Plasma hyaluronidase activity as an indicator of atherosclerosis in patients with coronary artery disease.

BACKGROUND AND OBJECTIVE: Recent information has highlightened the impact of HA metabolism alterations in vascular permeability through its actions on endothelial glycocalyx and the importance of HA-cell interactions in cell behavior of arterial endothelial and smooth muscle cells. Therefore hyaluronan is thought to involve in pathophysiology of atherosclerosis. The aim of this study is to investigate the association of plasma hyaluronidase activity with atherosclerosis in non-diabetic patients with stable coronary artery disease. METHODS: In the present study we used plasma hyaluronidase measurement as an indicator of hyaluronan metabolism and activity. A total of 162 subjects undergoing to coronary angiography were divided into two groups according to presence or absence of coronary artery disease, and their serum hyaluronidase activity were measured. RESULTS: Serum hyaluronidase activities were 3797+/-670.62 mU/L and 2838+/-417.67 mU/L for patients with CAD (n:109) and control patients without CAD (n:53), respectively. Serum hyaluronidase activity in patients with coronary artery disease (CAD) were significantly higher than control subjects without CAD (p<0.001). CONCLUSION: In the present study hyaluronidase activity was found to be associated with coronary artery disease reflecting the role of hyaluronan in atherosclerosis. We believe that the demonstration of relationship between serum hyaluronidase activity and atherosclerosis represents a remarkable finding highlighting the potential role of hyaluronan in pathophysiology of atherosclerosis (Tab. 2, Fig. 3, Ref. 28). Full Text (Free, PDF) www.bmj.sk.

Serum chitotriosidase activity in patients with coronary artery disease.

BACKGROUND: Atherosclerosis is considered to be an inflammatory disease in which the initial process is augmented infiltration of monocytes into the vessel wall and their subsequent differentiation from macrophages into lipid-laden foam cells. Chitotriosidase is one of the most quantitative proteins secreted by activated macrophages, so the aim of this study was to investigate the association of the level of serum chitotriosidase activity with atherosclerotic coronary artery disease (CAD). METHODS AND RESULTS: A total of 200 subjects undergoing coronary angiography were divided into 4 subgroups according to the number of diseased vessels and their serum chitotriosidase activity levels were measured. Serum chitotriosidase activity in patients with CAD was significantly higher than in normal control subjects (p<0.001). Serum chitotriosidase activity was also significantly associated with the extent of CAD as defined by the number of stenosed vessels (p<0.001). CONCLUSION: Serum chitotriosidase activity can be considered a strong inflammatory marker of CAD. Moreover, plasma chitotriosidase activity may be also regarded as a quantitative indicator of disease extent, as well as being a marker of disease presence.

Post-exercise cardiac asystole in persons without underlying heart disease: management and follow-up of three cases.

We report post-exercise cardiac asystole after treadmill exercise test in three patients without structural heart disease. Post-exercise asystole in healthy individuals is a potentially life-threatening incident with a presumably underestimated prevalence. It may be responsible for some of the sudden deaths in young persons and athletes. Although the underlying mechanism of this event is not clear, it is hypothesised to be due to a vasovagally mediated cardioinhibition. While tilt table testing is a useful tool in evaluating these patients, its use in guiding therapy is far less clear. Owing to the reproducible nature of syncope documented by a positive tilt table test, permanent pacemakers (DDDR) were implanted in two of our patients. Both remained asymptomatic during a follow-up period of 12 and 26 months, respectively. The third patient, who refused further evaluation and management, also remained asymptomatic for 3 years with the advice to avoid strenuous exercise. At present, there is no general agreement on the management of patients with post-exercise cardiac asystole. The prognosis of this syndrome and management modalities are not well defined. Diagnosis of this syndrome and appropriate management may decrease the risk of sudden death and improve the quality of life in many patients.

Serum YKL-40 levels in patients with coronary artery disease.

Atherosclerosis is considered to be an inflammatory disease in which the initial process is the augmented infiltration of monocytes into the vessel wall and their subsequent differentiation from macrophages into lipid-laden foam cells. Human cartilage glycoprotein-39 (YKL-40) is a new inflammatory marker found to be secreted by lipid-laden macrophages inside human atherosclerotic vessel wall. The aim of this study was to investigate the association of serum YKL-40 levels with the presence and extent of coronary artery disease (CAD) assessed by coronary angiography. We also studied the relation of high-sensitivity C-reactive protein with the presence and angiographic severity of CAD. A total of 200 participants undergoing to coronary angiography was divided into four subgroups: control patients without CAD (n=53), and those with one-vessel disease (n=52), two-vessel disease (n=47), or three-vessel disease (n=48). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Both serum YKL-40 levels and high-sensitivity C-reactive protein concentrations in patients with CAD were significantly higher than in control participants (P<0.001). We also found a significant association between the levels of YKL-40 and the extent of CAD defined by the number of stenosed vessels (P<0.001). The relationship between the serum YKL-40 level and atherosclerosis may represent a new opportunity for the possible utility of serum YKL-40 as an inflammatory marker for coronary artery disease. Moreover, our findings revealed that plasma YKL-40 measurement might also be regarded as a quantitative indicator of disease extent besides being a marker of disease presence.