RESUMO
BACKGROUND: Remote ischemic postconditioning (RIPC) decreases infarct size and prevents left ventricular (LV) remodeling in patients with myocardial infarction. However, there is no study that evaluates the effect of RIPC on LV mechanics assessed by speckle tracking echocardiography. Therefore, we aimed to test the effects of RIPC on LV deformation parameters such as strain, strain rate, rotation, and twist in healthy subjects. METHODS: The study group consisted of 22 healthy subjects. To test the effects of RIPC, 3 cycles of reperfusion followed by ischemia (each lasting 10 or 30 seconds) were applied immediately after 20 minutes of nondominant arm ischemia. Transthoracic echocardiography (TTE) was obtained at baseline and repeated 30 minutes after the completion of these cycles. In TTE images, apical 4-3-2 chamber longitudinal strain (LS)/strain rate, basal and apical circumferential strain/strain rate, and rotational parameters, such as basal rotation, apical rotation, and LV twist, were recorded. RESULTS: Apical 4-3-2 chamber LS and apical circumferential strain/strain rate measurements were comparable before and after RIPC, whereas basal circumferential strain was significantly decreased after RIPC (-23 ± 3.4 vs. -18.9 ± 6.9, P = 0.017). After RIPC, apical rotation was significantly increased (11.6 ± 3.7 vs. 16.7 ± 4.0, P < 0.001) and basal rotation was significantly decreased (-6.1 ± 2.1 vs. -4.7 ± 2.4, P = 0.03).Consequently, net LV twist was significantly increased (17.4 ± 4.5 vs. 21.7 ± 4.7). CONCLUSIONS: We proposed that RIPC affects the rotational mechanics of the heart rather than longitudinal mechanics. These results might give new insights into understanding the favorable effects of the post- conditioning.
Assuntos
Ecocardiografia/métodos , Ventrículos do Coração/diagnóstico por imagem , Pós-Condicionamento Isquêmico/métodos , Volume Sistólico , Função Ventricular Esquerda/fisiologia , Adulto , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
OBJECTIVES: To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion. SUBJECTS AND METHODS: Our study population consisted of 275 consecutive patients with chronic total occlusion. One hundred and thirty-eight patients with chronic total occlusion were included in the study. They were classified into 2 groups as follows: impaired CCC (group 1: Rentrop grades 0-1) and good CCC (group 2: Rentrop grades 2-3). The NLR was calculated from the complete blood count. RESULTS: The NLR values of the patients with impaired CCC (4.5 ± 0.7) were significantly higher than of those with good CCC (2.7 ± 0.6, p < 0.001). In the multivariate logistic regression test, NLR (OR 33.36, 95% CI 8.189-135.7, p < 0.001), high-sensitivity C-reactive protein (hs-CRP; OR 2.152, 95% CI 1.226-3.777, p = 0.008), estimated glomerular filtration rate (OR 1.167, 95% CI 1.049-1.298, p = 0.004) and systolic blood pressure (OR 1.068, 95% CI 1.009-1.1310, p = 0.025) were independent predictors of impaired CCC. The NLR value >3.55 yielded an area under the curve value of 0.957 (95% CI 0.921-0.992, p < 0.001) and demonstrated a sensitivity of 95% and a specificity of 90% for the prediction of CCC. A moderate correlation between NLR and hs-CRP was observed (r = 0.443; p < 0.001). CONCLUSION: Our findings reveal that NLR correlates with the impaired development of coronary collaterals.
Assuntos
Circulação Colateral/imunologia , Circulação Coronária/imunologia , Oclusão Coronária/sangue , Linfócitos/fisiologia , Neutrófilos/fisiologia , Adulto , Idoso , Biomarcadores/sangue , Pressão Sanguínea , Proteína C-Reativa/análise , Doença Crônica , Angiografia Coronária , Feminino , Taxa de Filtração Glomerular , Humanos , Inflamação/sangue , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença , TurquiaRESUMO
AIM: We aimed to evaluate and compare the left ventricular (LV) functions of pre- and postmenopausal women at similar ages with none of the known cardiovascular risk factors, by both conventional and advanced echocardiographic methods such as 2-D strain imaging via speckle tracking echocardiography. METHODS: The study population consisted of 40 healthy postmenopausal women aged 45-50 years and 40 healthy premenopausal women of the same age group. None of the subjects had any cardiovascular risk factors and were on hormone replacement therapy. LV strain and strain rate parameters were measured by 2-D strain imaging. The main outcome measure was effect of menopause on LV function. RESULTS: There were no significant differences between the pre- and postmenopausal groups with regard to conventional echocardiographic parameters. LV longitudinal strain and LV early diastolic strain rate values were significantly lower in the postmenopausal group when compared to the premenopausal group. Also, there was a significant negative correlation between LV global strain and serum follicle-stimulating hormone (r = -0.349, P = 0.002). CONCLUSION: Our study results demonstrated that healthy postmenopausal women had lower LV longitudinal strain values when compared to the healthy premenopausal women of the same age group by speckle tracking echocardiography.
