Telomerase activity and hTERT gene expression in patients with acute coronary syndrome and stable coronary artery disease.

BACKGROUND: In this study, we aimed to examine the telomerase activity and hTERT gene expression in patients with acute coronary syndrome (ACS) and those with stable coronary artery disease (SCAD) and compare the results to controls. Additionally, we compared overall mortality rates relative to the telomerase activity. METHODS: A total of 211 patients (78 ACS and 71 SCAD patients) were included in the study. The telomerase concentration was measured by ELISA and used to determine telomerase activity. The hTERT gene expression was determined by real-time PCR. RESULTS: The serum telomerase enzyme concentration was lower in ACS (36.61 ± 1.54) and SCAD (36.79 ± 1.57) when compared to the control group (37.03 ± 2.25). However, this difference did not reach statistical significance (p = 0.890). The hTERT gene expression acting in telomerase enzyme synthesis was 2.7-fold lower in ACS group (p = 0.070) and 2.2-fold lower in the SCAD group (p = 0.101) compared to the control group. Patients were followed for a median of 32 months (minimum: 0.1, maximum: 46.8). The serum telomerase concentrations in patients who died and those survived in the SCAD group (35.98 ± 2.02 vs 36.86 ± 1.52 ng/ml, respectively; p = 0.529) were similar to those in the ACS group (36.39 ± 1.08 vs 36.63 ± 1.60 ng/ml, respectively p = 0.993). CONCLUSIONS: In the current study, telomerase activity or hTERT expression was similar in patients with ACS, SCAD, and controls. Moreover, telomerase activity was not associated with all- cause mortality during the 32-month follow-up (Tab. 3, Fig. 1, Ref. 29).

Triglyceride glucose index reflects the unfavorable changes of left ventricular diastolic functions and structure in uncomplicated newly diagnosed hypertensive patients.

INTRODUCTION: Left ventricular (LV) diastolic dysfunction and structural abnormalities are common cardiac changes in hypertension (HTN), and several factors other than high blood pressure (BP) may play a role in these changes. The aim of this study was to reveal the relationship between triglyceride glucose (TyG) index, a novel parameter for insulin resistance (IR), with LV diastolic function and structure in hypertensive patients. MATERIAL AND METHOD: A total of 119 newly diagnosed, untrated hypertensive patients free of diabetes and/or cardiovascular complications were included in this study. IR was estimated with the TyG index calculated from ln [fasting TG (mg/dL) × fasting blood glucose (mg/dL)/2]. Two-dimensional and Doppler echocardiographic examinations were performed to assess LV diastolic functions and structure. RESULTS: Based on median TyG index, 51 patients was assigned as group I (<8.7) and 68 patients as group II (>8.7). In patients with high TyG index, left atrial volume index (LAVi) (p < .001) LV mass index (LVMI) (p = .016), E/e' ratio (p < .001) increased, and e' velocity (p < .001) and E/A ratio (p = .028) decreased. There was a statistically significant correlation between TyG index and these parameters (all p > .05). Stepwise multiple regression analysis demonstrated that the relationship of TyG index with LV diastolic function and structure was independent of potential confounders (all p < .001). CONCLUSION: This study suggest that a high TyG index is related to LV diastolic functional impairment and structure abnormality in newly diagnosed hypertensive patients in the absence of diabetes or CVD.

Assessment of triglyceride/glucose index with respect to coronary slow flow.

