Is there any relationship between RDW levels and atrial fibrillation in hypertensive patient?

African Health sciences Vol 14 No. 1 March 201

Ciddi aritmiye yol açan Deli-Balı zehirlenmesi

Deli balı zehirlenmesi nadir ve yerel görülen hafif düzeyden ciddi hayatı tehdit eden kardiyak aritmilere neden olabilmektedir. Olgumuz 52 yaşında bayan bir hasta deli balı alımı sonrası, yorgunluk, sersemlik ve baş dönmesi şikayeti ile acil servisimize başvurdu. Yapılan fizik muayenesinde tansiyonu 70/40 mmHg, nabzı 45/dk idi. Öncesinde kardiyak hastalığı ve ilaç kullanımı olmayan hastanın elektrokardiografi (EKG) kaydında atriyal fibrilasyon ve atriyoventriküler (AV) tam blok gözlendi. Hasta acil müdahale sonrası takibe alındı. Takiplerinde şikayetleri gerileyen ve genel durumu stabil olan hasta öneriler ile taburcu edildi. Sonuç olarak, deli balı alımı sonrası hayati tehdit eden aritmiler oluşabilmektedir. Bu sağlık problemi sadece Türkiye’de bazı bölgelerle sınırlı değildir, besin taşıyıcılığı ile bütün dünyada artış göstermektedir. Klin Deney Ar Derg 2011;2(2):216-8Mad honey intoxication is rarely and locally seen, and it can cause cardiac arrhythmias from mild to life threatening health problems. A 52 year-old female patient admitted to our emergency room with dizziness and fatigue after ingestion of bitter honey. On examination in emergency room, her blood pressure was 70/40 mmHg and pulse value was 45/min. Atrial fibrillation and AV complete block rhythm was detected on her Electrocardiography (ECG) recording. She had no history of known-cardiac disease and use of medicine. On follow-up, her general health status got back to normal. The patient was discharged after her medical status was improved. In conclusion bitter honey intoxication can be life-threatening arrhythmias in people after ingestion of it. It is not restricted health problem to only that region of Turkey, but also to worldwide due to increase in people movement and international nutrition transport. J Clin Exp Invest 2011;2(2):216-

Is there any relationship between RDW levels and atrial fibrillation in hypertensive patient?

Background: Atrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke. Objective: We aimed to investigate the relation between RDW and AF in patients with hypertensive Method: We retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex Results: The mean age of the study population was 71,09± 8,50 (af group) and 70,97±8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13±1,58 and 14,05±1,15 p<001) . Logistic regression analysis showed that RDW and left atrial dimension were only independently risk factory associated with atrial fibrillation. (Rdw odds ratio:1,846 CI; 1,221-2,793 p<0,05). Roc curve analyses were applied to determine the cut-off point. Cut-off point was at 14,195 and Sensitive, specificity was %71,4, %56 respectively. Conclusion: RDW levels were higher in hypertensive patients with atrial fibrillation. An increased RDW level in the patient with hypertension may alert physician on developing or presence of atrial fibrillation

Hipertansiyonlu hastalarda sol ventrikülün eş zamanlı kasılmasını etkileyen faktörler: Arteriyel katılık ve merkezi kan basıncı etkili mi?