Assuntos
Cardiomiopatias/diagnóstico por imagem , Pós-Menopausa/fisiologia , Pré-Menopausa/fisiologia , Função Ventricular Esquerda , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , UltrassonografiaRESUMO
BACKGROUND: Ventricular dyssynchrony is an co-determinant of progression and exacerbation of heart failure (HF). The co-existence of ventricular dyssynchrony with hypertension (HT) and HF were shown, however there is no data regarding the effect of circadian rhythm of blood pressure (BP) on ventricular synchrony. Therefore, we aimed to study the left ventricular synchrony in dipper and non-dipper normotensive and hypertensive participants. METHODS: Participants (n = 142) were categorized into four groups as "Normotensive-Dipper" (NT-D) (n = 40), "Normotensive-Non-dipper" (NT-ND) (n = 30), "Hypertensive-Dipper" (HT-D) (n = 38) and "Hypertensive-Non-dipper" (HT-ND) (n = 34). Left ventricular dyssynchrony was investigated by color-coded tissue Doppler imaging. RESULTS: Non-dippers had higher 24-h and night-time BP both in normotensives and hypertensives. The incidence of ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) was higher in the hypertensive group (47.2% vs 24.3%, p = 0.005). The frequency of ventricular dyssynchrony was higher in the HT-ND group than the HT-D group (58.8% vs 36.8%, p = 0.05); however, the frequency of ventricular dyssynchrony was similar among the normotensives (26.7% vs 22.5%, p = 0.45). Ts-SD-12 and Ts-12 were higher in NT-ND group than the NT-D group. CONCLUSIONS: Non-dipping BP pattern was associated with impaired left ventricular contraction synchrony in both normotensive and hypertensive participants, which may be related with short- and long-term effects of HT on myocardium.
Assuntos
Coração/fisiopatologia , Hipertensão/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Pressão Sanguínea/fisiologia , Ecocardiografia Doppler , Feminino , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Humanos , Hipertensão/diagnóstico por imagem , MasculinoRESUMO
BACKGROUND: Sickle cell anemia (SCA) is the most common inherited anemia. Although heart involvement in SCA is well-established, there is no data about changes of contraction synchrony in SCA. Therefore, we aimed to study the left ventricular contraction synchrony in SCA patients with narrow QRS and normal ejection fraction (EF). METHODS: Thirty-six patients with SCA and 37 age- and gender-matched control subjects were included in the study. Left ventricular dyssynchrony was investigated by color-coded tissue Doppler imaging. RESULTS: The SCA patients had lower hemoglobin (Hb) and higher ferritin, left ventricular end-diastolic diameter, left ventricular end-systolic diameter, left ventricular mass index (LVMI), and pulmonary artery pressure. Peak A velocity, Dt, and E/E' values were higher in the SCA group however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters including Ts-SD-12, Ts-12, Ts-SD-6, and Ts-6 were found to be higher in SCA group when compared with controls. In addition to that, the patients with ventricular dyssynchrony (a Ts-SD-12 > 34.4 msec) were higher in the SCA group than the control group (55.6% vs. 8.1%, P < 0.001). In the correlation analysis, systolic dyssynchrony parameters were found to be correlated with Hb, ferritin, LVMI, E/A, Dt, Em. CONCLUSION: Our results revealed that in SCA patients with normal EF and narrow QRS, left ventricular systolic dyssynchrony was an early manifestation of heart involvement and might be coexisted with or preceding diastolic dysfunction.