BACKGROUND: Coronary slow flow (CSF) is determined by delayed opacification of the epicardial coronary arteries without obstructive disease. The triglyceride glucose index (TGI) has been suggested as a useful marker of insulin resistance. Previous studies have shown that TGI is associated with cardiovascular disease, but no study has examined the relationship between TGI and CSF. OBJECTIVES: Therefore, the primary objective of the present study was to investigate the relationship between TGI and CSF. METHODS: This study retrospectively evaluated patients who were admitted to our clinic with complaints of chest pain and underwent coronary angiography between January and December 2018. A total of 1100 coronary angiography images were assessed, and 72 patients with CSF were detected. Coronary flow was quantified objectively using the TIMI (thrombolysis in myocardial infarction) frame count (TFC) method as described by Gibson et al. TGI was calculated as follows: ln [fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. RESULTS: The CSF group had significantly higher glucose levels (mg/dl) [ (114.92±30.92), (125.61±33.22), than the control and CSF groups, respectively, p=0.0001], TGI [ (9.02±0.56), (9.26±0.54), p=0.0001], and triglyceride levels (mg/dl) [ (170.67±110.81), (201.19±136.93), p=0.002]. There was no statistically significant correlation between TGI and left anterior descending artery TFC, circumflex artery TFC, right coronary artery TFC (r/p values; 0.24/0.06; 0.32/0.08; 0.18/0.36, respectively). TGI, HDL, HT, age, and sex were examined with a multiple logistic model, and TGI was found to be statistically significant for the risk of CSF (p=0.0001; O.R:7.459). CONCLUSION: TGI was statistically significantly higher in the CSF group than the control group. According to the multivariate logistic regression analysis, only TGI was independently associated with the risk of CSF, but higher TGI did not predict more slow coronary flow. Prospective studies are needed to clarify the prognostic relationship of TGI and CSF in terms of future cardiovascular events (Tab. 2, Fig. 1, Ref. 19).

Relationship between Fragmented QRS Complex and Aortic Stiffness in Chronic Hemodialysis Patients.

OBJECTIVE: This study aimed to evaluate the correlation between fragmented QRS complex (fQRS), aortic stiffness, and diastolic dysfunction in hemodialysis patients. SUBJECTS AND METHODS: A sample of 56 patients who received hemodialysis treatment was stratified into 2 groups according to their electrocardiography (ECG) patterns with or without fQRS. Baseline characteristics and laboratory parameters of patients were documented. Conventional echocardiographic and Doppler echocardiographic procedures were performed in all patients. The mean early (Em) diastolic and late (Am) diastolic myocardial velocities were calculated. These tests were performed before dialysis. The Student t test, Mann-Whitney U test, χ2 test, Spearman correlation, and multivariate linear regression analysis were used to analyze parameters where appropriate. RESULTS: Of the 56 patients under hemodialysis, fQRS in ECG was detected in 26 (46.4%). Echocardiographic evaluation showed that deceleration time (237.57 ± 40.10 ms; p = 0.030), isovolumic relaxation time (126.84 ± 15.62 ms; p < 0.001), early (E)/late (A) ventricular filling velocity (E/A) ratio (1.15 ± 0.40; p ≤ 0.001), and aortic stiffness index value (9.62 ± 4.53; p = 0.016) exhibited a statistical increase in hemodialysis patients with fQRS compared to patients without fQRS. E (58.23 ± 19.96 m/s; p = 0.004), and Em (5.96 ± 2.08 cm/s; p = 0.023) velocity levels were significantly lower in hemodialysis patients with fQRS than patients without fQRS. Aortic stiffness closely correlated with diastolic dysfunction (deceleration time r = 0.273, p = 0.042; isovolumic relaxation time r = 0.497, p < 0.001; E/A ratio r = -0.449, p = 0.001). On multivariate linear regression analysis, fQRS and aortic stiffness were independently associated in hemodialysis patients (ß = 0.321, p = 0.049). CONCLUSIONS: Increased aortic stiffness and left ventricular systolic dysfunction were observed more frequently in hemodialysis patients with fQRS than in patients without fQRS. fQRS is an important determinant of aortic stiffness in hemodialysis patients.

Assessment of Atrial Electromechanical Delay and Left Atrial Mechanical Functions in Patients with Ulcerative Colitis.

