Cluster analysis of clinical, angiographic, and laboratory parameters in patients with ST-segment elevation myocardial infarction.

INTRODUCTION: ST-segment elevation myocardial infarction (STEMI) represents the most harmful clinical manifestation of coronary artery disease. Risk assessment plays a beneficial role in determining both the treatment approach and the appropriate time for discharge. Hierarchical agglomerative clustering (HAC), a machine learning algorithm, is an innovative approach employed for the categorization of patients with comparable clinical and laboratory features. The aim of the present study was to investigate the role of HAC in categorizing STEMI patients and to compare the results of these patients. METHODS: A total of 3205 patients who were diagnosed with STEMI at the university hospital emergency clinic between 2015 and 2023 were included in the study. The patients were divided into 2 different phenotypic disease clusters using the HAC method, and their outcomes were compared. RESULTS: In the present study, a total of 3205 STEMI patients were included; 2731 patients were in cluster 1, and 474 patients were in cluster 2. Mortality was observed in 147 (5.4%) patients in cluster 1 and 108 (23%) patients in cluster 2 (chi-square P value < 0.01). Survival analysis revealed that patients in cluster 2 had a significantly greater risk of death than patients in cluster 1 did (log-rank P < 0.001). After adjustment for age and sex in the Cox proportional hazards model, cluster 2 exhibited a notably greater risk of death than did cluster 1 (HR = 3.51, 95% CI = 2.71-4.54; P < 0.001). CONCLUSION: Our study showed that the HAC method may be a potential tool for predicting one-month mortality in STEMI patients.

Carbon monoxide (CO) derived from the CO-releasing molecule CORM-2 reduces peritoneal adhesion formation in a rat model.

BACKGROUND: Although low-dose carbon monoxide (CO) administration has been shown to have an anti-fibrotic effect in various fibrotic diseases, its effects on peritoneal adhesion (PA), one of the postoperative complications, are not elucidated. In this study, the effect of CO-releasing tricarbonyldichlororuthenium (II) dimer (CORM-2) administration on the formation of PA and the underlying factors of its potential effect were investigated. METHODS AND RESULTS: After the induction of PA, rats were divided into four groups with 8 rats in each group. The rats received either (i) dimethyl sulfoxide:saline solution (1:10) as a vehicle, (ii) 2.5 mg/kg CORM-2, (iii) 5 mg/kg CORM-2, or (iv) inactive (i) CORM (iCORM) intragastrically every day for a duration of 7 days. PA was not induced in rats (n = 8) designated as sham controls. Gross, histological, immunohistochemical and quantitative real-time polymerase chain reaction analyses were performed to evaluate the effectiveness of CORM-2 administration. Gross analysis showed that CORM-2 administration reduced PA formation compared to rats treated with vehicle. Histological and immunohistochemical examinations showed that increased collagen deposition, myofibroblast accumulation, microvessel density, and M1 macrophage count in the peritoneal fibrosis area of vehicle-treated rats decreased following CORM-2 treatments. PCR analyses showed that CORM-2 treatments decreased hypoxia-induced Hif1a, profibrotic Tgfb1, ECM components Col1a1 and Col3a1, collagen degradation suppressor Timp1, fibrinolysis inhibitor Serpine1, and pro-inflammatory Tnf mRNA expressions, while increasing the M2 macrophage marker Arg1 mRNA expression. CONCLUSIONS: These results suggested that CORM-2 administration reduces PA formation by affecting adhesiogenic processes such as pro-inflammatory response, fibrinolytic system, angiogenesis and fibrogenesis.

Evaluation of Acetic Acid-Induced Chronic Gastric Ulcer Healing by Propionyl-L-Carnitine Administration.