Assuntos
Anemia Falciforme/epidemiologia , Ecocardiografia Doppler de Pulso/métodos , Volume Sistólico/fisiologia , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Anemia Falciforme/diagnóstico , Anemia Falciforme/fisiopatologia , Estudos de Casos e Controles , Comorbidade , Ecocardiografia Doppler em Cores/métodos , Eletrocardiografia/métodos , Feminino , Humanos , Incidência , Masculino , Valor Preditivo dos Testes , Valores de Referência , Medição de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Disfunção Ventricular Esquerda/fisiopatologia , Adulto JovemRESUMO
OBJECTIVES: The aim of the present study was to assess the association between the level of pentraxin-3 (PTX-3) and the severity of metabolic syndrome (MS). SUBJECTS AND METHOD: One hundred and two patients with MS and 101 consecutive age- and sex-matched control subjects were included in the study. The MS patients were classified into three groups based on the number of MS criteria, i.e. group 1: patients with 3 MS criteria, group 2: patients with 4 MS criteria, and group 3: patients with 5 MS criteria. Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. RESULTS: Group 1 had higher PTX-3 levels compared to the control group (0.58 ± 0.11 ng/ml vs. 0.36 ± 0.15 ng/ml, p < 0.001). PTX-3 levels were higher in group 3 than in both group 1 (0.90 ± 0.06 ng/ml vs. 0.58 ± 0.11 ng/ml, p < 0.001) and group 2 (0.90 ± 0.06 ng/ml vs. 0.63 ± 0.12 ng/ml, p < 0.001). Group 3, however, had higher hs-CRP levels than both group 1 (1.89 ± 0.45 mg/dl vs. 1.40 ± 0.44 mg/dl, p = 0.007) and group 2 (1.89 ± 0.45 mg/dl vs. 1.47 ± 0.58 mg/dl, p = 0.01). The control group had lower hs-CRP levels than group 1 (0.81 ± 0.47 mg/dl vs. 1.40 ± 0.44 mg/dl, p < 0.001) and group 2 (0.81 ± 0.47 mg/dl vs. 1.47 ± 0.58 mg/dl, p < 0.001). Serum PTX-3 levels correlated with serum hs-CRP levels (r = 0.49, p < 0.001). CONCLUSIONS: PTX-3, a novel inflammatory marker, was found to be associated with the severity of MS.
Assuntos
Proteína C-Reativa/análise , Síndrome Metabólica/sangue , Componente Amiloide P Sérico/análise , Adulto , Biomarcadores , Índice de Massa Corporal , Pesos e Medidas Corporais , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Inflamação/sangue , Masculino , Síndrome Metabólica/epidemiologia , Pessoa de Meia-Idade , Gravidade do Paciente , Estudos Prospectivos , Distribuição AleatóriaRESUMO
OBJECTIVES: We aimed to investigate the anatomical and morphological characterization of coronary bifurcation lesions. STUDY DESIGN: The study population consisted of 542 stable patients who underwent coronary angiography. Bifurcation lesions were defined as a lesion >=50% diameter stenosis involving a main branch and/or contiguous side branch with a diameter of >=2.5 mm. Using these criteria, the presence and number of bifurcation lesions, bifurcation lesion location, lesion classification according to Medina classification and the angle of the bifurcation lesion were determined. RESULTS: According to the bifurcation definition 19.3% (n=105) of our patients had bifurcation lesions. In 77% of all bifurcation lesions, the bifurcation angle was <70°. About 37% of all lesions were concordant with the Medina 1.1.1 classification. Approximately 56% of bifurcation lesions were in the LAD region, 25.4% in the Cx region, and 12.5% in the RCA region. Medina 1.1.1 was the most frequently observed in the LAD and RCA regions, while it was least common in the Cx and LMCA regions. Diabetes was observed to be significantly higher in those with bifurcation lesions than in those without. CONCLUSION: Bifurcation lesions are frequently observed in coronary angiography practice. Angiographic characteristics and the relationship of these lesions with clinical conditions may be a crucial factor in choosing the appropriate interventional procedure.