OBJECTIVE: Ulcerative colitis (UC) is a common inflammatory bowel disease causing systemic inflammation, which may also affect the cardiovascular system, as well as other organ systems. The aim of the current study was to evaluate left atrial (LA) mechanical functions and duration of atrial electromechanical delay (AEMD) with echocardiography in patients with UC. METHOD: A total of 91 patients, 45 with UC (Group 1) and 46 healthy individuals as control (Group 2) were included in the study. The demographic and laboratory data were recorded, and echocardiographic measurements were taken for all patients. RESULTS: In the evaluation of basal clinical and laboratory findings, no difference was detected between the two groups, except for white blood cell count (WBC) (8.26 ± 2.71 vs. 7.06 ± 1.70, P = 0.013) and high-sensitivity C-reactive protein (Hs-CRP; 3.4 ± 1.7 vs. 1.0 ± 0.8, P < 0.001). The echocardiographic assessment revealed that the diastolic parameters such as E-, E/A-, and E- waves decreased in the UC group when compared to the control group. LA mechanical functions were different between groups, except for left atrial (LA) maximal volume: LA minimum volume (22.2 ± 12.9 vs. 15.3 ± 4.7, P = 0.001), LA volume before atrial systole (29.9 ± 14.2 vs. 24.2 ± 4.9, P = 0.021), LA ejection fraction (27.4 ± 16.5 vs. 38.6 ± 10.1, P < 0.001), LA total emptying volume (17.9 ± 6.9 vs. 21.9 ± 5.9, P = 0.004), LA active emptying fraction (27.4 ± 16.5 vs. 38.6 ± 10.1, P < 0.001), LA active emptying volume (7.7 ± 3.6 vs. 9.4 ± 2.9, P = 0.013), LA passive emptying fraction (26.8 ± 10.2 vs. 33.2 ± 9.2, P = 0.002), and LA passive emptying volume (10.3 ± 4.9 vs. 12.5 ± 4.5, P = 0.029). There was a significant difference between the groups in terms of AEMD durations, except time interval from the onset of the P-wave on the surface ECG to the peak of the late diastolic wave (PA) of the tricuspid valve. The correlation analysis revealed that age and duration of disease were correlated with AEMD. CONCLUSION: The current study reported that LA volume and mechanical functions degenerated and AEMD increased in patients with UC when compared to the control group. These findings demonstrate that UC may have effects on LA electromechanical functions related to duration of disease.

Serum neutrophil gelatinase-associated lipocalin levels in patients with non-dipper hypertension.

PURPOSE: Neutrophil gelatinase-associated lipocalin (NGAL) is a protein belonging to the lipocalin superfamily and plays a role in atherosclerosis, renal injury and inflammation. The present study aimed to investigate serum NGAL concentrations in groups of patients with dipper and non-dipper hypertension (HT) and to characterize the relationship between NGAL concentration and circadian blood pressure in hypertensive patients. METHODS: A total of 41 (22 male, 19 female, mean age: 56.1 ±8.9 years) non-dipper HT patients, 40 (19 male, 21 female, mean age: 54.0 ±10.0 years) dipper HT patients and 42 age- and gender-matched healthy individuals were enrolled in the study. Dipper and non-dipper HT were diagnosed via ambulatory blood pressure monitoring. Serum NGAL concentrations were measured by enzyme-linked immunosorbent assay from blood samples obtained from patients. RESULTS: Serum NGAL concentrations were found to be significantly higher in the non-dipper and dipper HT patient groups in comparison with the control group (84.9 ±23.0 ng/ml and 62.1 ±17.8 vs. 46.6 ± 13.7 ng/ml, p <0.017, respectively). Moreover, serum NGAL concentrations were significantly higher in the non-dipper HT group in comparison with the dipper HT group (p<0.017). Serum NGAL concentration showed significant correlation with overall ambulatory BP levels both in non-dipper and dipper HP groups. CONCLUSION: Serum NGAL concentrations increased significantly in non-dipper HT patients in comparison with dipper HT patients and normotensive patients and show significant correlation with ambulatory BP levels. Serum NGAL concentration might be a useful marker in identifying HT patients with higher risk for cardiovascular mortality.

Exercise-Induced Repolarization Changes in Patients with Isolated Myocardial Bridging.

