The relationship between adiponectin levels and epicardial adipose tissue thickness in non-obese children with asthma

Background: There is an association between adiponectin (APN) and asthma. However, the mechanisms underlying this association is unclear. APN is a predominantly antiinflammatory protein with possible signalling activity in the lung that can be secreted by Epicardial Adipose Tissue (EAT). Our hypothesis is that serum APN levels may be directly and simply related to the amount of EAT accumulation, particularly when it is expressed as thickness in children with asthma. Objective: The aim of this study was to investigate whether serum adiponectin (APN) and epicardial adipose tissue thickness (EATT) have an effect in non-obese children with asthma and in healthy non-asthmatic children, and analyze their relationships with clinical outcomes. Methods: 68 childrens diagnosed with asthma (20 girls/48 boys) who had applied at the pediatric allergy and clinical immunology clinic of the hospital were included in this cross-sectional, observational study. The age-matched control group included 39 healthy children (18 girls/21 boys). EATT was measured by transthoracic echocardiography. The serum APN levels were also checked. Statistical analysis was performed by using independent sample t-test and Spearman correlation analyses. Results: The mean age of the asthma group was 10.2 ± 2.7 years, and the average EATT was found to be 5.7±1.1 mm. The mean age of the control group was 10.5 ± 2.8 years, and the average EATT was found to be 5.1 ± 0.7 mm. The EATT of the asthma group was found to be significantly higher (p < 0.001) in study group. In the asthma group the APN was 10.0 ± 5.3 mg/L, and in the control group the APN was 15.8 ± 10.5 mg/L (p < 0.001). We found that APN was significantly negatively correlated with EATT (r = -0.266, p = 0.006) in asthma and control groups. Conclusion: EATT is associated with non-obese asthmatic childrens. High EATT may be related with high release of pro-inflammatory cytokine and low release of APN. Low levels of APN may be related to low anti-inflammatory effects. Therefore, high EATT and low levels of APN may indicate pro-inflammantory profiles in nonobese asthmatic childrens. © 2009 is a Digital Portal of health science journals in Thailand

Clinical Markers of Clopidogrel Resistance in Percutaneous Coronary-Treated Patients

WOS: 000464326000009Objective: Antiplatelet therapy is an indispensable part of current coronary artery disease and resistance to ADP inhibitors leads to adverse cardiovascular events on patients. In current study, it was aimed to detect clopidogrel resistance markers in patients undergoing percutaneous coronary intervention. Methods: Eighty consecutive patients (38 clopidogrel resistance individuals, 42 healthy individuals) who underwent percutan intervention procedure due to coronary artery disease and who had tested positive for clopidogrel resistance at the end of the first week were included in study. In the VerifyNow test,> 208 platelet reactivity unit clopidogrel resistance and> 550 aspirin reaction unit were accepted as aspirin resistance. 28 patients were treated with ST elevation MI, 18 patients without ST elevation MI, and the other patients were treated for stable coronary disease. Demographic findings, CV, family background variables, body mass index, injection fraction, aspirin resistance and biochemical parameters were compared between groups. Results: The mean age of the patients were 59 +/- 12 and 15 were female. Subjects with clopidogrel resistance were significantly lower in Hemoglobin values. Resistance was more frequent in hypertension, while female sex and smokers were more frequent. Logistic regression analysis showed that hemoglobin (odds ratio = 0.8; 95 % safety interval (0.678-0.945), p = 0.008] significantly predicted clopidogrel resistance. Conclusion: Low hemoglobin level predicts clopidogrel resistance independently of other clinical variables

Relationship Between the Reciprocal Change in Inflammation-Related Biomarkers (Fibrinogen-to-Albumin and hsCRP-to-Albumin Ratios) and the Presence and Severity of Coronary Slow Flow

