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Background/Aim: Diabetes Mellitus (DM), considered the equivalent of coronary artery disease, is one cause of ventricular repolarization (VR) dispersion. Retinopathy is one of the vascular consequences of diabetes. The association between myocardial repolarization dispersion and diabetic retinopathy is not fully elucidated. We aimed to evaluate ventricular repolarization using Tp-e interval and corrected (c) Tp-e/QT ratio in DM patients with and without retinopathy.Methods: A total of 124 diabetic subjects were included in this retrospective cohort study. All medical data were obtained from the electronic database of our university hospital. The subjects were divided into the no diabetic retinopathy (NDR) group (n=45), and the diabetic retinopathy (DR) group (n=79), which were compared in terms of demographic features, clinic and laboratory findings, and electrocardiographic findings such as QT, QTc, Tp-e, Tp-e/QT, Tp-e/QTc.Results: The groups were similar in terms of demographic features (P>0.05). Both Tp-e interval and Tp-e/QTc were significantly prolonged in the DR group compared to the NDR group. There were significant correlations between Tp-e, Tp-e/QTc, DM duration, and age. In multivariate logistic regression analysis, Tp-e (OR=6.01, %95 CI=4.17-7.52, P=0.012), Tp-e/QTc (OR=1.215, 95% CI=0.874-1.612, P=0.029), and DM duration (OR=1.422, 95% CI= 1.146–1.712, P

OBJECTIVE To assess P-wave duration and dispersion (PD) in morbidly obese young subjects who do not have co-associated atrial fibrillation (AF) risk factors, such as hypertension, diabetes, atrial enlargement and diastolic dysfunction. STUDY DESIGN An observational cross-sectional study. PLACE AND DURATION OF STUDY Bolu Abant Izzet Baysal University Medical Faculty, Turkey; and the study was conducted between October 2017 and June 2018. METHODOLOGY P-wave duration and dispersions were determined on 12-lead surface ECG in 47 morbidly obese and 44 healthy weight subjects, aged between 21-40 years. Above mentioned risk factors were studied. The correlation between BMI, PD and Pmax were investigated by Pearson correlation analysis. Results: Average body mass index (BMI) of obese and control groups were 42.3 (8.5) vs. 19.5 (1.5) (P

Objectives: Several risk scoring systems have been validated for cardiovascular risk prediction and prognosis. PATIMA index combining Carotid intima media thickness (CIMT), carotid extra media thickness (CEMT), cardiac epicardial fat thickness (EFT) and body mass index (BMI)), are related to coronary artery disease (CAD). Materials and Methods: One-hudered-twenty-four patients were categorized as low SYNTAX (

Aim: Multiple sclerosis (MS), which is inflammatory in its pathogenesis, damages the myelin sheath in the central nervous system (CNS) and causes axonal loss. Epicardial fat tissue (EFT), located between the myocardium and the visceral layer of the pericardium, surrounds the heart and several inflammatory cytokines is secreted from this tissue. In this study, we aimed to investigate EFT thickness in MS patients and compared with that of volunteer non-MS subjects. Methods: A total of 154 subjects comprising 61 MS patients and 93 volunteers matched for gender and age were included in our study. Epicardial fat tissue thickness was measured by echocardiography. All values were compared between groups. Results: Echocardiographic parameters were similar in both groups. However, the mean EFT thickness was significantly higher in the MS group than in the control group (p

WOS:000562623600020 PubMed: 32844936 OBJECTIVE: Inflammation-related markers provide diagnostic and prognostic information for coronary artery disease and acute coronary syndrome. We aimed to compare neutrophil count and neutrophil/lymphocyte ratio (NLR) in acute coronary syndrome patients with coronary collateral development in our study. METHODS: A total of 426 patients (102 unstable angina pectoris (USAP), 223 non-ST-elevation myocardial infarction (non-STEM!), 103 ST-elevation myocardial infarction (STEMI) were compared regarding hemoglobin, platelet, lymphocyte, neutrophil count, and NLR. RESULTS: Neutrophil count and NLR were significantly lower in USAP patients and higher in STEMI patients; 5.14 +/- 1.79 vs. 721 +/- 3.05 vs. 9.93 +/- 4.67 and 2.92 +/- 2.39 vs. 5.19 +/- 4.80 vs. 7.93 +/- 6.38, p

Background: Varicocele is abnormal dilation of testis veins. The precise mechanism of varicocele is not fully understood despite some hypothesis were suggested in the literature. Disequilibrium between constrictor and dilatator mechanism of the veins have been shown to cause varicocele. High-grade varicoceles have been also linked to endothelial dysfunction and increased vasoconstriction. Objectives: We hypothesized that epicardial fat thickness (EFT), flow-mediated dilatation (FMD) and aortic stiffness (AS) could be associated with varicocele. In the present study, we aimed to compare vascular parameters such as FMD, EFT and AS in healthy subjects and high-grade varicocele patients. Methods: The study population consisted of 35 men with high-grade varicocele and 32 age- and sex-matched control subjects younger than 45 years old. This is a cross-sectional study conducted at Bolu Abant Izzet Baysal University Hospital between May to October 2018. Results: EFT, aortic diastolic diameters (AoDD) and EFT/BMI ratio were significantly higher in control group than in pa- tients with high-grade (p=0.012, p=0.044, p=0.026, respectively). EFT and EFT /BMI ratio were significantly and inversely correlated with presence of varicocele (r=-0.422, p=0.009; r=-0.38, p=0.026, respectively). Conclusion: The present study suggests that high-grade varicocele may be associated with decreased echocardiographic EFT but not with aortic stiffness and FMD. Keywords: High-grade varicocele; epicardial fat thickness, flow-mediated dilatation, aortic stiffness.