BACKGROUND: Although myocardial bridging (MB) is defined as an angiographic phenomenon with a benign course, it has also been associated with adverse cardiovascular events. The effects of exercise on myocardial repolarization in patients with MB were tested in this study, with Tp-e and Tp-e/QT repolarization indexes. MATERIAL AND METHODS: A total of 50 patients in whom isolated MB was diagnosed at coronary angiography (CAG) (Group I) and 48 patients with normal CAG results (Group II) were included in this study. The participants underwent treadmill exercise stress testing according to the Bruce protocol. QT dispersion (QTd) was defined as the minimum QT interval subtracted from the maximum. The Tp-e interval was defined as the difference between the QT and the QT peak time period. QTd and Tp-e intervals were calculated for all patients before and after exercise testing and differences between groups were compared. RESULTS: At peak exercise, QTd and cQTd showed a significant increase in comparison to baseline values in the group of patients with myocardial bridges. Significant increases were also found with exercise in the Tp-e, cTp-e durations and Tp-e/QT ratio of the MB patient group in comparison to the baseline values. On the other hand, significant differences in QTd, cQTd, Tp-e, cTp-e intervals, and Tp-e/QT ratio during peak exercise in comparison with baseline values were not detected in the control group (p>0.05). CONCLUSIONS: Significant increases in QTd, cQTd, Tp-e and cTp-e intervals and Tp-e/QT ratio were detected in the MB patients during exercise testing.

The Relationships between Atrial Electromechanical Delay and CHA2DS2-VASc Score in Patients Diagnosed with Paroxysmal AF.

AIM: This study aims to evaluate the relationship between atrial electromechanical delay (AEMD) times and CHA2DS2-VASc scores in patients diagnosed with paroxysmal atrial fibrillation (PAF). MATERIALS AND METHODS: The study included a total of 74 patients, 34 of whom were diagnosed with PAF and 40 were included in the control group. The CHA2DS2-VASc score was calculated for each patient. Additionally, blood samples were taken from all patients and transthoracic echocardiographic measurements were made. Left atrial mechanical functions and AEMD were calculated. RESULTS: Mean CHA2DS2-VASc score measured was 2.24 ± 1.53 in PAF group. There was no significant difference between the groups when the patients were evaluated for baseline characteristics and laboratory parameters (P > 0.05) The echocardiographic evaluation of LA mechanical functions showed that only LA minimum volume (19 ± 6.4 vs. 16.7 ± 4.6, P = 0.02) and LA presystolic volume (28.9 ± 7 vs. 25.1 ± 5.7, P = 0.01) were higher in the PAF group. When AEMD was compared between the groups; lateral PA, septal PA, tricuspid PA, Interatrial EMD, and intraatrial EMD were significantly extended compared to control group (P < 0.001) CHA2DS2-VASc score was correlated with Lateral atrial PA (P < 0.001, r = 0.524), Septal atrial PA (P < 0.001, r = 0.45), Interatrial EMD (P < 0.001, r = 0.54), and intraatrial EMD (P < 0.001, r = 0.51) times. CONCLUSION: The present study shows that AEMD times increase in patients with PAF compared to the control group. Furthermore, this study revealed a correlation between AEMD times and CHA2DS2-VASc score, as well showed that extended AEMD time may be associated with thromboembolism risk.

The effects of successful percutaneous mitral balloon valvuloplasty on acute and intermediate term aortic stiffness.

AIM: The aim of this study was to evaluate the effects of percutaneous mitral balloon valvuloplasty (PMBV) on short- and intermediate-term aortic stiffness in patients with mitral stenosis. MATERIALS AND METHODS: This prospective study included 56 patients with critical mitral stenosis in normal sinus rhythm (68% female; mean age: 42 ± 11 years) and 37 healthy controls. Aortic stiffness was measured using transthoracic echocardiography before PMBV, and 24-48 hours and 1 year post procedure. RESULTS: Aortic strain and distensibility were significantly higher in the patients with mitral stenosis, both after PMBV and 1 year post procedure, whereas the aortic stiffness index (ASI) was significantly lower. There was also a significant decrease in mitral mean gradient (MMG) and systolic pulmonary artery pressure (sPAP) after PMBV, based on echocardiography and catheterization. Mitral valve area (MVA) significantly increased after PMBV. There was a significant correlation between change in ∆MVA and ∆MMG and aortic elastic properties. There was a significantly negative correlation between the ∆MVA and ∆∆ aortic stiffness (r = -0.62, P < 0.001), and a significantly positive correlation between ∆MMG and ∆ASI (r = 0.60, P < 0.001). CONCLUSION: Mitral valve stenosis was associated with impaired aortic stiffness and following PMBV, aortic stiffness decreased during both the acute period and the intermediate period.