WOS: 000461045000001PubMed: 30857397Inflammation has been implicated in the pathogenesis of endothelial dysfunction, atherosclerosis, and microvascular coronary dysfunction. In this context, it is thought that fibrinogen, high-sensitive C-reactive protein (hsCRP), and albumin may be associated with the pathogenesis of coronary slow flow (CSF). We aimed to evaluate the ratios of fibrinogen-to-albumin and hsCRP-to-albumin in patients with CSF compared to patients with angiographically normal coronary arteries and stable coronary artery disease (CAD). In all, 65 patients with CSF, 65 patients with newly diagnosed stable CAD, and 65 control participants with angiographically normal coronary arteries were included. The coronary flow rates of all patients were determined by the Thrombolysis in Myocardial Infarction frame count method. Fibrinogen, hsCRP, and albumin levels were analyzed in all patients, and the fibrinogen-to-albumin and hsCRP-to-albumin ratios were calculated. The baseline characteristics of the 3 groups were similar. The plasma albumin level was significantly lower, whereas the fibrinogen and the hsCRP levels were significantly higher, in the CSF and CAD groups compared to the controls. The fibrinogen-to-albumin and hsCRP-to-albumin ratios were significantly higher in both the CSF and the CAD groups compared to the control group. The hsCRP-to-albumin ratio was positively correlated with the mean Thrombolysis in Myocardial Infarction frame count in the whole study population. According to the receiver-operating characteristic analysis, the efficacies of the fibrinogen-to-albumin and hsCRP-to-albumin ratios in predicting CSF were significant. The fibrinogen-to-albumin and hsCRP-to-albumin ratios, which were increased by a reciprocal change, suggest that inflammation may play a role in the pathogenesis of CSF

Subclinical right ventricular dysfunction in intermittent and persistent mildly asthmatic children on tissue Doppler echocardiography and serum NT-proBNP: Observational study

kaya, adnan/0000-0002-9225-8353WOS: 000489002900007PubMed: 30179288Background Bronchial asthma may lead to pulmonary hypertension, right ventricular (RV) dysfunction, and cor pulmonale due to elevated afterload on the RV later in life. The aim of this study was to determine whether serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) might serve as a biomarker for detecting subclinical RV dysfunction using echocardiography during the early stages of bronchial asthma. Methods Sixty-eight pediatric patients with asthma (asthma group) and 69 age- and sex-matched healthy children (control group) were enrolled. The study was conducted in a tertiary woman and child diseases education and research hospital from January 2013 to December 2013. RV function (2-D and tissue-Doppler echocardiography), pulmonary function (spirometry) and serum NT-proBNP concentration were evaluated. Results Mean age was 10.5 +/- 2.8 years in the asthma group and 10.2 +/- 2.7 years in the control group (P = 0.522). RV diastolic function was significantly decreased in the asthma group (ratio of tricuspid lateral annular early diastolic peak velocity to tricuspid lateral annular late diastolic peak velocity [E '/A '], 1.29 +/- 0.68 vs 1.74 +/- 0.89, P = 0.001). RV myocardial performance index was significantly higher in the asthma group than in the control group (0.28 +/- 0.06 vs 0.24 +/- 0.07, respectively; P = 0.003). Finally, serum NT-proBNP concentration was significantly higher in the asthma group than in the control group (292.3 +/- 142.2 pg/mL vs 208.2 +/- 70.1 pg/mL, respectively; P = 0.003). Conclusion Increased serum NT-proBNP is associated with subclinical RV dysfunction in asthmatic children. RV function is significantly affected in children with bronchial asthma