Assuntos
Anomalias dos Vasos Coronários/patologia , Vasos Coronários/patologia , Angina Estável/complicações , Angina Estável/terapia , Angiografia Coronária , Ponte de Artéria Coronária , Anomalias dos Vasos Coronários/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Complicações do Diabetes/diagnóstico , Humanos , Hipertensão/complicações , Obesidade/complicações , Intervenção Coronária Percutânea , Insuficiência Renal Crônica/complicaçõesRESUMO
OBJECTIVES: Cardiac syndrome X (CSX) is a clinical entity that is defined as normal coronary arteries with angina pectoris and objective sins of ischemia. The correlation between CSX and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) is well established, however an association with pentraxin-3 (PTX-3) has not been examined. The aim of this study was to investigate the association between PTX-3 and CSX. STUDY DESIGN: A total of 122 patients (58 female, 64 male, mean age 49.6±5.8 years) with suspected of coronary artery disease (CAD) were included in the study. Those with evidence of ischemia (50 patients with positive treadmill tests, 32 patients with positive myocardial perfusion scintography) underwent coronary angiography (82 patients). Patients with a normal angiogram were considered the CSX group (n=41) and patients with coronary lesions were referred to as the CAD group (n=41). Patients without signs of ischemia served as the control group. Serum PTX-3 and hs-CRP levels were measured in all patients. RESULTS: The CSX group had significantly increased PTX-3 levels relative to the control group (0.46±0.16 vs. 0.23±0.09 ng/ml, p<0.001). However there were no differences in levels of PTX-3 and hs-CRP between the CSX and the CAD groups (PTX-3: 0.46±0.16 vs. 0.51±0.13 ng/ml, p=0.21; hs-CRP: 1.04±0.45 vs. 1.16±0.64 mg/dl, p=0.62). The control group had significantly lower hs-CRP levels (0.73±0.51 mg/dl) when compared to the both CSX and CAD groups (p=0.03 and p=0.002, respectively). Serum PTX-3 levels were weakly correlated with hs-CRP levels (r=0.30, p=0.001). CONCLUSION: PTX-3, a novel inflammatory marker, is elevated in patients with CSX, similar to the well known inflammatory marker hs-CRP, and may be a promising biomarker reflecting inflammatory status in these patients.
Assuntos
Biomarcadores/sangue , Proteína C-Reativa/metabolismo , Doença da Artéria Coronariana/sangue , Angina Microvascular/sangue , Componente Amiloide P Sérico/metabolismo , Angiografia Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Masculino , Angina Microvascular/complicações , Pessoa de Meia-IdadeRESUMO
BACKGROUND AIM OF THE STUDY: In this study, we hypothesized that subclinical impairment of left ventricular (LV) mechanical function in bicuspid aortic valve (BAV) patients is independent of valvular hemodynamics represented by valvuloarterial impedance and aortic elastic characteristics. Therefore, we aimed to test left ventricular mechanics in cases of isolated non-stenotic BAV with non-dilated aorta. METHODS: Thirty-three patients with isolated BAV exhibiting non-dilated aorta, and 25 age-and gender-matched healthy subjects were included in the study. Patients with aortic valve velocity > 1.5 m/s and mild-to-moderate aortic regurgitation or ascending aorta diameter > 3.5 cm were excluded from the study. Aortic elasticity parameters and valvulo-arterial impedance were calculated. Strain measurements were reported as the peak longitudinal strain (LS) for four chamber (4C), long axis (LAX) and two chamber (2C) views. Strain rate (Sr) measurements were reported as the peak systolic strain rate (Sr-sm), early diastolic strain rate (Sr-em) and late diastolic strain rate (Sr-am) for 4C, LAX and 2C views. RESULTS: Systolic and diastolic diameters of the ascending aorta, aortic elastic properties (aortic strain, aortic distensibility, aortic stiffness and aortic elastic modulus), and valvulo-arterial impedances were found to be comparable between the BAV and control groups. BAV group was observed to have statistically significantly lower 4C (18.9 +/- 1.7 vs. 17.8 +/- 1.5, p = 0.02), LAX (19.7 +/- 1.7 vs. 17.7 +/- 1.3, p = 0.001) and 2C (20.1 +/- 1.8 vs. 17.7 +/- 1.2, p < 0.001) peak longitudinal strain values compared with the control group. Moreover, LV-GS values were found to be significantly lower in the BAV group than in the control group (19.6 +/- 1.1 vs. 17.7 +/- 0.9, p < 0.001). However, there was no statistically significant difference between the groups in terms of Sr-sm, Sr-em ve Sr-am values in the 4C, LAX, and 2C views. CONCLUSION: BAV might affect LV systolic functions, assessed by 2D strain imaging, in a fashion independent from the valvular dynamics and aortic elasticity. This might show that BAV is not only a valvular disease, but possibly a ventricular disease as well.