Assessment of atrial electromechanical delay and left atrial mechanical functions in patients with psoriasis vulgaris.

OBJECTIVES: Increased frequency of atrial fibrillation (AF) has been demonstrated in psoriasis cases. Prolongation of the duration of atrial electromechanical delay (AEMD) is a well-known characteristic of the atrium, which is vulnerable to AF. In the current study, our aims are to investigate AEMD durations and mechanical functions of the left atrium (LA) in patients with psoriasis. METHODS: A total of 90 patients, 45 with psoriasis vulgaris and 45 as the control group, were included in the study. Atrial electromechanical coupling (PA) and intra- and inter-atrial electromechanical delay (IA-AEMD) were measured with tissue Doppler echocardiography. P-wave dispersion (PWD) was calculated from the 12-lead electrocardiogram. The severity of the disease was evaluated by the Psoriasis Area and Severity Index. RESULTS: The durations of PA lateral and PA septal were significantly high in the psoriasis group when compared with the control group (47.7 ± 9.8 vs. 57.1 ± 8.4 msec, P < 0.001 and 38.6 ± 9.9 vs. 43.6 ± 8 msec, P = 0.016, respectively). The durations of IA-AEMD, intra-right electromechanical delay, and intra-left electromechanical delay in the psoriasis group were significantly prolonged compared with the control group (15.2 ± 4.1 vs. 21.7 ± 5.6 msec, P < 0.001; 6 ± 2.5 vs. 8.7 ± 2.7 msec, P < 0.001; and 9.1 ± 3.9 vs. 13.5 ± 5.2 msec, P < 0.001; respectively). PWD was significantly higher in patients with psoriasis vulgaris compared with controls (36.1 ± 7.9 vs. 40.2 ± 9.1 msec, P = 0.043). CONCLUSION: In the present study, we found prolongation in the durations of AEMD and PWD in the psoriasis group compared with the control group. These results might be an early predictor of AF and other arrhythmias.

Relationship Between Mean Platelet Volume and Pulmonary Embolism in Patients With Deep Vein Thrombosis.

BACKGROUND: Mean platelet volume (MPV) has been demonstrated to be associated with deep vein thrombosis (DVT). However, its role in the prediction of pulmonary embolism (PE), which is a major complication of DVT, is still unclear. Therefore, we investigated the association of MPV values with acute PE in patients with DVT. METHOD: The study included three groups: patients with DVT and PE (n=98); patients with DVT without PE (n=97); and control group (No DVT, No PE, n=98). We also evaluated DVT patients according to the MPV values on admission and categorised them into two groups: MPV≤9.15 fL (n=82) and MPV>9.15 fL (n=113). RESULTS: MPV was significantly higher in all DVT patients than controls (9.3±0.9 fL vs 7.9±0.7 fL, p<0.001) and in DVT patients with PE than DVT patients without PE (9.9±0.6 fL vs 8.7±0.7 fL, p<0.001). The rate of PE was higher in patients with DVT with MPV>9.15 fL than those with MVP≤9.15 fL (75.2% vs 15.9%, p<0.001). The presence of PE in patients with DVT was independently associated with MPV (OR: 22.19, 95%CI: 9.39-53.19, P<0.001). CONCLUSION: Although our findings should be considered within the limitations of the study, they suggest that MPV measures may be elevated in DVT patients and a higher MPV may be associated with PE in patients with DVT.

P-Wave Dispersion and Atrial Electromechanical Delay in Patients with Preeclampsia.