New-generation oral anticoagulants (NOACs) are now preferred as a first-line treatment in the management of atrial fibrillation for prevention of thromboembolic complications. Mean platelet volume (MPV), one of the indicators of increased platelet activity, is also associated with an increased stroke risk in atrial fibrillation patients. The aim of this study was to evaluate changes in MPV, platelet distribution width (PDW) and plateletcrit following use of NOACs. The study included 116 patients with non-valvular atrial fibrillation without previous NOAC use. Complete blood counts, biochemical analyses and echocardiography were performed for all patients. No significant differences were observed in MPV or other platelet indices at 6 months compared to baseline. Our results indicate that MPV and other platelet indices are not affected by NOAC use in non-valvular atrial fibrillation patients.Neue orale Antikoagulanzien (NOAC) werden mittlerweile für die Erstlinientherapie bei Vorhofflimmern zur Prävention thromboembolischer Komplikationen bevorzugt eingesetzt. Das mittlere Thrombozytenvolumen („mean platelet volume“ [MPV]), ein Indikator der erhöhten Thrombozytenaktivität, ist auch mit einem erhöhten Schlaganfallrisiko bei Patienten mit Vorhofflimmern assoziiert. Ziel der vorliegenden Studie war es, Veränderungen im MPV, der Thrombozytenverteilungsbreite und dem Thrombokrit nach Einsatz von NOAC zu untersuchen. Eingeschlossen wurden 116 Patienten mit nichtvalvulärem Vorhofflimmern ohne vorherige NOAC-Einnahme. Bei allen Patienten wurden große Blutbilder erstellt, zudem wurden biochemische Analysen und eine Echokardiographie durchgeführt. Im Vergleich zur Ausgangsmessung fanden sich nach 6 Monaten keine signifikanten Unterschiede im MPV oder in anderen Thrombozytenparametern. Unsere Ergebnisse zeigen, dass das MPV und andere Thrombozytenparameter bei Patienten mit nichtvalvulärem Vorhofflimmern nicht durch eine NOAC-Einnahme beeinträchtigt sind.

Catheter-directed intra-arterial thrombolysis (CDT) is a rational treatment method in patients with acute/subacute and even some chronic occlusions of lower extremity arteries and bypass grafts having salvageable limb ischemia. Immediate vessel patency can be achieved with an acceptable complication rate in many patients, especially those with fresh thrombus or emboli. It can be also an adjuvant treatment modality for endovascular interventions for chronic occlusions. There is no standard method of CDT including thrombolytic agent dose and technique. Selection of treatment strategy should be based on individual judgment based on viability of limb, lesion characteristics, and risks of hemorrhage.

We aimed to search eosinophil (EOS) counts in elderly acute coronary syndrome (ACS) subjects and to investigate its value for discrimation between unstable angina pectoris (UAP) and myocardial infarction (MI) [non-ST elevation MI (NSTEMI) or ST elevation MI (STEMI)]. The patients were divided into three groups regarding the diagnosis: patients with UAP (63), with NSTEMI (154), and with STEMI (73). General characteristics such as gender, age, systolic and diastolic blood pressure were obtained from patients' files. Complete blood count and biochemical parameters were measured before coronary angiography. EOS was found significantly higher in UAP (0.134 (0.002-0.746) u/mm

Resumo Fundamento: Sabe-se que a inflamação desempenha um papel crucial em muitas doenças, incluindo a COVID-19. Objetivo: Utilizando a dilatação fluxo-mediada (DFM), objetivou-se avaliar os efeitos da inflamação na função endotelial de pacientes com COVID-19. Métodos: Este estudo foi realizado com um total de 161 indivíduos, dos quais 80 foram diagnosticados com COVID-19 nos últimos seis meses (48 mulheres e 32 homens com idade média de 32,10±5,87 anos) e 81 eram controles saudáveis (45 mulheres e 36 homens com idade média de 30,51±7,33 anos). Os achados do ecocardiograma transtorácico e da DFM foram analisados em todos os indivíduos. Resultados com p

Aim: To examine the relationship between the SYNTAX score (SS) and cardiac repolarization parameters such as cQTd and Tp-e values, and Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios in patients who have stable angina pectoris. Methods: 12-lead resting electrocardiograms (ECGs) and SS of 160 patients (51 female and 109 male) undergoing coronary angiography with the pre-diagnosis of stable angina pectoris were evaluated. Patients with a SS below 22 were classified as Group 1 (low-SYNTAX), and those above 22 (high-SYNTAX) as Group 2. Forty-four patients with normal coronary angiography were included in Group 3. Results: Mean age of the patients was 62.4±9.1 years. The heart rate, QRS, QT, cQT and JT durations between the groups were similar. In addition, relatively recent ventricular repolarization indices such as Tp-e interval and Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios were also not substantially different between groups. Conclusion: Several surface ECG predictors of ventricular arrhythmias, including QTd, JT and Tp-e intervals and their ratios to QT and JT, are not significantly correlated with SYNTAX score-assessed CAD severity in patients with stable angina pectoris.