Amaç: Sol ventrikül (SV) eş zamanlı kasılma bozukluğu hipertansiyonlu hastalarda sık rastlanılan bir bulgu olup SV hipertrofisi ile ilişkilidir. Arteriyel katılık (AK) ve merkezi (aortik) kan basıncı, SV hipertrofisi gibi hipertansiyon kaynaklı hedef organ hasarında önemli rol oynar. Bu çalışmada, AK, merkezi sistolik ve diyastolik kan basınçları (KB) ve SV senkronizasyon bozukluğu arasındaki ilişki incelendi. Çalışma planı: Yeni hipertansiyon tanısı konmuş 35 hasta ve 40 kontrol çalışmaya alındı. Tüm çalışma popülasyonuna ‘doku senkronizasyon görüntülemesini’ (DSG) de içeren kapsamlı ekokardiyografik inceleme yapıldı. SV’nin pik sistolik doku hız zamanı (Zs) 12 segment modeli ile ölçüldü ve iki eş zamanlı kasılma bozukluğu indeksi hesaplandı. Nabız dalga hızı (NDH) ve artış indeksini (AIx@75) içeren AK parametreleri ile merkezil sistolik ve diyastolik KB aplanasyon tonometresi ile değerlendirildi. Bulgular: Kan basınçları dışında her iki grubun temel klinik ve ekokardiyografik parametreleri benzerdi. Eş zamanlı kasılma bozukluğu indeksleri hipertansiyonlu hastalarda kontrol grubuna göre uzamıştı: 12 segmentin Zs’nın standart sapması (48.7±18.8 ve 25.8±13.1, p<0.001); herhangi iki segmentin maksimum Zs farkı (143.9±52.2 ve 83.8±39.4, p<0.001), NDH (11.9±2.5 ve 9.5±1.4, p<0.001), AIx@75 (27.4±8.3 ve 18.3±9, p=0.009), merkezi sistolik (147.6±20.8 ve 105.4±11, p<0.001) ve diyastolik (99.8±14.4 ve 72.8±9.5, p<0.001) basınçlar hipertansiyonlu hastalarda kontrol grubundan daha yüksekti. Çok değişkenli analizde, merkezi sistolik KB (?=0.496, p=0.03), SV kitle indeksi (?=0.232, p=0.027) ve beden kütle indeksi (?=0.308, p=0.002) eş zamanlı kasılma bozukluğu ile bağımsız ilişkili bulundu. Sonuç: Merkezi sistolik KB, yeni tanı konmuş hipertansiyonlu hastalarda SV’nin eş zamanlı kasılma bozukluğunun bağımsız öngördürücüsüdür. Ancak AIx@75, SV eş zamanlı kasılması üzerinde doğrudan etkiye sahip değildir.Objectives: Left ventricular (LV) dyssynchrony is a common finding in patients with hypertension and is associated with LV hypertrophy. Arterial stiffness (AS) and central (aortic) blood pressures play a significant role in end-organ damage such as LV hypertrophy caused by hypertension. The objective of this study was to investigate the relationship between AS, central blood pressures (BP) and LV dyssynchrony. Study design: Thirty-five newly diagnosed hypertensive patients and 40 controls were enrolled in the study. The entire study population underwent a comprehensive echocardiographic study including tissue synchrony imaging. The 12 segmental model was used to measure the time to regional peak systolic tissue velocity (Ts) in the LV and two dyssynchrony indices were computed. Parameters of AS including pulse wave velocity (PWV), augmentation index (AIx@75), and central systolic and diastolic BP were evaluated by applanation tonometry. Results: The baseline clinical and echocardiographic parameters of both groups were similar except for their BPs. Dyssynchrony indices were prolonged in patients with hypertension as compared to the controls. The standart deviation of Ts of 12 LV segments in patients with hypertension and the controls were 48.7±18.8 vs. 25.8±13.1, respectively (p<0.001), and the maximal difference in Ts between any 2 of 12 LV segments was 143.9±52.2 for hypertension patients vs. 83.8±39.4 for controls (p<0.001). PWV (11.9±2.5 vs. 9.5±1.4, p<0.001), AIx@75 (27.4±8.3 vs. 18.3±9, p=0.009), and central systolic (147.6±20.8 vs. 105.4±11, p<0.001) and diastolic (99.8±14.4 vs. 72.8±9.5, p<0.001) pressures were higher in patients with hypertension than in the controls, respectively. In multivariable analysis, central systolic BP (?=0.496, p=0.03), LV mass index (?=0.232, p=0.027), and body mass index (?=0.308, p=0.002) were found to be independently related to dyssynchrony. Conclusion: Central systolic BP is an independent predictor of LV dyssynchrony, but AIx@75 did not have an independent effect on LV synchronicity in patients with newly-diagnosed hypertension

Evaluation of the relationship between coronary slow flow phenomenon and serum magnesium levels