OBJECTIVES: To investigate the duration of atrial electromechanical delay (EMD) and left atrial mechanical function in patients with preeclampsia. MATERIALS AND METHODS: This study included 26 pregnant women with preeclampsia and 24 age-matched pregnant women without preeclampsia (control group). Atrial electromechanical coupling (PA) and intra-atrial and interatrial EMD were measured using tissue Doppler echocardiography. P-wave dispersion (PWD) was measured via 12-lead electrocardiography. All data were analyzed using SPSS v.15.0 for Windows (SPSS, Inc., Chicago, Ill., USA). Differences in continuous variables between groups were examined using a nonparametric Mann-Whitney U test. Correlation analysis was performed using Spearman's coefficient of correlation. Categorical values were compared using a χ2 test. RESULTS: PA lateral and PA septal durations were significantly longer in the preeclampsia group than in the control group [74.6 ± 8.1 vs. 62.3 ± 5.3 ms (p < 0.001) and 59.7 ± 5.3 vs. 56.2 ± 4.9 ms (p = 0.005), respectively]. The duration of interatrial EMD and intra-atrial EMD in the preeclampsia group was significantly longer than in the control group [25.4 ± 4.6 vs. 13.2 ± 3.9 ms (p < 0.001) and 10.5 ± 1.9 vs. 7.1 ± 1.2 ms (p < 0.001), respectively]. PWD was significantly higher in patients with preeclampsia (43.1 ± 9.1 ms) than in the controls (37.6 ± 7.9 ms; p = 0.008). There was a significant correlation between PWD and interatrial EMD and intra-atrial EMD [r = 0.46 (p < 0.001) and r = 0.39 (p < 0.001), respectively]. CONCLUSION: The duration of atrial EMD and PWD was prolonged in patients with preeclampsia.

Prevalence and characteristics of coronary-cameral communications in adult patients: coronary angiographic analysis of 16,573 patients.

OBJECTIVE: To analyze the coronary angiograms of patients with symptomatic heart disease in order to determine the frequency and characteristics of coronary-cameral communications (CCCs) in a single center. SUBJECTS AND METHODS: The coronary angiograms of 16,573 patients with symptomatic heart disease performed from November 2001 to January 2011 were analyzed. The diagnosis of coronary fistula and coronary-cameral microcommunications (CCMCs) was made according to previously defined criteria. RESULTS: Of the 16,573 patients, 15 (0.09%; 8 males and 7 females, mean age 63 ± 12 years) had CCCs, while coronary fistulas were identified in 2 (0.01%). In the first patient, the coronary fistula arose from the branches of the left anterior descending (LAD) artery and the right coronary artery (RCA) and drained into the right ventricle. In the second patient, the fistula originated from branches of the LAD artery, the circumflex (Cx) artery and the RCA and drained into the left ventricle. In 7 patients, the CCMCs originated from the LAD artery. In 3 patients, the Cx artery was the origin. The CCMCs originated from the RCA in 2 patients. In 1 patient the CCMC took its origin from the RCA and the Cx artery, while in 2 patients the CCMCs were associated with intracardiac masses in the left atrium and the right atrium, respectively. CONCLUSION: The prevalence of CCCs in adult patients was low and that of large coronary fistulas was even lower; coronary fistulas are probably very rare in adult patients because the majority of them are detected and treated during childhood.

Evaluation of the relationship between arterial blood pressure, aortic stiffness and serum endothelin-1 levels in patients with essential hypertension.

This study has attempted to evaluate the relationship between aortic stiffness, blood pressure (BP) and serum endothelin-1 (ET-1) levels in patients with essential HT. Totally 152 subjects, consisting of 103 patients diagnosed with HT at least 1 year previously and 49 healthy individuals, were enrolled in this study. They were subdivided, on the basis of BP measurements made at home, into three groups as the hypertensives with dysregulated BP (n = 56), the hypertensives with regulated BP (n = 47) and the normotensive controls (n = 49). Statistically significant differences were observed between the three groups with respect to aortic elasticity parameters (p < 0.01 for aortic strain, aortic distensibility and aortic stiffness). Serum ET-1 levels in the three groups were similar (p = 0.101), but a significant correlation was observed between the ET-1 values and the aortic elasticity parameters (p = 0.004). Alteration of the aortic elasticity parameters in patients with HT not only correlates with the serum ET-1 levels indicating endothelial dysfunction but also gives direct clues about status of BP regulation.

