Echocardiographic and hemodynamic changes in patients with high-grade varicocele

Varicocele is abnormal tortuosity and dilatation of the pampiniform plexus veins within the spermatic cord. Varicocele is associated with testicular atrophy, hypogonadism, impaired semen analysis values, or decreased testosterone production. Varicocele is a progressive disease and should be treated because it may be a systemic disease that can be associated with cardiovascular abnormalities. We hypothesize in this study that cardiovascular and hemodynamic pathologies may occur in varicocele patients. In this prospective, multicentric, multidisciplinary study, patients diagnosed with high-grade left varicocele in the urology clinic underwent semen analysis, total testosterone determination, and scrotal Doppler ultrasonography. In addition, blood pressure measurement and echocardiographic evaluation were performed by blinded cardiologists in both the varicocele patients and the healthy control group. The study was carried out with 103 varicocele patients and 133 healthy individuals who formed the control group. Diastolic blood pressure (P = 0.016), left ventricular end diastolic (P < 0.001) and systolic diameter (P < 0.001), ejection fraction (P < 0.001), pulmonary arterial pressure (P < 0.001), and aortic distensibility (P < 0.001) values were significantly higher in varicocele patients compared with controls; interventricular septum wall thickness (P = 0.022), aortic systolic (P < 0.001) and diastolic diameter (P < 0.001), aortic systolic (P < 0.001) and diastolic diameter index (P < 0.001), and aortic stiffness index (P < 0.001) values were significantly lower in varicocele patients. The mean aortic distensibility of non-normozoospermic group was lower than that of normozoospermic group (P = 0.041). There was no statistically significant relationship between thickest vein diameter in spermatic cord and cardiological parameters. This study showed that symptomatic patients with high-grade varicocele had a higher risk of cardiovascular and hemodynamic disease. We recommend that men with high-grade symptomatic varicocele with impaired semen analysis undergo cardiovascular and hemodynamic evaluation regardless of their spermatic vein diameter

Rheumatic valvular heart disease and serum tnf-alpha levels of hla-b27 and evaluation of the relationship between

Akut romatizmal ateş, grup A streptokokların etken olduğu üst solunum yolu enfeksiyonu sonrası görülen otoimmün bir hastalıktır. ARAnın kronik sekeli olan RKH, özellikle gelişmekte olan ülkelerde önemli bir morbidite ve mortalite nedenidir. Otoimmünite ile ilişkili hastalıklardaki rolü nedeni ile HLA altgrupları ile ARA ve RKH ilişkisini inceleyen pek çok çalışma yapılmıştır. Bu çalışmamızda amacımız; HLA-B27 başta olmak üzere bağışıklık sistemi ile ilgili olduğu düşünülen diğer HLA tipleri ve TNF-nın romatizmal kalp kapak hastalığı arasında bir ilişki olup olmadığını irdelemektir. Gazi Üniversitesi Tıp Fakültesi Kardiyoloji Anabilim dalında RKH tanısı almış olan 50 hasta grubu ve 50 sağlıklı kontrol grubunu çalışmamıza dahil ettik. Tüm vakalar ve kontrol grupları ekokardiyografi ile değerlendirildi, HLA tiplendirmesi yapıldı ve TNF- düzeylerine bakıldı. HLA-B35 ekspresyonu romatizmal mitral kapak hastalığına duyarlılığı artırdığını; HLA-B44 ekspresyonu romatizmal mitral kapak hastalığından koruyucu olduğunu; romatizmal aort kapak hastalığında sadece HLA-B51 ekspresyonun koruyucu olduğunu saptadık. Romatizmal mitral kapak hastalığı olanlarda hs-CRP düzeyinin yüksek olduğunu saptamamız dikkat çekiciydi. Daha da önemlisi hs-CRP düzeyi yüksek olan hastalarda mitral kapak alanının da daha dar olmasıdır. Trombosit sayılarının romatizmal kapak tutulumu olan hastalarda normal sayıda olsa da kontrol grubundan daha az olduğu saptanırken lökosit sayılarının romatizmal kapak tutulumu olan hastalarda daha fazla olduğunu gördük. Lökosit fazlalığını da hs-CRP yüksekliğini dikkate alarak kronik inflamasyonla ilişkilendirilebileceğini düşünmekteyiz. ARA geçiren hastalarda HLA tiplendirmesinin, hs-CRP ve lökosit takibinin anatomopatolojik ve klinik gidişte ve tedavide dikkate alınması gerektiği kanaatindeyiz.Acute rheumatic fever is a non-suppurative autoimmune complication of group A beta hemolytic streptococcal pharyngitis. Cardiac complications are significant in absence of secondary prophylaxis and lead to chronic and life threatening valvular heart disease. The chronic sequela of acute rheumatic fever, rheumatic heart disease is one of the leading causes of acquired heart diseases worldwide. Due to the association of HLA antigens with the autoimmune diseases, several studies investigating the association between the HLA antigens and the rheumatic fever/rheumatic heart disease have been performed. In this study, our aim; HLA-B27 is thought to be related to the immune system, particularly the other HLA types, and TNF-alpha to examine whether there is a relationship between rheumatic heart valve disease. Gazi University Faculty of Medicine in the department of Cardiology, rheumatic group of 50 patients who were diagnosed with heart disease and 50 healthy control subjects included in the study have. All cases and controls were evaluated by echocardiography, HLA typing was performed and TNF-alpha levels were determined. In our study, statistically significant association between HLA antigens with rheumatic heart disease were. Rheumatic mitral valve disease, the sensitivity increased expression of HLA-B35 and HLA-B44 expression of rheumatic mitral valve disease, the exact opposite appears to be protective. Rheumatic aortic valve disease can only say that the protective HLA-B51 expression. High levels of hs-CRP in patients with rheumatic mitral valve disease, we find that the remarkable. More importantly, a high level of hs-CRP in patients with mitral valve area is more narrow. Platelet counts in patients with rheumatic mitral valve involvement, even though the control group is less than the normal number of lesions. The number of leukocytes in patients with rheumatic mitral valve involvement, found that more than. Taking into account the height of hs-CRP in excess of leucocytes in the associate chronic inflammation. Search in patients undergoing HLA typing, hs-CRP and leukocyte anatomopathology and clinical follow-up and treatment follow-up is necessary to take into consideration

