Improved arterial stiffness in mitral stenosis after successful percutaneous balloon valvuloplasty

Background: Rheumatic mitral stenosis (MS) is still a common disease in developing countries with high morbidity and mortality rates. The purpose of the study was to evaluate arterial stiffness in severe MS before and after percutaneous mitral balloon valvuloplasty (PMBV). Methods: Thirty patients with MS in sinus rhythm requiring PMBV and 20 age-gender matched healthy volunteers. The analyze of pulse wave velocities (PWV) were performed using of the carotid artery at the femoral by PWV technique on patients at baseline and a week after PMBV. Results: The values of PWV were significantly decreased after successful PMBW in MS patients. Mitral mean gradients and systolic pulmonary artery pressures (sPAP) both on echocardiography and catheterization also had a significant decrease after PMBW. The mitral valve areas were significantly increased after PMBW. There was a highly significant negative correlation between mitral valve areas and PWV values. A highly significant positive correlation was seen between mitral mean gradient on catheterization and PWV (r = 0.830, p < 0.001). There was also a significant correlation between sPAP on catheterization and PWV values (r = 0.639, p < 0.001). Echocardiographic mitral mean gradients and PWV were highly positive correlated with each other (r = 0.841, p < 0.001). The sPAP on echocardiography had also a highly positive correlation with PWV (r = 0.681, p < 0.001). Conclusions: Mitral stenosis is a cause of impaired arterial stiffness and after the enlargened mitral valve area arterial stiffness improved in patients with MS

The contribution of implantable cardioverter defibrillators to systemic inflammation in heart failure patients

Heart failure (HF) is associated with an increased inflammatory burden, which is manifested by the elevation of serum levels of some inflammatory mediators such C-reactive protein (CRP), cytokines. In addition, high levels of inflammatory markers in patients with HF have been associated with poor outcomes. Lethal ventricular arrhythmias such as asystole and ventricular fibrillation-tachycardia are common in patients with HF and implantable cardioverter defibrillators (ICDs) are effective in preventing these situations. But like every foreign object in the body, ICDs also cause fibrosis and inflammation. This study aimed to show additional contribution of ICDs to systemic inflammation in patients with HF. This is a single centrer retrospective study included 140 HF patients with and without ICD (group 1 and 2) and 53 healty control subjects (group 3). Three groups were compared with regard to Hs-CRP and Neutrophil / Lymphocyte ratio (NL ratio). In order that acute inflammation did not affect the results, the earliest 6th month laboratory measures after ICD implantation were recorded. There are not significant difference between all groups in terms of age and gender, and among group 1 and 2 in terms of disease history, ejection fraction, heart rate and creatinine. When compared to the three groups according to Hs-CRP and NL ratio, there was a significant difference between the groups (both p [Med-Science 2019; 8(2.000): 282-6

Atrial electromechanical delay and left atrial mechanical functions in hemodialysis and peritoneal dialysis patients

Left atrium (LA) mechanical functions and atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity in general population. Data are scant about these parameters in end-stage renal disease (ESRD) patients receiving hemodialysis (HD) and peritoneal dialysis (PD). We aimed to evaluate AEMD times and LA mechanical functions and associated risk factors in HD and PD patients

Association between heart rate turbulence and anxiety symptom levels

General anxiety disorder (GAD) is a condition characterized by extreme, persistent, and uncontrollable worry lasting for more than six months. In addition to cognitive and behavioral symptoms, individuals with GAD also commonly exhibit physical signs and autonomic nervous system symptoms. Heart rate turbulence (HRT) is the assessment of sinus rhythm cycle fluctuation occurring in the presence of ventricular premature contraction (VPC), and is a parameter used to show autonomic dysfunction. There are no studies in the literature investigating the association between GAD and HRT. The aim of the present study was to determine the association between HRT and anxiety symptom levels. The study included 72 consecutive patients. The patients were fitted with Holter devices for 24-hr rhythm monitoring and asked to complete the Hospital Anxiety and Depression Scale (HADS) to assess their anxiety symptom levels. The study participants were grouped based on the severity of their anxiety symptoms as low (group 1) and high (group 2). Of the 72 participants, 26 had high anxiety levels and 46 had low anxiety levels. There was a significant difference between the two groups in HRT parameters. Patients in the high-anxiety group had significantly higher turbulence onset (TO) and significantly lower turbulence slope (TS) when compared with the low-anxiety group. Anxiety score was positively correlated with TO (r=0.296, p=0.01) and negatively correlated with TS (r=-0.304, p=0.009). In the present study, we found that patients with high anxiety levels showed greater abnormality in HRT parameters, indicating autonomic dysfunction. [Med-Science 2019; 8(1.000): 143-7

