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In this study, the correlation between pan-immune-inflammation value (PIV) and coronary collateral circulation (CCC) in patients with chronic coronary syndrome (CCS) was analyzed. The study included 663 patients with CCS who underwent coronary angiography and had coronary stenosis of ≥95% in at least one major coronary vessel. The participants were divided into two groups: good CCC (Rentrop score 2-3) and poor CCC (Rentrop score 0-1). PIV score was calculated as monocyte x platelet x neutrophil/lymphocyte count. When the patient groups who developed good and poor CCC were compared, neutrophil/lymphocyte ratio (NLR) (P < .001), C-reactive protein (CRP) levels, CRP/albumin ratio (CAR) (P < .001), systemic immune-inflammation index (SII) (P < .001), and PIV (P < .001) were higher in patients with poor CCC. In multivariate logistic regression analysis, age, SII, NLR, CRP, CAR, and PIV were found to be independent predictors of poor CCC (P < .001, for all). Receiver operating characteristic (ROC) analysis demonstrated that a cut-off value of 442.2 for PIV predicted poor CCC slightly better compared to other markers, with 76.8% sensitivity and 70.1% specificity (area under ROC curve = 0.808 (95% CI: 0.764-0.851), P < .001). These findings suggest that PIV can be used as an independent predictor of CCC development.
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OBJECTIVE: The MORtality in CORonary Care Units in Türkiye (MORCOR-TURK) trial is a national registry evaluating predictors and rates of in-hospital mortality in coronary care unit (CCU) patients in Türkiye. This report describes the baseline demographic characteristics of patients recruited for the MORCOR-TURK trial. METHODS: The study is a multicenter, cross-sectional, prospective national registry that included 50 centers capable of 24-hour CCU service, selected from all seven geographic regions of Türkiye. All consecutive patients admitted to CCUs with cardiovascular emergencies between September 1-30, 2022, were prospectively enrolled. Baseline demographic characteristics, admission diagnoses, laboratory data, and cardiovascular risk factors were recorded. RESULTS: A total of 3,157 patients with a mean age of 65 years (range: 56-73) and 2,087 (66.1%) males were included in the analysis. Patients with arterial hypertension [1,864 patients (59%)], diabetes mellitus (DM) [1,184 (37.5%)], hyperlipidemia [1,120 (35.5%)], and smoking [1,093 (34.6%)] were noted. Non-ST elevation myocardial infarction (NSTEMI) was the leading cause of admission [1,187 patients (37.6%)], followed by ST elevation myocardial infarction (STEMI) in 742 patients (23.5%). Other frequent diagnoses included decompensated heart failure (HF) [339 patients (10.7%)] and arrhythmia [272 patients (8.6%)], respectively. Atrial fibrillation (AF) was the most common pathological rhythm [442 patients (14%)], and chest pain was the most common primary complaint [2,173 patients (68.8%)]. CONCLUSION: The most common admission diagnosis was acute coronary syndrome (ACS), particularly NSTEMI. Hypertension and DM were found to be the two leading risk factors, and AF was the most commonly seen pathological rhythm in all hospitalized patients. These findings may be useful in understanding the characteristics of patients admitted to CCUs and thus in taking precautions to decrease CCU admissions.
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Fibrilação Atrial , Hipertensão , Infarto do Miocárdio sem Supradesnível do Segmento ST , Idoso , Feminino , Humanos , Masculino , Unidades de Cuidados Coronarianos , Estudos Transversais , Mortalidade Hospitalar , Estudos Prospectivos , Turquia , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Even though medication and interventional therapy have improved the death rate for non-ST elevation myocardial infarction (NSTEMI) patients, these patients still have a substantial residual risk of cardiovascular events. Early identification of high-risk individuals is critical for improving prognosis, especially in this patient group. The focus of recent research has switched to finding new related indicators that can help distinguish high-risk patients. For this purpose, we examined the relationship between the pan-immune-inflammation value (PIV) and the severity of coronary artery disease (CAD) defined by the SYNTAX score (SxS) in NSTEMI patients. METHODS: Based on the SxS, CAD patients were split into three groups. To evaluate the risk variables of CAD, multivariate logistic analysis was employed. RESULTS: The PIV (odds ratio: 1.003; 95% CI: 1.001-1.005; p = 0.005) was found to be an independent predictor of a high SxS in the multivariate logistic regression analysis. Additionally, there was a positive association between the PIV and SxS (r: 0.68; p < 0.001). The PIV predicted the severe coronary lesion in the receiver-operating characteristic curve analysis with a sensitivity of 91% and specificity of 81.1%, using an appropriate cutoff value of 568.2. CONCLUSIONS: In patients with non-STEMI, the PIV, a cheap and easily measured laboratory variable, was substantially correlated with a high SxS and the severity of CAD.