The aim of our study was to investigate the healing effect of propionyl-L-carnitine (PLC) on chronic gastric ulcers and its underlying mechanisms. This study included rats with gastric ulcers induced by applying serosal glacial acetic acid. These rats were then given either saline (vehicle) or PLC at doses of 60 and 120 mg/kg, administered orally 3 days after ulcer induction for 14 consecutive days. Our study found that treatment with PLC resulted in a reduction of the gastric ulcer area, a faster rate of ulcer healing, and stimulated mucosal restoration. Additionally, the treatment with PLC reduced the number of Iba-1+ M1 macrophages while increasing the number of galectin-3+ M2 macrophages, as well as desmin+ microvessels, and α-SMA+ myofibroblasts in the gastric ulcer bed. The mRNA expression of COX-2, eNOS, TGF-ß1, VEGFA, and EGF in the ulcerated gastric mucosa was greater in the PLC-treated groups compared with the vehicle-treated rats. In conclusion, these findings suggest that PLC treatment may accelerate gastric ulcer healing by stimulating mucosal reconstruction, macrophage polarization, angiogenesis, and fibroblast proliferation, as well as fibroblast-myofibroblast transition. This process is associated with the upregulation of TGF-ß1, VEGFA, and EGF, as well as modulation of the cyclooxygenase/nitric oxide synthase systems.

Intermittent dilution of dietary digestible lysine lowers the incidence of white striping by suppressing the growth, lipid synthesis, and muscle damage in broiler chickens.

BACKGROUND: White striping (WS) is a myopathy of breast muscle (Pectoralis major) that affects the quality and consumer acceptance of breast fillets of broiler chickens. Previous studies have shown that intermittent dilution of dietary nutrients suppresses the development of WS on the breast muscle of broiler chickens. However, the mechanism by which these interventions reduce the occurrence of WS remains inconclusive. In this study, we adopted intermittent reduction of dietary digestible lysine (dLys) density or metabolizable energy (ME) and amino acid (AA) density using chemical and fatty acid composition of breast fillets, and blood metabolites to understand the mechanism while histopathology and immunohistochemistry of breast muscles were used for confirmation. RESULTS: Occurrence of WS was lower in broiler chickens fed 85% dLys diets in comparison with other groups. Crude protein and ether extract in breast meat of 85% dLys groups were greater (P < 0.001) and lower (P = 0.010), respectively. Serum concentrations of lipid metabolites and enzymes were lower in broiler chickens fed 85% dLys diets than control group (P < 0.05). Feeding 85% dLys diets had low degree of myodegeneration and necrosis, inflammation, lipid deposition, infiltration of T-lymphocyte (CD3+) and macrophages (Iba-1+), and low expression of heat-shock protein 70 (HSP70) than other groups (P < 0.001). CONCLUSION: Dilution of dietary dLys to 85% of the required quantities reduces the development of WS in broiler chickens by slowing the growth, lipid synthesis, and muscle damage confirmed by lower extent of histopathological lesions. © 2022 Society of Chemical Industry.

Exposure of broiler chickens to chronic heat stress increases the severity of white striping on the pectoralis major muscle.

A study was conducted to evaluate the effect of cyclic or chronic heat stress (HS) on the incidence and severity of white striping (WS) and histopathological changes in breast muscle of broiler chickens. One hundred eighty 1-day-old male chickens were randomly assigned to three research groups: control (standard temperature throughout the experiment), cyclic HS (32 ºC between 0800 and 2000 h from day 21 until the end of the experiment), and chronic HS (32 ºC from day 21 onwards). Cyclic and chronic HS groups showed a significant (P < 0.05) decrease in body weight gain and feed intake and poor feed conversion ratio in grower, finisher, and overall period. Serum biochemical profile was not different among the groups except globulin and P which were significantly higher (P < 0.05 and P < 0.001, respectively), in cyclic and chronic HS groups. Overall, WS incidence was numerically higher in control birds followed by chronic HS and cyclic HS birds, respectively. The chronic HS group had a lower incidence of mild (score 1) and a higher incidence of severe (score 2) WS lesions compared to control and cyclic HS groups. Histopathological analysis revealed that broilers subjected to chronic HS showed increased severity of myodegenerative changes, perivenular CD3 + cell infiltration, and lipidosis compared to control group. However, control and cyclic HS groups were not different in terms of histopathological lesions. In conclusion, this study confirms that cyclic or chronic HS may adversely affect the growth performance and that chronic HS may increase the severity of WS in broiler chickens.

A Novel Marker of Inflammation: Azurocidin in Patients with ST Segment Elevation Myocardial Infarction.

