Syntax scores (p=0.029 and p=0.035, respectively), together with age (p=0.001 and p=0.002, respectively) and serum glucose levels (p=0.017 and p=0.012, respectively). CONCLUSION: Serum GGT levels on admission are associated with increased burden of atherosclerosis in patients with ACS. This may account for the cardiovascular outcomes associated with increased GGT levels.
Asunto(s)
Síndrome Coronario Agudo/enzimología , Biomarcadores/sangre , Enfermedad de la Arteria Coronaria/enzimología , gamma-Glutamiltransferasa/sangre , Síndrome Coronario Agudo/sangre , Síndrome Coronario Agudo/complicaciones , Anciano , Angiografía Coronaria , Enfermedad de la Arteria Coronaria/sangre , Enfermedad de la Arteria Coronaria/complicaciones , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Índice de Severidad de la EnfermedadRESUMEN
OBJECTIVE: In a significant proportion of patients with ST-elevation myocardial infarction (STEMI), microvascular and myocardial reperfusion cannot be regained despite successfully restored thrombolysis in myocardial infarction (TIMI) grade 3 epicardial blood flow. Myocardial blush grade (MBG) is a reliable marker for microvascular patency and predicts short-term and long-term mortality after primary percutaneous coronary intervention (PCI) in patients with acute STEMI, independent of other variables. Mean platelet volume (MPV), a unique measure of platelet size, is an indicator of platelet reactivity. In this study, we aimed to investigate the relation of admission MPV with postinterventional MBG in patients with STEMI and TIMI grade 3 flow at infarct artery after primary PCI. MATERIALS AND METHODS: Three hundred and ten patients were selected as a study group among patients with STEMI and TIMI grade 3 epicardial blood flow after primary PCI. Blood samples for analysis were obtained during the initial evaluation of patients at the emergency department. MBGs of patients were classified at the end of angioplasty. Patients with MBG 0 and 1 were defined as having poor myocardial blush and patients with MBG 2 and 3 were defined as having normal myocardial blush. RESULTS: Patients with poor myocardial blush had higher admission MPV (10.5±1.3 to 9.1±1 fl, P<0.001), higher peak creatine kinase myocardial band isoenzyme levels (260±53 to 190±38 U/l, P<0.001), higher white blood cell count (11.3±4 to 10.3±3×10/µl, P=0.012), and lower left ventricular ejection fraction (42±7 to 51±8%, P<0.001) compared with patients with normal myocardial blush. Linear regression analysis showed that admission MPV was significantly associated with postinterventional MBG (coefficient=0.598, P<0.001). Cardiovascular mortality (13-5%, P=0.013) and acute-subacute stent thrombosis at 3 months (12-8%, P=0.028) were significantly higher in patients with poor postinterventional myocardial blush compared with those with normal myocardial blush. CONCLUSION: The MPV measured at admission is significantly associated with poor postinterventional MBG in patients with STEMI and TIMI grade 3 flow at infarct artery after primary PCI.
Asunto(s)
Plaquetas/citología , Tamaño de la Célula , Circulación Coronaria , Infarto del Miocardio/sangre , Anciano , Angioplastia , Angiografía Coronaria , Femenino , Humanos , Masculino , Microcirculación , Persona de Mediana Edad , Infarto del Miocardio/terapia , Intervención Coronaria Percutánea , Pronóstico , Índice de Severidad de la Enfermedad , StentsRESUMEN
BACKGROUND AND OBJECTIVES: The aim of the present study was to evaluate left ventricle systolic and diastolic function, using tissue Doppler echocardiography (TDE), in relation to blood glucose status in prediabetic patients who had no evidence of heart disease by conventional echocardiography (CE). SUBJECTS AND METHODS: We included 60 patients (30 female, 30 male) and 20 healthy controls (10 male, 10 female). All participants were randomised into four groups according to their oral glucose tolerance test. Group-I consisted of those patients who had only impaired fasting glucose (IFG). group-II consisted of patients who had only impaired glucose tolerance (IGT) and group-III consisted of patients who had both IFG and IGT, that is so-called combined glucose intolerance. Group-IV included the healthy controls. All subjects underwent both CE and TDE. RESULTS: No significant differences were found among the four groups in terms of CE. There was no significant difference between group-IV and group-I with respect to the early peak diastolic velocity (Ea) of medial mitral annulus (11.65±0.66 vs. 9.72±1.58, p>0.05), whereas a statistically significant difference was found between group-IV and group-II (11.65±0.66 vs. 9.06±1.07, p<0.001) and between group-IV and group-III (11.65±0.66 vs. 9.74±1.09, p<0.05). CONCLUSION: Diastolic myocardial dysfunction in prediabetic patients may be identified by quantitative TDE before the appearance of CE indices of myocardial dysfunction.