The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia

This retrospective study aimed to investigate the diagnostic relation between the mean platelet volume (MPV) and supraventricular tachyarrhythmia (SVT) in patient with documented atrial tachyarrhythmia in the emergency department (ED). Two study groups were compared; a SVT group with arrive at the ED with documented SVT (n=122) and 100 healthy adult without any palpitation symptom, arrhythmic disease, and with normal physical examination results that were brought for checkups to the cardiology polyclinic were classified as control group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period. In terms of the focus of the study, hemoglobin, neutrophil count, mean cell volume (MCV), red cell distribution width (RDW), platelet, white blood cell (WBC), and lymphocyte counts were similar in both group (p > 0.05). MPV in the SVT group was signifi cantly higher than in the control group (9.12±1.22 fl vs 8.64±0.89 fl , p < 0.001). Multivariate logistic regression analysis showed that just MPV was independent predictor of SVT in patients with palpitation in ED (odds ratio [OR] 8.497, 95% confidence interval (6.181 to 12.325), p=0.012). The present study described that MPV is helpful parameter for the diagnosis of SVT in emergency department, for the first time in the literature.Keywords: mean platelet volume, inflammation, palpitation, supraventricular tachycardia, diagnosticAfrican Health sciences Vol 14 No. 1 March 201

Ocena zaburzeń przewodzenia przedsionkowego i czynności mechanicznej lewego przedsionka u chorych z subklinicznymi zaburzeniami czynności tarczycy

Introduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = –0.492, p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinica tlhyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias.Wstęp: Zmiany stężeń hormonów tarczycy mogą wpływać nie tylko na czynność komór serca, ale również na czynność przedsionków. Niniejsze badanie przeprowadzono w celu oceny czynności mechanicznej lewego przedsionka (LA), sprzężenia elektromechanicznego i dyspersji załamka P u chorych z subklinicznymi zaburzeniami czynności tarczycy. Materiał i metody: Do badania włączono 80 chorych z subklinicznymi zaburzeniami czynności tarczycy i 40 osób stanowiących grupę kontrolną. Zaburzenia czynności tarczycy rozpoznawano na podstawie obniżonego lub podwyższonego stężenia TSH w surowicy i prawidłowego stężenia wolnej T4 (fT4). Zmierzono objętości LA, posługując się dwupłaszczyznową metodą area-lenght (pole– wymiar podłużny). Obliczono również objętości i frakcje aktywnego i biernego opróżniania LA. Do pomiaru opóźnienia przewodnictwa wewnątrzi międzyprzedsionkowego zastosowano technikę doplera tkankowego. Wyniki: Grupy nie różniły się pod względem charakterystyki demograficznej. W grupie z zaburzeniami czynności tarczycy mechaniczna funkcja przedsionków była istotnie upośledzona w porównaniu z osobami z grupy kontrolnej. Opóźnienie przewodnictwa wewnątrzi międzyprzedsionkowego stwierdzano istotnie częściej u osób z zaburzeniami czynności tarczycy. Stwierdzono dodatnią korelację miedzy opóźnieniem elektromechanicznym (PA lateral) i opóźnieniem przewodzenia międzyprzedsionkowego a TSH (odpowiednio r = 0,507; p = 0,006 i r = 0,455; p = 0,015) u osób z subkliniczną niedoczynnością tarczycy. Z kolei u osób z subkliniczną nadczynnością tarczycy zaobserwowano ujemną korelację między TSH i opóźnieniem przewodzenia międzyprzedsionkowego (r = –0,492; p = 0,006). W wieloczynnikowej analizie regresji liniowej wykazano, że stężenie TSH było jedynym parametrem niezależnie związanym z opóźnieniem przewodzenia międzyprzedsionkowego u chorych z subklinicznymi zaburzeniami czynności tarczycy. Wnioski: W niniejszym badaniu wykazano upośledzoną czynność mechaniczną i elektromechaniczną LA u chorych z subklinicznymi zaburzeniami czynności tarczycy. Stężenie TSH było niezależnym czynnikiem determinującym opóźnienie przewodzenia międzyprzedsionkowego. Wydłużenie czasu sprzężenia elektromechanicznego i upośledzenie mechanicznej czynności przedsionków mogą się wiązać ze zwiększoną zapadalnością na zaburzenia rytmu

Aort nabız dalgası hızı ile aort yayı kalsifikasyonu arasındaki ilişkinin değerlendirilmesi