(1) To investigate the role of azurocidin, an antimicrobial protein, in patients with ST segment elevation myocardial infarction (STEMI). (2) This single-center prospective observational study included patients with STEMI and healthy age- and sex-matched control subjects. Baseline demographic, clinical and biochemical data were compared between the two groups. Azurocidin levels at baseline were determined using an enzyme-linked immunosorbent assay. Multivariate linear regression analysis with enter method was used to test the association between azurocidin and independent variables, such as the thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score, global registry of acute coronary events score, Killip class, C-reactive protein (CRP), and creatinine kinase-myocardial band (CK-MB). (3) A total of 76 patients with STEMI and 30 healthy control subjects were enrolled in the study. Mean ± SD azurocidin levels were significantly higher in patients compared with healthy controls (18.07 ± 13.99 versus 10.09 ± 5.29 ng/mL, respectively). In a receiver-operating characteristic curve analysis, an azurocidin cut-off level of >11.46 ng/mL had 74% sensitivity and 58% specificity in predicting myocardial infarction. Azurocidin levels had a positive correlation with TIMI score (r = 0.651). In multivariate linear regression analysis, the TIMI score was an independent predictor of the azurocidin level. (4) Azurocidin is an infection marker that may be important in patients with STEMI.

Hypertensive crisis: an update on clinical approach and management.

PURPOSE OF REVIEW: Here, we review current concepts on hypertensive crisis (HTN-C) with a focus on epidemiology, causes, pathophysiology and prognosis. We also offer a practical approach to the management of HTN-C. RECENT FINDINGS: HTN-C is characterized by a severe and abrupt increase in blood pressure (BP) with impending or progressive acute end-organ damage (EOD). HTN-C can be divided into hypertensive emergency (HTN-E) and hypertensive urgency (HTN-U) based on the presence or absence of acute EOD, respectively. Recent retrospective studies have demonstrated that emergency department (ED) referrals from an outpatient clinic or rapid BP-lowering strategies in the ED do not lead to improved outcomes in patients with HTN-U. SUMMARY: HTN-C can be a de-novo manifestation or a complication of essential or secondary HTN. The presence of acute EOD is a major poor prognostic indicator in HTN-C. The main objectives of the management of HTN-C are distinction of HTN-E from HTN-U and appropriate risk stratification, prevention or regression of acute EOD due to severely elevated BP, prevention of recurrence of HTN-C with an effective long-term management plan and avoidance of rapid lowering of BP except in some special circumstances. The majority of patients with asymptomatic HTN-U can be safely managed in the outpatient setting without exposing them to the risks of aggressive BP lowering. However, patients with HTN-E require hospitalization, prompt treatment and close monitoring.

The evaluation of myocardial function of patients in the early stage of acute ischemic stroke by two-dimensional speckle tracking echocardiography.

PURPOSE: To evaluate the myocardial dysfunction in the early stage of nonhemorrhagic stroke and its association with the National Institutes of Health Stroke Scale (NIHSS) score, by two-dimensional speckle tracking echocardiography. METHODS: We included 29 patients with acute ischemic stroke, in whom NIHSS scores were calculated and stroke infarct volumes recorded. Within 48 hours of admission, cardiac evaluation with speckle tracking echocardiography was performed and left ventricular global longitudinal strain (GLS) and global longitudinal systolic strain rate were obtained. These measurements were repeated on the 10th day. RESULTS: NIHSS score improved, but infarct volume increased (p = 0.011 and 0.065, respectively) from admission to day 10. Ejection fraction was 53.2% and 55.8%, respectively, at admission and day 10 (p = 0.482), while GLS improved from -16.41% to -18.76% (p = 0.003). CONCLUSIONS: GLS and global longitudinal systolic strain rate showed significant improvement together with NIHSS score. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 44:305-311, 2016.

Endoplasmic reticulum stress and associated apoptosis are linked with the pathogenesis of white striping in broiler breast muscles.

White striping (WS) that appears as white stripes parallel to the muscle fibrils is an emerging growth-related abnormality of broiler breast meat. The pathomechanism of this defect has not been fully understood despite intensive studies over the past decade. In the present study, endoplasmic reticulum (ER) stress and its associated apoptotic pathways were investigated to elucidate the potential role of these pathways in the development of WS. To this end, a total of 60 Pectoralis major (Pm) muscle samples were collected from 55-d-old Ross 308 male broiler chickens according to the severity of gross WS lesions (normal, mild, and severe). Histopathological and molecular analyses were conducted to evaluate the lesions and genes involved in the ER stress and related apoptosis. All the Pm samples, both with and without macroscopic WS lesions, showed varying degrees of myodegenerative lesions. Molecular analysis revealed that the transcript abundances of many components related to protein kinase R-like ER kinase (PERK) and inositol-requiring enzyme type 1 (IRE-1) signals of the ER stress response were significantly greater in severely WS-affected breast tissues compared to their mildly affected and normal counterparts. Similarly, the transcript abundances of apoptotic markers related to both signaling pathways were significantly greater in severe WS lesions than those of mildly affected and normal Pm tissues. Besides these, a significant increase in caspase-3 transcript abundance was seen in severe WS lesions in comparison with mild WS and normal breast muscles. Findings of this study suggest that ER stress response and its related apoptotic pathways are possibly activated in the breast muscle of broiler chickens with severe WS lesions. Based on these findings, it is speculated that ER stress-mediated apoptosis occupies a central role in the progression of WS in broiler chickens.

