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2.
Braz J Cardiovasc Surg ; 34(5): 535-541, 2019 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-31719007

RESUMO

INTRODUCTION: Metabolic syndrome (MetS) is defined as an association between diabetes, hypertension, obesity and dyslipidemia and an increased risk of cardiovascular disease. Mitral annular calcification (MAC) is associated with several cardiovascular disorders, including coronary artery disease, atrial fibrillation (AF), heart failure, ischemic stroke and increased mortality. The CHA2DS2-VASc score is used to estimate thromboembolic risk in AF. However, the association among MAC, MetS and thromboembolic risk is unknown and was evaluated in the current study. METHODS: The study group consisted of 94 patients with MAC and 86 patients with MetS. Patients were divided into two groups: those with and those without MAC. RESULTS: Patients with MAC had a higher MetS rate (P<0.001). In patients with MAC, the CHA2DS2-VASc scores and the rate of cerebrovascular accident and AF were significantly higher compared to those without MAC (P<0.001, for both parameters). The results of the multivariate regression analysis showed that history of smoking, presence of MetS and high CHA2DS2-VASc scores were associated with the development of MAC. ROC curve analyses showed that CHA2DS2-VASc scores were significant predictors for MAC (C-statistic: 0.78; 95% CI: 0.706-0.855, P<0.001). Correlation analysis indicated that MAC was positively correlated with the presence of MetS and CHA2DS2-VASc score (P=0.001, r=0.264; P<0.001, r=0.490). CONCLUSION: We have shown that CHA2DS2-VASc score and presence of MetS rates were significantly higher in patients with MAC compared without MAC. Presence of MAC was correlated with CHA2DS2-VASc score, presence of MetS, AF and left atrial diameter and negatively correlated with left ventricular ejection fraction.


Assuntos
Calcinose/complicações , Doenças das Valvas Cardíacas/complicações , Síndrome Metabólica/complicações , Valva Mitral , Tromboembolia/etiologia , Idoso , Idoso de 80 Anos ou mais , Fibrilação Atrial/fisiopatologia , Calcinose/fisiopatologia , Ecocardiografia , Feminino , Doenças das Valvas Cardíacas/fisiopatologia , Humanos , Modelos Logísticos , Masculino , Síndrome Metabólica/fisiopatologia , Pessoa de Meia-Idade , Valva Mitral/fisiopatologia , Estudos Prospectivos , Medição de Risco/métodos , Fatores de Risco , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Volume Sistólico/fisiologia , Tromboembolia/fisiopatologia
3.
Clin Nucl Med ; 44(12): 991-992, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31689283

RESUMO

A 48-year-old woman with intermittent lower back pain for 9 months and known retroperitoneal neurofibroma underwent F-NaF PET/CT scan to assess possible bony lesions causing the pain. Incidentally, the images showed elevated NaF activity in the retroperitoneal neurofibroma. In addition, uterine leiomyoma with heterogeneous calcifications revealed increased NaF activity.


Assuntos
Calcinose/complicações , Radioisótopos de Flúor , Leiomioma/complicações , Neurofibroma/metabolismo , Neoplasias Retroperitoneais/metabolismo , Fluoreto de Sódio/metabolismo , Transporte Biológico , Humanos , Masculino , Pessoa de Meia-Idade , Neurofibroma/complicações , Neurofibroma/diagnóstico por imagem , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Neoplasias Retroperitoneais/complicações , Neoplasias Retroperitoneais/diagnóstico por imagem
4.
Medicine (Baltimore) ; 98(43): e17456, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651848

RESUMO

INTRODUCTION: Calcification of ligamentum flavum (CLF) is an important cause of spinal stenosis and spinal cord compression. CLF does not usually induce immediate quadriparesis. Here we describe a rare case of immediate quadriparesis due to a large calcified mass containing liquids in the ligamentum flavum, which was easily confused with gout crystals. PATIENT CONCERNS: A 74-year-old Asian male felt progressive bilateral arm and leg weakness. On the fourth day, acute quadriparesis occurred. DIAGNOSIS: Coronal and sagittal computerized tomography (CT) and magnetic resonance imaging (MRI) showed a large circular mass in the left posterior part of the cervical 3/4 spinal canal, protruding into the canal, and occupying one-half of the spinal canal. INTERVENTIONS: Emergency laminectomy was performed at C3/4 level. The huge cyst was excised and 1 ml of white viscous liquid flowed out. OUTCOMES: After operation, CT and MRI showed a full laminectomy of C3/4 and complete decompression of the cervical spinal cord. Hematoxylin-eosin (HE) staining showed that large amounts of calcium was deposited around cystic tissues. Five-year follow-up after laminectomy showed good recovery. CONCLUSION: This case of immediate quadriparesis, caused by a large calcified mass containing fluid, is very rare. It should be at the earliest stage of calcification. Laminectomy is an effective treatment. This calcification was deceptive and was easily confused with gout crystals. It can help to understand the exact pathophysiology of CLF.


