Ocena zależności między ciśnieniem centralnym w aorcie a zesztywniającym zapaleniem stawów kręgosłupa

Introduction. Ankylosing spondylitis (AS) is a chronic inflammatory disease with an unknown etiology that belongs to the group of spondyloarthropathies. Patients with AS have an increased cardiovascular mortality but the reason is controversial. Central aortic pressure (CAP) is defined as the blood pressure in the aortic root and can be measured non-invasively via arteriography. Inflammation in the aortic root, which also causes aortic regurgitation in late sta ges of AS, possibly causes increased levels of central aortic pressure and this may explain the increased mortality rates from cardiovascular events in patients with AS. We investigated the CAP levels in patients with AS compared to healthy age- and sex-matched control group in this novel study. Material and methods. This is an observational case-control study composed of 30 patients with ankylosing spondylitis without conventional cardiovascular risk factors (such as known diabetes, hypertension, and smoking) or heart failure, peripheral or coronary artery disease. The peripheral blood pressures and CAP measurements were obtained with ‘arteriograph’ (TensioMed, Budapest, Hungary).Pulse wave velocity (PWV), peripheral and central augmentation index (pAIx and cAIx) and systolic central aortic pressure (sCAP) of both the AS and control group were compared. Results. There was no statistically significant difference between the groups for pAIx, cAIx, PWV or PP. Patient with AS had higher sCAP values but there wasn’t any statistically significant difference for sCAP. Conclusion. Our objective was to investigate the relationship between the AS and sCAP. There was an increase in sCAP in AS group compared to controls. But this was not statistically significant. This result can be due to the small population size and should be verified in larger population.Wstęp. Zesztywniające zapalenie stawów kręgosłupa (AS) to przewlekła choroba zapalna o nieznanej etiologii należąca do spondyloartropatii. U chorych z AS obserwuje się zwiększoną śmiertelność sercowo-naczyniową, jednak przyczyny tego zjawiska nie są znane. Ciśnienie centralne w aorcie (CAP) jest definiowane jako ciśnienie krwi w korzeniu aorty. Możliwy jest nieinwazyjny pomiar CAP metodą arteriografii. Zapalenie w obrębie korzenia aorty, będące również przyczyną niedomykalności w późnym stadium AS, może powodować wzrost ciśnienia centralnego w aorcie, co może tłumaczyć zwiększoną śmiertelność z powodu zdarzeń sercowo-naczyniowych w grupie chorych z AS. Autorzy zbadali wartości CAP u chorych z AS w porównaniu z wartościami uzyskanymi w grupie kontrolnej złożonej ze zdrowych osób dobranych pod względem wieku i płci. Materiał i metody. Tym obserwacyjnym badaniem kliniczno-kontrolnym objęto 30 chorych z AS, u których nie występowały tradycyjne czynniki ryzyka sercowo-naczyniowego (rozpoznana cukrzyca, nadciśnienie tętnicze, palenie tytoniu), niewydolność serca, choroba tętnic obwodowych ani choroba wieńcowa. Wartości obwodowego ciśnienia tętniczego i pomiary CAP uzyskano metodą arteriografii (TensioMed, Budapeszt, Węgry). Porównano wartości następujących parametrów w grupie AS i grupie kontrolnej: szybkość fali tętna (PWV), wskaźnik wzmocnienia ciśnienia obwodowego i centralnego (pAIx, cAIx) i skurczowe ciśnienie centralne w aorcie (sCAP). Wyniki. Nie stwierdzono statystycznie istotnych różnic między grupami pod względem wartości pAIx, cAIx, PWV ani PP. U chorych z AS zaobserwowano wyższe wartości sCAP, jednak różnice nie osiągnęły poziomu istotności statystycznej. Wnioski. Badanie przeprowadzono w celu zbadania zależności między AS a sCAP. W grupie chorych na AS wartości sCAP były wyższe niż w grupie kontrolnej. Jednak różnice nie były istotne statystycznie. Wyniki te mogą być spowodowane niewielką liczebnością badanej populacji i powinny zostać zweryfikowane w badaniu z większą liczbą uczestników

Endothelial dysfunction in patients with isolated coronary artery ectasia: Decreased flow-mediated dilatation in the brachial artery

© 2015, Biomed Res-India. All rights reserved.The underlying pathology of Isolated Coronary Artery Ectasia (ICAE) still remains unknown; however, endothelial dysfunction (ED) may be responsible for the disease process. The aim of this study was to assess the endothelial functions of patients with ICAE in comparison to patients with normal coronary arteries (NCA) by using flow-mediated dilatation (FMD) in the brachial artery. Thirty patients with ICAE, and 30 control subjects with angiographically NCA were included in this study. The FMD was measured in all patients using a high-resolution ultrasonographic system. The results showed that the baseline brachial artery diameters in patients with ICAE were not statistically different from those in patients with NCA (4.3 ± 0.3 vs.4.2 ± 0.3 mm, respectively, p = 0.265). However, the forearm FMD of the patients with ICAE was significantly lower than the values in the control group (8.5 ± 4.0 vs. 13.7 ± 3.0%, p <0.001). In addition, patients with ICAE have significantly higher levels of low-density lipoprotein (LDL) cholesterol compared to the control group (114.5 ± 28.8 vs. 97.9 ± 31.5 mg/dL, p = 0.03). Therefore, we conclude that patients with ICAE have more severe ED than patients with NCA, which supports the hypothesis that atherosclerosis may be involved in the pathogenesis of coronary ectasia. Hyperlipidemia may have a key role in the disease process