Speckle tracking echocardiographic analysis of left ventricular systolic and diastolic functions of young elite athletes with eccentric and concentric type of cardiac remodeling.

AIMS: In individuals who exercise regularly and for extended periods of time, some structural alterations in the heart, called the athlete's heart, develop in time. These alterations vary in type, can be eccentric or concentric, depending on the nature of exercise. Speckle tracking echocardiography (STE) is a novel, angle-independent method that accurately and reliably measures systolic and diastolic functions of the left ventricle (LV) with considerably lower inter-operator variability. METHODS AND RESULTS: Twenty-two marathon runners, 24 wrestlers, and 20 healthy sedentary individuals were included in the study. The average age of subjects is 17.5 ± 2.2 in marathon runners, 16.8 ± 1.9 in wrestlers, and 16.4 ± 1.8 in control group. The parameters of LV longitudinal strain (S), LV longitudinal strain rate systolic (SRS), LV longitudinal strain rate diastolic early filling (SRE), and longitudinal strain rate diastolic late filling (SRA) were evaluated by apical two-, three-, and four-chamber grayscale imaging using the global longitudinal strain (GLS) and GLS rate (GLSR). Conventional echocardiographic parameters demonstrated increased LV diameters and wall thickness in the marathon runners and increased wall thickness without increased LV diameters in the wrestlers. Systolic and diastolic functions were comparable between the marathon runners and wrestlers with conventional echocardiography. Analysis with STE, however, yielded higher systolic strain and strain rates in the athletes. Normalized GLS parameters and end-diastolic volume (EDV) were shown to be correlated. CONCLUSION: Overall, conventional echocardiography can detect some differences between young athletes with eccentric and concentric type of athlete's heart but it is incapable of revealing differences in intrinsic myocardial functions. However, analysis using STE demonstrated increased systolic functions in athletes commensurate with increased load, with unaltered diastolic functions.

Silymarin protects against doxorubicin induced cardiotoxicity by down-regulating topoisomerase IIß expression in mice.

We investigated the potential protective effects of silymarin (SLY) on doxorubicin (DOX) induced chronic cardiotoxicity in mice. We used 30 male BALB/c mice assigned randomly to four experimental groups: control group administered normal saline orally daily and intraperitoneally (i.p.) twice/week during weeks 1, 2, 5 and 6; SLY group (was administered 100 mg/kg SLY daily by oral gavage for 6 weeks; DOX group was administered 3 mg/kg DOX i.p. twice/week during weeks 1, 2, 5 and 6; DOX + SLY group administered DOX and SLY corresponding to the DOX and SLY groups. At the end of the experiment, heart tissues were collected for analysis. Cardiomyopathy was observed in the DOX group; this damage was reduced by SLY treatment. SLY administration in DOX treated mice decreased topoisomerase IIß (TopIIß) expression as indicated by qPCR and immunostaining. Immunohistochemistry and western blot analysis revealed decreased phosphorylated histone-2AX (γH2Ax) expression in the SLY + DOX group. SLY administration combined with DOX increased cardiac troponin T and I (cTnT and cTnI) expression based on immunohistochemical and western blot analyses. SLY administration with DOX was cardioprotective by reducing double-strand DNA breakage by blocking the DOX-TopIIß-DNA cleavage complex in response to down-regulation of TopIIß expression. SLY also preserved the contractility of the heart by decreasing DOX related loss of cTnT and cTnI expression.

Selenium protection from DNA damage and regulation of apoptosis signaling following cyclophosphamide induced cardiotoxicity in rats.