Assuntos
Calcinose/complicações , Vértebras Cervicais/patologia , Ligamento Amarelo/patologia , Quadriplegia/diagnóstico , Doenças da Coluna Vertebral/complicações , Idoso , Calcinose/patologia , Calcinose/cirurgia , Diagnóstico Diferencial , Humanos , Laminectomia/métodos , Masculino , Quadriplegia/etiologia , Quadriplegia/cirurgia , Doenças da Coluna Vertebral/patologia , Doenças da Coluna Vertebral/cirurgia , Resultado do Tratamento
8.
Phys Med ; 64: 1-9, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31515007

RESUMO

BACKGROUND: Microcalcification clusters in mammograms can be considered as early signs of breast cancer. However, their detection is a very challenging task because of different factors: large variety of breast composition, highly textured breast anatomy, impalpable size of microcalcifications in some cases, as well as inherent low contrast of mammograms. Thus, the need to support the clinicians' work with an automatic tool. METHODS: In this work a three-phases approach for clustered microcalcification detection is presented. Specifically, it is made up of a pre-processing step, aimed at highlighting potentially interesting breast structures, followed by a single microcalcification detection step, based on Hough transform, that is able to grasp the innate characteristic shape of the structures of interest. Finally, a cluster identification step to group microcalcifications is carried out by means of a clustering algorithm able to codify expert domain rules. RESULTS: The detection performance of the proposed method has been evaluated on 364 mammograms of 182 patients obtaining a true positive ratio of 91.78% with 2.87 false positives per image. CONCLUSIONS: Experimental results demonstrated that the proposed method is able to detect microcalcification clusters in digital mammograms showing performance comparable to different methodologies exploited in the state-of-art approaches, with the advantage that it does not require any training phase and a large set of data. The performance of the proposed approach remains high even for more difficult clinical cases of mammograms of young women having high-density breast tissue thus resulting in a reduced contrast between microcalcifications and surrounding dense tissues.


Assuntos
Calcinose/diagnóstico por imagem , Diagnóstico por Computador/métodos , Mamografia/métodos , Adulto , Idoso , Algoritmos , Automação , Neoplasias da Mama/complicações , Neoplasias da Mama/diagnóstico por imagem , Calcinose/complicações , Reações Falso-Positivas , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Pessoa de Meia-Idade
9.
World Neurosurg ; 132: 63-66, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31479787

RESUMO

BACKGROUND: Symptomatic calcification of the ligamentum flavum (CLF) is common in the cervical spine but rare in the thoracic spine. Rapidly progressing CLF in the thoracic spine has not been reported in the literature. CASE DESCRIPTION: A 76-year-old Asian male experienced back pain after a fall and was diagnosed with osteoporotic vertebral fractures at T11 and L1. He was treated conservatively because of the lack of neurologic deficits. Nine months after the initial visit, he complained of progressive incomplete paraplegia. Magnetic resonance imaging and computed tomography of the thoracic spine showed CLF at T11-T12 severely compressing the spinal cord. This finding had not been seen on imaging studies at the initial visit. The patient underwent surgical resection of CLF and posterior instrumented spine fusion. Symptoms of muscle weakness recovered postoperatively. CONCLUSIONS: In this case, sequential imaging studies with a 9-month interval showed evidence of rapidly progressing thoracic CLF. The preceding osteoporotic vertebral fracture may have triggered the development of CLF.


