Search

WOS: 000319503100006, PubMed ID: 23609339, Purpose: The aim of our study was to investigate the relationship between age, sex, obesity, nonalcoholic fatty liver disease (NAFLD), carotid intima-media thickness (CIMT), and both the presence and severity of coronary artery disease (CAD) and their predictive value for the presence and severity of CAD. Methods: Our study population consisted of 136 patients who underwent coronary angiography for various reasons. Gensini scoring was used to determine the severity of coronary atherosclerosis. Carotid intima-media thickness was estimated by carotid duplex ultrasound. Nonalcoholic fatty liver disease was diagnosed by abdominal ultrasonography. Body mass index (BMI) was calculated as kilograms divided by meters squared. Results: Coronary artery disease was detected in 74 patients (54%). In the whole group, patients with CAD had significantly higher CIMT measurements compared with those without CAD (0.93 [SD, 0.14] and 0.72 [SD, 0.12] mm, respectively, P < 0.001). Carotid intima-media thickness was correlated with BMI (P < 0.001, r = 0.453), age (P = 0.001, r = 0.389), and grade 2-3 NAFLD (P < 0.001, r = 0.356). In the multiple logistic regression model, CIMT (odds ratio, 1.189; 95% confidence interval, 1.122-1.261; P < 0.001) was the only independent predictor of the presence of CAD. In receiver operating characteristic curve analysis, optimal cutoff value of CIMT to predict the presence of CAD was found as greater than 0.75 mm with 93.2% sensitivity and 71% specificity. In CAD group patients, Gensini score was correlated with CIMT (P < 0.001, r = 0.604), grade 2-3 NAFLD (P < 0.001, r = 0.534), BMI (P < 0.001, r = 0.498), and age (P = 0.001, r = 0.385). In the multiple stepwise linear regression model, CIMT (beta = 0.444, P < 0.001) and grade 2-3 NAFLD (beta = 0.353, P < 0.001) were associated with severity of CAD. Conclusions: Our data suggest that CIMT is a strong independent predictor for the presence and severity of CAD. Furthermore, moderate to severe hepatosteatosis is also significantly associated with the severity of CAD. Therefore, detection of CIMT and NAFLD by ultrasonography, which is a very cheap, safe, and noninvasive radiological modality, can be used to improve CAD risk prediction.

Coronary artery ectasia is a variant of coronary atherosclerosis. Hyperhomocysteinemia has emerged as a major, independent risk factor for cardiovascular diseases. The purposes of this study were to determine plasma hyperhomocysteine levels in patients with coronary artery ectasia, and to compare patients with coronary artery ectasia, coronary artery disease, and controls with normal coronary angiogram.The study population included 37 patients with coronary artery ectasia and 36 patients with coronary artery disease. The control group consisted of 32 patients with angiographically proven normal coronary arteries. Plasma hyperhomocysteine levels were measured in all study patients with an enzyme-linked immunosorbent assay.Plasma homocysteine levels were significantly higher in patients with both coronary artery ectasia and coronary artery disease than in the controls (14.8+/-1.1 and 15.9+/-0.8 vs. 2.5+/-0.6 micromol/l; P0.001 and P0.001, respectively). No significant differences in plasma homocysteine levels were found among CAE and CAD groups (P0.05).We have demonstrated that patients with coronary artery ectasia and coronary artery disease have increased plasma hyperhomocysteine levels compared with the controls. These findings suggest that hyperhomocysteinemia may play an important role in the pathogenesis of coronary artery ectasia as in coronary artery disease.

OBJECTIVE Alterations in aortic stiffness may reflect the elastic properties of the larger arteries. In many diseases, aortic elastic properties have been investigated to show whether the larger arteries are involved. The elastic properties of aorta in patients with coronary artery ectasia, however, have not been studied yet. We aimed to investigate aortic stiffness parameters in patients with coronary artery ectasia and to compare patients with coronary artery ectasia and coronary artery disease with the control group. METHOD Thirty-three patients with coronary artery ectasia, 31 patients with coronary artery disease and 30 patients with angiographically normal coronary arteries were included in this study. Aortic diameters were measured on the M-mode tracing obtained at a level 3 cm beyond the aortic valve at parasternal long-axis view. Aortic diameter change, aortic strain, aortic distensibility and stiffness parameters were measured as aortic stiffness parameters. RESULTS Aortic diameter changes were fewer in the coronary artery ectasia and coronary artery disease group than in the control group (0.4 +/- 0.1 and 0.3 +/- 0.1 vs. 0.8 +/- 0.2; P < 0.001). Aortic distensibility and aortic strain were significantly lower in patients with coronary artery ectasia and coronary artery disease than in the controls (for aortic distensibility P < 0.001 and for aortic strain P < 0.001, < 0.001, respectively). In contrast, a significantly higher aortic stiffness index was observed in patients with coronary artery ectasia and coronary artery disease than in the control group (14.2+/-2.6 and 18.1 +/- 2.9 vs. 5.9 +/- 1.8; P < 0.001, respectively). CONCLUSIONS The impairment in aortic elastic properties in patients with coronary artery ectasia indicates that this disease is a generalized disease rather than a localized disease of the coronary arteries.

Background Coronary artery ectasia (CAE) is defined as localized or diffuse non-obstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Varicocele is the dilatation of the pampiniform plexus. Recently increased prevalence of peripheral varicose veins has been shown in patients with CAE. In this study we aimed to assess the prevalence of varicocele, which is dilatation of another venous system, in patients with CAE. Materials and methods Thirty-five male consecutive patients with coronary artery ectasia in combination with or without coronary artery disease (CAD) and 63 male, age-matched patients with coronary artery disease were included in the study. All patients were evaluated for the presence of varicocele. Results Twenty-one patients with CAE were found to have varicocele (62% of group I patients). In patients with CAD, 24 patients (38%) were found to have varicocele. The difference between the two groups in respect to presence of varicocele was statistically significant (P=0.02; odds ratio=1.57; 95% confidence interval 1.05- 2.3). Conclusion We have shown that patients with coronary artery ectasia have an increased prevalence of varicocele compared to those with coronary artery disease. The mechanism underlying coronary artery ectasia might further increase the prevalence of varicocele in susceptible patients.

We read the article by Worthmann et al1 with interest. The authors investigated whether the combination of recombinant tissue-type plasminogen activator (rtPA) and erythropoietin (EPO) increases the release of endogenous nitric oxide synthase inhibitor asymmetric dimethylarginine (ADMA). The patients were divided into 4 groups according to treatment: placebo, EPO, rtPA+placebo, and EPO+rtPA. They found that ADMA levels increased during the observation time in the EPO, the EPO+rtPA, and the placebo groups, whereas a treatment effect on ADMA levels was revealed only in the rtPA+placebo group when adjusted for age and infection at …