Hipertansif hastalarda N- amino terminal prohormon beyin natriüretik peptid düzeyleri ile ilişkili faktörler

Objectives: In this study we ınvestigated that which the factors affecting the level of N- amino terminal prohormone brain natriuretic peptid (NT-pro BNP) in hypertensive population. Methods: A total of 309 hypertensive patients (mean age 50.5 ± 10.7, 49.2% male) were enrolled into the study. Lower group was defined as NT-pro BNP 60 pg/dl or low, high group was defined as NT-pro BNP 60 pg/dl higher. The patients with secondary hypertensive, heart failure, coronary artery disease, valvular diseases, chronic renal failure (serum creatinine >1.5 mg/dl, blood urea nitrogen>30 mg/dl) and chronic obstructive pulmonary disease were excluded from the study. Results: Left ventricular mass index, 24-h systolic blood pressure, day systolic blood pressure, night systolic blood pressure and night diastolic blood pressure higher in high group than lower group. In stepwise linear regression analysis, a significant relation was found between sex, left ventricular mass index, age, night systolic blood pressure and higher NT-pro BNP levels (R²=0.236, ß= -0.258, P<0.001, ß=0.185, P=0.006, ß=0.174, P=0.010, ß=0.160, p=0.015 respectively)., Conclusion: Age, gender, left ventricle mass index and night systolic blood pressure were found as independent predictive factors on NT-pro BNP in hypertensive patients

The evaluation of relationship between neutrophil-to-lymphocyte ratio and slow coronary flow

Objective: The aim of this study was to investigate thecorrelations between leukocyte counts, the neutrophil-tolymphocyteratio (NLR), and slow coronary flow (SCF).Methods: We evaluated 135 patients undergoing coronaryangiography (CAG) within coronary artery disease(CAD) indication. We divided patients into three groupsaccording to the CAG findings. Group 1 consisted of 45patients with an SCF pattern; group 2 consisted of 45 patientswith at least 50% lumen narrowing in at least oneepicardial coronary artery; and group 3 (control group)consisted of 45 patients with normal coronary arteries.The quantification of the coronary flow was assessed usingthe thrombolysis in myocardial infarction (TIMI) framecount method for each of the coronary arteries. Bloodsamples were collected from the patients after a 12 hovernight fasting. The NLR ratio was calculated from theautomated complete blood count.Results: NLR in CAD was higher than in both the SCFand control groups (p=0.008, p<0.001, respectively).However, there was no statistically significant differencebetween SCF and control group (p=0.768). Neutrophilcounts in CAD were higher than in both SCF and controlgroups, but only the difference between CAD and SCFgroups was statistically significant (p=0.010).Conclusion: Our study revealed that circulating neutrophilcounts and NLR were related to the coronary arterydisease, as expected.Key words: Neutrophil-to-lymphocyte ratio, leukocyte subtype, slow coronary flow, coronary artery diseas

Can percutaneous mitral balloon valvuloplasty reduce ongoing inflammation in patients with rheumatic mitral stenosis?

Objective: In the pathophysiology of rheumatic heart valve disease, chronic systemic inflammatory process plays an important role. In this study, we aimed to investigate whether the percutaneous transluminal mitral balloon valvuloplasty (PTMV) has any effect on the chronic systemic inflammatory response in patients with rheumatic mitral stenosis (RMS). Methods: In this study, we used neutrophil to lymphocyte ratio (NLR), which is a simply available and inexpensive biomarker of systemic inflammatory response, to evaluate the level of inflammation. A total of 41 consecutive patients with severe RMS undergoing successful PTMV were included in the study. Laboratory assessments of all patients by the measuring of NLR before and after the PTMV procedure were performed. Results: Before and after the PTMV, the mean lymphocyte counts were found 2.1±0.6 x103 /µL and 1.9±0.6 x103 / µL (p=0.01), and the mean leukocyte counts were 4.8±1.4 x103 /µL and 4.4±1.3 x103 /µL (p=0.069) respectively. NLR values were determined as 2.7 ± 1.0 and 2.2 ± 0.8. After the PTMV, there was a significant decrease in NLR in patients with rheumatic mitral stenosis patients (p=0.001). In the correlation analysis, there was significant negative correlation between the mitral valve area and NLR (p= 0.004- r=0.440), and there was significant positive correlation between left atrial diameter and NLR (p=0.028 r=0.344). Conclusion: This study showed significant decrease in NLR after PTMV in patients with RMS, which means reduced inflammation after PTMV. Larger studies are needed to confirm the results