Androgenetic alopecia as an indicator of metabolic syndrome and cardiovascular risk

Numerous studies have investigated a probable association between androgenetic alopecia (AGA) and cardiovascular disease (CVD) by researching limited and dispersed parameters. We aimed to evaluate both traditional and non-traditional cardiovascular risk factors in male patients with early-onset AGA. This case-control study included 68 participants: 51 male patients with early-onset AGA and 17 healthy male controls. Patients with AGA were classified into three groups according to the Hamilton-Norwood scale and the presence of vertex hair loss. Traditional and non-traditional cardiovascular risk factors were examined in all study subjects. Metabolic syndrome was diagnosed in 25 patients with AGA and in two control subjects (p<0.05). The carotid intima-media thickness values were found to be significantly higher in patients with vertex pattern AGA than in patients without vertex baldness and controls (p<0.05). The pulse-wave velocity values were also found to be significantly higher in patients (p<0.001). A limitation of this study was the small study population. In conclusion, vertex pattern AGA appears to be a marker for early atherosclerosis. This finding supports the hypothesis that early-onset AGA alone could be an independent risk factor for CVD and metabolic syndrome

Predictive Value of Atrial Electromechanical Delay on Long-Term Cardiovascular Outcomes in Hemodialysis Patients

Background: Atrial electromechanical delay (AEMD) times were considered independent predictors of cardiovascular morbidity among the general population. We aimed at evaluating AEMD times and other risk factors associated with 2-year combined cardiovascular (CV) events in HD patients. Material and Methods: Sixty hemodialysis (HD) and 44 healthy individuals were enrolled in this prospective study. Echocardiography was performed before the mid-week dialysis session for HD patients. Data were expressed as mean SD. Spearman test was used to assess linear associations. Survival was examined with the Kaplan-Meier method. Multivariate Cox regression analysis was used to determine the predictors of combined CV events in this cohort. Results: At the beginning of the study, left intra-atrial-AEMD times were significantly longer in HD patients compared to the left intra-atrial-AEMD times in healthy individuals. After 24 months, 41 patients were still on HD treatment and 19 (31.6%) had died. Serum triglyceride, total cholesterol and albumin were found to be higher and C-reactive protein (CRP) levels, left intra-atrial EMD time (LIAT) and interatrial EMD times were found to be lower in survived HD patients. With the cut-off median values of 3.5 g/dl for albumin, 0.87 mg/dl for CRP, 157 mg/dl for total cholesterol and 151 mg/dl for triglyceride, the Kaplan-Meier curves demonstrated significant differences in terms of all-cause mortality. We also demonstrated the Kaplan-Meier survival curves of HD patients according to tertile values of LIAT. Cox regression analysis revealed that increased CRP and higher LIAT were found to be independent predictors of combined CV events. Conclusions: Increased LIAT and inflammation were found to be closely associated with 2 years combined CV events and all-cause mortality in HD patients. (C) 2015 S. Karger AG, Base

Effect of altitude on ticagrelor-induced dyspnea in patients with acute coronary syndrome

OBJECTIVE: This study aimed to define the association between altitude and ticagrelor-associated dyspnea in patients with acute coronary syndrome (ACS). METHODS: We studied consecutive patients with de novo ACS who were admitted to two centers at a low altitude (18 and 25 m, n = 65) and two centers at a high altitude (1313 and 1041 m, n = 136). We managed them with ticagrelor between May 2017 and September 2017. Patients with ACS underwent an interventional procedure within <90 minutes in those with ST elevation and within <3 hours in those without ST elevation. We recorded the incidence of dyspnea in patients with ACS receiving ticagrelor therapy. RESULTS: The mean age was 59.5 ± 10 years, and the mean ejection fraction was 43% ± 18%. A total of 110 (56.7%) patients had ST elevation and 84 (43.3%) did not. There were no significant differences in cardiac risk factors, concurrent medications, or procedural variables between the two groups. Dyspnea developed during hospitalization in 53 (38%) patients from high-altitude centers and in 13 (20%) patients from low-altitude centers (66 patients represented 32% of the total ACS cohort). CONCLUSIONS: Dyspnea is a common multifactorial symptom in patients following development of ACS. Ticagrelor-induced dyspnea appears to be associated with altitude

Acute Effects of Intracoronary Nitroglycerin and Diltiazem in Coronary Slow Flow Phenomenon

Background: The coronary slow flow phenomenon (CSFP) is a coronary microvascular disorder angiographically defined by delayed opacification of the distal vasculature in the absence of obstructive coronary artery disease. We aimed to investigate and compare the effects of intracoronary nitrate and diltiazem on thrombolysis in myocardial infarction frame count (TFC) in patients with CSFP during coronary angiography