Relationship between circulating serum omentin-1 levels and nascent metabolic syndrome in patients with hypertension.

The prevalence of metabolic syndrome (MetS) is more common in patients with hypertension and is associated with an increased risk of target organ damage and/or cardiovascular disease (CVD). Omentin-1 is a beneficial adipokine considered to play a role in MetS and MetS-related states such as obesity, diabetes, and coronary artery disease. The aim of this study was to determine the relationship between circulating omentin-1 levels and MetS uncomplicated by diabetes or CVD (nascent MetS) in patients with hypertension. In this study, 110 patients (54 men, 49%; average age: 49.72±11.32 years) treated for hypertension but without overt diabetes and/or CVD were enrolled. 66 patients were stratified into MetS (+) (group 1) and 44 patients into MetS (-) (group 2) according to the American Heart Association/National Heart, Lung, and Blood Institute criteria. The triglyceride glucose (TyG) index was used to assess insulin resistance. Circulating omentin-1 levels in venous blood samples were measured by an ELISA kit. Circulating omentin-1 levels in patients with MetS were significantly lower than in patients without MetS (46.35 ng/mL (42.70-57.70 ng/mL) vs 130.95 ng/mL (62.83-236.48 ng/mL), p<0.001). Omentin-1 was inversely correlated with TyG index (r=-0.204, p=0.033). In a multivariate logistic regression analysis, omentin-1, TyG index, and body mass index were independent predictors of MetS. A receiver operating characteristic curve analysis determined that the best cut-off value for omentin-1 in predicting MetS was 62.20 ng/mL and the area under the curve was 0.880 (95% CI 0.817 to 0.942, p<0.001). The findings of this study suggest that circulating omentin-1 levels are inversely related to the presence of MetS and may be a reliable marker to predict the development of MetS in patients with hypertension.

Is serum fibroblast growth factor 21 associated with the severity or presence of coronary artery disease?

Background: Recent studies have shown that increased circulating concentrations of fibroblast growth factor 21 (FGF21) are associated with obesity, metabolic disorder, and atherosclerosis. However the relationship between FGF21 and coronary artery disease (CAD) is controversial This study was planned to investigate the role of FGF21 in CAD development and CAD severity. Methods: Seventy-eight patients with stable angina pectoris (SAP) (lesion positive) and 40 control patients (lesion negative) with similar cardiovascular risk factors were included in the study. Serum FGF21 levels were measured by ELISA method. CAD severity was evaluated by using SYNTAX and GENSINI risk scores. Results: FGF21 concentrations were found significantly higher in the SAP group than in the control group. [101.18 ± 141.62 vs. 47.93 ± 58.74 pg/mL; p = 0.03], no correlation was found between the SYNTAX (r = 0.146 and p = 0.134) and GENSINI (r = 0.211 and p = 0.084) scores with serum FGF21 levels. There was a negative relationship between serum FGF21 and serum HDL-C levels in correlation analysis (r = - 0.272; p = 0.026). Conclusions: The serum FGF21 levels are different between SAP and control patients. FGF21 is a marker for CAD diagnosis, but not for the evaluation of CAD severity.

Retinol binding protein 4 levels relate to the presence and severity of coronary artery disease.

