ABSTRACT
SUMMARY OBJECTIVE: In the current literature, there are few studies investigating the relationship between premature coronary atherosclerosis and nonalcoholic fatty liver disease. We aimed to evaluate the relationship between nonalcoholic fatty liver disease and premature coronary atherosclerosis. METHODS: In this cross-sectional study, female patients aged <55 years and male patients aged <50 years were enrolled. Both male and female patients underwent coronary angiography and abdomen ultrasonography between 2014 and 2019. A stepwise binary logistic regression analysis was carried out to evaluate the independent variables related to premature coronary atherosclerosis and nonalcoholic fatty liver disease. A p-value<0.05 was considered statistically significant. RESULTS: nonalcoholic fatty liver disease was present in 44% of patients (n=377). Notably, 62% of the patients were female and the mean age was 44.5 (39-49) years. In a multivariate analysis, nonalcoholic fatty liver disease was shown to be an independent risk factor of premature coronary atherosclerosis (OR 1.438; 95%CI, 1.050-1.969; p=0.024). CONCLUSIONS: The presence of nonalcoholic fatty liver disease is an important independent risk factor for the development of premature coronary atherosclerosis.
ABSTRACT
SUMMARY OBJECTIVE: Prealbumin has been a reliable marker to predict protein energy malnutrition and hypercatabolic state. In this analysis, we particularly aimed to investigate the potential association between serum prealbumin levels and right ventricular dysfunction in patients receiving programmed hemodialysis. METHODS: A total of 57 subjects were included in the analysis. The subjects were then categorized into two groups: right ventricular dysfunction (n=18) and non-right ventricular dysfunction (n=39) groups. In all patients, detailed transthoracic echocardiography (following hemodialysis) were performed along with the evaluation of complete blood count, routine biochemistry parameters, and, in particular, serum prealbumin levels. RESULTS: Mortality rate at 3 years was found to be significantly higher in the right ventricular dysfunction group (p=0.042). Serum prealbumin levels were also significantly lower in the right ventricular dysfunction group compared with the non-right ventricular dysfunction group (23.83±8.50 mg/dL versus 31.38±6.81 mg/dL, p=0.001). In the receiver operating characteristics curve analysis, a prealbumin cutoff value of <28.5 mg/dL was found to predict right ventricular dysfunction, with a sensitivity of 67% and a specificity of 62% (area under the curve: 0.744). In the correlation analysis, a moderate yet significant positive correlation was demonstrated between serum prealbumin and tricuspid annular plane systolic excursion (r=0.365, p=0.005). CONCLUSION: This study suggests that low serum prealbumin might serve as a potential predictor of right ventricular dysfunction (and its clinical consequences) in patients receiving programmed hemodialysis.
ABSTRACT
Abstract Background: Implantable cardioverter-defibrillator (ICD) therapy is well known to reduce mortality in selected patients with heart failure (HF). Objective: To investigate whether monitored episodes of non-sustained ventricular tachycardia (NSVT) might predict future HF hospitalizations in ICD recipients with HF. Methods: We examined 104 ICD recipients (mean age: 60 ± 10.1 years, 80.8 % male) with HF who were referred to our outpatient clinic for device follow-up. After device interrogation, patients were divided into NSVT positive and negative groups. The primary endpoint was the rate of hospitalization within the next 6 months after initial ICD evaluation. Results: Device evaluation demonstrated at least one episode of monitored NSVT in 50 out of 104 patients. As expected, no device therapy (shock or anti-tachycardia) was needed for such episodes. At 6 months, 24 patients were hospitalized due to acute decompensated HF. Hospitalization rate was significantly lower in the NSVT negative as compared with positive groups (38% versus 62%; adjusted hazard ratio [HR] 0.166 ; 95% CI 0.056 to 0.492; p = 0.01). Conclusions: Monitored NSVT bouts in ICD recordings may serve as a predictor of future HF hospitalizations in ICD recipients with HF suggesting optimization of therapeutic modalities in these patients along with a close supervision in the clinical setting.
Resumo Fundamentos: A terapia de cardioversor-desfibrilador implantável (CDI) é bem conhecida por reduzir a mortalidade em pacientes selecionados com insuficiência cardíaca (IC). Objetivo: Investigar se os episódios monitorados de taquicardia ventricular não sustentada (TVNS) poderiam prever futuras hospitalizações por IC em receptores de CDI com IC. Métodos: Examinamos 104 receptores da CDI (idade média: 60 ± 10,1 anos, 80,8% do sexo masculino) com IC que foram encaminhados para o nosso ambulatório para acompanhamento do dispositivo. Após a interrogação do dispositivo, os pacientes foram divididos em grupos positivo e negativo de TVNS. O desfecho primário foi a taxa de hospitalização nos próximos 6 meses após a avaliação inicial do CID. Resultados: A avaliação do dispositivo demonstrou pelo menos um episódio de TVNS monitorado em 50 dos 104 pacientes. Como esperado, não foi necessária terapia de dispositivo (choque ou anti-taquicardia) para tais episódios. Aos 6 meses, 24 pacientes foram hospitalizados por insuficiência cardíaca descompensada aguda. A taxa de hospitalização foi significativamente menor na TVNS negativa em relação ao grupo positivo (38% contra 62%; Razão de risco ajustada [RR] 0,166; IC 95%: 0,056 a 0,492; p = 0,01). Conclusões: Os episódios de TVNS monitorados em gravações de CDI podem servir como preditores de hospitalizações futuras por insuficiência cardíaca em receptores CDI com IC sugerindo otimização de modalidades terapêuticas nesses pacientes, além de uma estreita supervisão no cenário clínico.