Diagnostic value of BNP in diastolic heart failure

Dijastoličko zatajivanje srca zahvaća otprilike 40-50% bolesnika koji imaju znakove i simptome zatajivanja srca. BNP (engl. brain natriureticpeptide, moždani natrijuretski peptid; B-tip natrijuretskog peptida) je srčani neurohormon koji izlučuju mišićne stanice klijetke kao odgovor na povećan tlak ili volumen na kraju dijastole. Sve brojniji dokazi pokazali su da su koncentracije BNP povećane u slučaju zatajivanja srca, te da su te koncentracije osobito važne kod diferencijalne dijagnoze dispneje. Koncentracije BNP su povećane kod dijastoličkog, no obično su niže nego kod sistoličkog zatajivanja srca. Koncentracije BNP su u uzajamnoj vezi sa stupnjem dijastoličke disfunkcije, te su blago povišene među bolesnicima sa simptomima poremećenog opuštanja srčanog mišića, a najviše su među onima s restriktivnim tipom punjenja. Kod asimptomatičnih bolesnika s blagim oblikom dijastoličke disfunkcije, koncentracije BNP mogu biti unutar granica referentnog raspona. U ovom preglednom članku raspravljamo o dijagnostičkoj vrijednosti BNP u dijagnostici dijastoličkog zatajivanja srca.Diastolic heart failure affects approximately 40%-50% of patients presenting with signs and symptoms of heart failure. Brain natriuretic peptide (BNP) is a cardiac neurohormone secreted from ventricular myocytes in response to increased end-diastolic pressure or volume. Accumulating evidence showed that BNP concentrations are increased in heart failure, and it is especially important in the differential diagnosis of dyspnea. BNP concentrations are increased in diastolic heart failure, but they are typically lower in diastolic than that in systolic heart failure. BNP concentrations are correlated with the stage of diastolic dysfunction, being mild-moderately elevated among patients with evidence of impaired relaxation and highest among those with a restrictive filling pattern. In asymptomatic patients with mild degree of diastolic dysfunction BNP concentrations may be within normal range. In this review we discuss the diagnostic value of BNP in diastolic heart failure

How do we measure epicardial adipose tissue thickness by transthoracic echocardiography?

Epicardial adipose tissue (EAT) is a component of the visceral adiposity located between the heart and pericardium. It is associated with certain diseases, such as metabolic syndrome, coronary artery disease, and hypertension. Therefore, measurement of EAT thickness has recently gained importance. Examination by transthoracic echocardiography for measuring EAT thickness is preferable because of easy availability and low cost. The present review focuses on the method of measuring EAT thickness by transthoracic echocardiography as well as the issues of concern

Implications Of The Cultural And Biological Deformations Of An Iron Age Individual

The skeleton of an adult male, dating to the Early Iron Age of the Assyrian Period (B.C. 8th-7th cc), recovered in South Eastern Turkey was analyzed. It reveals significant biological and cultural deformations. This so-called Zeviya Tivilki individual represents the first known record of circular-type double bandage artificial cranial deformation from the Iron Age in Anatolia. The presence of cranial pathology temporomandibular joint disorder (TMJD) on the left side of the mandible, most probably caused by a trauma, was identified and negatively affected dental function and health. In particular, the occlusal surface of the left upper teeth covered by dental plaque indicates that the individual was not able to use this side of his jaw. Signs of the postcranial pathology diffuse idiopathic skeletal hyperostosis (DISH) reveal that the individual's physical behaviors were effected (limited). Deformations due to physical and physiological stresses on the postcranial and cranial parts indicate the individual severely suffered during his lifetime.Wo

Vascular Endothelial Growth Factor (Vegf)-C, Vegf-D, Vegfr-3 And D2-40 Expressions In Primary Breast Cancer: Association With Lymph Node Metastasis

Background. Two members of the vascular endothelial growth factor (VEGF) family, VEGF-C and -D, are known as lymphangiogenic growth factors and play an important role in tumor lymphangiogenesis via activation of the VEGF receptor (VEGFR)-3, which is expressed in lymphatic endothelial cells. D2-40 is a specific antibody for lymphatic vessel density (LVD). Objectives. In the present study, we have aimed to evaluate whether intra-and peri-tumoral D2-40-positive lymphatic vessels affect lymph node metastasis and to investigate the relationship between LVD and lymph node metastasis in breast cancer. Material and methods. We have evaluated the relationships between lymph node metastasis and VEGF-C, VEGF-D, VEGFR-3 and D2-40 expressions in breast cancer cells using immunohistochemistry. VEGF-C, VEGF-D and VEGFR-3 expression were found in tumor cells in the majority of the cases (83.75, 97.5 and 95%, respectively). Results. There was a significant positive relationship between VEGF-D expression and lymph node metastasis (p < 0.05) however no significant association was found in VEGF-C and VEGFR-3 expressions. It was found that patients with high-expression of VEGF-D have a high level of both peri-and intra-tumoral LVD compared to those with low expression of VEGF-D (p < 0.05). Conclusions. Our results support that examination of VEGF-D expression in breast cancer cells may be beneficial in the identification of lymph node metastasis.WoSScopu

In vitro antioxidant and cytotoxic activity of Muscari neglectum growing in Turkey

