Enhanced serum levels of matrix Gla protein and bone morphogenetic protein in acute coronary syndrome patients.

BACKGROUND: Vascular calcification has been found to be associated with increased risk of cardiovascular (CV) morbidity and mortality. Various bone-associated proteins have been suggested to be related with this process. In this study, we aimed to evaluate whether serum levels of bone morphogenic protein-4 (BMP-4) and matrix Gla protein (MGP) differed in patients who were found to have normal epicardial coronary arteries or a culprit lesion in the coronary angiography leading to acute coronary syndrome (ACS). METHODS: Patients admitted to emergency department with the diagnosis of ACS who underwent primary percutaneous coronary intervention (PCI) between October 2015 and April 2016 were consecutively recruited as the patient group. Age and gender-matched subjects who underwent coronary angiography following non-invasive ischemia assessment made the control group. RESULTS: A total of 90 subjects (63.00±14.02 years, 70% male) were included in this study. MGP (<0.001) and BMP-4 (<0.001) levels were significantly elevated when compared to subjects with normal coronary arteries. Fasting blood glucose (P=.024), HDL-cholesterol (P=.002), C-reactive protein (CRP) (P=.001) levels, and left ventricular ejection fraction (LVEF) (P=.021) were significantly correlated with serum MGP levels. HDL-cholesterol (P=.001) and CRP (P=.030) levels were also significantly correlated with serum BMP-4 levels. In the model including HDL-cholesterol, CRP, MGP, and BMP-4 levels, only MGP (odds ratio[OR]: 1.018, P=.019) and BMP-4 (OR: 1.313, P=.023) were found to be independently associated with ACS. CONCLUSION: This study shows that serum BMP-4 and MGP are independently associated with ACS occurrence when adjusted for other CV risk factors. These biomarkers may have a diagnostic potential in ACS patients.

Impaired Left Ventricular Diastolic Functions and Thickened Epicardial Adipose Tissue in Rheumatoid Arthritis Patients is Correlated with DAS-28 Score.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory disease that is known to be associated with high cardiovascular (CV) morbidity and mortality. In this study, we aimed to demonstrate whether RA disease activity reflected with disease activity score-28 (DAS-28) had an impact on left ventricular diastolic functions and epicardial adipose tissue (EAT) thickness in RA patients with no traditional CV risk factors. METHODS: In this retrospective study, 41 patients newly diagnosed with RA were included. In addition to medical history, detailed physical examination findings and laboratory tests, left ventricular systolic and diastolic functions, chamber dimensions, and EAT thickness were evaluated with transthoracic echocardiography in the study population. RESULTS: This study included 41 subjects with a median age of 45 years (38.00-55.50), of which 29.27% were male. In the binomial logistic regression analysis, DAS-28 score was found to be an independent associate of diastolic dysfunction, Additionally, DAS-28 was found to be independently associated with EAT thickness. CONCLUSIONS: Patients with high DAS-28 score should be evaluated thoroughly for CV disease, and patients should undergo advanced diagnostic studies as required and receive appropriate treatment.

Morning blood pressure surge is associated with carotid intima-media thickness in prehypertensive patients.

OBJECTIVE: Morning blood pressure (BP) surge (MBPS) is defined as an excessive increase in the morning BP from the lowest systolic BP during sleep and is reported as a risk factor for cardiovascular events in current clinical studies. In this study, we aimed to investigate the relationship between MBPS and carotid intima-media thickness (C-IMT) in prehypertensive patients. PATIENTS AND METHODS: We evaluated the association between the rate of BP variation derived from ambulatory BP monitoring and C-IMT in patients with prehypertension. RESULTS: One hundred and seventy patients with prehypertension were included in the study. All office BP measurements and ambulatory 24-h, day-time, and night-time measurements were similar between each group. C-IMT [0.60 (range: 0.57-0.65) vs. 0.55 (range: 0.50-0.60) cm; P<0.001] and the mean platelet volume [8.7 (range: 7.9-9.1) vs. 7.9 (range: 7.3-8.8) fl; P=0.002] were significantly higher in the greater MBPS group than the lower group. In multivariate analysis, male sex [odds ratio (OR): 2.271, confidence interval (CI): 1.011-5.100, P=0.047], greater MBPS (OR: 8.474, CI: 3.623-19.608, P<0.001), and elevated mean platelet volume levels (OR: 3.359, CI: 1.978-5.705, P<0.001) were found to be independent predictors of greater C-IMT in prehypertensive patients. CONCLUSION: Our study suggests that greater MBPS is associated independently with C-IMT in prehypertensive patients.

Enhanced S100A9 and S100A12 expression in acute coronary syndrome.

AIMS: In this study, we aimed to investigate whether serum S100A8, S100A9 and S100A12 levels were markers of acute coronary syndrome (ACS). MATERIALS & METHODS: Patients who underwent coronary angiography and/or percutaneous coronary interventions between June 2015-October 2015 were consecutively recruited in this study and categorized three groups each containing 30 patients (normal coronary arteries, stable coronary artery disease, and acute coronary syndrome). Baseline characteristics, including co- morbidities and medications, were recorded and serum S100A8, S100A9, S100A12, and C- reactive protein levels were measured besides routine laboratory tests. RESULTS: A total of 90 patients (63.00 [56.00-73.00] years, 62.89% male) have been included. None of the groups differed from each other regarding baseline characteristics (p > 0.05). S100A9 levels were elevated in ACS when compared with the normal coronary arteries (p = 0.033) and S100A12 levels were found to be elevated in ACS when compared with both patients with normal coronary arteries and stable coronary artery disease (p = 0.001). S100A12 was identified as an independent associate of ACS (p = 0.002). CONCLUSION: These results suggest that S100A12 may serve as a marker of coronary plaque instability, and may have a therapeutic implication in ACS treatment.

Analysis of athletes' heart by tissue Doppler and strain/strain rate imaging.

After regular and prolonged training, some physical and structural changes occur in the heart. Strain (S) imaging and Strain Rate (SR) imaging are new and effective techniques derived from tissue Doppler imaging (TDI) which examine systolic and diastolic functions. The aim of the present study was to evaluate left ventricular TDI and S/SR imaging properties in athletes and sedentary controls. The study population consisted of 26 highly trained athletes (group I) and age, sex and body mass index (BMI) adjusted 23 control subjects (group II) who had no pathological conditions. Using standard transthoracic and Doppler echocardiographical measurements and reconstructed spectral pulsed wave tissue Doppler velocities, the S/SR imaging of six different myocardial regions were evaluated. There was a significant increase in left ventricular systolic (LVSD) and diastolic (LVDD) diameter, inter-ventricular septum (IVS), left ventricular mass (LVm), left atrial diameter (LA), and transmitral Doppler peak E velocity (flow velocity in early diastole) between group I and group II in the case of echocardiographic findings. In athletes, TDI analysis showed a significantly increased mitral annulus lateral TDI peak early diastolic (E) velocity (18.8 ± 4.1 cm/s vs. 15 ± 3.5 cm/s, P < 0.01), septal TDI peak E velocity (15.8 ± 2.8 cm/s vs. 12.8 ± 2.4 P < 0.001). There were no significant differences in myocardial velocity imaging parameters between group I and group II. Peak systolic strain/strain rates of septal and lateral walls in group I were significantly higher than group II. This study demonstrates that left ventricular S/SR imaging was higher in athletes than in healthy subjects. In addition to traditional echocardiographic parameters, SI/SRI could be utilised as a useful echocardiographic method for cardiac functions of athletes.