ABSTRACT
BACKGROUND: The measurement of carotid intima-media thickness (IMT) is useful for detection of early atherosclerotic disease. But, IMT are influenced by various factors including hypertension, age, diabetes, etc. We tried to estimate the correlation between carotid IMT and coronary artery disease in diabetics. METHODS: The B-mode ultrasonography and coronary angiography was perfomed in 50 as type 2 diabetes and 226 as nondiabetes. Carotid IMT was measured at around carotid bulb. Coronary artery lesions was evaluated based on quantitative coronary analysis (QCA) from coronary angiogram. RESULTS: Type 2 diabetic group (mean age 64.5+/-8.9 years old) included 21 patients without coronary artery disease and 29 patients with coronary artery disease. Non-diabetic group (mean age 61.0+/-10.1) included 138 patients without coronary artery disease and 88 patients with coronary artery disease. In type 2 diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was similar to that of subjects without coronary disease (mean Rt. IMT, 1.26+/-0.62 mm vs. 1.03+/-0.29 mm, respectively, p=0.11, mean Lt IMT, 1.30+/-0.70 mm vs. 1.17+/-0.43 mm, respectively, p=0.46). But in non-diabetic group, the mean value of measured max IMT of subjects with coronary artery disease was more than that of subjects without coronary disease, and it is statistically significant (mean Rt. IMT, 1.09+/-0.32 mm vs. 0.96+/-0.25 mm, respectively, p=0.01, mean Lt IMT, 1.19+/-0.47 mm vs. 1.01+/-0.32 mm, respectively, p=0.01). CONCLUSION: This study shows weak correlation power between carotid IMT and coronary artery diseases in diabetics, contrast to non-diabetes.
Subject(s)
Humans , Carotid Arteries , Carotid Intima-Media Thickness , Coronary Angiography , Coronary Artery Disease , Coronary Disease , Coronary Vessels , HypertensionABSTRACT
Cancer is a major risk factor for pulmonary thromboembolism. Occasionally, the thromboembolic event occurs before the diagnosis of cancer. We report a rare case of massive pulmonary thromboembolism with multiple myeloma diagnosed by transthoracic echocardiography.
Subject(s)
Diagnosis , Echocardiography , Multiple Myeloma , Pulmonary Embolism , Risk FactorsABSTRACT
BACKGROUND: Cardiovascular disease is the leading cause of morbidity and mortality in kidney transplantion recipients. Enhanced cardiac load by the persistence of functioning AVF in posttransplant period is associated with LV hypertrophy and may adversely influence cardiac outcome. METHODS: To investigate the impact of AVF on LV mass and function in kidney transplant recipients, 46 patients with functioning AVF were randomly assigned to surgical closure of AVF (fistular closing group, FC, n=23) or maintenance of fistula (fistular maintenance group, FM, n=23). Serum creatinine of all participants was stable(1.4+/-0.3). Mean age was 46+/-11. Mean posttransplant month was 78+/-53 (12-161). Echocardiography and determination of N-terminal pro-BNP, cTnT and CRP were done at 0, 1 and 6 months in group 1 (FC), and at 0 and 6 months in group 2 (FM). RESULTS: Baseline echocardiographic indices of systolic and diastolic LV function such as EF, E/A, E/E' and Tei index were not significantly different between groups. In patients whose AVF was surgically closed, LV mass (247.7+/-76.8 to 235.2+/-66.5, p=0.015) and LV mass index (144.0+/-10.1 to 137.1+/-8.6, p=0.02) significantly reduced at one month after closure, and no further significant change was observed at 6 months. In two groups no significant change in LV systolic and diastolic performance indices were observed. BNP, cTnT and CRP did not differ between groups in baseline value and did not change after closure. CONCLUSION: We conclude that the persistence of functioning AVF in kidney transplantation recipients is associated with LVH, and which can be reduced by closure of fistula. As LVH is one of major determinants of cardiovascular outcome in transplant patients as well as in general population, it would be prudent to close the fistula in patients with stable graft function.