Heart rate variability and turbulence to determine true coronary artery disease in patients with ST segment depression without angina during exercise stress testing

Purpose: ST segment depression without angina during an exercise stress test causes diagnostic problems, particularly in non-diabetic patients. Heart rate variability (HRV) and heart rate turbulence (HRT) are used to evaluate the changes in cardiac autonomic functions and are also both decreased in patients with coronary artery disease. The aim of this study was determine the values of HRV and HRT that discriminate true coronary artery disease from false positive stress test results. Methods: Ninety non-diabetic patients who underwent diagnostic coronary angiography (CA) due to suspected coronary artery disease after ST segment depression without angina during an exercise stress test were enrolled in the study. Prior to CA, 24 hour ambulatory electrocardiogram recordings were taken and HRV and HRT parameters were calculated. Results: Patients were divided into three groups according to the severity of their coronary lesions: (group 1 normal, group 2 non-obstructive and group 3 obstructive. There were no differences among the groups with regards to age, sex, medical history, medications, systolic and diastolic blood pressures, body mass index, fasting glucose, anemia and thyroid status, lipid profile and creatinine clearance. HRV parameters and turbulence slope (TS) were significantly lower while turbulence onset (TO) was significantly higher in group 3 than groups 1 and 2. According to the cut-off values calculated using ROC analysis, SDNN≤69.63 msec, TO > 0.14%, and TS≤2.78 msec/RR have high diagnostic accuracy for predicting obstructive coronary artery disease. Conclusion: HRV and HRT parameters may provide additional information for discriminating between patients who do and do not truly need CA

Cognitive Functioning and Silent Neurological Manifestations in Behcet's Disease with Ocular Involvement

Introduction: Various reports have revealed a cognitive dysfunction in Behcet's disease (BD). In this study, we aimed to assess the silent neurological manifestations, behavioral and neuropsychiological impairments of Behcet's disease patients with ocular involvement

Coronary Ectasia Is Associated with Impaired Left Ventricular Myocardial Performance in Patients without Significant Coronary Artery Stenosis

Objectives: To determine both ventricular functions and tissue Doppler echocardiography (TDE)-derived myocardial performance index (MPI) in patients with coronary artery ectasia (CAE). Subjects and Methods: Twenty-five patients with CAE (13 men; mean age 57 +/- 9 years) and 25 age- and sex-matched controls without CAE (8 men; mean age 54 +/- 10 years) were enrolled in the study. Left and right ventricular functions were detected using conventional echocardiography and TDE. Results: Left ventricle-lateral wall (0.61 +/- 0.17; 0.50 +/- 0.10, p = 0.02), interventricular septum (0.66 +/- 0.17; 0.52 +/- 0.10, p = 0.007) and mean MPI (0.63 +/- 0.15; 0.51 +/- 0.09, p = 0.004) were increased in the CAE group compared to the control group. Right ventricular MPI was similar in both the CAE and control groups (0.58 +/- 0.18; 0.52 +/- 0.19, p > 0.05). Conclusion: The findings show that left ventricular MPI is different in CAE patients without obstructive coronary artery disease compared to the normal control group. Also in these patients, right ventricular MPI was similar to the control group. Copyright (C) 2011 S. Karger AG, Base

Assessment of myocardial repolarisation parameters in patients with familial Mediterranean fever

Background: Familial Mediterranean fever (FMF) is a chronic, recurrent auto-inflammatory disease characterised by self-terminating attacks of fever and sterile polyserositis. The main cause of death in auto-inflammatory diseases is cardiovascular events. Additionally, auto-inflammatory diseases have potential effects on the myocardial repolarisation parameters, including the T-wave peak-to-end (Tp-Te) interval, cTp-Te interval (corrected Tp-Te) and the cTp-Te/QT ratio. The aim of this study was to analyse the efficacy of myocardial repolarisation alterations in anticipation of cardiovascular risks in patients with FMF

Antioxidant status and levels of antioxidant vitamins in coronary artery ectasia

Background Coronary artery ectasia (CAE) is a rare coronary artery anomaly. In this study, we investigated superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and gamma-glutamyltransferase (GGT) activities, and antioxidant vitamin levels (vitamins A and E) in patients with CAE

Relationship between L-arginine/asymmetric dimethylarginine, homocysteine, folic acid, vitamin B levels, and coronary artery ectasia

Background Coronary artery ectasia (CAE) is characterized by an abnormal dilatation of the coronary arteries. The ratio of L-arginine/asymmetric dimethylarginine (ADMA) and homocysteine are important factors for endothelial function. In this study, we investigate the ratio of L-arginine/ADMA, homocysteine, and folic acid/vitamin B levels in patients with CAE