Assuntos
Calcinose/cirurgia , Ligamento Amarelo/cirurgia , Vértebras Lombares/cirurgia , Fraturas por Osteoporose/terapia , Fraturas da Coluna Vertebral/terapia , Vértebras Torácicas/cirurgia , Idoso , Calcinose/complicações , Calcinose/diagnóstico por imagem , Tratamento Conservador , Progressão da Doença , Humanos , Ligamento Amarelo/diagnóstico por imagem , Masculino , Aparelhos Ortopédicos , Fraturas por Osteoporose/complicações , Paraplegia/etiologia , Fraturas da Coluna Vertebral/complicações , Fusão Vertebral , Vértebras Torácicas/lesões , Vertebroplastia
11.
Medicina (Kaunas) ; 55(8)2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31362438

RESUMO

Background and objectives: Mechanical stress is currently considered as the main factor promoting calcific aortic valve stenosis (AS) onset. It causes endothelial damage and dysfunction. The chronic inflammatory process causes oxidative stress. Oxidative stress-induced high-density lipoprotein cholesterol (HDL-C) dysfunction is an important component of the development of AS. The aim of the study was to evaluate the role of HDL-C in AS patients in three severity grades and in relation to the biomarkers of oxidative stress, thioredoxin reductase 1 (TrxR1) and myeloperoxidase (MPO). Materials and Methods: 18 patients with mild, 19 with moderate. and 15 with severe AS were included in the study, and 50 individuals were enrolled in the control group. Stenosis severity was determined by echocardiography. The TrxR1 and MPO were analyzed by ELISA, and HDL-C by commercially available tests. Data were analyzed using GraphPad Prism 8. Results: HDL-C in AS patients vs. control substantially decreases and this decline was observed in all three AS severity groups: mild (p = 0.018), moderate (p = 0.0002), and severe (p = 0.004). In both the control and the stenosis group, the HDL-C was higher in women than in men. In comparison to control, the HDL-C level was lower in the AS group, and more pronounced in women (p = 0.0001) than in men (p = 0.049). A higher TrxR1 level was observed in patients with mild (p = 0.0001) and severe AS (p = 0.047). However, a clear correlation between TrxR1 and HDL-C was not obtained. Analysis of MPO showed differences in all severity grades vs. control (p = 0.024 mild stenosis; p = 0.002 moderate stenosis; p = 0.0015 severe stenosis). A negative correlation (p = 0.047; rp = -0.28) was found between MPO and HDL-C, which confirms the adverse effects of MPO resulting in HDL-C dysfunction. Conclusions: In this study, we justified HDL-C level association with AS development process. The results unequivocally substantiated the association between HDL-C and AS in all severity grades in women, but only in moderate AS for men, which we explained by the small number of men in the groups. The obtained correlation between the HDL-C and MPO levels, as well as the concurrent decrease in the HDL-C level and increase in the TrxR1 level, indicate in general an HDL-C association with oxidative stress in AS patients.


Assuntos
Estenose da Valva Aórtica/sangue , HDL-Colesterol/análise , Estresse Oxidativo/fisiologia , Idoso , Valva Aórtica/patologia , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/fisiopatologia , Biomarcadores/análise , Biomarcadores/sangue , Calcinose/sangue , Calcinose/complicações , HDL-Colesterol/sangue , Ecocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
12.
Am J Case Rep ; 20: 1114-1119, 2019 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-31352464

RESUMO

BACKGROUND Pulmonary alveolar microlithiasis is an autosomal recessive disease in which a mutation in the SLC34A2 gene that codes for a sodium phosphate type IIb transporter protein (expressed in human epithelial tissues and functions in the clearance of phosphate ions) leads to the formation of extensive pulmonary intra-alveolar microliths. The subsequent characteristic clinical features of dyspnea and hypoxia are a manifestation of these microliths. There have been fewer than 1000 cases of pulmonary alveolar microlithiasis reported worldwide, and there have been 19 reported lung-transplanted patients. CASE REPORT A 49-year-old Saudi male patient presented with longstanding history of easy fatigability and tiredness on exertion since he was 16 years old. Throughout his follow-up in different hospitals (1986-1989), tuberculosis and pulmonary fibrosis were suspected. The patient was lost to follow-up between 1989 and 2001. In 2002, he presented to the emergency room with coughing, shortness of breath on exertion, abdominal swelling, and pedal edema. An investigation with chest x-rays, CT scan, electrocardiogram, and an echocardiogram was conducted. After referral to a tertiary care center, the patient was diagnosed with pulmonary alveolar microlithiasis. He subsequently developed pulmonary hypertension and polycythemia and therefore received a bilateral lung transplant in 2016. Following the lung transplant, he developed a mild reperfusion injury and tonic-clonic seizures, requiring ICU admission. After a successful extubatation with stable vitals and good recovery, he was discharged home in stable condition with planned follow-up. CONCLUSIONS We report a case of pulmonary alveolar microlithiasis successfully treated with a bilateral lung transplant. Although pulmonary alveolar microlithiasis is a rare entity, healthcare providers should consider it in the differential diagnoses of parenchymal lung diseases and differentiate it from tuberculosis and pulmonary fibrosis.