The effect of sleep apnea severity on cardiac autonomic activity during night time in obstructive sleep apnea patients

ABSTRACT CONTEXT AND OBJECTIVE: Impaired autonomic cardiac function is an important consequence of obstructive sleep apnea (OSA). This impairment is mainly due to intermittent hypoxia episodes following apneas. However, the impact of apnea severity on autonomic cardiac function remains unclear. The aim of this study was to evaluate the relationship between the severity of sleep apnea and heart rate turbulence (HRT) and heart rate variability (HRV) in OSA. DESIGN AND SETTING: Observational cross-sectional study conducted in the Departments of Cardiology and Pulmonary Diseases, Afyon Kocatepe University, Turkey. METHODS: 106 patients with OSA and 27 healthy volunteers were enrolled. Based on apnea hypopnea index (AHI) values, obstructive sleep apnea severity was classified as follows: mild OSA (AHI ≥ 5 and 30). HRV and HRT parameters were assessed via 24-hour digital Holter electrocardiogram recordings for all subjects. RESULTS: HRV and HRT results were significantly lower among OSA patients than among control subjects (P < 0.05). However, there were no significant differences in HRT and HRV between the three patient subgroups. Correlations did emerge between AHI and the NN-interval parameter RMSSD and between oxygen desaturation and turbulence slope (respectively: r = -0.22, P = 0.037; and r = -0.28, P = 0.025). CONCLUSION: HRT and HRV results deteriorate in OSA. Correlations between apnea severity and these parameters seem to be present

Heart rate variability and heart rate turbulence in patients with polycystic ovary syndrome

Objective: Cardiac autonomic dysfunction may develop in patients with polycystic ovary syndrome (PCOS). Heart rate variability (HRV) and heart rate turbulence (HRT) are used in assessing cardiac autonomic functions. The goal of this study was to compare the cardiac autonomic functions in patients with PCOS and healthy controls. To our knowledge, this is the first study evaluating cardiac autonomic functions in patients with PCOS with respect to both HRV and HRT

Heart rate variability and heart rate turbulence in patients with polycystic ovary syndrome

Objective: Cardiac autonomic dysfunction may develop in patients with polycystic ovary syndrome (PCOS). Heart rate variability (HRV) and heart rate turbulence (HRT) are used in assessing cardiac autonomic functions. The goal of this study was to compare the cardiac autonomic functions in patients with PCOS and healthy controls. To our knowledge, this is the first study evaluating cardiac autonomic functions in patients with PCOS with respect to both HRV and HRT

Atherogenic index as a predictor of atherosclerosis in subjects with familial Mediterranean fever

Background and objective: Numerous inflammatory and innate immune pathways are involved in atherogenesis. We aimed to investigate the atherogenic index and other lipid parameters in individuals with familial Mediterranean fever (FMF), as a predictor of atherosclerosis. Materials and methods: A total of 60 patients with FMF and 60 healthy age- and sex- matched controls were included in this study. The patients with acute infection, chronic metabolic and rheumatic diseases, use of drugs other than colchicine and smoking history were excluded. CRP, ESR, total cholesterol, triglycerides, LDL-C, and HDL-C levels of patients and the control group were measured. Atherogenic index (TG/HDL-C) was calculated. Results: We found that the atherogenic index values of the patients were significantly higher than those of the control group. HDL-C levels were lower and ESR and TG levels were higher in patients. Total cholesterol, LDL-C and CRP levels did not differ significantly between the two groups. There was no significant difference in the values of total cholesterol, LDL-C, triglycerides (TG), HDL-C, and atherogenic indexes between the groups of patients with and without M694V mutation. Conclusions: Elaboration of clinical models of inflammation-induced atherogenesis may further advance our knowledge of multiple inflammatory pathways implicated in atherogenesis and provide a useful tool for cardiovascular prevention. We believe that the atherogenic index also be used as a preliminary indication of accelerated atherosclerosis in FMF. However, large- scale prospective studies on this issue are needed

The Effect of Sleep Apnea Severity on Cardiac Autonomic Activity During Night Time in Obstructive Sleep Apnea Patients

CONTEXT AND OBJECTIVE: Impaired autonomic cardiac function is an important consequence of obstructive sleep apnea (OSA). This impairment is mainly due to intermittent hypoxia episodes following apneas. However, the impact of apnea severity on autonomic cardiac function remains unclear. The aim of this study was to evaluate the relationship between the severity of sleep apnea and heart rate turbulence (HRT) and heart rate variability (HRV) in OSA. DESIGN AND SETTING: Observational cross-sectional study conducted in the Departments of Cardiology and Pulmonary Diseases, Afyon Kocatepe University, Turkey. METHODS: 106 patients with OSA and 27 healthy volunteers were enrolled. Based on apnea hypopnea index (AHI) values, obstructive sleep apnea severity was classified as follows: mild OSA (AHI >= 5 and = 15 and 30). HRV and HRT parameters were assessed via 24-hour digital Holter electrocardiogram recordings for all subjects. RESULTS: HRV and HRT results were significantly lower among OSA patients than among control subjects (P < 0.05). However, there were no significant differences in HRT and HRV between the three patient subgroups. Correlations did emerge between AHI and the NN-interval parameter RMSSD and between oxygen desaturation and turbulence slope (respectively: r = -0.22, P = 0.037; and r = -0.28, P = 0.025). CONCLUSION: HRT and HRV results deteriorate in OSA. Correlations between apnea severity and these parameters seem to be present.WoSScopu