Postsystolic index for distinguishing coronary artery disease in left bundle branch block.

BACKGROUND: Left bundle branch block (LBBB) is associated with a high risk of death, particularly from ventricular tachyarrhythmia and myocardial infarction. It is difficult to clinically differentiate between ischemic and nonischemic LBBB. In this study, we investigated whether advanced echocardiographic variables, such as strain delay index (SDI) and postsystolic index (PSI), can be used to distinguish coronary artery disease (CAD) in patients with LBBB. METHODS: Our study included 102 patients with LBBB. All patients underwent echocardiography. The left ventricular ejection fraction (LVEF), left ventricular mass, PSI, SDI, global longitudinal strain (GLS), and time-to-peak longitudinal strain were then calculated. Coronary angiography was performed, and the patients were divided into groups with significant CAD and without significant CAD. RESULTS: Patients in the group with significant CAD were older than the patients in the group without significant CAD. The group had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and family history of CAD than the group without significant CAD. The group with significant CAD also had lower LVEF and GLS than the group without significant CAD. The group without significant CAD showed a direct correlation between LVEF and SDI and an inverse correlation between LVEF and PSI: P value = 0.040 and r = 0.255, and P value = 0.001 and r = -0.427, respectively. However, the group with significant CAD did not show any significant correlation between LVEF and SDI or PSI. CONCLUSION: Strain delay index and PSI may be useful markers in distinguishing CAD in patients with LBBB and preserved LVEF.

Neck circumference and metabolic syndrome: A cross-sectional population-based study.

OBJECTIVES: This study aimed to investigate the possible association of neck circumference with cardiometabolic risk factors, and to find out the possible cutoff points of neck circumference for the diagnosis of metabolic syndrome among the Iranian population. METHOD: This is a cross-sectional study in 1619 participants who were selected through clustered random sampling, as a part of a health cohort in Amol, Iran. Diagnosis of metabolic syndrome (MetS) was based on the modified criteria of the National Cholesterol Educational Program Adult Treatment Panel (NCEP ATP III). Associations of neck circumference with Mets and its components were studied using logistic regression. The optimal cutoff point of neck circumference for MetS diagnosis was calculated based on the Youden index. RESULTS: Metabolic syndrome was diagnosed in 433 (26.7%) of patients. Neck circumference was shown to be significantly associated with central obesity, hypertension, hypertriglyceridemia, impaired fasting glucose, and low serum high-density lipoprotein (HDL) level, as well as MetS. The optimal cutoff points of neck circumference in the diagnosis of MetS are 36 cm and 42 cm for women and men, respectively. Sensitivity of the optimal cut-off point of NC for diagnosing patients with MetS was higher in women compared to men (70.6% compared to 55.9%). CONCLUSION: A significant association was observed between neck circumference and the presence of MetS among the Iranian population and neck circumference can be offered as a new index in screening and diagnosis for MetS and assessing cardiometabolic risk factors.