BACKGROUND: The previous studies have showed that serum retinol binding protein 4 (RBP4) levels increase in metabolic disorders which are closely associated with cardiovascular diseases (CVD). However, the human studies investigating the role of RBP4 in CVD are conflicted. Therefore, we aimed to evaluate the relationship between RBP4 with the presence and severity of coronary artery disease (CAD) in this study. METHODS: 55 patients with presenting acute coronary syndrome (ACS) and 43 control subjects who had various cardiovascular risk factors with normal coronary artery on coronary angiography were included in this study. The serum RBP4 concentrations were measured using ELISA method, clinically and anatomically score models were used to assess the severity of coronary lesion. RESULTS: Serum RBP4 levels were significantly higher in patients with ACS compared to the without ACS (68.40 ± 47.94 mg/L vs. 49.46 ± 13.64 mg/L; p = 0.014). RBP4 was correlated with GENSINI and SYNTAX I score (r = 0.286 p = 0.034; r = 0.403 p = 0.002 respectively). However, there was no relationship between RBP4 and GRACE score. CONCLUSIONS: The serum RBP4 levels increase in patients with CAD and its increased levels may be correlated with CAD severity.

Clinical significance of chitotriosidase in outpatients with advanced heart failure.

The previous studies have shown that plasma chitotriosidase (CHIT) levels increase in many diseases with inflammation. However, there are no reported studies investigating the relationship between CHIT and chronic heart failure (CHF) which is an inflammatory process. Therefore, we aimed to investigate the role of CHIT in diagnosis and severity of CHF in this study. 36 patients (50% male, mean age 63.17±10.18 years) with left ventricular ejection fraction <40% and 27 controls (44% male, mean age 61.33±8.73 years) were included in this study. Patients with CHF were divided into two groups as ischemic heart failure (IHF) and non-ischemic heart failure (NIHF) according to the underlying etiology. Plasma CHIT and N-terminal pro brain natriuretic peptide (NT-proBNP) levels were measured by ELISA method. Plasma CHIT and NT-proBNP levels were higher in patients with CHF than in controls (CHIT 931.25±461.39 ng/mL, 232.79±61.28 ng/mL, p<0.001; NT-proBNP, 595.31±428.11 pg/mL vs 78.13±30.47 pg/L; p<0.001). Also, the levels of these parameters increased in IHF compared with NIHF (CHIT, 1139.28±495.22 ng/mL, 671.22±237.21 ng/mL, p=0.002; NT-proBNP, 792.87±461.26 pg/mL vs 348.36±202.61 pg/mL, p=0.001) and there was a strong correlation between NT-proBNP and CHIT (r=0.969, p<0.001). According to this study findings, plasma CHIT level increases in CHF and its increased levels are correlated with NT-proBNP which is used diagnosis and prognosis of HF.

Serum omentin-1 levels in hypertensive patients.

Hypertension (HT) is a disease that can cause death due to multiple target organ damage and eventually related vascular system damage. High blood pressure is known increased inflammatory activity and to cause endothelial dysfunction has been showed in HT patients. Omentin-1 is a glucoprotein of the adiponectin family released from visceral adipose tissue, endothelial cells, and visceral fat stromal-vascular cells. It has anti-inflammatory effect and circulating omentin-1 concentration correlates negatively with waist circumference, insulin resistance, and body-mass index. Serum omentin-1 is used as a biomarker of coronary artery disease, obesity, cancer, metabolic syndrome, inflammatorydisease, atherosclerosis, and diabetes mellitus. The aim of our study is to investigate circulating omentin-1 levels in HT patients compared to healthy normotensive controls. Patients diagnosed with new essential HT (n = 61) and healthy normotensive individuals (n = 60) were enrolled in this study. The HT group was separated into two subgroups. There were 30 patients in stage 2 HT group and 31 patients in stage 1 HT group. Omentin-1 levels were significantly lower both in stage 1 and 2 HT subgroup as compared with the normotensive controls (72.19 ± 54.33 ng/ml for stage 1 HT subgroup; 62.45 ± 47.01 ng/ml for stage 2 HT subgroup; and, 147.84 ± 58.55 ng/ml for healthy normotensive controls; overall P < 0.001). The present study demonstrated that serum Omentin-1 levels decreased in patients with HT compared with normotensive controls. These lower concentrations may be attributed to a combined outcome of endothelial dysfunction, renal injury, and inflammation in the setting of hypertension.