Serum Cystatin-C levels could be predictor of Diastolic Heart Failure

WOS: 000441304600011Amaç: Diyastolik kalp yetmezliği; sistolik kalp yetmezliği gibi değerlendirilirken aslında bunların birbirinden ayrı patofizyolojik mekanizmalarla ilerlediği bilinmektedir. Çalışmamızda serum Sistatin C düzeyi ve diyastolik fonksiyon bozukluğu arasındaki ilişkiyi incelemeyi hedefledik. Gereç ve Yöntem: Mayıs 2010 ve Eylül 2010 tarihleri arasında Düzce Üniversitesi Tıp Fakültesi Hastanesi Kardiyoloji polikliniğine başvuranlar kabul edildi. Hastaların diyastolik parametreleri değerlendirildi ve serum Sistatin C düzeyleri çalışıldı. Hastalar diyastolik fonksiyonlarına göre normal, grade 1, grade 2 olarak üç gruba ayrıldı ve serum Sistain C düzeyi ile bu gruplar arasında ilişki araştırıldı. Bulgular: Grade 1 ve grade 2 diyastolik disfonksiyonu olan hastalar ile diyastolik fonksiyon bozukluğu olmayanlar serum Sistatin C seviyelerine göre karşılaştırıldı. Diyastolik disfonksiyon olan gruplarda Sistatin C düzeyinde anlamlı düzeyde artış olduğu gösterildi (grade 1:p<0,0001, grade 2: P<0,004). Serum sistatin C seviyeleri için Reciever operating eğrisi (ROC) , serum sistatin C > 0,997 ng / ml seviyesinde, diyastolik disfonksiyonu % 80 özgüllük ve% 78.95 duyarlılık ile tanımlayabildi. Sonuç: Serum sistain C düzeyi diyastolik disfonksiyonun erken tespitinde ve takibinde faydalı olabilir.Objective: Diastolic heart failure was accepted as systolic heart failure but nowadays it is known they have distinct pathophysiological mechanism. We aimed to investigate the association between diastolic dysfunction and serum cystatin C concentrations. Methods: Patients admitted to cardiology clinic of Duzce University School of Medicine from May 2010 to September 2010 were included. Serum cystatin C concentrations and diastolic echocardiography parameters were studied. Diastolic echocardiographic parameters were measured with 2D echocardiography, TDI (Tissue Doppler imaging) and PW (Pulsed Wave) Doppler. Patients were categorized into three groups; grade 1, grade 2, grade 3 according to their diastolic functions. Serum cystatin C levels were compared among the groups. Results: Patients with diastolic dysfunction were compared with controls (patients without diastolic dysfunction) according to their serum cystatin C levels. A statistically significant increase in serum cystatin C level was observed in patients with diastolic dysfunction (grade1:p<0,0001, grade 2:p<0,004). The receiver operating characteristic curve for serum cystatin C levels revealed a level > 0,997 ng/ml could identify diastolic dysfunction with a specificity of % 80 and a sensitivity of %78.95. Conclusion: Serum Cystatin C levels may be useful in the early detection and monitoring of diastolic dysfunction

Evaluating the effect of nasal septoplasty on atrial electromechanical features

WOS: 000460493900011PubMed: 30621931Background: Recent studies have demonstrated that right ventricular (RV) dysfunction and increased pulmonary artery pressure may be frequent in patients with upper airway obstruction. In this study, we evaluated atrial conduction delays in patients with upper airway obstruction secondary to nasal septum deviation (NSD). Methods: A total of 32 patients with upper airway obstruction secondary to NSD undergoing a septoplasty procedure were enrolled in this study. Preoperative electrocardiography and transthoracic echocardiography were performed in all patients who underwent surgery. The mean pulmonary artery pressure (mPAP) and atrial conduction time (ACT) were recorded before and 6 months after the surgical procedures. Results: The PAP was significantly lower postoperatively than preoperatively (20.75 +/- 4.83 vs. 24.68 +/- 5.26; P < 0.001). The postoperative Electromechanical Delay of Mitral septal wall (EMD-MS) value was significantly lower than that preoperatively (46.20 +/- 8.5 vs. 40.5 +/- 9.9; P < 0.001). The postoperative Electromechanical Delay of Mitral lateral wall (EMD-ML) value decreased significantly compared to the preoperative period (46.3 +/- 7.4 vs. 40.6 +/- 9.3; P < 0.001). The postoperative Electromechanical Delay of Tricuspit lateral wall (EMD-TL) value was significantly lower than that preoperatively (43.8 +/- 7.0 vs. 38.1 +/- 9.1; P < 0.001). There was no significant change in pre- or postoperative measurements of inter- and intra-atrial conduction delays. Conclusions: We demonstrated that upper airway obstruction secondary to NSD causes a significant increase in mPAP and a significant delay in ACT, which improved after nasal septoplasty. According to these results, we conclude that upper airway obstruction may be an important risk factor for pulmonary arterial hypertension, RV dysfunction, and atrial arrhythmias, especially in unoperated cases

