The association between coronary flow rate and impaired heart rate recovery in patients with metabolic syndrome: A preliminary report

Background: The aim of this study is to evaluate heart rate recovery (HRR) and association between coronary flow rate and HRR in patients with metabolic syndrome (MS) who had morphologically normal coronary angiogram.Methods: Study population included 43 patients with MS and 37 control subjects without MS. All patients were selected from individuals who had recently undergone coronary angiography in our hospital and were diagnosed as having angiographically normal coronary arteries. Exercise stress test results obtained prior to coronary angiography were evaluated for calculating HRR and other parameters. In addition, coronary flow was objectively evaluated for each major coronary artery in each subject using TIMI frame count method.Results: All HRR values calculated were detected significantly lower in MS group compared to controls (HRR first: 32 ± 9 vs. 37 ± 10; p = 0.01, second: 46 ± 11 vs. 52 ± 11; p = 0.03, third: 51 ± 12 vs. 59 ± 12; p = 0.00, fourth: 54 ± 13 vs. 61 ± 2; p = 0.02). TIMI frame counts for each major epicardial coronary artery and mean TIMI frame count were also found to be significantly higher in MS group compared to controls (left anterior descending artery:51 ± 24 vs. 39 ± 15; p = 0.009, left circumflex artery: 32 ± 11 vs. 24 ± 7; p = 0.001, right coronary artery: 33 ± 14 vs. 24 ± 10; p = 0.003, mean TIMI frame count: 38 ± 15 vs. 29 ± 9;p = 0.002). Additionally, significant negative correlations were also detected between HRR first minute and coronary TIMI frame count values in patients with MS. None of MS parameters did not affect HRR values, however mean TIMI frame count independently associated with HRR first minute (p = 0.04) in patients with MS.Conclusions: Impaired coronary blood flow occurring in MS might be a clue of autonomic dysfunction in addition to previously known endothelial dysfunction.

atherosclerosis

Background and Objective: Obstructive sleep apnea (OSA) has a critical association with cardiovascular mortality and morbidity. Carotid intima-media thickness (IMT), flow-mediated dilatation (FMD) and aortic stiffness are early signs of atherosclerosis. The presence of subclinical atherosclerosis was assessed in OSA patients using these parameters. Methods: 40 patients with OSA showing an apnea-hypopnea index (AHI) >= 5 (mean age 51.3 +/- 9 years, 32 males) and 24 controls ( HI < 5, mean age 51.9 +/- 5.2 years, 19 males) were enrolled in the study. In all subjects, polysomnographic examination and recordings were performed during sleep. IMT of the carotid artery, endothelium-dependent/-independent vasodilation of the brachial artery and aortic elastic parameters were investigated using high-resolution Doppler echocardiography. Results: The demographic data of the patients with OSA and controls were not significantly different. Subjects with OSA demonstrated higher values of aortic stiffness (7.1 +/- 1.88 vs. 6.42 +/- 1.56, respectively) and IMT (0.85 +/- 0.13 vs. 0.63 +/- 0.11 mm, p = 0.0001, respectively) but lower distensibility (9.47 +/- 1.33 vs. 11.8 +/- 3.36 cm(2)/dyn/10(6)) and FMD (4.57 +/- 1.3 vs. 6.34 +/- 0.83%, p = 0.0001, respectively) than the controls. The respiratory disturbance index correlated positively with aortic stiffness and IMT and negatively with distensibility and FMD. Conclusion: We observed blunted endothelium-dependent dilatation, increased carotid IMT and aortic stiffness in patients with OSA compared with matched control subjects. This is evident in the absence of other diseases, suggesting that OSA is an independent cause of atherosclerosis. These simple and noninvasive methods help to detect subclinical atherosclerosis in OSA. Copyright (C) 2006 S. Karger AG, Basel

Plasma Urotensin II Concentration In Gestational Diabetes

Aim: Urotensin II (UII) and its system is implicated in the etiology of many diseases (including diabetes mellitus). We tried in this study to evaluate and compare UII levels in gestational diabetes mellitus (GDM).Methods: Thirty-six pregnant women (15 non-GDM patients consisted group 1 and 21 GDM patients consisted group 2) enrolled in this study. The 3rd group consisted of age matched 22 non pregnant healthy women. Plasma UII levels were determined at the beginning of the study. After 12 weeks of delivery, a second plasma UII was determined from group 1 and 2.Results: Gestational UII levels of both GDM and non-GDM patients were higher than non-pregnant healthy controls (p=0.0001 for both). Both gestational and postpartum UII levels of GDM patients were higher than non-GDM patients but had not reached statistical significance (P≥0.05). Plasma UII concentrations in non-GDM patients significantly decreased after delivery but not in GDM patients (p=0.036 and p≥0.05, respectively). Conclusion: The finding of elevated gestational plasma UII concentrations in GDM patients which did not decrease significantly after delivery (in compare to non-GDM patients) shows that plasma UII levels may have a role in the pathogenesis of GDM. Further detailed studies are needed in this field

Plasma Urotensin II concentration in gestational diabetes

<p>Aim: Urotensin II (UII) and its system is implicated in the etiology of many diseases (including diabetes mellitus). We tried in this study to evaluate and compare UII levels in gestational diabetes mellitus (GDM).<br></p> <p>Methods: Thirty-six pregnant women (15 non-GDM patients consisted group 1 and 21 GDM patients consisted group 2) enrolled in this study. The 3rd group consisted of age matched 22 non pregnant healthy women. Plasma UII levels were determined at the beginning of the study. After 12 weeks of delivery, a second plasma UII was determined from group 1 and 2. </p> <p>Results: Gestational UII levels of both GDM and non-GDM patients were higher than non-pregnant healthy controls (p=0.0001 for both). Both gestational and postpartum UII levels of GDM patients were higher than non-GDM patients but had not reached statistical significance (P≥0.05). Plasma UII concentrations in non-GDM patients significantly decreased after delivery but not in GDM patients (p=0.036 and p≥0.05, respectively) </p> <p>Conclusions: The finding of elevated gestational plasma UII concentrations in GDM patients which did not decrease significantly after delivery (in compare to non-GDM patients) shows that plasma UII levels may have a role in the pathogenesis of GDM. Further detailed studies are needed in this field. </p