It is known that eosinophils (EOS) are essential for thrombus formation. Studies have demonstrated the association of EOS with coronary artery disease, stent thrombosis, coronary collateral development, and vasospastic angina. However, there is little data about the association of hemogram parameters, especially EOS counts, with deep venous thrombosis (DVT) subgroups.The present study comprised 243 patients diagnosed with DVT (of whom 86 were acute, 72 were indeterminate, and 85 were chronic) and 75 control patients. Medical records of all the patients were reviewed, and relevant data were collected retrospectively. The baseline characteristics, as well as hemogram and biochemistry parameters, were recorded.The patients with DVT had significantly lower median EOS count yet higher median neutrophil to lymphocyte ratio (NLR) than those of control patients (P .001). Similarly, acute DVT patients had lower EOS count yet higher NLR values compared with those of indeterminate and chronic DVT patients. However, EOS count was not significantly different between chronic DVT and control groups. While NLR ratio was significantly correlated with acute DVT (r = 0.34; P .001), Spearman's correlation test revealed that EOS count was inversely correlated with the presence of acute DVT (r = -0.52; P .001).Low EOS count may lead the physician to a higher probability of acute DVT rather than indeterminate and chronic DVT.

Aim: The prognostic value of blood pressure and the association between these parameters and cardiovascular conditions have been established in literature. In this study, we aimed to investigate the correlation between peripheral blood pressure parameters with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical artery stenosis. Methods: A total of 363 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: group with adequate CCD (n=120) and group with inadequate CCD (n=243). Peripheral blood pressure parameters were evaluated before coronary arteriography. Results: Peripheral diastolic blood pressure (DBP) and mean arterial pressure (MAP) levels were significantly higher in the inadequate CCC group (81.5±10.7 vs 77.9±9.9 p=0.02 and 100.6±11.8 vs 96.6±9.3 99,8mmHG, sensitivity and specificity of MAP were 57% and 69%, respectively. At the cut-off value of >79,5 mmHg, sensitivity and specificity of DAP were 72% and 42%, respectively. Conclusion: The present study suggests that Peripheral DBP and MAP levels may be associated with degree of collateral development in chronic stable CAD. Low peripheral DBP and MAP in the case of severe coronary stenosis in stable CAD may be an important stimulus for coronary collateral development.

Hyponatremia is a common electrolyte disorder, but symptomatic hyponatremia following coronary angiography is rare. Although patients with hyponatremia are generally asymptomatic, neurological manifestations may result in lethal complications. Here we presented a 69-year-old female, admitted for elective coronary angiography due to exertional chest pain. Seven hours later after coronary angiography, however, the patient had a headache, temporary mental confusion and her speech was slurring. A brain magnetic resonance imaging (MRI) test, arterial blood gas analysis, and the neurological examination were carried out. The neurological examination showed no focality and brain diffusion MRI was normal. Arterial blood gas analysis revealed sodium of 110 mmol/L and potassium of2.8 mmol/L. The patient was treated with hypertonic saline (3% NaCl) and vasopressin antagonist tolvaptan 15 mg at first and isotonic saline (0,09 NaCl) with a gradual normalization of electrolytes. Diagnosis of acute hyperosmolar hyponatremia should be considered in patients with developing mental or behavioral abnormalities following coronary angiography.

Objectives: This study aims to assess the thickness of epicardial fat tissue (EFT), a sign of cardiovascular risk, using echocardiography in patients with severe periodontitis. Methods: Thirty-three patients with stage III or IV periodontitis and 33 healthy participants were enrolled into the study. Epicardial fat tissue thickness was measured perpendicularly via echocardiography of the free wall of the right ventricular at end-diastole in three cardiac cycles. Body mass index (BMI) was calculated by dividing weight in kilograms by the height in meters squared. EFT to BMI ratio (EFT/BMI) was measured by dividing EFT by the BMI. Results: There was no significant difference between study patients and the control group as regards to the frequency of diabetes, hypertension, smoking, and hyperlipidemia. The EFT and EFT/ BMI ratio were significantly different in the control and periodontitis groups (0.51±0.17 vs. 0.77±0.16, respectively; p ≤0.001) (0.021±0.008 vs. 0.030±0.006, respectively; p≤0.001). Pearson's correlation coefficient demonstrated a significant relationship between EFT and the clinical parameters of periodontitis (p

Aim: We aimed to compare platelet counts (Plt), plateletcrit (PCT) and platelet distribution width (PDW) values of type 1 diabetes mellitus (T1DM) patients with those of healthy subjects. Methods: The records of 39 T1DM patients who were hospitalized between January 2016 and May 2018 were retrospectively analyzed. Control group consisted age and body mass index matched nondiabetic patients. Subjects having history of cardiovascular disease or any other systemic disease were excluded. Results: Compared to control group Plt (270±63 vs. 215±35 k/$mm^3$ ), PCT (0.217±0.057 vs. 0.168±0.034 %) and PDW [17.4(16.2-20.4) vs. 17(12.5-19.4) %] were significantly higher in T1DM patients. Conclusion: Platelet indices which are common, simple and inexpensive hemogram parameters are increased T1DM patients.