Assuntos
Calcinose/cirurgia , Doenças Genéticas Inatas/cirurgia , Hipertensão Pulmonar/cirurgia , Pneumopatias/cirurgia , Transplante de Pulmão , Policitemia/etiologia , Calcinose/complicações , Calcinose/diagnóstico por imagem , Doenças Genéticas Inatas/complicações , Doenças Genéticas Inatas/diagnóstico por imagem , Humanos , Hipertensão Pulmonar/etiologia , Pneumopatias/complicações , Pneumopatias/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X
13.
Cancer Imaging ; 19(1): 46, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269987

RESUMO

BACKGROUND: Mammography (MG) is highly sensitive for detecting microcalcifications, but has low specificity. This study investigates whether establishing a preoperative nomogram including ultrasonographic findings can help predict the likelihood of malignancy in patients with mammographic microcalcification. METHODS: Between May 2012 and January 2017, 475 patients with suspicious microcalcifications detected on MG underwent ultrasonography (US). The χ2 test was used to screen risk factors among the variables. Then, a multivariate logistic regression analysis was performed to identify independent predictors of malignant microcalcifications. A mammographic nomogram (M nomogram) and mammographic-ultrasonographic nomogram (M-U nomogram) were established based on multivariate logistic regression models. The discriminatory ability and clinical utility of both nomograms were compared by the receiver operating characteristics curve and decision curve analysis. The calibration ability was evaluated using a calibration curve. RESULTS: Among the cases, 68.2% (324/475) were pathologically diagnosed as breast cancer and 31.8% (151/475) were benign lesions. Based on multivariate logistic regression analysis, age, clinical manifestation, morphology and distribution of microcalcifications on MG and lesions associated with microcalcifications on US were confirmed as independent predictors of malignant microcalcifications. In terms of discrimination ability, the C-index of the M-U nomogram was significantly higher than that of the M nomogram (0.917 vs 0.897, p = 0.006). The bias-corrected curve was close to the ideal line in the calibration curve. Decision curve analysis suggested that the M-U nomogram was superior to M nomogram. CONCLUSIONS: Combining mammographic parameters with ultrasonographic findings in a nomogram provided better performance than an M nomogram alone, especially for dense breasts, which suggests the value of ultrasonographic finding for individualized prediction of malignancy in patients with microcalcifications.


Assuntos
Neoplasias da Mama/diagnóstico por imagem , Calcinose/diagnóstico por imagem , Mamografia/métodos , Ultrassonografia/métodos , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/patologia , Calcinose/complicações , Calcinose/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Nomogramas , Período Pré-Operatório , Sensibilidade e Especificidade
14.
Medicine (Baltimore) ; 98(27): e16183, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277123

RESUMO

RATIONALE: Apical hypertrophic cardiomyopathy (AHCM) is a rare form of hypertrophic cardiomyopathy which affects predominantly the apex of the left ventricle. Generally, left ventricular enlargement is not present in AHCM; additionally, endomyocardial fibrosis, and calcification are also rare. PATIENT CONCERNS: A 61-year-old female (Case 1) and a 60-year-old female (Case 2) both presented with the symptoms of atypical chest pain, dyspnoea, exercise intolerance, palpitations. DIAGNOSIS: Magnetic resonance and single-photon emission computed tomography (SPECT) revealed apical hypertrophic cardiomyopathy. Furthermore, 2D-transthoracic echocardiogram showed left atrium and ventricular enlargement, as well as endomyocardial fibrosis and calcification. Based on these findings, the patients were diagnosed with AHCM. INTERVENTIONS: Both the patients were treated with ACEI, metoprolol, and aspirin. Additionally, both these patient underwent genetic test. OUTCOMES: The results of the genetic test of the 2 cases for hypertrophic cardiomyopathy (HCM) were negative. However, the gene mutation for dilated cardiomyopathy (TMPO) was detected in one of the cases. No change in condition during follow-up. LESSONS: In past reports, Apical hypertrophic cardiomyopathy has been shown to have a benign prognosis. But in this case report, the imaging studies of the 2 patients suggest a poor prognosis. Furthermore, diagnosing cardiomyopathy should require multimodality imaging examinations to rule out differential diagnoses.


