Mean platelet volume, in predicting severity of mitral regurgitation and left atrial appendage thrombosis.

The incidence of thromboembolism is higher in mitral regurgitation. Mean platelet volume (MPV), which is calculated automatically in the complete blood count tests, indicates platelet production, function and activation. Elevated MPV levels in cardiovascular diseases and some heart valve diseases have been shown before. We aimed to investigate the relationship between MPV and mitral regurgitation, and to evaluate the MPV levels according to the presence of atrial fibrillation or left atrial appendage thrombus in patients with mitral regurgitation for the first time. The study included 57 patients who had undergone transthoracic and transesophageal echocardiography for the classic symptoms and diagnosed with primary (organic) mitral regurgitation. The control group was composed of 46 age, sex and BMI-matched healthy individuals who had undergone transthoracic echocardiography and obtained normal findings. Echocardiographic evaluation was performed according to the recommendations of the American Echocardiography Society. Mean MPV values in patients with mitral regurgitation were significantly higher than the control group (P < 0.001). MPV levels and the thrombus risk were correlated with the severity of the disease. When the patients with mitral regurgitation were classified according to the presence of atrial fibrillation and left atrial appendage thrombus, patients with atrial fibrillation had higher MPV levels compared to patients with normal sinus rhythm (P < 0.001). In addition, highest MPV levels were found in patients with both atrial fibrillation and thrombosis (P < 0.001). In conclusion, measurement of MPV may be considered as a quick and reliable guide in the assessment of mitral regurgitation and thrombus, without any cost or any advanced expensive technology.

Associations between serum hepcidin level, FGF-21 level and oxidative stress with arterial stiffness in CAPD patients.

BACKGROUND: Patients on continuous ambulatory peritoneal dialysis (CAPD) and hemodialysis have accelerated atherosclerosis associated with an increase in cardiovascular morbidity and mortality. Atherosclerosis is associated with increased arterial stiffness (AS), endothelial dysfunction and elevated oxidative stress (OS) and inflammation. We aimed to investigate the relationship between oxidative stress status, arterial stiffness, hepcidin and fibroblast growth factor-21 (FGF-21) levels in CAPD patients. METHODS: As a prospective observational study, we analyzed 56 CAPD patients, aged between 30 and 63 years. Serum hepcidin, FGF-21 levels, OS status and AS were determined. Arterial stiffness was measured by flow-mediated dilatation (FMD). Oxidative stress status was determined by total antioxidant status, total oxidant status (TOS) and oxidative stress index (OSI). RESULTS: FMD was negatively correlated with TOS, OSI, hepcidin and FGF-21 (r: -0.313, p: 0.020; r: -0.0331, p: 0.014; r: -0.498, p < 0.001; r: -0.403, p: 0.002, respectively). OSI was positively correlated with hepcidin, parathormone and negatively correlated with FMD (r: 0.278, p: 0.040; r: 0.462, p < 0.001; r: -0.0331, p: 0.014, respectively). CONCLUSION: There are many factors affecting arterial stiffness in CAPD patients. In our study, higher levels of OS status, hepcidin and FGF-21 were independent determinants of arterial stiffness in PD patients. Therefore, definition and improvement of these new parameters will be helpful to reduce the cardiovascular disease risk and mortality in CAPD patients.

Neutrophil-to-lymphocyte ratio as a quick and reliable predictive marker to diagnose the severity of diabetic retinopathy.

INTRODUCTION: Diabetic retinopathy (DR) is the most common complication and cause of visual impairment in diabetes patients. The pathogenesis is not fully understood, but several studies have suggested that inflammation plays an important role. The neutrophil-to-lymphocyte ratio (NLR) was defined as a novel potential marker to determine inflammation. We aimed to evaluate the relationship between DR and inflammation by using NLR. PATIENTS AND METHODS: The study was included 58 patients diagnosed with type 2 diabetes mellitus. Twenty-four of them had DR. The control group was composed of 52 age- and sex-matched healthy subjects. Retinopathy was graded using the International Clinical Diabetic Retinopathy Disease Severity Scale. RESULTS: NLR values of the diabetes patients were significantly higher than those of the healthy control group (P<0.001), and NLR levels of the patients with DR were higher than those of the patients without DR (P<0.001). In addition, NLR values were correlated with the presence of DR and DR grades (r=0.466, P<0.001; and r=0.630, P<0.001, respectively). CONCLUSIONS: According to our knowledge, this is the first study investigating the relationship between NLR, which is an inflammatory marker, and DR and its severity. Our results suggest that while evaluating diabetes patients in terms of DR, higher NLR values may be a remarkable marker.