Amaç: Semptomlu aterosklerotik hastalığı olmayan hastalarda arteryel sertlik parametreleri ile aort kalsifikasyonu arasındaki ilişkiyi incelemeyi amaçladık. Çalışma planı: Çalışma popülasyonu göğüs grafisinde aort yayı kalsifikasyonu olan 41 hasta (grup I, 17 erkek, ortalama yaş 705 yıl) ve kalsifikasyonu olmayan yaş ve cinsiyet eşleştirilmiş 41 kişiden (grup II, 17 erkek, ortalama yaş 686 yıl) oluşturuldu. Semptomlu veya bilinen vasküler hastalığı olanlar çalışmadan dışlandı. Tüm bireylerin arteryel sertlik parametreleri SphygmoCor cihazı ile ölçüldü. Aort nabzı dalga hızı (PWV), augmentasyon basıncı (AP), augmentasyon indeksi (AIx) ve kalp hızına göre düzeltilmiş augmentasyon indeksi (AIx@75) arteryel sertlik parametreleri olarak değerlendirildi. Bulgular: İki grup demografik özellikler, ilaç kullanımı ve serum lipit düzeyleri açısından karşılaştırıldı, gruplar arasında anlamlı fark yoktu. AP grup Ide grup IIye göre anlamlı olarak yüksek bulundu (p0.002). AIx ve AIx@75 gruplar arası benzerdi. Aort PWVsi grup I de grup IIye göre anlamlı olarak yüksek bulundu (p0.0001). Sonuç: Bu çalışmanın bulgularına göre göğüs grafisinde tespit edilen aort yayı kalsifikasyonu artmış aort nabzı dalga hızı ile ilişkilidir.Objectives: We aimed to assess arterial stiffness parameters and to investigate the relationship between these parameters and aortic calcification in patients with aortic arch calcification and without symptomatic atherosclerotic disease. Study design: The population of this study consisted of 41 patients with aortic arch calcification verified by chest X-ray (group I, 17 males, mean age 70±5 years) and individuals without aortic arch calcification (group II, 17 males, mean age 68±6 years). Subjects with symptomatic or known vascular disease were excluded from the study. The arterial stiffness parameters of all subjects were measured noninvasively with a SphygmoCor device. Aortic pulse wave velocity (PWV), augmentation pressure (AP), augmentation index (AIx) and heart rate normalized augmentation index (AIx@75) were used as parameters of arterial stiffness. Results: The two groups were compared according to demographic characteristics, medications currently being taken, and levels of serum lipids. There was no significant difference between the groups. AP in group I was significantly higher than that of group II (p0.002). AIx and AIx@75 were similar in both groups. Aortic PWV of group I was significantly higher than that of group II (p<0.0001). Conclusion: According to the results of this study, the presence of aortic calcification, verified by chest radiography, was associated with increased aortic PWV

Evaulation of atrial conduction abnormalities and left atrial mechanical functions in patients with subclinical thyroid disorders

Alcelik, Aytekin/0000-0002-3156-1076WOS: 000310110900006PubMed: 22933164Introduction: Changes of thyroid hormones levels may lead to effects, not only in ventricular function, but also atrial function. The aim of this study was to investigate left atrial (LA) mechanical functions, atrial electromechanical coupling and P wave dispersion in patients with subclinical thyroid disorders. Material and methods: Eighty patients with subclinical thyroid disorders and forty controls were included. A diagnosis of subclinical thyroid disorders were reached with increased or decreased serum TSH and normal free T4 (fT4) levels. LA volumes were measured using the biplane area length method and LA active and passive emptying volumes and fraction were calculated. Intra- and interatrial electromechanical delay were measured by tissue Doppler imaging (TDI). Results: All groups had similar demographic findings. LA mechanical functions significantly impaired in subclinical thyroid disorders than control group. Intra- and Interatrial delay, were measured significantly higher in patients with subclinical thyroid disorders than control group. PA lateral and interatrial delay were positively correlated with TSH (r = 0.507, p = 0.006 and r = 0.455, p = 0.015, respectively) in subclinical hypothyroid patients. There was negative correlation between TSH and interatrial delay (r = -0.492,p = 0.006) in subclinical hyperthyroid patients. Linear multivariate regression analysis demonstrated that, TSH was the only an independent factor of interatrial delay in patients with subclinical thyroid disorders. Conclusions: This study showed that impaired LA mechanical and electromechanical function in subclinical thyroid disorders. TSH was an independent determinant of interatrial delay. Prolonged atrial electromechanical coupling time and impaired mechanical atrial functions may be related to the increased incidence of arrhythmias. (Endokrynol Pol 2012; 63 (4): 286-293