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OBJECTIVE: The metabolic equivalent (MET) and Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) score are two parameters with known cardiovascular prognostic significance. In this study, we aimed to investigate the direct relationship between MET and SYNTAX score in patients with chronic coronary syndrome (CCS). METHOD: This retrospective study included 200 patients over 18 years of age who underwent coronary angiography and had a positive exercise electrocardiography test result. Patients were divided into two groups: Group 1 with a low SYNTAX score and Group 2 with a medium-high SYNTAX score. MET values were then compared between these groups. RESULTS: Baseline demographic characteristics and laboratory values were similar between the groups. The mean MET values in the low and medium-high SYNTAX score groups were 9.36 ± 2.38 and 8.78 ± 2.43, respectively. No statistical difference was observed (P = 0.086). Additionally, there was no statistical difference between the two groups in terms of MET values being 10 ≤ or 10 > (P = 0.172). CONCLUSION: The main conclusion of our study is that there is no correlation between the SYNTAX score and functional MET value in CCS.
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Doença da Artéria Coronariana , Intervenção Coronária Percutânea , Humanos , Adolescente , Adulto , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/cirurgia , Prognóstico , Estudos Retrospectivos , Equivalente Metabólico , Medição de Risco , Resultado do Tratamento , Angiografia Coronária , Fatores de RiscoRESUMO
BACKGROUND: The reasons for the etiology of premature ventricular contractions (PVCs) are not specifically known. Many patients are resistant to medical treatment, and a factor that would predict response to medical treatment cannot be identified. This study aims to investigate if a high catecholamine level results in polymorphic PVC. METHODS: This study was obtained by prospective data registry analysis. A total of 100 patients, 50 from the PVC group, and 50 from the control group have been evaluated. The participants who were included in the patient group had a polymorphic PVC of 5% or more in their 24-h Holter evaluations. Metanephrine showing the level of adrenaline and normetanephrine, showing the level of noradrenaline levels have been measured from these urine samples. RESULT: There was no difference between the two groups in terms of biochemical and essential characteristics. Normetanephrine level has been significantly higher in the PVC group compared to the control group (323.9 ± 208.9 µg to 129.25 ± 67.88 µg; p < 0.001). Similarly, metanephrine level has also been higher in the PVC group (124.75 ± 82.43 µg to 52.615 ± 36,54 µg; p < 0.001). A positive and moderate correlation has been identified between the number and ratio of PVC and the metanephrine and normetanephrine levels. CONCLUSION: In this study, we found that the catecholamine levels were higher in the polymorphic PVC group than in the healthy volunteers. Also, an increase in the number and rate of PVC has been observed as the catecholamine levels increased. CLINICAL TRIAL REGISTRATION: Urine Levels of Metanephrine and Normetanephrine in Patients With Frequent PVC; ClinicalTrials.gov number NCT03447002.
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Complexos Ventriculares Prematuros , Humanos , Complexos Ventriculares Prematuros/diagnóstico , Eletrocardiografia , Metanefrina , Normetanefrina/uso terapêutico , Estudos ProspectivosRESUMO
Contrast-induced nephropathy (CIN), which can develop after procedures involving contrast agents, is a significant cause of patient morbidity and mortality. This study aims to investigate the role of pre-procedural pan-immune-inflammation value (PIV) in predicting CIN development in patients undergoing percutaneous coronary intervention (PCI) due to non-ST segment elevation myocardial infarction (NSTEMI). A total of 1006 NSTEMI patients were included in the study. CIN was defined as an increase of at least 0.5 mg/dl or 25% in serum baseline creatinine level 72 h after the procedure. Patients were divided into two groups: those with and without CIN. NSTEMI patients who developed CIN, glucose level (P = .01), platelet count (P < .01), monocyte count (P < .001), neutrophil-to-lymphocyte ratio (NLR) (P < .001), systemic immune inflammation index (SII) score (P < .001), and PIV (P < .001) were higher compared with those without CIN. In the multivariate analysis of all these parameters, the Odds ratios of PIV and SII were similar and slightly lower than NLR. Receiver operating characteristic curve analysis (ROC) showed a PIV cut-off value of 448.43 with a sensitivity of 83.1% and a specificity of 72.8% in patients with CIN. Our study demonstrated an independent relationship between PIV at admission and CIN development in NSTEMI patients.