Aim: Elevated levels of uric acid and low levels of high-density lipoprotein (HDL) cholesterol are associated with cardiovascular events and mortality. We investigated a novel marker, uric acid/HDLratio (UHR), in coronary artery ectasia patients (CAE). Materials and Methods: The present study included 104 patients (58 male, 46 female; mean age, 61±12 years) diagnosed as having isolated CAE and 110 controls (44 male, 66 female; mean age, 60±12 years) whose coronary artery findings were normal as revealed by coronary angiography. Medical records of all the patients were reviewed and the data were collected retrospectively. Baseline characteristics, hematologic and biochemistry parameters were recorded, and we calculated the value of UHRResults: The CAE group had significantly higher values of uric acid (6.48±1.62 vs. 5.37±1.12; p0.001) and UHR (0.15±0.05 vs. 0.11±0.05; p0.001). Spearman’s correlation test showed a significant association of uric acid and UHR with CAE (r=0.40, p0.001 and r=0.51, p0.001, respectively). On the other hand, HDL had a negative correlation with the presence of CAE (r=0.44, p0.120 UHR (%) values had a sensitivity of 72% and specificity of 68% for the determination of CEA.Conclusion: We observed in our study the finding in which the uric acid and UHR values were higher in individuals with CAE compared to non-CAE subjects. There was an association between UHR and CAE.

SUMMARY OBJECTIVE Metabolic syndrome (MS) is a clinical entity that associated with increased risk of type 2 Diabetes Mellitus (DM) and cardiovascular diseases. Serum uric acid levels are correlated MS criteria. We hypothesized whether a uric acid to HDL-cholesterol ratio (UHR) could predict diabetic regulation and presence of MS in type 2 diabetic subjects. METHODS Admissions of the subjects with type 2 DM to outpatient clinics of our institution were retrospectively analyzed. Study population grouped into well-controlled and poorly controlled diabetics according to the HbA1c level (cut off 7%) and further grouped into type 2 DM with and without MS according to the presence of MS. UHR of study groups compared. RESULTS A hundred diabetic subjects enrolled. Mean UHR was significantly lower in well-controlled diabetics (9.7 ± 3.7%) compared to poorly controlled subjects (14 ± 5.4%) (p

Fundamento: O risco de eventos cardiovasculares e morte súbita aumenta com diabetes mellitus tipo 1 (DM1). Objetivo: Avaliar alguns marcadores eletrocardiográficos de arritmias em pacientes com DM1. Métodos: Parâmetros eletrocardiográficos que refletem despolarização e repolarização ventricular, a saber, os intervalos QT, QTc, QTd, QTdc, Tp-e, JT e JTc e as relações Tp-e/QT e Tp-e/QTc, de 46 pacientes diagnosticados com DM1 foram retrospectivamente analisados e comparados com 46 controles saudáveis, pareados por idade, sexo e massa corporal. As correlações entre duração de DM1, HbA1c e variáveis de repolarização ventricular foram analisadas. Foram considerados estatisticamente significativos os valores de p inferiores a 0,05. Resultados: A duração de diabetes foi de 16,6 ± 7,1 anos, e HbA1c foi 10,81% ± 3,27% no grupo DM1. Em comparação com o grupo controle, a frequência cardíaca, os intervalos QTc, QTd, QTdc, Tp-e e JTc, a relação Tp-e/QT (p < 0,001) e a relação Tp-e/QTc (p = 0,007) foram significativamente mais altos em pacientes com DM1. A duração de DM1 e os níveis de HbA1c foram significativamente correlacionados com os intervalos QTc, QTd, QTdc, Tp-e e JTc e com as relações Tp-e/QT e Tp-e/QTc. Conclusões: Em pacientes com DM1, potenciais preditores eletrocardiográficos de repolarização foram significativamente aumentados em correlação com a duração da doença e com os níveis de HbA1c. Estes achados podem contribuir à compreensão da morte súbita cardíaca em pacientes com DM1. (Arq Bras Cardiol. 2019; [online].ahead print, PP.0-0)

Aim: In this study, we aimed to evaluate retrospectively uric acid and uric acid / high-density lipoprotein (HDL) ratio in patients with coronary artery fistula who underwent coronary angiography in our cardiology clinic. Coronary artery fistulas (CAF) are seen most often congenitally but also may be acquired and often encounter an asymptomatic clinic. In chronic diseases, e.g., chronic kidney disease, metabolic syndrome, a decrease in HDL is observed, while high uric acid levels have been associated with adverse events. Material and Methods: A total of 111 patients were included in the study, including 46 patients with coronary fistula and 65 controls with normal coronary arteries. Demographic data, laboratory parameters and structural features of the fistula were recorded. Transthoracic echocardiography was performed in all patients. Results: Baseline characteristics were similar between the groups. Previous medications were similar between the two groups. Uric acid [5.9 (4.0-8.0) vs. 4.5 (3.5-8.3)) and uric acid / HDL ratio (14 (7-30) vs. 10 (5-32)] were found to be significantly higher in the fistula group (p

