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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: To investigate the markers that may predict both atrial fibrillation (AF) and atherosclerosis in obese patients. Method: This study was conducted on 108 participants (54 women and 54 men) with a body mass index (i.e., BMI) of at least 30. In addition to the electrocardiogram (ECG) and transthoracic echocardiography (TTE) findings, we also analyzed the findings of body composition by means of the bioelectric impedance analysis method using the Tanita MC 780 MA analyzer in all participants. Results: We found that the minimal area of the left atrium (LA) had a very strong (r = 0.978, p = 0.022) correlation with visceral adiposity and a weak positive correlation with waist circumference. Aortic stiffness had a weak positive correlation with visceral adiposity ratio (p = 0.022) and fat mass (r = 0.323, p = 0.001). The diameter of LA had weak positive correlations with visceral adiposity (p = 0.018), waist circumference (r = 0.336, p < 0.001), fat-free mass (r = 0.323, p = 0.001), muscle mass (r = 0.324, p = 0.001), liquid mass (r = 0.323, p = 0.001) and metabolic age (r = 0.364, p < 0.001). Again, we found weak positive correlations of epicardial fat tissue with visceral adiposity (r = 0.459, p = 0.018) and metabolic age (r = 0.350, p < 0.001). Conclusions: In our study, it has been noted that obese patients may have different levels of risk for AF and atherosclerosis, and there may be a more risky subgroup in which the distribution of some anthropometric and body tissue components differs.

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

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.

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

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

Deteriorated aortic elasticity is part of the atherosclerotic process. Inflammation is an underlying factor in both COVID-19 and atherosclerosis.Using aortic elastic properties, we aimed to assess the subclinical indicators of susceptibility to inflammatory atherosclerosis in patients with COVID-19.Out of 194 participants included in this study, 100 were diagnosed with COVID-19 in the last 6 months (60 women and 40 men with a mean age of 34.13 ± 6.45 years) and 94 were healthy controls (55 women and 39 men with a mean age of 30.39 ± 7.21 years). We analyzed transthoracic echocardiographic and aortic stiffness parameters in all participants.Values of systolic blood pressure (110 [85-140] vs. 110 [80-140],Measurement of aortic stiffness is a simple, practical yet inexpensive method in COVID-19 patients, and therefore, may be used as an early marker for COVID-19-induced subclinical atherosclerosis.

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.

SUMMARY OBJECTIVE: Inflammation has been suggested as a potential mechanism in the pathogenesis of arrhythmia. Hemogram parameters such as monocyte count to high-density lipoprotein cholesterol ratio (MHR), neutrophil/lymphocyte ratio (NLR), and monocyte/lymphocyte ratio (MLR) have been considered to be markers of inflammation and new cardiovascular risk predictors. This retrospective study aimed to investigate the relationship between MHR, NLR, and MLR in patients with paroxysmal supraventricular tachycardia (PSVT). METHODS: A retrospective study conducted at a university hospital in Bolu, Turkey, between 2017 and 2019. Our study included 196 patients who underwent electrophysiological study (EPS) due to palpitation or documented PSVT on electrocardiography (ECG). Patients having documented atrioventricular nodal re-entrant tachycardia (AVNRT) on ECG or inducible AVNRT on EPS were included in the PSVT group (n=130), and patients with palpitation but without inducible arrhythmia on EPS (n=66) were included in the control group. Routine biochemical and hemogram tests were performed before the EPS procedure. RESULTS: When hemogram parameters were compared, there was no statistically significant difference in MHR values [0.010 (0.001-0.030) vs 0.010 (0.001-0.020) p =0.67]. Additionally, both NLR [2.21(0.74-11.36) vs 1.98(0.72-24.87) p=0.13] and MLR [0.25 (0.03-1.05) vs 0.24(0.07-1.39) p=0.41] were not statistically significant between the two groups. CONCLUSION: There is no significant difference in PSVT patients regarding hemogram parameters including white blood cell subtypes, MLR, NLR, and MHR. Therefore the evaluation of hemogram parameters may not be clinically relevant for PSVT patients. RESUMO OBJETIVO: A inflamação tem sido sugerida como um mecanismo potencial na patogênese da arritmia. Parâmetros do hemograma, como contagem de monócitos e razão de colesterol lipoproteína de alta densidade (MHP), proporção de neutrófilos / linfócitos (NLP) e proporção de monócitos / linfócitos (MLR), foram considerados marcadores de inflamação e novos preditores de risco cardiovascular. Este estudo retrospectivo teve como objetivo investigar a relação entre MHP, NLP e MLP em pacientes com taquicardia paroxística supraventricular (PSVT). MÉTODOS: Estudo retrospectivo realizado em um hospital universitário em Bolu, Turquia, entre 2017 e 2019. Nosso estudo incluiu 196 pacientes submetidos a estudo eletrofisiológico (EPS) devido a palpitações ou PSVT documentada na eletrocardiografia (ECG). Os pacientes com taquicardia nodal atrioventricular reentrante (AVNRT) no ECG ou AVNRT indutível no EPS foram incluídos no grupo PSVT (n = 130) e os pacientes com palpitações sem arritmia induzível no EPS (n = 66) foram incluídos no grupo controle. Testes bioquímicos e de hemograma de rotina foram realizados antes do procedimento de EPS. RESULTADOS: Quando os parâmetros do hemograma foram comparados, não houve diferença estatisticamente significante nos valores de MHP (0,010 (0,001-0,030) vs 0,010 (0,001-0,020) p = 0,67). Além disso, tanto o NLP (2,21 (0,74-11,36) vs 1,98 (0,72-24,87) p = 0,13) quanto o MLP (0,25 (0,03-1,05) vs 0,24 (0,07-1,39) p = 0,41) não foram estatisticamente significantes entre os dois grupos. CONCLUSÃO: Não há diferença significativa nos pacientes com PSVT em relação aos parâmetros do hemograma, incluindo os subtipos de glóbulos brancos, MHP, NLP e MHP. Portanto, a avaliação dos parâmetros do hemograma pode não ser clinicamente relevante para pacientes com PSVT.