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BACKGROUND: Atrial fibrillation (AF) is a common cardiac rhythm disorder associated with hemodynamic disruptions and thromboembolic events. While antiarrhythmic drugs are often recommended as the initial treatment, catheter ablation has emerged as a viable alternative. However, the recurrence of AF following ablation remains a challenge, and there is growing interest in exploring inflammatory markers as predictors of recurrence. METHODS: This retrospective, cross-sectional analysis included 249 patients who underwent cryoablation for paroxysmal AF. The relationship between the 'C-reactive protein (CRP) to albumin ratio (CAR)' and AF recurrence was examined. RESULTS: Two hundred and forty-nine patients with paroxysmal non-valvular atrial fibrillation were included. They were divided into two groups: those without recurrence (Group 1) and those with recurrence (Group 2). Significant differences were observed in age (57.2 ± 9.9 vs. 62.5 ± 8.4, p = 0.001) and left atrial size (4.0 ± 0.5 vs. 4.2 ± 0.7, p = 0.001) between the two groups. In blood parameters, significant differences were found in CRP (5.2 ± 1.3 vs. 9.4 ± 2.8, p < 0.001) and neutrophil counts (5.1 ± 2.2 vs. 6.7 ± 3.6, p = 0.001). In univariate regression analysis, age (OR: 1.058, CI: 1.024-1.093, p = 0.001), WBC count (OR: 1.201, CI: 1.092-1.322, p < 0.001), neutrophil count (OR: 1.239, CI: 1.114-1.378, p = 0.001), CAR (OR: 1.409, CI: 1.183-1.678, p < 0.001), and left atrial diameter (OR: 0.968, CI: 0.948-0.989, p = 0.002) showed significant associations with AF recurrence. CONCLUSIONS: Inflammation plays a crucial role in the initiation and progression of AF. This study demonstrated that along with age, the CAR can serve as an independent predictor of AF recurrence following cryoablation.
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Our aim was to investigate the relationship between thiol, which is the main component of the antioxidant system, and coronary collateral circulation (CCC). Our patients consisted of people with stable coronary artery disease (sCAD) and total occlusion in at least one vessel (n = 249). We divided the patients into two groups, good and poor, according to their CCC degree. We determined that DM, total thiol, and disulfide are independent predictors of poor CCC in multivariate logistic regression analysis (OR: 1.012, 95% CI: 1.008-1.017, p < 0.001; OR: 1.022, 95% CI: 1.000-1.044, p = 0.044; OR: 2.671, 95% CI: 1.238-5.761, p = 0.012, respectively). The ROC analysis showed a cut-off value of 328.7 for native thiol regarding the prediction of poor CCC, with 67.4% specificity and 78% sensitivity. For disulfide, it revealed a cut-off value of 15.1 regarding the prediction of poor CCC, with 57.9% specificity and 69.5% sensitivity. In this study, we detected that the patients with sCAD who developed poor CCC had lower levels of native thiol, total thiol, and disulfide compared to those with good CCC. The most interesting finding of our study is that CCC formation is an effective predictor of the antioxidant cascade rather than the inflammation cascade in sCAD patients.
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Background: The CRP/albumin ratio (CAR), a new inflammatory marker, is associated with adverse outcomes in various cardiovascular diseases. We evaluated the effectiveness of CAR in predicting embolic events in patients diagnosed with infective endocarditis (IE). Methods: A total of 145 patients with IE were included in the study and categorized into two groups according to the presence of embolic events. We retrospectively analyzed the patients' clinical, laboratory and echocardiographic data. Results: CRP (94.2 vs 63.3; p < 0.001) and CAR (25.8 vs 15.1; p < 0.001) values were significantly higher in patients who experienced embolic events. Multivariate analysis showed that a high CAR value (odds ratio: 1.030; 95% CI: 1.000-1.060; p = 0.041) was an independent predictor of embolic events in patients with IE. Conclusion: The CAR is a cheap and easily accessible marker that can predict the development of embolic events in patients diagnosed with IE.