Aim: Varicocele is abnormal dilation of testis veins without unclear pathophysiology. Morphological studies showed imbalance between vasoconstrictor and vasodilator mechanisms. We aimed to determine the relationship between varicocele and cardiovascular system disorders with electrocardiography (ECG) parameters. Methods: This is a prospective study which was conducted in a University Hospital between February and June 2018. Thirty patients (18-45 years old) with high grade varicocele from urology outpatient clinic and 32 healthy volunteers for the control group were recruited to the study. Results: P-min. value was significantly higher in control group than patients with high grade varicocele (p= 0.03). PR, QT and QTc intervals, PWD and P-max values were similar. Also, there were no significant differences in terms of the other ECG parametersbetween the groups. Conclusions: In this small prospective study we have found no association between high grade varicocele and potential electrocardiographic arrhythmia predictors namely OTd, QTc interval, PWD, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Long-term follow-up and large-scale prospective studies are needed to confirm our results.

WOS:000445242800008 PubMed: 30302102 Introduction: The prognostic value of hematological indices in cardiovascular diseases and the association between these parameters and cardiovascular conditions have been established in the literature. Aim: In this study, we aimed to investigate the relation of mean platelet volume (MPV), MPV to platelet ratio (MPR) and red cell distribution width (RDW) with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical coronary artery stenosis. Material and methods: A total of 306 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: a group with adequate CCD (n = 214) and a group with impaired CCD (n = 92). Routine complete blood count and biochemical parameters were measured before coronary arteriography. Results: The MPV and MPR levels were significantly higher in the inadequate CCD group (10.5 +/- 1.8 fl vs. 8.7 +/- 1.9 fl, p < 0.001 and 0.06 +/- 0.08 vs. 0.05 +/- 0.07, p = 0.036). Patients with inadequate CCD had significantly higher RDW levels compared to patients with adequate CCD (15.5 +/- 1.7% vs. 15.0 +/- 1.9%, p = 0.01). MPV and RDW were significantly associated with Rentrop collateral grading (r = -0.523, p < 0.001 and r = -0.239, p < 0.001, respectively), whereas the association with MPR was not significant. An MPV value greater than 9.95 fl, determined with ROC curve analysis, had 71% sensitivity and 70% specificity in predicting inadequate CCD. An RDW greater than 14.3% has 71% sensitivity and 53% specificity in selecting patients with adequate CCD. Conclusions: The present study suggests that MPV and MPR may be associated with the degree of collateral development in chronic stable CAD. However, the negative association of RDW with inadequate CCD, in combination with previous contradictory reports, raises a doubt about the possible value of RDW in stable CAD. Although these parameters may be affected by various conditions, a high MPV may lead clinicians to suspect possible inadequate collateral development in stable CAD patients.

Objective: Endothelial dysfunction (ED) is a condition that involves increased oxidative stress and decreased total antioxidant status (TAS) levels. Systemic lupus erythematosus (SLE) is also associated with ED. We aimed to determine the association between serum TAS and ED as assessed by flow-mediated dilation (FMD) in patients with SLE. Methods: Thirty-four patients with stable SLE who were not undergoing any treatment and 39 healthy volunteers without any overt cardiovascular disease were included in this cross-sectional study. Doppler ultrasound was used to measure FMD to assess ED in the study groups. Serum TAS levels were measured using a TAS kit. High-sensitivity C-reactive protein (hs-CRP) and anticardiolipin antibody (aCLA) levels were also measured to assess the inflammatory state. The SLE group further was divided into 2 groups according to presence or absence of aCLA. SLE disease activity was assessed using the SLE disease activity index (SLEDAI). Regression analysis was used to define independent predictors. Results: The mean TAS levels were significantly lower in patients with SLE than in controls (1.60±0.11 versus 1.73±0.15 mmol/L, p

Cardiovascular diseases are still in the 1st place in the world among cause of deaths. Data accumulates about publications investigating the effect of radiation on cardiovascular disease. Ionized radiation is used for diagnosis and treatment of many disease, recently. As for invasive cardiology; coronary artery disease, cardiac valve diseases, electrophysiological studies require radiation assistance. It is very important for invasive cardiologists to know the cardiovascular adverse effects of radiation and radiation protection methods.

Aim: Several studies have found a correlation between coronary slow flow (CSF) and low serum high-density lipoprotein cholesterol (HDL-C) levels or high serum uric acid levels. The present study aimed to evaluate whether serum uric acid to HDL-C ratio predicts CSF.Material and Methods: The experimental (CSF) group included 91 patients (40 females, 51 males, mean age: 52±9) who had angiographically normal coronary arteries but had slow flow in one or more coronary arteries. The control group included 96 patients (57 females, 39 males, mean age: 50±9) with normal coronary anatomy and without slow flow. The uric acid to HDL-C ratio was calculated for the two groups and compared.Results: The HDL-C levels of the CSF group (37±8 mg/dL) were significantly lower compared to the controls (49±10 mg/dL, p0.001), whereas serum uric acid levels (5.33±0.97 mg/dL) and uric acid to HDL-C ratio (0.14±0.03) of the CSF group were significantly higher compared to the controls (4.37±0.88 mg/dL and 0.09±0.02, p0.001 and p4.64 mg/dL uric acid and >0.119 % uric acid to HDL-C ratio had a sensitivity of 81% and 85% and specificity of 76% and 80% for determination of CSF, respectively (AUC=0.850, 95% CI: 0.792 - 0.908 and AUC=0.890, 95% CI: 0.841 - 0.940,respectively).Spearman's correlation test has been performed and a significant positive correlation has been detected between the uric acid to HDL-C ratio and the mean thrombolysis in myocardial infarction (TIMI) frame count (r=0.62, p0.001).Conclusion: In this study, higher uric acid to HDL-C ratio values of the CSF group was found compared to the control group. Furthermore, uric acid to HDL-C ratio performed better than serum uric acid levels in predicting CSF.

