Subendocardial Viability Ratio Predictive Value for Cardiovascular Risk in Hypertensive Patients.

Background: The subendocardial viability ratio (SEVR), also known as the Buckberg index, is a parameter of arterial stiffness with indirect prognostic value in assessing long-term cardiovascular risk. Materials and Methods: We conducted a prospective cohort study on 70 patients with uncomplicated hypertension admitted to a county medical reference hospital. We analyzed demographics, laboratory data, arterial stiffness parameters and cardiovascular risk scores (SCORE and Framingham risk scores) and aimed to identify paraclinical parameters associated with increased cardiovascular risk. Results: Of the arterial stiffness parameters, SEVR correlates statistically significantly with age, central and peripheral systolic blood pressure, as well as with heart rate. SEVR seems to have prognostic value among hypertensive patients by increasing the risk of major cardiovascular events assessed by SCORE and Framingham risk scores. SEVR correlates statistically significantly with serum fibrinogen (p = 0.02) and hemoglobin (p = 0.046). Between pulse wave velocity and lipid parameters (p = 0.021 for low-density lipoprotein cholesterol and p = 0.030 for triglycerides) a statistically significant relationship was found for the study group. The augmentation index of the aorta also correlated with serum LDL-cholesterol (p = 0.032) and the hemoglobin levels (p = 0.040) of hypertensive patients. Conclusions: Age, abdominal circumference and Framingham score are independent predictors for SEVR in our study group, further highlighting the need for early therapeutic measures to control risk factors in this category of patients.

Cardiovascular Involvement in Tuberculosis: From Pathophysiology to Diagnosis and Complications-A Narrative Review.

Although primarily a lung disease, extra-pulmonary tuberculosis (TB) can affect any organ or system. Of these, cardiovascular complications associated with disease or drug toxicity significantly worsen the prognosis. Approximately 60% of patients with TB have a cardiovascular disease, the most common associated pathological entities being pericarditis, myocarditis, and coronary artery disease. We searched the electronic databases PubMed, MEDLINE, and EMBASE for studies that evaluated the impact of TB on the cardiovascular system, from pathophysiological mechanisms to clinical and paraclinical diagnosis of cardiovascular involvement as well as the management of cardiotoxicity associated with antituberculosis medication. The occurrence of pericarditis in all its forms and the possibility of developing constrictive pericarditis, the association of concomitant myocarditis with severe systolic dysfunction and complication with acute heart failure phenomena, and the long-term development of aortic aneurysms with risk of complications, as well as drug-induced toxicity, pose complex additional problems in the management of patients with TB. In the era of multidisciplinarity and polymedication, evidence-based medicine provides various tools that facilitate an integrative management that allows early diagnosis and treatment of cardiac pathologies associated with TB.

Mortality Risk Assessment in Peripheral Arterial Disease-The Burden of Cardiovascular Risk Factors over the Years: A Single Center's Experience.

Atherosclerosis is the basis of the cardiovascular continuum in peripheral artery disease (PAD) patients. Limiting functional decline and increasing quality of life are the main objectives for these patients. We conducted a prospective cohort study on 101 patients with PAD admitted to a single center in Northeast Romania. We used an index score to evaluate the 10-year mortality risk assessment and based on the scores we divided the patients into two groups: a low and low-intermediate risk mortality group (49 cases, 48.5%) and a high-intermediate and high-risk mortality group (52 cases, 51.5%). We analyzed demographics, comorbidities, clinical and paraclinical parameters and we aimed to identify the parameters associated with an unfavorable prognosis. Patients in the high-intermediate and high-risk mortality group were associated more with cardiovascular risk factors. Hypertension (p = 0.046), dyslipidemia (p < 0.001), diabetes mellitus (p < 0.001), and tobacco use (p = 0.018) were statistically significant factors. Lipid profile (low-density lipoprotein cholesterol, p = 0.005) and fasting blood glucose (p = 0.013) had higher mean serum values in the high-intermediate and high-risk mortality group, with a positive correlation between them and the ankle-brachial index value (p = 0.003). A multidisciplinary assessment and, especially, correction of associated cardiovascular risk factors prevent complications, and thus, improve the prognosis in the medium and long term.