Relationship of serum HLA-B alleles and TNF-α with rheumatic heart disease

Background/aim: Acute rheumatic fever and rheumatic heart disease are major causes of morbidity and mortality in developing countries. Genetic studies have determined that the immune response in rheumatic heart disease is genetically controlled and that there is a close relationship between the gene of concern and the class II human leukocyte antigen (HLA) gene. The aim of this study was to evaluate the relationship of serum HLA-B alleles and tumor necrosis factor alpha (TNF-alpha) with rheumatic heart disease. Materials and methods: A total of 50 consecutive patients with rheumatic heart disease and 50 controls were enrolled in the study. HLA alleles were analyzed using sequence-specific primer-polymerase chain reaction and nucleotide sequencing. Results: The HLA-B35 allele was significantly more common in patients with rheumatic heart disease than the control group (P = 0.043). The HLA-B44 allele was significantly more common in control patients than in patients with rheumatic heart disease (P = 0.014). There was a significant inverse correlation between high-sensitivity C-reactive protein and mitral valve area (P = 0.001). There was no correlation between TNF-alpha levels and mitral valve area (P = 0.066). Conclusion: Our findings confirmed the association between HLA-B alleles and rheumatic heart disease

Association of rs10757274 and rs2383206 Polymorphisms on 9p21 locus with Coronary Artery Disease in Turkish Population

Background and Objectives: Genetic predisposition is an important risk factor for coronary artery disease (CAD). In this study, we aimed to evaluate the impact of rs10757274 and rs2383206 polymorphisms in chromosome 9p21 on presence and severity of CAD in a Turkish population. Subjects and Methods: A total of 646 patients who underwent coronary angiography were included in this study. Coronary vessel score and Gensini score were calculated to assess the angiographic severity of CAD. Alleles of AA, AG, and GG were determined for rs10757274 (polymorphism-1) and rs2383206 (polymorphism-2) polymorphisms located in chromosome 9p21 from the blood samples. Results: There was a significant difference between the alleles in polymorphism-1 in the presence of coronary artery disease (38.9\% in AA, 48.0\% in GG and 56.4\% in AG, p=0.017). However, there was no difference between the alleles in polymorphism-2. According to vessel scores, there was a significant difference between the alleles in polymorphism-1 (AA 0.71 +/- 1.04, GG 0.88 +/- 1.07, AG 1.06 +/- 1.12, p=0.018). In polymorphism-2, vessel scores did not show a difference between the alleles. In polymorphism-1, there was a significant difference in Gensini score (p=0.041). Gensini scores did not differ between the alleles in polymorphism-2 (p>0.05 for all). In multivariate analyses, none of the alleles was an independent factor for presence of CAD. Conclusion: The presence of rs10757274 polymorphism including AG allele in chromosome 9p21 was related to CAD. However, this relationship was not independent of other cardiovascular risk factors

Association of rs10757274 and rs2383206 Polymorphisms on 9p21 locus with Coronary Artery Disease in Turkish Population

Background and Objectives: Genetic predisposition is an important risk factor for coronary artery disease (CAD). In this study, we aimed to evaluate the impact of rs10757274 and rs2383206 polymorphisms in chromosome 9p21 on presence and severity of CAD in a Turkish population. Subjects and Methods: A total of 646 patients who underwent coronary angiography were included in this study. Coronary vessel score and Gensini score were calculated to assess the angiographic severity of CAD. Alleles of AA, AG, and GG were determined for rs10757274 (polymorphism-1) and rs2383206 (polymorphism-2) polymorphisms located in chromosome 9p21 from the blood samples. Results: There was a significant difference between the alleles in polymorphism-1 in the presence of coronary artery disease (38.9% in AA, 48.0% in GG and 56.4% in AG, p=0.017). However, there was no difference between the alleles in polymorphism-2. According to vessel scores, there was a significant difference between the alleles in polymorphism-1 (AA 0.71 +/- 1.04, GG 0.88 +/- 1.07, AG 1.06 +/- 1.12, p=0.018). In polymorphism-2, vessel scores did not show a difference between the alleles. In polymorphism-1, there was a significant difference in Gensini score (p=0.041). Gensini scores did not differ between the alleles in polymorphism-2 (p>0.05 for all). In multivariate analyses, none of the alleles was an independent factor for presence of CAD. Conclusion: The presence of rs10757274 polymorphism including AG allele in chromosome 9p21 was related to CAD. However, this relationship was not independent of other cardiovascular risk factors