WOS: 000338997700008, PubMed ID: 24555420, Background: Serum uric acid (UA) level is associated with prognosis in cardiovascular disorders such as sustained hypertension, diabetes mellitus and chronic kidney diseases. Increased UA levels in sustained hypertension may reflect early renal vascular alterations. However, it remains unclear if serum UA is associated with endothelial dysfunction in masked hypertensive patients. Methods: A total of 100 individuals (57% men and 43% women; mean 45 +/- 8 years) with masked hypertension were included in the present study. The clinical and laboratory data were collected. Endothelial function was estimated by flow-mediated dilatation (FMD) of the brachial artery and expressed as percentage change relative to baseline diameter. Results: Univariate regression analysis showed that the FMD was significantly negative correlated with uric acid (r = -0.300, p = 0.002), ambulatory 24-h systolic blood pressure (SBP) (r = -0.275, p = 0.008), hs-CRP (r = -0.222, p = 0.033) and diastolic aortic diameter (r = -0.243, p = 0.019). In multivariate linear regression analysis, only uric acid levels and ambulatory 24-h SBP were significantly associated with FMD. Conclusion: There was an independent correlation between UA and FMD, and a higher UA level was related to worse endothelial function which may contribute to hypertension and cardiovascular morbidity.

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.

Collaterals, which develop in response to ischemic stimuli derived from coronary artery disease (CAD), contribute to reduction of infarct size, left ventricular dysfunction, and mortality. However, there is considerable variation among patients with coronary heart disease regarding the extent of coronary collateral development (CCD). In this study, we aimed to investigate the association of the degree of platelet activation via mean platelet volume (MPV) with coronary collateral circulation. Therefore, 210 patients who underwent coronary angiography and had coronary stenosis ≥50 % in at least one coronary artery were included in the study. Clinical information and analyses of blood samples were obtained from a review of the patients' chart. Blood samples for MPV were analyzed by K3 EDTA and collateral vessels were graded according to the Rentrop classification. In the study group, 150 of the 210 patients were found to have inadequate CCD. Although there was no difference between the two groups with regard to platelet count, MPV levels were significantly higher in the patients who had inadequate CCD (11.3 ± 1.0 fl vs. 9.5 ± 1.5 fl, p 0.001). Furthermore, the Gensini score was significantly lower in patients who had inadequate CCD (45 ± 46 vs. 91 ± 35, p 0.001). MPV, Gensini score, age, female gender, total cholesterol, red cell distribution width, triglyceride, and fasting glucose levels were found to have univariate association with poor CCD. In multivariate logistic regression model, MPV (OR = 2.45, p 0.001) and Gensini score (OR = 0.98, p 0.001) were found to be the independent predictors of impaired CCD. In receiver operator characteristic curve analysis, optimal cut-off value of MPV to predict inadequate CCD was found as9.6 fl, with 96% sensitivity and 84.7% positive predictive value. In conclusion, we can say that MPV is an important, simple, effortless, and cost effective tool and can be useful in predicting the CCD in patients with significant CAD.

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.

In the present study, we aimed to investigate whether tissue Doppler imaging could provide more information than standard echocardiography about left and right ventricular functions and their relations to homocysteine and C-reactive protein (CRP) levels in the course of Behcet's disease (BD). In the right ventricle, patients with BD had lower early diastolic tricuspid annular velocity and early diastolic/late diastolic tricuspid annular velocity ratios than the control group. Mitral and tricuspid annular systolic velocities did not significantly differ; however, diastolic velocities were correlated with duration of the disease. In addition, early/late diastolic mitral annular velocity ratio and early/late diastolic tricuspid annular velocity ratios showed an inverse relation with ocular involvement, serum homocysteine, and CRP levels in patients with BD.

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.

Although cardiac lipomas are quite rare, they represent the second most common primary benign cardiac tumors. In this case report we present a 71-year-old man with a large intrapericardial lipoma originating from pericardium. In this case, intrapericardial lipoma was diagnosed by echocardiographic methods (transthoracic and transesophageal echocardiography) and imaging techniques such as computed tomography, magnetic resonance imaging. The patient had an uneventful postoperative recovery. She is currently asymptomatic and has no evidence of recurrence at 12 months follow-up.