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Embolia , Endocardite Bacteriana , Endocardite , Humanos , Albuminas/química , Embolia/complicações , Embolia/diagnóstico , Endocardite/complicações , Endocardite/diagnóstico , Endocardite Bacteriana/complicações , Estudos Retrospectivos , Proteína C-Reativa/químicaRESUMO
ABSTRACT Introduction: We investigated the relationship between the newly-defined systemic immune-inflammation index and the new-onset atrial fibrillation in patients undergoing coronary artery bypass grafting. Method: This study included 392 patients who underwent coronary artery bypass grafting. We divided the participants into two groups as those with and without new-onset atrial fibrillation. Prior to coronary artery bypass grafting, we evaluated blood samples, including systemic immune-inflammation index, and other laboratory parameters of the patients. We formulized the systemic immune-inflammation index score as platelet × neutrophil/lymphocyte counts. Results: The findings revealed that new-onset atrial fibrillation occurred in 80 (20.4%) of 392 patients during follow-ups. Such patients had higher systemic immune-inflammation index, neutrophil/lymphocyte ratio, and C-reactive protein levels than those who did not develop new-onset atrial fibrillation (P<0.001, P<0.001, P=0.010, respectively). In receiver operating characteristic curve analysis, systemic immune-inflammation index levels > 712.8 predicted new-onset atrial fibrillation with a sensitivity of 85% and a specificity of 61.2% (area under the curve: 0.781, 95% confidence interval: 0.727-0.835; P<0.001). Conclusion: Overall, systemic immune-inflammation index, a novel inflammatory marker, may be used as a decisive marker to predict the development of atrial fibrillation following coronary artery bypass grafting.
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INTRODUCTION: We investigated the relationship between the newly-defined systemic immune-inflammation index and the new-onset atrial fibrillation in patients undergoing coronary artery bypass grafting. METHOD: This study included 392 patients who underwent coronary artery bypass grafting. We divided the participants into two groups as those with and without new-onset atrial fibrillation. Prior to coronary artery bypass grafting, we evaluated blood samples, including systemic immune-inflammation index, and other laboratory parameters of the patients. We formulized the systemic immune-inflammation index score as platelet × neutrophil/lymphocyte counts. RESULTS: The findings revealed that new-onset atrial fibrillation occurred in 80 (20.4%) of 392 patients during follow-ups. Such patients had higher systemic immune-inflammation index, neutrophil/lymphocyte ratio, and C-reactive protein levels than those who did not develop new-onset atrial fibrillation (P<0.001, P<0.001, P=0.010, respectively). In receiver operating characteristic curve analysis, systemic immune-inflammation index levels > 712.8 predicted new-onset atrial fibrillation with a sensitivity of 85% and a specificity of 61.2% (area under the curve: 0.781, 95% confidence interval: 0.727-0.835; P<0.001). CONCLUSION: Overall, systemic immune-inflammation index, a novel inflammatory marker, may be used as a decisive marker to predict the development of atrial fibrillation following coronary artery bypass grafting.
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Fibrilação Atrial , Humanos , Fibrilação Atrial/etiologia , Ponte de Artéria Coronária/efeitos adversos , Inflamação/etiologia , Contagem de Linfócitos , Neutrófilos , Complicações Pós-Operatórias/etiologia , Fatores de RiscoRESUMO
This study sought to analyze the relationship between pulse pressure (PP) index (PPI) (PP/systolic blood pressure; a less variable and objective form of PP) and coronary artery disease (CAD) progression. A registry of 193 patients was evaluated to show CAD progression by comparing current vs previous (6 months to 3 years prior) angiograms. One day after the second angiogram, we conducted ambulatory blood pressure measurements on the patients. Of the 193 patients, 65 (34%) had CAD progression. The PP and PPI were significantly higher in the progression than in the non-progression group (55 ± 12 vs. 51 ± 10 mmHg, P = .02 and .47 ± .06 vs. .42 ± .05, P = .004, respectively). Also, the PP and PPI were independently predictive of CAD progression (OR = 1.03, P = .03 and OR = 6.47, P = .01, respectively). Moreover, the correlation of PPI with low-density lipoprotein cholesterol and glycosylated hemoglobin was greater than their correlation with PP. In addition, PPI predicted CAD progression better than PP (area under the curve [AUC] = .649 vs. .574, P = .03). Elevated PP and PPI may be associated with the progression of CAD. PPI seems more successful in predicting CAD progression than PP.