Assuntos
Doenças das Valvas Cardíacas/fisiopatologia , Função Ventricular Esquerda , Adulto , Aorta/fisiopatologia , Valva Aórtica/anormalidades , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/fisiopatologia , Doença da Válvula Aórtica Bicúspide , Estudos de Casos e Controles , Ecocardiografia , Feminino , Doenças das Valvas Cardíacas/diagnóstico por imagem , Humanos , Masculino , Adulto JovemRESUMO
PURPOSE: The most important complication encountered in patients with b-thalassaemia major is degenerative fibrosis developing as a result of iron accumulation in myocardial tissue. Dysfunction pursues this accumulation. Recently, presence of fragmented QRS (fQRS) in ECG has been regarded as a predictor of myocardial fibrosis. We aimed in our study to investigate the frequency with which fQRS develops in patients with b-thalassaemia major and to disclose the correlation between fQRS frequency and Doppler-derived indices. METHODS: The patients with b-thalassaemia major (n=66; mean age: 23±6 years) and healthy controls (n=30; mean age: 23±4 years) were included. fQRS pattern was described as presence of RSR' manifested as existence of additional R wave and notching in either R or S waves in ECG recordings. 2D, M-mode, conventional Doppler, tissue Doppler echocardiography parameters were assessed. Mean serum ferritin levels over past 5 years were also calculated. RESULTS: When compared to those in control group, fQRS was more frequent in b-thalassaemia major group, indicating statistical significance (p = 0.001). While E/Em and ferritin level exhibited statistically significant increase in thalassaemia patients with fQRS (p < 0.05), the mean Em and Sm values were found to be significantly low (p < 0.05). CONCLUSIONS: fQRS was frequently observed in the patients with b-thalassaemia major, which was of statistical significance. Tissue Doppler-derived diastolic and systolic indices in thalassaemia cases with fQRS showed statistically significant impairment compared to those without fQRS. In conclusion, fQRS may represent a novel noninvasive marker for cardiac involvement in patients with b-thalassaemia major.
Assuntos
Miocárdio/patologia , Talassemia beta/complicações , Estudos de Casos e Controles , Ecocardiografia Doppler , Eletrocardiografia , Feminino , Fibrose , Coração/fisiopatologia , Humanos , Masculino , Adulto Jovem , Talassemia beta/patologia , Talassemia beta/fisiopatologiaRESUMO
OBJECTIVES: In this study, we aimed to investigate the association between the presence and severity of metabolic syndrome (MetS) with intra- and inter-atrial electromechanical delay (AEMD) and P-wave dispersion (PWD). STUDY DESIGN: A total of 144 patients (72 MetS patients and 72 age- and sex-matched control subjects) were included in the study. Patients with MetS were classified into three groups based on the number of MetS criteria as follows: Group 1 (patients with three MetS criteria), Group 2 (patients with four MetS criteria) and Group 3 (patients with five MetS criteria). Intra- and inter-AEMD were measured from parameters of tissue Doppler imaging. PWD was calculated from the 12-lead electrocardiogram. RESULTS: Both inter-AEMD (22.9±15 vs. 11.5±14, p<0.001) and intra-AEMD (23.6±12 vs. 8.3±19, p<0.001) were found to be significantly longer in patients with MetS than the control group. Similarly, PWD (49±25 vs. 36±24, p=0.001) were found to be significantly longer in the MetS patients than the controls. However, both inter-AEMD and intra-AEMD and P wave measurements were not found to be associated with the severity of MetS. While inter and intra-AEMD were better correlated with LV mass index and LA volume index, PWD correlated better with mitral inflow Doppler parameters. According to multivariate analyses, inter-AEMD, HDL-C, and systolic and diastolic blood pressure were found to be independent predictors, whereas E/A and LDL-C had borderline significance. For the intra-AEMD, systolic and diastolic blood pressure, body mass index and E/A were found to be independent predictors. CONCLUSION: In patients with MetS, inter- and intra-AEMD, and P dispersion were found to be lengthened when compared with the controls. However, these parameters were not associated with the severity of MetS.