WOS: 000329046500011, PubMed ID: 23857994, Transoesophageal echocardiography (TEE) and venous intracardiac echocardiography (ICE) are traditionally used to visualize the interatrial septum (IAS) and the tenting effect of the fossa ovalis in patients undergoing percutaneous balloon mitral valvuloplasty (PBMV). The aim of the present study was to assess the comparative efficacy and safety of arterial (intra-aortic) ICE and venous ICE, compared with TEE (traditional approach), in the patients undergoing PBMV. TEE, aortic ICE, and venous ICE were consecutively performed in 50 patients (40 9 years, 86 female). The images of intracardiac structures were obtained from both aortic and right atrial loci. The IAS was visualized using TEE, aortic ICE, and venous ICE. The mean mitral valve area was 1.14 0.2 cm(2), and the mean left atrial volume index was 57.5 12 mL/m(2). The mean size of the visualized septal length was 48 5 mm by TEE, 51 5 mm by aortic ICE, and 33 6 mm by venous ICE. The BlandAltman test indicated that the 95 limits of agreement for the measurement of septal diameter ranged from 11.0 to 5.9 mm (mean 2.5 mm) between TEE and aortic ICE, 2.8 to 33.5 mm (mean 15.3 mm) between TEE and venous ICE, and 36.6 to 0.8 mm (mean 17.9 mm) between venous and aortic ICE. Standard venous ICE generally tended to yield smaller values compared with TEE and aortic ICE for the measurement of septal length. Furthermore, the view of fossa ovalis and tenting effect was optimal in 11 patients on venous ICE; however, the fossa ovalis and tip of the needle were well visualized in all patients on aortic ICE (P 0.001). There were no major complications with the use of aortic ICE. Aortic ICE is a superior alternative to venous ICE and facilitates trans-septal puncture in patients with mitral stenosis.

Elevated plasma levels of asymmetric dimethylarginine (ADMA) are prevalent in patients with hypercholesterolemia and coronary artery disease. A total of 83 patients with hypercholesterolemia and angiographically documented mild coronary artery stenosis were randomized to rosuvastatin treatment (20 mg) or atorvastatin treatment (40 mg) once daily for 6 weeks after a 4-week dietary lead-in phase. Both statins decreased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels effectively. Only rosuvastatin increased high-density lipoprotein cholesterol (HDL-C) levels. Both rosuvastatin and atorvastatin decreased plasma ADMA levels; rosuvastatin had a significantly greater effect. The reduction in ADMA levels were correlated with the reduction in TC and LDL-C levels as well as LDL-C–HDL-C ratio. Treatment with rosuvastatin or atorvastatin in patients with hyperlipidemia with mild coronary artery stenosis may lead to a decrease in ADMA levels, which may contribute to improved endothelial function.

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEY, WOS: 000329858400063, …, Turkish Soc Cardiol

WOS: 000303845000005, PubMed ID: 21996616, BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a progressively debilitating disease limiting patients' survival. The prognosis of COPD worsens with the addition of right ventricular (RV) failure. Red cell distribution width (RDW) is a measure of variability in the size of circulating erythrocytes, and is a powerful predictor of outcomes in patients with both chronic and acute left heart failure. Here we attempted to test whether RDW could provide an early marker of RV failure in patients with COPD. METHODS: Thirty-nine consecutive patients with COPD were enrolled in the study. All patients had at least 10 years' history of COPD, and all were treated appropriately. Thirty-nine age-matched and sex-matched individuals were enrolled for comparison. Red cell distribution width was obtained in all patients before transthoracic echocardiography. Right ventricular parameters were evaluated, and RV failure was identified via lateral tricuspid annulus longitudinal motion and systolic-tissue Doppler velocity, using transthoracic echocardiography. RESULTS: Patients with COPD had significantly higher RDW values compared with control subjects (patients with COPD, mean +/- SD, 16.1 +/- 2.5; range, 12.3 to 23.3; control subjects, mean +/- SD, 13.6 +/- 1.3; range, 11.7 to 18.3; P < .001). In multivariable logistic regression, the presence of high RDW was the only parameter independently predicting RV failure in patients with COPD (odds ratio, 2.098; P = .017). Levels of RDW, obtained before echocardiography, predicted the presence of RV failure with a sensitivity of 70% and specificity of 93.1%, with a cutoff value of >17.7. CONCLUSION: Red cell distribution width may be used to identify COPD patients with RV failure. Cite this article: Sincer, I., Zorlu, A., Yilmaz, M. B., Dogan, O. T., Ege, M. R., Amioglu, G., Aydin, G., Ardic, I., & Tandogan, I. (2012, MAY/JUNE). Relationship between red cell distribution width and right ventricular dysfunction in patients with chronic obstructive pulmonary disease. Heart & Lung, 41(3), 238-243. doi:10.1016/j.hrtlng.2011.07.011.

WOS: 000303508600007, PubMed ID: 22139027, Heart failure (HF) is one of the most common and leading cause of death worldwide. Clinical trials provide evidence that the development of atrial fibrillation (AF) is a marker of poor prognosis in patients with HF. Furthermore, elevated D-dimer level is associated with increased cardiovascular mortality independent of AF in HF patients. We investigated whether plasma D-dimer levels in patients with hospitalized systolic HF could predict development of AF. A total of 150 consecutive patients with sinus rhythm who admitted to the emergency department with hospitalized systolic HF were evaluated. All hospitalized patients were obtained D-dimer levels within the first 24 h following admission. Atrial fibrillation developed in 31 (20.7%) patients during follow-up period of 6.3 +/- A 5 months. Patients who developed atrial fibrillation had significantly increased levels of D-dimer [608 (339-1,022) ng/ml versus 1,100 (608-2,599) ng/ml, P = 0.001]. Optimal cut-off level of D-dimer to predict development of AF was found to be > 792 ng/ml. D-dimer > 792 ng/ml, right ventricular dilatation, age, systolic pulmonary pressure, left atrium size, moderate to severe tricuspid regurgitation, and beta blocker usage were found to have prognostic significance in univariate analysis. In multivariate Cox proportional-hazards model, D-dimer levels > 792 ng/ml (HR = 3.019, P = 0.006), and right ventricular dilatation (HR = 8.676, P = 0.003) were associated with an increased risk of new-onset AF. In conclusion, D-dimer could predict development of AF in patients with hospitalized systolic HF.