We investigated the mechanism of the cardioprotective effect of selenium (Se) against cyclophosphamide (CPA) induced cardiotoxicity in rats. We divided 24 female Wistar albino rats into four groups. The control group was injected intraperitoneally (i.p.) with normal saline. The CPA group was injected i.p. with 200 mg/kg CPA. The Se group was injected i.p. with 1 mg/kg Se. The CPA + Se group was injected i.p. with 200 mg/kg CPA and 1 mg/kg Se. Rats were euthanized 24 h after injection and heart tissues were harvested. Histopathological examination revealed reduced severity of myocardial lesions in the CPA + Se group compared to CPA induced cardiotoxicity of the CPA group; this finding was confirmed by increased immunoreactivity of cardiac troponin-I (cTn-I) in the CPA + Se group compared to decreased cTn-I immunoreactivity in the CPA group. Administration of CPA increased the immunoreactivity of phosphorylated histone-2AX (γH2AX). Se reduced the CPA induced increase in γH2AX immunoreactivity. Se administration reversed the CPA induced increase of Bax and decrease of Bcl2 gene expressions. Our findings suggest that Se is cardioprotective by reducing DNA damage and regulating the genes responsible for apoptosis caused by CPA in rats.

Immunolabelling of SCF and c-KIT in canine perianal gland tumours.

c-KIT and its ligand stem cell factor (SCF) play a direct role in the oncogenesis of various cancers by regulating the cell fate. Recent evidence indicates that an increased expression of c-KIT/SCF, driven by hormonal imbalances, is an important step in the development of hormone-dependent cancers. We investigated the possible role of the c-KIT/SCF system in the carcinogenesis in 44 perianal gland tumours (16 adenomas, 15 epitheliomas and 13 carcinomas) and 10 normal perianal gland tissues by assessing the percentage and type of cells that expressed c-KIT and SCF as well as the cellular localization of immunoreactivity. No differences in immunolabelling of SCF were found between normal glands and neoplastic cells of any histotype. The highest expression of c-KIT was seen in carcinomas and a positive correlation was found between c-KIT labelling score and mitotic index (R = 0.876; P <0.01). c-KIT labelling patterns in hepatoid cells varied among the tumour histotypes with adenomas having only membranous labelling. Three labelling patterns (membranous only, membranous and cytosolic, and cytosolic only) were seen in the other tumour histotypes. Cytosolic labelling was statistically more frequent in carcinomas than in adenomas (P <0.001). These findings suggest that c-KIT expression and its cellular localization may play a role in the development and progression of perianal gland tumours by influencing cell proliferation.

Immunolabelling of c-KIT and CAM5.2 in Canine Anal Sac Gland Adenocarcinoma.

The role of c-KIT receptor in anal sac gland adenocarcinoma (ASGAC) is unclear despite its importance in the development of tumours. In this preliminary study, the expression of c-KIT was investigated in rarely observed canine ASGAC. The potential use of CAM5.2 in distinguishing ASGAC from perianal gland tumours was also evaluated. ASGAC was diagnosed in five out of 25 examined perianal tumours. By immunohistochemistry, cytosolic (abnormal) c-KIT expression was seen in four of the five cases. CAM5.2 immunoreactivity was detected in neoplastic cells of all ASGAC cases examined, whereas it was not evident in any case of perianal gland tumour. The findings suggest that c-KIT expression and its cellular localization may be important in the oncogenesis of ASGAC and CAM5.2 can be used to distinguish between ASGAC and perianal gland tumours.

Effects of adipose tissue-derived mesenchymal stem cells and/or sildenafil citrate in experimental colon anastomosis model.

