The effect of radiotherapy on cardiac function.

BACKGROUND: Radiation-induced heart disease is a complication that may be encountered after radiotherapy (RT) of tumors in the vicinity of the heart. In this study, we aimed to evaluate the effect of RT on the heart, by comparing conventional and tissue Doppler echocardiography parameters obtained before and after RT. METHODS: Forty patients who had undergone RT for either lung or left breast cancer were included in the study. ECG, conventional, and tissue Doppler echocardiography were performed before and 4-6 weeks after RT. RESULTS: The mean value of the radiation dose applied to all regions of the heart was calculated as 13.1±2.2 Gy (maximum 41.7 Gy). The value for the left ventricle was 10.2±2.0 Gy (maximum 43.6 Gy). A decrease in early transmitral diastolic velocity (E), E/A ratio, EF, Em, and Em/Am, and an increase in E-wave deceleration time, isovolumic relaxation time, isovolumic contraction time, ejection time, and QTc were found after RT. CONCLUSION: We found detrimental effects of RT on systolic and diastolic cardiac functions and the electrical conduction system of the heart. Maximal prevention should be provided for the patients during RT.

The levels of tumor necrosis factor-alpha and interleukin-6 in patients with isolated coronary artery ectasia.

BACKGROUND/AIM: Coronary artery ectasia (CAE) is considered as a variant of atherosclerosis. Tumor necrosis factor-alpha (TNF-alpha) and interleukin-6 (IL-6) are among the sensitive markers of systemic inflammation. The aim of this study was to evaluate the plasma levels of the cytokines; TNF-alpha and IL-6 in CAE patients. METHODS: Plasma concentrations of TNF-alpha and IL-6 were measured in 36 patients with CAE (28 males, mean age: 58.2 +/- 12 years), and results were compared with age and sex-matched controls (n = 32) without coronary artery ectasia. TNF-alpha and IL-6 concentrations in blood were assessed by enzyme-linked immunosorbent assay (ELISA). RESULTS: Baseline characteristics of the two groups were similar. TNF-alpha and IL-6 levels were significantly higher in CAE group than controls (15.6 +/- 11.2 pg/mL versus 7.8 +/- 3.7 pg/mL, P < .001, and 17.2 +/- 12.6 versus 7.6 +/- 2.1 P < .0001, resp.). CONCLUSION: CAE patients showed increases in TNF-alpha and IL-6 levels compared to the controls. This study provides evidence for alterations in the proinflammatory cytokines which suggest the involvement of the immune system in the pathophysiology of CAE. Further placebo-controlled studies are needed to evaluate the clinical significance of this increase in TNF-alpha and IL-6 levels.

[The effect of statin treatment on inflammation in patients with metabolic syndrome]. / Metabolik sendromlu hastalarda statin tedavisinin inflamasyon üzerine etkisi.

OBJECTIVES: Inflammation plays an important role in the pathogenesis of metabolic syndrome (MS). We investigated the effect of fluvastatin treatment on inflammatory markers in patients with MS. STUDY DESIGN: The study included 47 patients (36 females; 11 males; mean age 55+/-8 years) with MS. The diagnosis of MS was based on the presence of at least three criteria of the NCEP ATP III guidelines. All the patients received 80 mg fluvastatin treatment for six weeks. Laboratory parameters were measured before and after treatment, and flow cytometric analysis of peripheral blood leukocytes was performed. The results were compared with those of 47 age- and sex-matched healthy controls (33 females, 14 males; mean age 52+/-8 years). RESULTS: Fluvastatin treatment resulted in significant decreases in levels of total cholesterol, LDL cholesterol, triglyceride (p<0.005), and C-reactive protein (p<0.05). Thirty-three patients (70.2%) had insulin resistance, which remained unchanged following treatment. Flow cytometric analysis after treatment showed significant decreases in total lymphocytes, and in surface antigens of CD16+56 and CD8+(CD28+) on leukocytes, CD11c on granulocytes, and a significant increase in the CD4/CD8 ratio (p<0.05). Compared to the control group, the mean baseline values of fluorescence density (FD) of CD14, CD11b, CD11c, and CD63 on monocytes, and CD11b and CD11c on granulocytes were significantly higher in patients with MS (p<0.05). Following fluvastatin treatment, there were significant decreases in the mean FD of CD3 on lymphocytes, and of CD11b and CD11c on both monocytes and granulocytes (p<0.05); of these, all FD values were similar to those in the control group (p>0.05). CONCLUSION: Our data demonstrate that inflammation may have a significant role in the pathogenesis of MS and that this effect can be controlled with statin treatment.