Background: Coronary artery fistula (CAF) is an abnormal connection that links a coronary artery to a cardiac chamber or another major blood vessel. Several studies have shown the association between mean platelet volume (MPV) and cardiovascular diseases. In the literature, there is no previous study about the association between hematologic parameters and congenital CAF. For this reason, we aimed to investigate the association of MPV with CAF. Methods: 70 patients with normal coronary arteries and 50 with coronary artery fistulas were included. Routine blood and biochemical parameters were measured before the arteriography. Differences between groups for continuous variables were analyzed with t- test or Mann-Whitney test. P values < 0.05 were considered significant. Regression analysis was used to find independent predictors of CAF. Results: Baseline patient demographics, including age and clinical risk factors, were similar between the groups. Compared to the control group, median (IQR) High-density lipoprotein cholesterol (HDL) levels were significantly higher (p=0.04) and MPV levels were significantly lower in the CAF group (8.84 ± 1.71fL vs. 10.43 ± 1.34, p < 0.001). In the multivariate analysis, only MPV was a significant predictor of CAF (p < 0.001, 95% CI for OR: 0.438 (0.306-0.629). A negative correlation was found between MPV and fistulae in Pearson's correlation test (r: -0.454, p < 0.001). An MPV level of < 9,6 fL showed sensitivity, specificity, positive predictive value and negative predictive value of 80%, 68%, 71% and 78% respectively (AUC = 0.766, 95% CI, 0.678-0.854) for the prediction of CAF. Conclusion: The present study suggests that MPV may decrease in patients with CAF. Resumo Fundamento: A fístula da artéria coronária (FAC) é uma conexão anormal que liga a artéria coronária a uma câmara cardíaca ou outro importante vaso sanguíneo. Vários estudos mostraram a associação entre o volume plaquetário médio (VPM) e as doenças cardiovasculares. Na literatura, não há estudo prévio sobre a associação entre os parâmetros hematológicos e a FAC congênita. Por essa razão, nosso objetivo foi investigar a relação do VPM com a FAC. Métodos: Foram incluídos 70 pacientes com artérias coronárias normais e 50 com fístulas de artérias coronárias. Os parâmetros sanguíneos e bioquímicos de rotina foram medidos antes da arteriografia. As diferenças entre os grupos para as variáveis contínuas foram analisadas com o teste t ou teste de Mann-Whitney. Valores de p < 0,05 foram considerados significativos. A análise de regressão foi utilizada para encontrar preditores independentes de FAC. Resultados: Os dados demográficos basais dos pacientes, incluindo idade e fatores de risco clínicos, foram semelhantes entre os grupos. Comparados à mediana do grupo controle (IIQ), os níveis de HDL-colesterol foram significativamente mais altos (p = 0,04) e os níveis de VPM foram significativamente mais baixos no grupo FAC (8,84 ± 1,71fL vs. 10,43 ± 1,34, p < 0,001). Na análise multivariada, apenas o VPM foi um preditor significativo de FAC (p