BACKGROUND: This study aimed to evaluate the healing effects of adipose tissue-derived mesenchymal stem cells (AT-MSC) and sildenafil citrate alone or in combination of colon anastomosis experimental model. METHODS: A total of 40 female Wistar rats were randomly distributed to four groups: Control (without any intervention post-anas-tomosis), stem cell (AT-MSC injection on the anastomosis site), SIL (oral gavage of 10 mg/kg sildenafil citrate), and stem cell + SIL (AT-MSC injection and oral administration of sildenafil citrate) groups. Rats were euthanized 5 days post-anastomosis. Intra-abdominal adhesion status and anastomotic burst pressure were measured to assess anastomotic healing. Hydroxyproline and TNF-α level, neu-trophil leukocyte infiltration, epithelial regeneration, and necrosis in the anastomosis tissue were examined. RESULTS: Anastomosis leakage and anastomosis burst pressure were not different among the groups. Treatment with sildenafil, stem cell, and stem cell + SIL reduced the degree of perianastomotic adhesions compared to control (p<0.05). A significant increase was noted in hydroxyproline in the stem cell and stem cell + SIL groups (p=0.001). AT-MSC injection alone or in combination with sildenafil citrate reduced the TNF-α concentration at the anastomosis site (p=0.001). Histopathological examination revealed that all treatments enhanced the clearance of the necrotic debris, reduced leukocytes infiltration, and accelerated the retraction of anastomo-sed ends except control (p=0.001). Epithelial regeneration was more pronounced in the stem cell group than other groups (p=0.001). Macrophage density was lower in groups treated with the SIL or stem cell groups than the control and stem cell + SIL groups (p=0.001). CONCLUSION: Sildenafil citrate and/or AT-MSC in the anastomosed rats promoted the anastomosis healing that was more pro-nounced in groups receiving stem cell injections.

The effect of hypothermia in a rat testicular torsion/detorsion model.

BACKGROUND: Testicular torsion is an emergent condition. The protective effect of medical hypothermia in ischemia/reperfusion injury is well defined. OBJECTIVES: To evaluate the late results of hypothermia through a rat testicular torsion/detorsion model compatible with human testicular torsion. STUDY DESIGN: Rats were divided into 5 groups (n = 7): (1)Sham (S) group, (2)T/D group: right testis was torted for 1-h, (3)T/D + H30 group: hypothermia at 4 °C was applied for 30 min before detorsion, (4)T/D + H90 group: hypothermia at 4 °C was applied for a total of 90 min (30 min before and 1-h after detorsion), (5)H group: hypothermia at 4 °C was applied to right testis for 90 min. Testicular diameters at preoperative period and 8th postoperative week were measured. Biochemically, MPO, NO, 3-NT and 4-HNE in testicular tissue and serum levels of NO, PGF 2α, 3-NT, 8-OHdG and 4-HNE were studied. Histopathologic examination and TUNEL assay were also performed. RESULTS: Biochemical and macroscopical parameters of both T/D + H30 and T/D + H90 groups were statistically different from group T/D with respect to protective effects of hypothermia. Johnsen's score was also statistically different in group T/D + H90. DISCUSSION: Hypothermia can easily be applied with ice bags both in perioperative period. This is the first study evaluating the effect of hypothermia applied postoperatively. Tissue level of protein oxidation marker (3-NT) and serum levels of DNA damage (8-OHdG), lipid peroxidation (4-HNE), protein oxidation (3-NT) and oxidative stress (PGF-2α) markers were measured for the first time. CONCLUSIONS: Hypothermia has been shown to be macroscopically, biochemically and histopathologically beneficial in the long-term experimental testicular torsion model.

P-wave duration and dispersion in patients with metabolic syndrome.

BACKGROUND: Metabolic syndrome (MS) has been reported to be associated with an increased risk of atrial fibrillation (AF). The aim of this study was to investigate P-wave dispersion (PWD) in patients with MS. METHODS: The study population included 66 patients with MS (21 men, 45 women; mean age, 49.7 +/- 9.1 years) and 63 control subjects without MS (26 men, 37 women; mean age, 47.0 +/- 10.6 years). The diagnosis of MS was based on the National Cholesterol Education Program Adult Treatment Panel III criteria. A 12-lead electrocardiogram was recorded for each subject. The difference between maximum and minimum P-wave duration was calculated and defined as PWD. An echocardiographic examination was also performed for each subject. RESULTS: Maximum P-wave duration and PWD were found to be significantly higher in patients with MS compared with the control subjects (Maximum P-wave duration: 113.5 +/- 9.7 ms vs 101.0 +/- 8.1 ms, PWD: 37.8 +/- 7.6 vs 23.3 +/- 5.9, respectively, P < 0.001 for both). However, there was no statistically significant difference between two groups regarding minimum P-wave duration (75.6 +/- 6.9 ms vs 77.6 +/- 7.8 ms, respectively, P = 0.18). In addition, PWD was positively correlated with age, body mass index, waist circumference, systolic and diastolic blood pressure, triglyceride level, deceleration time, isovolumetric relaxation time and negatively correlated with high-density lipoprotein cholesterol level and early-to-late diastolic velocity ratio. CONCLUSION: We have shown that patients with MS have higher PWD, indicating increased risk for AF, compared to the control subjects without MS.