Evaluating the effect of nasal septoplasty on atrial electromechanical features

WOS: 000460493900011PubMed: 30621931Background: Recent studies have demonstrated that right ventricular (RV) dysfunction and increased pulmonary artery pressure may be frequent in patients with upper airway obstruction. In this study, we evaluated atrial conduction delays in patients with upper airway obstruction secondary to nasal septum deviation (NSD). Methods: A total of 32 patients with upper airway obstruction secondary to NSD undergoing a septoplasty procedure were enrolled in this study. Preoperative electrocardiography and transthoracic echocardiography were performed in all patients who underwent surgery. The mean pulmonary artery pressure (mPAP) and atrial conduction time (ACT) were recorded before and 6 months after the surgical procedures. Results: The PAP was significantly lower postoperatively than preoperatively (20.75 +/- 4.83 vs. 24.68 +/- 5.26; P < 0.001). The postoperative Electromechanical Delay of Mitral septal wall (EMD-MS) value was significantly lower than that preoperatively (46.20 +/- 8.5 vs. 40.5 +/- 9.9; P < 0.001). The postoperative Electromechanical Delay of Mitral lateral wall (EMD-ML) value decreased significantly compared to the preoperative period (46.3 +/- 7.4 vs. 40.6 +/- 9.3; P < 0.001). The postoperative Electromechanical Delay of Tricuspit lateral wall (EMD-TL) value was significantly lower than that preoperatively (43.8 +/- 7.0 vs. 38.1 +/- 9.1; P < 0.001). There was no significant change in pre- or postoperative measurements of inter- and intra-atrial conduction delays. Conclusions: We demonstrated that upper airway obstruction secondary to NSD causes a significant increase in mPAP and a significant delay in ACT, which improved after nasal septoplasty. According to these results, we conclude that upper airway obstruction may be an important risk factor for pulmonary arterial hypertension, RV dysfunction, and atrial arrhythmias, especially in unoperated cases

Prevalence and characteristics of CAAs in the black sea region

WOS: 000435652100003Aim: To date there has been no data about the prevalence of coronary artery anomaly (CAA) in the Turkish population of the Black Sea Region who underwent trans-radial coronary angiography. We aimed to determine the frequency and characteristics of CAA in our patients. Material and Method: All the coronary angiographies performed from September 2015 to September 2016 in our hospital were reviewed. Demographic characteristics and laboratory parameters of patients were reviewed retrospectively from the patients' data set. A total of 1617 patient were included in our study. Results: CAAs were found in 73 patients (4.51%), of whom 41 (56.16%) had intrinsic coronary artery anatomy. Twenty-two (30.13%) patients had anomaly of origination and course and 10 (13.69%) patients had anomaly of coronary artery termination. The mean age was 59.35 +/- 11.86 in the study group and 60.11 +/- 6.61 in the control group. Myocardial bridge was the most common anomaly in our study with a prevalence of 2.16%. Absent LMCA was the second most common anomaly in our study with a prevalence of 0.80% and coronary artery fistula was third with a prevalence of 0.61%. Discussion: We found the prevalence of CAAs among the Turkish population of the Black Sea Region to be similar to previously published studies from our country. To avoid misunderstandings one must know the normal anatomy of coronary vasculature, variations, and the anomalies. When coronary angioplasty or cardiac surgery is planned in patients with CAA, special attention must be paid not to harm coronary arteries in unexpected locations

Assessment of the relationship between coronary flow rates and myocardial perfusion abnormality in patients with nonobstructive coronary artery disease: an observational study in cardiac syndrome X and coronary slow flow

WOS: 000509346000005PubMed: 31568270Objectives In this study, we evaluated and compared the level of myocardial ischaemia caused by cardiac syndrome X (CSX) and coronary slow flow (CSF) with single photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), and determined if changes in the level of myocardial ischaemia exist in CSF and CSX cases according to thrombolysis in myocardial infarction frame count (TFC). Materials and methods The study population consisted of 66 patients with CSF and 78 angiographically normal patients (36 of them with CSX and 42 of them healthy controls). The coronary flow rates of all patients were documented using TFC. Subsequently, all patients were evaluated with SPECT-MPI and categorized into the following groups according to their results: patients with CSF, patients with CSX, and patients with normal coronary arteries. Finally, we investigated whether a relationship existed between the SPECT-MPI and TFC results from these three groups. Results All ischaemia scores for MPI were significantly higher in the CSF group than in the CSX and control groups (P < 0.05). TFC was significantly associated with the severity of ischaemia in the CSF patients. There was a significant positive correlation between the summon difference score (SDS) and mean TFC value (P < 0.05) as well as between the SDS and each individual coronary TFC value in the CSF patients (P < 0.05). The number of vessels involved in CSF was positively correlated with the SDS. Conclusion CSF is associated with more severe myocardial ischaemia than CSX. The level of myocardial ischaemia on SPECT-MPI was correlated with the TFC and the number of affected coronary vessels in patients with CSF. These results suggest that CSF is a more serious clinical entity than CSX, and that the clinical severity of CSF appears to increase as the coronary flow rate decreases