Introduction: Myocardial infarction continues to be the most important cause of morbidity and mortality, and recently this disease has begun to be seen uncommonly at young ages. In our study we aimed to assess microvolt T-wave alternans in young patients who had ST segment elevation myocardial infarction with preserved left ventricular function and who underwent single-vessel revascularization. Material and methods: We enrolled 108 consecutive patients (age: 39.5 ±4.1) with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention and 43 patients (age: 38.5 ±3.7) with normal coronary angiograms as a control group. The myocardial infarction patients were younger than 45 and had a preserved left ventricular ejection fraction. They were divided into three groups according to the culprit artery. The microvolt T-wave alternans (MTWA) values were calculated an average of 12 months after the primary percutaneous coronary intervention using the modified moving average method. Results: The MTWA positivity was significantly higher in the STEMI group compared to the controls (p < 0.001). It was also significantly higher in STEMI patients with left anterior descending artery lesions compared to patients with circumflex artery and right coronary artery lesions (p = 0.013). Moreover, the culprit artery was an independent predictor of MTWA positivity (p = 0.043). Conclusions: In STEMI patients of a young age, MTWA positivity was higher than in healthy individuals, especially when the responsible vessel fed a wider region.

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.

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

The risk of sudden death and cardiac arrhythmia increases in morbidly obese patients. We aimed to evaluate the marker of arrhythmias such as Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc ratios in extreme obesity.The study included 41 extremely obese patients and 41 control subjects. QTmax, QTmin, QRS, JT and Tp-e intervals were measured od 12‑lead electrocardiographies. In addition, Tp-e/QT, Tp-e/QTc, Tp-e/JT and Tp-e/JTc rates and QTc, cQTd and JTc intervals were calculated.Tp-e interval (79.2 ± 9.7 ms (milisecond) vs. 68.6 ± 8.1, p 0.001), QTc interval (395.9 ± 18.8 vs. 377.9 ± 19.3 ms, p 0.001), JTc interval (317.1 ± 27.0 vs. 297.4 ± 23.2 ms, p = 0.001), Tp-e/QT ratio (0.22 ± 0.03vs. 0.19 ± 0.02, p 0.001), Tp-e/QTc ratio (0.20 ± 0.26vs. 0.18 ± 0.02, p = 0.001), Tp-e/JT ratio (0.29 ± 0.04 vs. 0.25 ± 0.03, p 0.001), TPe/JTc ratio (0.25 ± 0.04 vs. 0.23 ± 0.03, p = 0.018), QTd (32.8 ± 10 vs.15 ± 6.4 ms, p 0.001) and cQTd (70.0 ± 30.1 vs. 31.3 ± 22.4 ms, p 0.001) were significantly higher in obese patients.Compared to healthy subjects potential ECG repolarization predictors were significantly increased in extremely obese patients.

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.

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.

Hypothesis: We examined the hypothesis that a specific myocardial injury marker, namely high sensitive cardiac troponin-I (HsTn-I), is elevated in patients with slow coronary flow (SCF) pattern. Aim: To examine the above hypothesis by studying a group of patients who had undergone coronary angiography for the detection of their chest pain aetiology with SCF pattern despite an angiographically normal coronary arteriogram. Methods: We evaluated and performed coronary angiography (CAG) of 97 patients with chest discomfort. The indication forCAG was at least Canada class 3 angina and/or proven myocardial ischaemia according to noninvasive diagnostic tests. We further divided patients into three subgroups according to CAG images and compared HsTn-I plasma levels in 39 patients with SCF pattern, 28 patients with coronary artery disease (CAD), and 30 patients with normal coronary arteries. We researched the association between qualitative HsTn-I positivity and demographic features including cardiovascular risk factors, inflammation markers and TIMI frame count for each of the epicardial coronary arteries. Results: TIMI frame count for each epicardial coronary artery was significantly higher in patients with SCF pattern than in patients with CAD and normal coronary arteries (p < 0.001). HsTn-I positivity was not statistically different between patients with SCF pattern and normal coronary arteries (p = 512), but it was significantly higher in the CAD group than the other two group of patients (p < 0.001). Conclusions: In patients with SCF, HsTn-I may be detectable, but it is not elevated as in patients with normal coronary arteries.