Assuntos
Arritmias Cardíacas/complicações , Átrios do Coração/fisiopatologia , Síndrome Metabólica/complicações , Arritmias Cardíacas/diagnóstico por imagem , Arritmias Cardíacas/fisiopatologia , Estudos de Casos e Controles , Ecocardiografia Doppler , Eletrocardiografia , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Índice de Gravidade de DoençaRESUMO
Using tissue Doppler echocardiography, we evaluated left ventricular long-axis function in 65 mitral stenosis patients, 30 of whom were in sinus rhythm and 35 of whom were in chronic atrial fibrillation. There were 35 healthy control subjects. Conventional echocardiography was used to evaluate left ventricular diameters, left atrial diameters, left ventricular ejection fractions, and mitral valve areas. Tissue Doppler echocardiography was used to evaluate isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), ejection time (ET), and peak systolic myocardial velocities. The myocardial performance index was calculated with the formula (ICT+IRT)/ET. Mean and segmental left ventricular IRT and ICT values were significantly longer in mitral stenosis patients than in control subjects, but were similar in the sinus rhythm and atrial fibrillation subgroups. Ejection times were significantly lower in the mitral stenosis with atrial fibrillation group than in the mitral stenosis with sinus rhythm and control groups (P<0.001), but were similar when the sinus rhythm group was compared with the control group (P<0.05). Myocardial performance index values were higher in mitral stenosis patients, significantly so in those with atrial fibrillation when compared with the control group (P<0.001). Systolic velocity values were significantly lower in mitral stenosis patients, more markedly so in those with atrial fibrillation than in the control group (P<0.001). We conclude that patients with pure rheumatic mitral stenosis, most particularly when in combination with atrial fibrillation, have significantly impaired left ventricular long-axis function as evaluated by tissue Doppler echocardiography, although global systolic function may be normal.
Assuntos
Fibrilação Atrial/fisiopatologia , Estenose da Valva Mitral/fisiopatologia , Cardiopatia Reumática/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto , Fibrilação Atrial/etiologia , Doença Crônica , Ecocardiografia Doppler , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/complicações , Volume Sistólico , Disfunção Ventricular Esquerda/etiologiaRESUMO
Aim Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure(BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated. Methods A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper(HT-ND). RDW and hs-CRP levels were measured. Results Hypertensive patients had higher RDW and hs-CRP levels(14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52 vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D) Conclusion RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with increased inflammatory state.
Assuntos
Hipertensão/sangue , Adulto , Monitorização Ambulatorial da Pressão Arterial , Tamanho Celular , Índices de Eritrócitos , Feminino , Humanos , Hipertensão/patologia , Masculino , Estudos Prospectivos , Distribuição AleatóriaRESUMO
BACKGROUND: Psoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. OBJECTIVES: This study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. METHODS: The study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. RESULTS: Patients with psoriasis had significantly lower mean ± standard deviation (SD) 4C (17.1 ± 1.7 vs. 19.2 ± 2.3; P < 0.01), LAX (16.6 ± 1.5 vs. 19.5 ± 2.3; P < 0.01), and 2C (16.5 ± 1.5 vs. 19.4 ± 2.2; P < 0.01) peak longitudinal strain values compared with the control group. Moreover, mean ± SD LV global strain (16.6 ± 1.5 vs. 19.9 ± 2.1; P < 0.01) and strain rate (1.39 ± 0.30 vs. 1.51 ± 0.20; P < 0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (ß = 0.29, P = 0.04), duration of disease (ß = 0.35, P < 0.01), ejection fraction (EF) (ß = 0.38, P =0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E' ratio) (ß = 0.34, P =0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (ß = 0.36, P < 0.01), EF (ß = 0.32, P = 0.01), and E/E' ratio (ß = 0.35, P < 0.01). CONCLUSIONS: Using 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.
Assuntos
Ecocardiografia/métodos , Psoríase/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagem , Adulto , Velocidade do Fluxo Sanguíneo , Proteína C-Reativa/metabolismo , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psoríase/sangue , Volume Sistólico , Fatores de Tempo , Ultrassonografia Doppler em Cores , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/fisiopatologiaRESUMO
BACKGROUND: Familial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. METHODS: This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR', evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. RESULTS: There was no significant difference between groups regarding age (29 ± 12 vs 29 ± 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p < 0.01). E/Em ratio showed a statistically significant increase in the FMF group with fQRS (p < 0.0001), while the mean Em value was markedly lower (p < 0.0001). CONCLUSIONS: FMF patients displayed a statistically significant increase in frequency of fQRS. Doppler-derived diastolic index was statistically significantly impaired in FMF patients with fQRS as compared with the patients without fQRS. In conclusion, fQRS might be a new noninvasive marker for cardiac involvement in FMF patients.
