Brucellosis impairs endothelial functions in chronic symptomatic patients without overt cardiac involvement.

OBJECTIVE: Brucellosis is an important infectious disease, especially in developing countries, and may involve any organ, including the cardiovascular system. This study aimed to assess cardiac and endothelial functions in brucellosis patients. METHODS: Seventy-three patients with brucellosis and seventy-five healthy volunteers from Turkey were enrolled between 2011 and 2013 in this cross-sectional study. Diagnosis was established by the Rose-Bengal test, positive Brucella standart tube agglutination test, and Coombs STA and/or isolation Brucella species from blood. Cases were divided into three groups: Group I; acute brucellosis, Group II; subacute brucellosis, and Group III; chronic brucellosis. Healthy individuals comprised Group IV. All patients underwent transthoracic echocardiography and brachial artery flow-mediated dilatation (FMD) test. RESULTS: Groups I to IV comprised 35, 18, and 20 patients, and 75 controls respectively. The most frequent symptoms were arthralgia (82%), fever (92%), and fatigue (97%). Echocardiography revealed no difference among the 4 groups regarding left ventricular systolic and diastolic functions and valvular functions. Brachial artery diameter after hyperemia was significantly different among the groups (p=0.002). Post hoc test showed Group III to have significantly lower brachial artery diameter after hyperemia compared to other groups (p=0.02, p=0.004 and p=0.001, respectively). FMD was also significantly lower in Group III compared to Groups I, II and IV (p<0.001 for each). CONCLUSION: Brucellosis impairs endothelial functions in chronic symptomatic patients without overt cardiac involvement.

Effects of Long-term Use of Proton Pump Inhibitors on Systemic Arterial Stiffness and Pulse Wave Velocity.

BACKGROUND AND AIM: Proton pump inhibitors (PPIs) are among the most widely prescribed agents. Although PPIs are widely regarded as harmlesss, long-term use of PPIs (LTUPPI) can have the potential to increase the risk of developing cardiovascular (CV) disease (CVD). Pulse wave velocity (PWV) is a good indicator of arterial stiffness. Several studies show a relationship between LTUPPI and CVD. However, the association between LTUPPI and PWV or arterial stiffness has not been reported. PATIENTS AND METHODS: Patients (n=64) with LTUPPI and controls (n=91) were included. PWV, glucose, creatinine, total cholesterol, triglyceride, low-density lipoprotein cholesterol, cholesterol, highdensity lipoprotein cholesterol, and magnesium levels were measured. RESULTS: In the LTUPPI group, PWV was greater than in controls (9.08±2.04 vs. 7.77±1.52 m/s, respectively, p=0.01); 34.4% of patients and 8.8% of controls had PWV levels >10 m/s (p=0.000). Multiple logistic regression analysis showed age (p<0.001) and LTUPPI (p=0.024) as predictors of elevated PWV. CONCLUSION: PWV values are increased in patients with LTUPPI compared to controls independently of conventional CV risk factors. Measurement of PWV and other arterial stiffness parameters in cases with LTUPPI may be useful to predict possible CVD. Studies involving greater numbers are needed to confirm these findings.