Assuntos
Calcinose/complicações , Cardiomiopatia Hipertrófica/complicações , Fibrose Endomiocárdica/complicações , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Aspirina/uso terapêutico , Calcinose/diagnóstico por imagem , Calcinose/tratamento farmacológico , Calcinose/patologia , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Cardiomiopatia Hipertrófica/tratamento farmacológico , Cardiomiopatia Hipertrófica/patologia , Ecocardiografia , Eletrocardiografia , Fibrose Endomiocárdica/diagnóstico por imagem , Fibrose Endomiocárdica/tratamento farmacológico , Feminino , Humanos , Imagem por Ressonância Magnética , Metoprolol/uso terapêutico , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão de Fóton Único
15.
Georgian Med News ; (290): 63-68, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31322517

RESUMO

Little is known about the gender differences of left ventricular (LV) remodeling in patients with aortic valve calcification (AVC). The aim was to assess gender differences of structure functional changes and LV myocardial remodeling in patients with AVC depending on the type of valve lesion. 293 patients (131 men) with revealed AVC by transthoracic echocardioscopy without aortic stenosis and 76 patients (50 men) without AVC were examined. Men had normal geometry of LV more often than women (15.7% vs. 4.4 % in isolated AVC and 11.9% vs. 2.8 % in combined lesion of aortic valve (AV) and mitral valves ring (MVR), р<0.052), and eccentric hypertrophy was registered more often in man with combined AV and MVR lesion (38.1% vs. 15.5 % in women with combined AV and MVR lesion and vs. 20.2 % in men with isolated AVC, р<0.029). LV systolic function was worse in men with combined valves lesion (ejection fraction was 54.0 (48.0; 65.0) vs. 66.0 (60.0; 71.0) % in women with combined valves lesion and vs. 63.0 (55.0; 70.0) % in men with isolated AVC, р<0.022). Men with combined valves lesion also had a larger right ventricle (RV) size (RV index was 1.3 (1.2; 1.5) vs. 1.2 (1.1; 1.4) cm/m2 in women with combined valves lesion and vs. 1.2 (1.1; 1.4) cm/m2 in men with isolated AVC, р<0.036) and had tricuspid regurgitation more often (76.2% vs. 56.3 % in women with combined valves lesion and vs. 58.4 % in men with isolated AVC, р<0.029). Women had higher peak aortic jet velocity (1.5 (1.4; 1.7) vs. 1.4 (1.2; 1.6) m/s in man, р<0.0001). Dominating models of LV remodeling in women were concentric, mainly concentric hypertrophy (61.5% vs. 31.5 % in men in groups with isolated AVC and 64.8% vs. 31.0 % in combined valves lesion groups, р<0.001). Also women had a higher left auricle index than men (2.3 (2.0; 2.5) vs. 2.1 (1.9; 2.4) cm/m2, р<0.015). There were revealed differences in distribution of LV remodeling types depending on the gender and the type of valve lesion.


Assuntos
Estenose da Valva Aórtica/patologia , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/patologia , Calcinose/sangue , Função Ventricular Esquerda/fisiologia , Remodelação Ventricular , Idoso , Idoso de 80 Anos ou mais , Valva Aórtica/fisiologia , Valva Aórtica/cirurgia , Biomarcadores/sangue , Calcinose/complicações , Calcinose/patologia , Calcinose/fisiopatologia , Calcinose/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais
16.
World Neurosurg ; 130: 165-169, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31299306

RESUMO

BACKGROUND: Ossified chronic subdural hematoma (CSH) associated with neoplasm has rarely been reported in the literature. We describe a patient with ossified CSH and underlying large B-cell lymphoma and discuss the relationship between lymphoma and CSH, emphasizing clinical characteristics, tumorigenic mechanism, and histopathologic analysis. CASE DESCRIPTION: A 46-year-old man with a history of alcohol abuse and a right frontotemporoparietal and left frontal ossified CSH that was diagnosed 2 years previously presented with headache and memory loss over 6 days. The patient was being followed with serial imaging, which showed the static state of the mass and no other lesions 7 months before admission. He underwent right frontotemporoparietal craniectomy to remove the ossified CSH and tumor. When the bone was lifted and the thin dura was opened, a hard, thick, ossified capsule was observed. No apparent tumor invasion was noted in the skull or epidural space. Despite refusing further chemotherapy and radiation therapy, the patient has been disease-free and working for 5 years. CONCLUSIONS: Based on reported cases and relevant literature, large B-cell lymphoma may be associated with ossified CSH.