OBJECTIVE Previous studies have shown an association between high sensitive C-reactive protein (hsCRP) and arterial stiffness in most cardiovascular diseases. High sensitive C-reactive protein and arterial stiffness have been considered as independent predictors of cardiovascular mortality in cardiovascular disease. The aim of this study was to investigate the relationship between hsCRP, a marker of systemic inflammation and aortic stiffness in patients with coronary artery ectasia (CAE). METHODS Our study was designed as cross-sectional study. Serum hsCRP levels and aortic stiffness parameters were measured in CAE patients (n=28) and age - and gender-matched control subjects (n=25). Serum hsCRP levels were determined by an immunonephelometry assay. Aortic strain (AS) and aortic distensibility (AD) were calculated from the aortic diameters measured using M-mode echocardiography and blood pressure obtained by sphygmomanometry. Independent samples "t" test, Chi-square test and Spearman correlation test were used for statistical analysis. RESULTS Serum levels of hsCRP in CAE group were higher than in the controls (p

Objective To evaluate cardiovascular risk factors and demographic parameters in patients with varicocele. Design Although some pathophysiologic hypotheses have been suggested to explain the etiology of varicocele, the exact mechanism underlying varicocele is not yet known. The coexistence of arterial and venous system pathologic conditions has been reported recently, including varicosities of the coronary venous system and leg veins. Cardiovascular risk factors have not been evaluated previously in patients with varicocele. In addition to the presence of cardiovascular risk factors and demographic parameters, we assessed the prevalence of peripheral varicose veins in patients with and without varicocele. Patient(s) Study groups consisted of 52 patients with varicocele and 100 patients without varicocele younger than 50 years old. Result(s) There were no statistically significant differences between the two groups with respect to presence of hypertension, diabetes mellitus, hyperlipidemia, family history of coronary artery disease, body mass index, age, and height. The weight and presence of peripheral varicose veins in the patients with varicocele were significantly higher than in those without varicocele. It was found that presence of peripheral varicose veins was independently and positively associated with varicocele. Conclusion(s) We have demonstrated that varicocele is not associated with cardiovascular risk factors or demographic parameters. However, the presence of peripheral varicose veins is positively associated with varicocele, suggesting a possible common pathologic step.

SUMMARY OBJECTIVE Coronary collateral development (CCD) predicts the severity of coronary heart disease. Hemogram parameters, such as mean platelet volume (MPV), eosinophil, red cell distribution width, and platelet distribution width (PDW), are supposed novel inflammatory markers. We aimed to compare hemogram parameter values in patients presenting with non-ST-elevation myocardial infarction (NSTEMI) with adequate or inadequate CCD. METHODS A total of 177 patients with NSTEMI undergoing coronary arteriography were enrolled and divided into two groups based on the development of CCD: one group with adequate CCD (n=88) and the other with impaired CCD (n=89). RESULTS Baseline demographics and clinical risk factors were similar between the groups. Hemogram parameters were not significantly different between the two groups. However, compared to the inadequate CCD group, the median PDW was significantly higher in the adequate CCD group, 17.6 (1.4) vs. 17.8 (1.6) p=0.004. In a multivariate analysis, PDW (p=0.001, 95% CI for OR: 0.489(0,319-0,750) was found to be significantly different in the adequate CCD group compared to the inadequate CCD group. Pearson’s correlation analysis revealed that PDW was significantly correlated with the Rentrop score (r=0.26, p

WOS:000562623600026 PubMed: 32844919 OBJECTIVE: Our aim is to determine whether radiation affects the endothelial function of hospital staff working in the radiation unit for diagnostic and therapeutic purposes. We have evaluated endothelial function with vascular imaging parameters such as flow-mediated dilatation (FMD) and aortic stiffness index (ASI). METHODS: A total of 75 employees, 35 of whom are exposed to radiation due to their profession and 40 as the control group, were included in our single-centered study. Demographic data, FMD, aortic stiffness, and echocardiographic findings of the two groups were compared. RESULTS: There were no significant differences in demographic data. Median FMD values tended to be lower in the radiation exposure group [7.89 (2.17-21.88) vs. 11.69 (5.13-27.27) p=0.09]. The FMD value was significantly lower in the catheter laboratory group than in the radiation-exposed (p=0.034) and control (p=0.012) groups. However, there was no statistically significant difference between the non-catheter lab radiation exposed group and the control group (p=0.804). In addition, there was no statistically significant difference in the ASI value between the groups (p=0.201). CONCLUSION: We have found that FMD is decreased among hospital staff working in radiation-associated areas. This may be an early marker for radiation-induced endothelial dysfunction.