Functional variants of ERAP1 gene are associated with HLA-B27 positive spondyloarthritis.

We investigated two nonsynonymous variants (rs30187 and rs27044) of ERAP1 gene in HLA-B27 positive individuals (150 spondyloarthritis and 108 controls) and in general ankylosing spondylitis (AS) patients (n = 137) vs random controls (n = 139). Both single nucleotide polymorphisms (SNPs) were associated with the risk of spondyloarthritis [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.24-2.62, P = 0.001 for rs30187, OR 1.58, 95% CI 1.07-2.34, P = 0.02 for rs27044]. The CC haplotype was a protective factor (P = 0.002), while the TG haplotype was a risk factor (P = 0.01) for spondyloarthritis. The SNP rs30187 was also associated with the risk of HLA-B27+ AS. For the general group of AS, the carriers of minor alleles showed an increased risk for the disease (OR 1.92, 95% CI 1.17-3.13 for rs30187, OR 1.74, 95% CI 1.08-2.80 for rs27044). This is the first study that shows the association of ERAP1 gene variants and haplotypes with HLA-B27 positive spondyloarthritis.

Absence of increased cardiac voltage and the importance of Q vectors for the diagnosis of left ventricular hypertrophy in early stages of hypertension in patients over 40 years of age.

The quantitative VCG criteria (VCGer) for left ventricular hypertrophy (LVH) and their diagnostic power were determined in 165 hypertensive men and 86 women over 40 years of age without congestive cardiac failure in comparison with 91 normal men and 108 normal women. The patients were grouped according to the presence or absence of LVH determined by X-ray (men: 96 without and 69 with LVH, women: 41 without and 45 with LVH). The proper statistical methods were used taking into account whether their distributions were symmetrical or asymmetrical. We found some sex differences of VCG criteria. The most striking results were the lack of increased voltage, and the great sensitivity of the orientation of Q vectors to the left (Q left). Q left may be induced by: 1. a septal hypertrophy, alone or accompanied by a hypertrophy of the anterior and posterior paraseptal regions of LV wall, 2. by a subendocardial ischemia at these levels induced by the increase of intraventricular pressure, 3. by possible spatial change of the septum, 4. by all these factors acting synchronously, 5. by other, unknown factors. These VCGcr for LVH found by us are different from those in the literature, but they are valid in Romania.

Studies concerning the significance of orthogonal ECG changes with age in normal men and in arterial hypertension without congestive cardiac failure in men past forty.

Great ECG changes (Frank system) with age were found in normal men. ECG diagnostic criteria valid in Romania were studied by multivariate analyses in men aged 40--60 suffering from hypertension (Hyp) without cardiac congestive failure (CCF), out of which one group with left ventricular hypertrophy (LVH) and another one without it. Echocardiographic studies in normal and hypertensive men past forty, as well as studies in experimental Hyp with LVH and without CCF were carried out. Heart X-ray evaluation is not a functional one. Some non-invasive methods in men do not determine an accurate evaluation of LV performance. The increase of LV muscular mass alone cannot explain the ECG changes in LVH in Hyp without CCF. Two conditional adaptive mechanisms: the liberation of catecholamines from the myocardium storage, induced by the pressure overload stress, and the increase of intracellular Ca++ influx could contribute to the respective ECG changes.

New mathematical statistical methods for detecting correct echocardiographic (ECG) and vectorcardiographic (VCG) diagnosis criteria by computerization. I. The determination of the upper (Lu) and low (Ll) limits for VCG amplitudes. The multivariate analysis.

The mathematical statistical methods for the determination of the upper (Lu) and low (Ll) limits of the 95 percentile range of symmetrical and asymmetrical frequency distribution curves for electrocardiographic (ECG) or vectorcardiographic (VCG) amplitudes, ECG and VCG diagnostic criteria, and the multivariate analysis as well as the bases of their computerization-program have been presented, in order to find out the ECG and VCG diagnostic criteria. The formulae for the determination of sensitivity, specificity and performance score of the ECG and VCG diagnostic criteria, in both the above mentioned methods are presented.

The Bucharest multifactorial prevention trial of coronary heart disease. General methodology and risk factor correction after five year follow-up (1971-1977).

Both the intervention and the control group included each 5000 men aged 40-60 years, randomly selected by their home address in five districts of the city of Bucharest. The intervention group underwent an "at entry" examination for risk factor detection (high serum cholesterol, high blood pressure, overweight, diabetes, minor ECG abnormalities, family history) and subsequently a five-year multifactorial intervention aimed to reduce the risk factors. Both groups were followed up in this lapse of time for major end-points: myocardial infarction, stroke, sudden death. The qualitative analysis of the results used ten evolution indices based on a quantal counting and lead to a classification of risk factors which allowed the setting up of a strategy for their correction. The quantitative analysis showed the following decreases between the first and the last examination in the intervention group: for serum cholesterol greater than or equal to 250 mg/dl -17%; for cigarettes/day greater than or equal to 15-53%; for overweight greater than or equal to 30% - 13.57%; for high blood pressure -8%; for the overall risk computed by multiple regression -33.8%.