Assuntos
Dura-Máter/cirurgia , Hematoma Subdural Crônico/cirurgia , Linfoma de Células B/virologia , Linfoma/cirurgia , Calcinose/complicações , Calcinose/cirurgia , Dura-Máter/patologia , Dura-Máter/virologia , Hematoma Subdural Crônico/complicações , Hematoma Subdural Crônico/diagnóstico , Herpesvirus Humano 4/patogenicidade , Humanos , Linfoma/complicações , Linfoma/virologia , Linfoma de Células B/diagnóstico , Linfoma de Células B/cirurgia , Masculino , Pessoa de Meia-Idade
17.
J Diabetes Res ; 2019: 9484717, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192264

RESUMO

Objectives: Type 2 diabetes mellitus (T2DM) is associated with coronary artery calcification (CAC) which is an independent risk factor for cardiovascular events. Metformin is the first-line antidiabetic medication. We aimed to investigate the association between metformin use and CAC. Methods: We included 369 patients with T2DM in this cross-sectional study. CAC scores, clinical characteristics, and antidiabetic drug prescription information of the patients were acquired. Baseline parameters were balanced for metformin and nonmetformin users using the propensity score matching (PSM) strategy. Results: Among the 369 subjects who met our inclusion criteria, 288 subjects were included for further analysis after PSM. Metformin prescription rather than other antidiabetic medications was related to lower CAC scores (OR [95% CI] = 0.55 [0.34-0.90]; P = 0.018). Further multivariable logistic regression analysis demonstrated that metformin was negatively associated with CAC severity (OR [95% CI] = 0.58 [0.34-0.99]; P = 0.048), which was independent of age, BMI, eGFR, gender, cigarette smoking, duration of diabetes, hypertension, statin prescription, and number of nonmetformin antidiabetic agents. A subgroup analysis revealed a significant association between metformin and CAC scores in smokers (OR [95% CI] = 0.38 [0.16-0.93]; P = 0.035), but the association was not observed in never-smokers (OR [95% CI] = 0.72 [0.34-1.51]; P = 0.383). Conclusions: Metformin usage was independently associated with lower CAC scores in T2DM patients. The negative correlation between CAC scores and metformin was most prominent in patients with a history of cigarette smoking.


Assuntos
Calcinose/etiologia , Doença da Artéria Coronariana/etiologia , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/efeitos adversos , Metformina/efeitos adversos , Idoso , Calcinose/complicações , Doença da Artéria Coronariana/complicações , Vasos Coronários/efeitos dos fármacos , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Feminino , Taxa de Filtração Glomerular , Humanos , Hipertensão/complicações , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estresse Oxidativo , Pontuação de Propensão , Fatores de Risco , Fumar , Tomografia Computadorizada por Raios X
18.
Afr Health Sci ; 19(1): 1657-1664, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31148995

RESUMO

Background: Mitral annular calcification (MAC) is associated with several cardiovascular disorders including coronary artery disease (CAD), atrial fibrillation, heart failure, ischemic stroke and increased mortality. Epicardial fat thickness (EFT) has strong correlation with obesity, CAD, insulin resistance, metabolic syndrome, hypertension, diabetes mellitus, and atherosclerosis. There are strong similarities between EFT and MAC from the aspect of risk factors and pathogenesis. Objective: In this study we aimed to investigate the EFT in patients with MAC. Methods: The study group consisted of 78 patients with MAC. An age, gender and body mass index matched control group consisted of 47 subjects who admitted to echocardiography laboratory due to suspicion of organic heart disease and eventually found to be free of MAC. We measured EFT in patients with MAC and control subjects. Results: EFT was significantly higher in patients with MAC than in control subjects (5.7±0.9 vs. 4.4±0.6 mm respectively; P< 0.001). Correlation analysis indicated that EFT was positively correlated with presence of MAC (p<0.001, r=0.597). Conclusion: We showed that EFT was significantly elevated in patients with MAC and it was positively correlated with MAC.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Calcinose/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Ecocardiografia Doppler/métodos , Valva Mitral/diagnóstico por imagem , Pericárdio/diagnóstico por imagem , Tecido Adiposo/patologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Doença da Artéria Coronariana/patologia , Vasos Coronários/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/patologia , Pericárdio/patologia , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/patologia
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