Assuntos
Técnicas de Imagem por Elasticidade/métodos , Eletrocardiografia/métodos , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/diagnóstico , Miocardite/diagnóstico , Miocardite/etiologia , Adulto , Diagnóstico por Computador/métodos , Diagnóstico Diferencial , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Estatística como Assunto , Volume SistólicoRESUMO
BACKGROUND: We aimed to investigate the association between electrocardiographic (ECG) grade III ischemia and angiographic thrombus burden in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). METHODS: The study population consisted of 307 patients with STEMI. Baseline ECGs of the patients were analyzed for grade III ischemia; angiographic thrombus burden was assessed by thrombolysis in myocardial infarction thrombus classification. RESULTS: A total of 108 (35%) patients had low thrombus burden whereas 199 (65%) patients had high thrombus burden. Grade III ischemia was more prevalent in patients with high thrombus burden (25.1% vs 11.1%, P = .004). Only grade III ischemia (odds ratio: 2.59, 95% confidence interval 1.24-5.39, P = .011) and history of coronary artery disease (CAD) were found to be the independent predictors of high thrombus burden. CONCLUSION: Grade III ischemia on ECG and previous history of CAD were independent predictors of coronary thrombus burden in patients with STEMI who underwent pPCI.
Assuntos
Trombose Coronária/etiologia , Infarto do Miocárdio/sangue , Isquemia Miocárdica/sangue , Angiografia , Trombose Coronária/sangue , Trombose Coronária/patologia , Eletrocardiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/patologia , Infarto do Miocárdio/cirurgia , Isquemia Miocárdica/patologia , Isquemia Miocárdica/cirurgia , Intervenção Coronária Percutânea , Estudos Retrospectivos , Resultado do TratamentoRESUMO
BACKGROUND: Red cell distribution width (RDW) has been shown to be helpful in predicting adverse long-term events in patients with cardiovascular diseases. However, to date, no study has been conducted on the relationship between RDW and thromboembolism risk in atrial fibrillation (AF). Therefore, we aimed to investigate the relationship between RDW and CHA2DS2-VASc score used for the evaluation of thromboembolism risk in patients with AF. METHODS: The study population consisted of 320 patients with AF. We calculated CHA2DS2-VASc risk score for each patient and baseline hemoglobin, white blood cell, RDW, mean platelet volume, platelet counts, estimated glomerular filtration rate (eGFR), left ventricular ejection fraction (LVEF), and left atrial volume index (LAVi) were measured. RESULTS: High CHA2DS2-VASc score group had higher RDW, lower LVEF, higher LAVi, and lower eGFR values when compared to the low CHA2DS2-VASc score group. The multivariate logistic regression analysis performed to predict high CHA2DS2-VASc scores revealed that RDW eGFR, LVEF, and LAVi were independent predictors. The area under the receiver-operating characteristic curve of RDW was 0.65 (0.59-0.71, P < .001) to predict high CHA2DS2-VASc score. CONCLUSION: Our study results indicate that RDW values are significantly correlated with CHA2DS2-VASc score in nonanemic patients with AF, while also being independent predictor of high CHA2DS2-VASc score.