Ortner's Syndrome in a Patient with Idiopathic Dilated Cardiomyopathy

Ortner’s syndrome is a rare cause of hoarseness. It occurs due to left recurrent laryngeal nerve paralysis caused by an identifiable cardiovascular disease. Here, we present a case of Ortner's syndrome emerging due to pulmonary artery dilatation in a patient with idiopathic dilated cardiomyopathy

The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia

Background: The diagnosis of palpitation can be difficult in the emergency department (ED) and the waiting time for a first appointment with an arrhythmia clinic can be very long. The inflammation is sufficient to facilitate the initiation of supraventricular tachyarrhythmia (SVT). The increased mean platelet volume (MPV) is closely correlated with inflammation and to reflect inflammatory burden in different condition. Objective: In this study, we aimed to investigate the relation between MPV and SVT in patient with documented atrial tachyarrhythmia in ED. Methods: Two study groups were compared; a SVT group with arrive at the ED with documented SVT (n=122) and 100 healthy adult without any palpitation symptom, arrhythmic disease, and with normal physical examination results that were brought for checkups to the cardiology polyclinic were classified as control group. Blood samples were obtained from all patients for determining the hematologic counts and MPV during first hour in ED period. Results: In terms of the focus of the study, hemoglobin, neutrophil count, mean cell volume (MCV), red cell distribution width (RDW), platelet, white blood cell (WBC), and lymphocyte counts were similar in both group (p>0.05). MPV in the SVT group was signifi cantly higher than in the control group (9.12±1.22 fl vs 8.64±0.89 fl , p<0.001). Multivariate logistic regression analysis showed that just MPV was independent predictor of SVT in patients with palpitation in ED (odds ratio [OR] 8.497, 95% confidence interval (6.181 to 12.325), p=0.012). Conclusions: Our study described that MPV is helpful parameter for the diagnosis of SVT in emergency department, for the first time in the literature

Predictive value of total atrial conduction time measured with tissue Doppler imaging for postoperative atrial fibrillation after coronary artery bypass surgery

Postoperative atrial fibrillation (POAF) complicating coronary artery bypass grafting surgery (CABG) increases morbidity and stroke risk. Total atrial conduction time (PA-TDI duration) has been identified as an independent predictor of new-onset atrial fibrillation (AF). We aimed to assess whether PA-TDI duration is a predictor of AF after CABG

The diagnostic significance of NT-proBNP and troponin I in emergency department patients presenting with palpitations

OBJECTIVE: This prospective study investigated the diagnostic significance of the N-terminal pro-brain natriuretic (NT-proBNP) and troponin I peptides in emergency department patients presenting with palpitations. METHODS: Two groups of patients with palpitations but without documented supraventricular tachycardia were compared: a group with supraventricular tachycardia (n&#8202;=&#8202;49) and a control group (n&#8202;=&#8202;47). Both groups were diagnosed using electrophysiological studies during the study period. Blood samples were obtained from all of the patients to determine the NT-proBNP and troponin I levels within the first hour following arrival in the emergency department. RESULT: The mean NT-proBNP levels were 207.74&#177;197.11 in supraventricular tachyarrhythmia group and 39.99&#177;32.83 pg/mL in control group (p<0.001). To predict supraventricular tachycardia, the optimum NT-proBNP threshold was 61.15 pg/mL, as defined by the receiver operating characteristic (ROC) curve, with a non-significant area under the ROC curve of 0.920 (95% CI, 0.86-0.97, p<0.001). The NT-proBNP cut-off for diagnosing supraventricular tachycardia had 81.6% sensitivity and 91.5% specificity. Supraventricular tachycardia was significantly more frequent in the patients with NT-proBNP levels &#8805;61.15 pg/mL (n&#8202;=&#8202;44, 90.9%, p>0.001). The mean troponin I levels were 0.17&#177;0.56 and 0.01&#177;0.06 pg/mL for the patients with and without supraventricular tachycardia, respectively (p<0.05). Of the 96 patients, 21 (21.87%) had troponin I levels &#8805;0.01: 2 (4.25%) in the control group and 19 (38.77%) in the supraventricular tachycardia group (p<0.001). CONCLUSION: Troponin I and, in particular, NT-proBNP peptide were helpful for differentiating supraventricular tachycardia from non- supraventricular tachycardia palpitations. Further randomized, large, multicenter trials are needed to define the benefit and diagnostic role of NT-proBNP and troponin I in the management algorithm of patients presenting with palpitations in emergency departments