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Doença da Artéria Coronariana , Humanos , Pressão Sanguínea/fisiologia , Doença da Artéria Coronariana/diagnóstico por imagem , Monitorização Ambulatorial da Pressão Arterial , Estudos Transversais , ArtériasRESUMO
Stroke is a significant contributor to morbidity and mortality. The present study investigated how the systemic immune inflammation index (SII) could be used to predict the likelihood of developing carotid artery stenosis (CAS), which can be seen using carotid artery angiography (CAAG). This study comprised 418 individuals who underwent CAAG for CAS. SII was calculated by multiplying the platelet count by the neutrophil/lymphocyte ratio (NLR). The patients were divided into two groups: non-critical and critical CAS (stenosis below %70 and above ≥70%, respectively). Compared with the non-critical CAS, the critical CAS group had greater high sensitivity C-reactive protein levels (4.5 [3.1-5.7] vs 3.9 [2-5] [mg/L], P < .001), NLR (4.1 [2.9-7.5] vs 2.9 [1.8-3.7], P < .001), platelet/lymphocyte ratio (233 [110-297] vs 119 [96-197], P < .001), and SII (860 [608-2455] vs 604 [458-740], P < .001). Receiver Operating Characteristic Curve analysis demonstrated the best cutoff value of 672.3 for SII to predict the critical CAS with 71.2% sensitivity and 60.1% specificity. According to our study, an increase in SII is an independent predictor of the severity of CAS in patients undergoing CAAG.
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Estenose das Carótidas , Humanos , Estenose das Carótidas/diagnóstico por imagem , Inflamação , Linfócitos , Proteína C-Reativa/análise , Angiografia , Estudos RetrospectivosRESUMO
Background/aim: Despite advancements in valve technology and increased clinical experience, complications related to conduction defects after transcatheter aortic valve implantation (TAVR) have not improved as rapidly as expected. In this study, we aimed to predict the development of complete atrioventricular (AV) block and bundle branch block during and after the TAVR procedure and to investigate any changes in the cardiac conduction system before and after the procedure using electrophysiological study. Materials and methods: A total of 30 patients who were scheduled for TAVR at our cardiovascular council were planned to be included in the study. TAVR was performed on patients at Erciyes University Medical Faculty Hospital as a single center between May 2019 and August 2020 Diagnostic electrophysiological study was performed before the TAVR procedure and after its completion. Changes in the cardiac conduction system during the preprocedure, intra-procedure, and postprocedure periods were recorded. Results: Significant increases in baseline cycle length, atrial-His (AH) interval, his-ventricular (HV) interval and atrioventricular (AV) distance were observed before and after the TAVR procedure (p = 0.039, p < 0.001, p = 0.018, p < 0.001, respectively). During the TAVR procedure, the preprocedural HV interval was longer in patients who developed AV block and bundle branch block compared to those who did not and this difference was statistically significant (p = 0.024). ROC curve analysis revealed that a TAVR preprocedure HV value >59.5 ms had 86% specificity and 75% sensitivity in detecting AV block and bundle branch block (AUC = 0.83, 95% CI: 0.664-0.996, p = 0.013). The preprocedure HV distance was 98 ± 10.55ms in the group with permanent pacemaker implantation and the mean value in the group without permanent pacemaker implantation was 66.27 ± 15.55 ms, showing a borderline significant difference (p = 0.049). Conclusion: The prolongation of HV interval in patients with AV block and bundle branch block suggests that the block predominantly occurs at the infra-hisian level. Patients with longer preprocedural HV intervals should be closely monitored for the need for permanent pacemaker implantation after the TAVR procedure.