Assuntos
Fibrilação Atrial , Índices de Eritrócitos , Tromboembolia , Idoso , Fibrilação Atrial/sangue , Fibrilação Atrial/complicações , Fibrilação Atrial/epidemiologia , Fibrilação Atrial/fisiopatologia , Taxa de Filtração Glomerular , Humanos , Masculino , Volume Plaquetário Médio , Pessoa de Meia-Idade , Contagem de Plaquetas , Estudos Retrospectivos , Volume Sistólico , Tromboembolia/sangue , Tromboembolia/epidemiologia , Tromboembolia/etiologia , Tromboembolia/fisiopatologiaRESUMO
PURPOSE: The aim of this study is to investigate the relationship between the criteria comprising metabolic syndrome (MS) and neutrophil-lymphocyte ratio (NLR), a simple and reliable indicator of inflammation. METHOD: Seventy patients with MS and 71 age- and sex-matched control participants were included. Patients were classified into 3 groups based on the number of MS criteria: group 1 (with 3 criteria), group 2 (with 4 criteria), and group 3 (with 5 criteria). The NLR was calculated from complete blood count. RESULTS: Patients with MS had significantly higher NLR compared to the control group. Moreover, the group 3 patients had higher NLR than those in groups 2 and 1 (P = .008 and P = .078, respectively), whereas there was no difference between the patients meeting 3 and 4 MS criteria (P = .320). Besides, NLR increased as the severity of MS increased (r = .586, P < .001). The cutoff level for NLR with optimal sensitivity and specificity was calculated as 1.84. Serum glucose and high-sensitive C-reactive protein level were found to be independent predictors of an NLR value greater than 1.84. CONCLUSION: The present study indicated a significant correlation between the criteria of MS and inflammation on the basis of NLR. Furthermore, there an increase in NLR as the severity of MS increases.
Assuntos
Linfócitos/patologia , Síndrome Metabólica/sangue , Neutrófilos/patologia , Proteína C-Reativa/imunologia , Estudos de Casos e Controles , Feminino , Humanos , Inflamação/sangue , Linfócitos/imunologia , Masculino , Síndrome Metabólica/classificação , Pessoa de Meia-Idade , Neutrófilos/imunologiaRESUMO
BACKGROUND: Psoriasis is an inflammatory disorder, which has been reported to be associated with cardiovascular (CV) risks. Although increased CV risks in psoriasis are well established, there are no data about changes of contraction synchrony in psoriasis. Therefore, we aimed to study the left ventricular (LV) contraction synchrony in patients with psoriasis with narrow QRS and normal ejection fraction. METHODS: Fifty patients with psoriasis and 50 age- and sex-matched control subjects were included in the study. LV dyssynchrony was investigated by color-coded tissue Doppler imaging. RESULTS: In the psoriasis group, the mean high-sensitive C-reactive protein values were significantly higher compared with the controls. Peak A velocity, deceleration time, isovolumetric relaxation time, and E/E' values were higher in the psoriasis group; however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters [including standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments, standard deviation of Ts of the six basal LV segments, and maximal difference in Ts between any two of the six basal LV segments] were found to be higher in the psoriasis group. The patients with ventricular dyssynchrony (a Ts-SD-12 >34.4 ms) were higher in the psoriasis group than the control group (34% vs. 6%, P < 0.01). CONCLUSION: In patients with psoriasis with normal ejection fractions and narrow QRS, LV systolic dyssynchrony is an early manifestation of heart involvement and may coexist with diastolic dysfunction.
Assuntos
Ventrículos do Coração/fisiopatologia , Psoríase/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Psoríase/complicações , Disfunção Ventricular Esquerda/etiologiaRESUMO
OBJECTIVE: We aimed to investigate left atrium (LA) function by speckle tracking echocardiography in patients with metabolic syndrome (MetSyn) and to show a possible relationship between the severity of MetSyn and LA function and to determine the predictors of low strain in MetSyn patients. METHODS: Our study design was observational and cross-sectional design consisted of 80 MetSyn patients without overt diabetes and 50 controls. The patients were classified into three groups based on the number of MetSyn criteria. The peak LA strain at the end of the ventricular systole (LAs-strain) as well as the LA strain with LA contraction (LAa-strain) was obtained. Correlation analysis performed to assess the association of LA strain parameters with the severity of MetSyn and logistic regression analysis performed to assess the relationship of low LA strain with MetSyn. RESULTS: Both LAs (37.5±8.7 vs. 26.0±10.2, p<0.001) and LAa (19.9±6.3 vs. 13.0±6.4, p<0.001) strain measurements were found to be significantly decreased in patients with MetSyn when compared to the control group. Moreover, both LAs and LAa were found to be significantly decreased with the increasing severity of the MetSyn. A multiple logistic regression analysis demonstrated that the presence of MetSyn [OR:0.26 (95% CI 0.06-0.89), p=0.032] and left ventricular ejection fraction [OR:1.14 (95% CI 1.03-1.27), p=0.021] were independent predictors of LAs strain. CONCLUSION: MetSyn is associated with reduced LAs strain and LAa strain representing LA reservoir and pump function, respectively. Furthermore, LA mechanical function decreases even more with the increasing severity of the MetSyn.