Muscari species have been used as antirheumatic, stomachic, diuretic, expectorant and anti verruca in folk medicine. The species have also been used as food for humans and animals in Turkey. In this study, the antioxidant and cytotoxic activities of different extracts obtained from Muscari neglectum were studied. The antioxidant capacities of the extracts were evaluated with DPPH free radical scavenging activity, metal chelating capacity and ABTS cation radical scavenging capacity assays. The cytotoxic potentials of the extracts were determined by MTT and LDH assays on HeLa-cells (human cancer cell line) and NRK-52E-cells (rat kidney cell line). The aqueous extracts from M. neglectum bulbs (IC50 : 2.83 +/- 0.54 mg/mL) and herba (IC 50 : 8.52 +/- 1.3 mg/mL) exhibited stronger DPPH free radical scavenging activity than other extracts, respectively. The ethanol extract from M. neglectum bulbs showed the highest ABTS (27.88 %) cation radical scavenging activity. According to the metal chelating activity test results, the aqueous extracts from M. neglectum herba and bulbs showed the strongest metal chelating activity (28.99% and 28.07%, respectively)

Coronary flow reserve is impaired in patients with obstructive sleep apnea

STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is common in adult populations. Accumulating data indicate that it is independently associated with a variety of cardiovascular diseases and has prognostic importance in affected cases. In this study, we aimed to evaluate coronary flow reserve (CFR) in patients with OSA and controls. METHODS: Sixty-one patients undergoing an overnight polysomnography were enrolled in this study. Patients with an apneauhypopnea index (AHI) 5 were accepted as OSA group (n = 45) and those with an AHI <5 were taken as controls (n = 16). Using Doppler echocardiography at baseline and following dipyridamole infusion, coronary peak flow velocities were obtained. CFR was calculated as the ratio of peak diastolic flow to baseline diastolic flow. A CFR value <2 was accepted as impaired coronary microvascular function. RESULTS: The mean age was 50.8 10.8 years, of which 16 (26.2%) were female. Both groups had similar features with regard to demographic and clinical variables. The mean value of CFR was significantly lower in patients with OSA compared to those controls (2.24 0.46 vs. 2.74 0.62, respectively, P = 0.001). An abnormal CFR value was observed in 12 (26.7%) patients with OSA and in 1 (6.3%) participant in control group. CONCLUSIONS: The findings of this study indicate that CFR, an indicator of coronary microvascular function, is significantly impaired in patients with OSA. Coronary microvascular function, an early sign of atherosclerosis, can be evaluated noninvasively in these patients might be used as a predictor of cardiovascular risk

Molecular analysis of factor v leiden, factor v Hong Kong, factor II G20210A, methylenetetrahydrofolate reductase C677T, and a 1298C mutations related to Turkish thrombosis patients

Inherited gene disorders related to the hemostatic system have been documented as risk factors for thrombosis. The roles of factor V Hong Kong (FV Hong Kong), factor V Leiden (FV Leiden), factor II G20210A (FII G20210A), methylenetetrahydrofolate reductase (MTHFR) C677T, and MTHFR A1298C mutations in Turkish patients with thrombosis (270 patients) compared with healthy controls (114 subjects) were evaluated. Polymerase chain reaction-based restriction enzyme analysis was carried out to screen these mutations, and single-strand conformation analysis was established to identify variations using the primers selected for restriction enzyme analysis studies. As a result, a significant relationship was determined among FV Leiden, FII G20210A, and thrombosis. The FV Hong Kong mutation was observed in only 2 patients with pulmonary vein thrombosis who are FV Leiden/FV Hong Kong compound heterozygous for FV gene. MTHFR C677T and A1298C were equally distributed in the patient group compared with the control group. All named mutations were also identified with single-strand conformation analysis, but a new variant/polymorphism during studies was not found. Because some inherited abnormalities are associated with thromboembolic disorders, determining the mutations and gene-to-gene interactions in patients with thrombosis history has a great impact on diagnosis and treatment of these diseases

Pulmonary Artery Distensibility is Worsened in Obstructive Sleep Apnea Syndrome

Background: Obstructive sleep apnea syndrome (OSAS) leads to right ventricular (RV) dysfunction and pulmonary hypertension (PH) in the later stages. Early determination of these conditions is very important

IDENTIFICATION OF VOLATILE COMPOUNDS AND ANTIMICROBIAL ACTIVITIES OF MUSCARI NEGLECTUM GROWING IN TURKEY

The absolute essential oils obtained from the bulbs and the aerial parts of M. neglectum collected from Kahramanmaras (Turkey) were analysed by GC-FID and GC-MS. In GC-MS analyses, 17 components comprising 100% of the essential oil of the bulbs and 17 components comprising 97.1% of the essential oil of the aerial parts. Major constituents of the absolute essential oil of the bulbs were found to be ethyl palmitate (18.7%), ethyl linoleate (16.3%), palmitic acid (15.2%) and linoleic acid (10.8%). The aerial parts oil mainly contents palmitic acid (28.5%), oleic acid (10.9%), linoleic acid (22.6%) and linolenic acid (11.4%). The absolute essential oils were analyzed by using microdilution assay for antimicrobial activity against three Gram-positive, four Gram-negative bacteria and one of fungus. The oils obtained from bulbs and aerial parts possessed activity against Staphylococcus epidermidis with MIC values of 625 and 1250 mu g/mL, respectively. The bulbs oil showed antibacterial activity against Enterococcus faecalis and Escherichia coli with 156.2 mu g/mL and 625 mu g/mL MIC values. The bulbs oil exhibited antifungal activity against Candida albicans with 312.5 mu g/mL MIC value. This is the first report on the chemical composition and antimicrobial activity of the essential oils obtained from M. neglectum growing in Turkey