Assessment of side branch patency using a jailed semi-inflated balloon technique with coronary bifurcation lesions.

OBJECTIVE: Many interventional cardiologists are concerned about the risk of side branch (SB) loss during main vessel (MV) stenting in complex bifurcation lesions. Therefore, novel techniques are required to reduce the risk of SB occlusion. The jailed semi-inflated balloon technique (JSBT) is one of these techniques. This article is a description of clinical experience with SB patency assessment using the JSBT. METHODS: A total of 64 patients with 82 distinct coronary bifurcation lesions underwent percutaneous coronary intervention (PCI) via JSBT at this institution. In the majority of patients, the SB balloon was inflated with a greater pressure (4.8±2.0 atm) than in the standard JSBT. Procedural and immediate clinical outcomes were reviewed via baseline and post-procedural quantitative coronary angiography analysis. RESULTS: The majority of the patients had acute coronary syndrome (60.9%) and almost one-third of the patients were Medina class 1.1.1. (32.8%). A jailed-balloon or wire was not entrapped during any PCI. SB ostial dissection was seen in only 2 patients. The minimal lumen diameter was improved in the MV and SB following PCI. There were no adverse cardiac events during in-hospital stay or at 1-month follow-up. CONCLUSION: JSBT provides maximum SB protection with bifurcation lesions and requires less time than a complex technique. There was no significant SB occlusion risk even though the SB balloon was inflated with a slightly higher pressure. The immediate clinical outcomes and procedural success of this study may encourage interventional cardiologists to use this technique safely with reliable preservation of SB patency.

The Comparison of Angiographic Scoring Systems With the Predictors of Atherosclerosis.

Syntax score (SS) and Gensini score (GS) are used to determine the complexity and severity of coronary artery disease. Although there are some studies indicating the individual relationship of these scoring systems with the carotid intima-media thickness (cIMT) and epicardial fat tissue (EFT), there was no previous study that compared the SS and GS in that respect. We aimed to assess the relationship of SS and GS with predictors of atherosclerosis. We enrolled 522 patients. There were positive correlations between GS and SS tertiles with cIMT and EFT. According to multivariate linear regression analysis for GS, EFT (ß: 0.035, t: 2.63, and P = .49) and cIMT (ß: 0.339, t: 2.97, and P = .053) were not independently associated. For SS, EFT (ß: 0.009, t: 6.5, and P = .006) and cIMT (ß: 1.2, t: 10.1, and P = .001) were independently and significantly associated. We showed that the SS is significantly associated more with surrogate markers of atherosclerosis such as EFT and cIMT than the GS.

The relationship between serum lipid parameters and renal frame count in hypertensive patients with normal renal functions.

OBJECTIVE: Atherosclerosis can contribute to renovascular disease, and high cholesterol level is an independent risk factor for disease progression. Renal frame count (RFC) is an objective angiographic method of measuring macrovascular blood flow in the main renal artery and its segmental branches. The aim of the present study was to demonstrate relationship between serum lipid parameters and RFC. METHODS: In this cross-sectional study, 116 hypertensive patients were allocated into 2 groups according to serum low-density lipoprotein (LDL) levels. Group 1 comprised 60 patients with LDL <130 mg/dL and Group 2 consisted of 56 individuals with LDL ≥130 mg/dL. The patients were also divided into 2 groups according to total cholesterol (TC) levels (52 patients in group with TC <200 mg/dL and 64 patients in group with TC ≥200 mg/dL). RESULTS: Group 2 had higher mean RFC than Group 1 (p<0.001). RFC of both kidneys in Group 2 was significantly higher than results in Group 1 (p<0.001 and p=0.023, respectively). We found similar significant results in comparison of TC-based patient groups. RFC had positive correlation with smoking, TC, and LDL (r=0.326, p=0.035; r=0.393, p=0.010; and r=0.386, p=0.012, respectively). In multivariate linear regression analysis, LDL, TC, smoking, and creatinine clearance were independent predictors of RFC. CONCLUSION: In conclusion, in hypertensive patients with normal renal function, LDL, TC, and smoking may be predictors of RFC and aggressive risk factor modification may help to reduce the risk of renal failure.