Aim: Coronary slow flow phenomenon (CSFP) is a microvascular circulation disorder. It is known that serum magnesium has positive effects on anti-inflammation, vasodilatation and endothelial functions. This observational study investigated the association of serum magnesium levels with CSFP.Materials and Methods: Patients who had undergone coronary angiography (CAG) after noninvasive testing were included in the study. CAG records were reassessed for CSFP and 100 patients were diagnosed as having CSFP. Control subjects (n = 80) had normal coronary flow. Serum Mg levels and other biochemical parameters such as glucose, creatinine, cholesterol levels and hemoglobin samples were collected before CAG. Serum Mg values were categorized into two groups: Mg levels equal/under and above 1.9 mg/dL.Results: The mean patient age was 56.1±9.7 years; 68.9% of patients were men. Patient’s hypertension, diabetes mellitus history and smoking habits rate were similar between groups. Biochemical tests revealed lower serum magnesium levels (1.87 vs 1.95mg/dL, p=0.02) for CSFP patients and controls, respectively. In multivariate regression analysis, a serum magnesium level under 1.9 mg/dL (OR:3.33, 95% CI:1.75-6.37, p<0.001) and male gender (OR:2.08, 95% CI: 1.016-4.34, p=0.04) were found to be independent predictors of CSFP.Conclusion: Low serum magnesium levels were associated with CSFP. However, these results are not sufficient to fully determine the role of Mg levels in the mechanism of CSFP-related chest pain

Tumor-Cut: segmentation of brain tumors on contrast enhanced MR images for radiosurgery applications

In this paper, we present a fast and robust practical tool for segmentation of solid tumors with minimal user interaction to assist clinicians and researchers in radiosurgery planning and assessment of the response to the therapy. Particularly, a cellular automata (CA) based seeded tumor segmentation method on contrast enhanced T1 weighted magnetic resonance (MR) images, which standardizes the volume of interest (VOI) and seed selection, is proposed. First, we establish the connection of the CA-based segmentation to the graph-theoretic methods to show that the iterative CA framework solves the shortest path problem. In that regard, we modify the state transition function of the CA to calculate the exact shortest path solution. Furthermore, a sensitivity parameter is introduced to adapt to the heterogeneous tumor segmentation problem, and an implicit level set surface is evolved on a tumor probability map constructed from CA states to impose spatial smoothness. Sufficient information to initialize the algorithm is gathered from the user simply by a line drawn on the maximum diameter of the tumor, in line with the clinical practice. Furthermore, an algorithm based on CA is presented to differentiate necrotic and enhancing tumor tissue content, which gains importance for a detailed assessment of radiation therapy response. Validation studies on both clinical and synthetic brain tumor datasets demonstrate 80%-90% overlap performance of the proposed algorithm with an emphasis on less sensitivity to seed initialization, robustness with respect to different and heterogeneous tumor types, and its efficiency in terms of computation time

Analyses of C-Reactive Protein, Endothelial Nitric Oxide Synthase and Interleukin-6 Gene Polymorphisms in Adolescents with a Family History of Premature Coronary Artery Disease: A Pilot Study

Background: Family history of premature atherosclerosis imposes a high risk to people. The relationship between atherosclerosis and gene polymorphisms of various biomarkers such as Endothelial Nitric Oxide Synthase (eNOS), C-Reactive Protein (CRP), and Interleukin-6 (IL-6) has shown in previous studies. Aims: The major aim of the study was to evaluate the CRP, eNOS, and IL-6 gene polymorphisms in a group of adolescents who have a parental history of early coronary artery disease (CAD). Study Design: Case-control study. Methods: Thirty-six volunteers with a father with obstructive CAD during the first four decades and 46 subjects with a father with normal coronary arteries documented with coronary angiography were included in the study. Polymerase chain reaction-restriction fragment length polymorphism techniques were used to analyze CRP, eNOS, and IL-6 polymorphisms. Results: We did not find any differences between the two groups with regard to age, sex, body mass index, renal functions, systolic and diastolic blood pressures, lipid profile, and fasting glucose, hemoglobin, and high sensitivity CRP. A significant difference was only observed in IL-6-572 G/C genotype distribution and allele frequency between two groups (Pc=0.036 OR=3.48 CI (95%) 1.17-10.32). Conclusion: The present study showed a significant association between the IL-6-572 G/C gene polymorphism (presence of C allele) and adolescents with a parental history of premature CAD