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Bloqueio Atrioventricular , Marca-Passo Artificial , Substituição da Valva Aórtica Transcateter , Humanos , Substituição da Valva Aórtica Transcateter/efeitos adversos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Bloqueio Atrioventricular/terapia , Bloqueio Atrioventricular/etiologia , Bloqueio Atrioventricular/fisiopatologia , Bloqueio de Ramo/fisiopatologia , Bloqueio de Ramo/terapia , Bloqueio de Ramo/etiologia , Estenose da Valva Aórtica/cirurgia , Eletrocardiografia , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Sistema de Condução Cardíaco/fisiopatologiaRESUMO
OBJECTIVE: Spontaneous echo contrast (SEC) is the appearance of swirling, smoke-like echoes in the left atrium (LA) and is accepted as an independent predictor of thromboembolic risk. There is an established relationship between the inflammatory state and the prothrombotic state. Therefore, we investigated the relationship between the Systemic Immune Inflammation Index (SII), a new inflammation parameter introduced recently, and SEC in patients with mitral stenosis (MS). MATERIAL AND METHODS: A total of 262 patients who underwent percutaneous mitral valvuloplasty (PMBV) for MS were included in this study. The patients were divided into two groups: patients with MS complicated by SEC and patients with MS without SEC, based on whether SEC occurred in the LA. RESULTS: There were 79 patients (mean age 47.1 ± 6.6, 30.3% male gender) in the SEC (+) group, while there were 183 patients (mean age 46.4 ± 8.6, 29.5% male gender) in the SEC (-) group. In multivariate analysis, high levels of SII were an independent risk factor for SEC in patients with MS (OR: 1.001, 95% confidence interval (CI): 1.000-1.001, p<0.001) together with high levels of C-reactive protein (OR: 1.145, 95% CI: 1.027-1.277, p=0.014). The receiver operating characteristics (ROC) curve analysis showed that at a cutoff value of 547.6 for SII to predict SEC with 74.6% sensitivity and 77.6% specificity (area under ROC curve=0.736 (95% CI: 0.668-0.805), p<0.001). CONCLUSION: Our study showed that the SII levels were independently associated with SEC in patients with MS.
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Estenose da Valva Mitral , Humanos , Masculino , Feminino , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/complicações , Átrios do Coração/diagnóstico por imagem , Inflamação , Proteína C-Reativa , Fatores de Risco , Ecocardiografia TransesofagianaRESUMO
BACKGROUND: Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by hypercalcemia caused by excessive parathyroid hormone (PTH) secretion from the parathyroid gland. PHPT was previously shown to increase cardiac arrhythmias. Besides, new indices, such as the Tpeak-Tend (Tp-e) interval, Tp-e interval/QT interval (Tp-e/QT) ratio, and Tp-e interval/corrected QT interval (Tp-e/QTc) ratio may be associated with ventricular arrhythmias and sudden cardiac death. Therefore, we aimed to investigate the relationship between PHPT and the changes to Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio. METHODS: We carried out the study with 41 patients with PHPT and 40 control subjects. We calculated the Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio of the participants from the V5 derivations on their ECG papers. While we defined Tp-e interval as the distance between the peak and the end of the T wave, Tp-e/QT and Tp-e/QTc ratios were calculated by dividing Tp-e by QT and Tp-e by QTc, respectively. RESULTS: Total calcium, albumin-corrected calcium, phosphorus, and PTH levels were significantly higher in patients with PHPT. We also found positive correlations between albumin-corrected calcium and PTH levels and Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio (p < 0.001). DISCUSSION: : Our results suggest that Tp-e may enhance the current knowledge on arrhythmic risk in PHPT patients better than basal ECG. In addition, both high PTH and high calcium levels appear to have the potential to cause arrhythmogenic effects.
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Eletrocardiografia , Hiperparatireoidismo Primário , Albuminas , Arritmias Cardíacas/etiologia , Cálcio , Humanos , Hiperparatireoidismo Primário/complicações , Hormônio Paratireóideo , FósforoRESUMO
Abstract Introduction: Endothelial progenitor cells (EPCs) and nicotinamide adenine dinucleotide phosphate (NADPH) oxidase enzyme activity may affect the vessel wall and have a role in development of aortic aneurysms. EPCs originate from hematopoietic stem cells and can be enumerated from peripheral blood samples by flow cytometry. In this study, we aimed to evaluate the relation of EPC number and NADPH oxidase enzyme activity in the development of thoracic aortic aneurysm (TAA). Methods: Patients with TAA (n=30) and healthy individuals without TAA (control, n=10) were included in our study. Characterization and enumeration of EPC from peripheral blood samples were performed by flow cytometry with panels including markers of EPCs (CD34/CD133/CD309/CD146/CD144). Additionally, NADPH oxidase enzyme activity (capacity) was also measured by the dihydrorhodamine 123 (DHR 123) test. Results: The enumeration of EPC with CD34+/CD146+ marker showed that the number of mean EPC/106 cells was increased in the patient group (41.5/106 cells), but not in the control group (20.50/105 cells) (P<0.01). Additionally, patients with TAA presented significantly lower NADPH oxidase activity by DHR assay than healthy controls (mean stimulation index: 60.40± 7.86 and 75.10±5.21, respectively) (P<0.01). Conclusion: Our results showed that the number of EPCs is significantly higher in aortic aneurysm patients and may have a role in disease progression. The crosstalk between NADPH oxidase enzyme capacity and EPC number may be useful as a parameter to explain the clinical progression of TAA.