A review of cardiovascular disease induced by radiation

Cardiovascular diseases are still in the 1st place in the world among cause of deaths. Data accumulates about publications investigating the effect of radiation on cardiovascular disease. Ionized radiation is used for diagnosis and treatment of many disease, recently. As for invasive cardiology; coronary artery disease, cardiac valve diseases, electrophysiological studies require radiation assistance.  It is very important for invasive cardiologists to know the cardiovascular adverse effects of radiation and radiation protection methods

Relationship of coronary collateral development with mean arterial pressure in patients with stable coronary artery disease

Aim: The prognostic value of blood pressure and the association between these parameters and cardiovascular conditions have been established in literature. In this study, we aimed to investigate the correlation between peripheral blood pressure parameters with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical artery stenosis. Methods: A total of 363 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: group with adequate CCD (n=120) and group with inadequate CCD (n=243). Peripheral blood pressure parameters were evaluated before coronary arteriography. Results: Peripheral diastolic blood pressure (DBP) and mean arterial pressure (MAP) levels were significantly higher in the inadequate CCC group (81.5±10.7 vs 77.9±9.9 p=0.02 and 100.6±11.8 vs 96.6±9.3 <.001). In Pearson’s correlation analysis revealed that, Peripheral DBP and MAP levels were significantly correlated with Rentrope Collateral Grading (r= 0.26, p<0.003 and r=0.29, p<0.001, respectively). ROC curve analysis of MAP and DBP for prediction of inadequate. At the cut-off value of > 99,8mmHG, sensitivity and specificity of MAP were 57% and 69%, respectively. At the cut-off value of >79,5 mmHg, sensitivity and specificity of DAP were 72% and 42%, respectively. Conclusion: The present study suggests that Peripheral DBP and MAP levels may be associated with degree of collateral development in chronic stable CAD. Low peripheral DBP and MAP in the case of severe coronary stenosis in stable CAD may be an important stimulus for coronary collateral development

Platelet indices in type 1 diabetes mellitus

Aim: We aimed to compare platelet counts (Plt), plateletcrit (PCT) and platelet distribution width (PDW) values of type 1 diabetes mellitus (T1DM) patients with those of healthy subjects. Methods: The records of 39 T1DM patients who were hospitalized between January 2016 and May 2018 were retrospectively analyzed. Control group consisted age and body mass index matched nondiabetic patients. Subjects having history of cardiovascular disease or any other systemic disease were excluded. Results: Compared to control group Plt (270±63 vs. 215±35 k/mm3), PCT (0.217±0.057 vs. 0.168±0.034 %) and PDW [17.4(16.2-20.4) vs. 17(12.5-19.4) %] were significantly higher in T1DM patients. Conclusion: Platelet indices which are common, simple and inexpensive hemogram parameters are increased T1DM patients

Comparison of platelet volume indices in acute coronary syndrome

Aim: To compare the parameters showing the platelet volume index in unstable angina pectoris (USAP), non-ST elevation myocardial infarction (non-STEMI) and ST elevation myocardial infarction (STEMI). Methods: The platelet volume indices of 94 USAP, 161 non-STEMI and 86 STEMI cases with a total of 341 patients (245 men, 96 women) were compared. The patients between March 2015 and October 2018 who admitted to Bolu Abant İzzet Baysal University Hospital with the diagnosis of acute coronary syndrome were compared using platelet distribution width (PDW), PDW to platelet ratio (PPR), mean platelet volume (MPV), MPV to platelet ratio (MPR). Results: No significant difference was found between the 3 groups in terms of PDW (p = 0.26), PPR (p = 0.87), MPV (p = 0.41) and MPR (p = 0.78) values. Conclusion: In our study, there was no statistically significant difference between the types of acute coronary syndrome and platelet volume indices

Comparison of eosinophil counts in patients with acute pulmonary embolism: Could it be a predictor factor?

Aim: To investigate whether there is a relationship between both massive and sub-massive pulmonary embolism (PE) and eosinophil counts in order to evaluate it as a predictor factor. Methods: This retrospective study included 108 patients (64 sub-massive and 44 massive) who received both tomographic and clinical diagnoses of pulmonary embolism, and 75 subjects served as controls. Hemogram parameters were compared between patients with massive and sub-massive pulmonary embolism and those of control groups.Results: In terms of white blood cell and eosinophil counts, the lowest value was evident in the massive PE group whereas the control group had the highest value. The eosinophil counts increased significantly one week after the treatment when compared to those at the presentation with PE (0.112 (0.003-0.853) vs. (0.144 (0.011-0.914), p=0.01). Spearman correlation test showed a significant positive correlation between right ventricular dysfunction or elevated cardiac troponin level and massive PE (r=0.54, p <0.001), whereas a negative correlation was detected between eosinophil count and the presence of massive PE (r=-0.36, p<0.001). Conclusion: The results of our study suggest that lower eosinophil counts may lead a physician to suggest a higher probability of acute massive pulmonary embolism rather than sub-massive pulmonary embolism. However, further randomized studies are required to confirm these findings

Evaluation of epicardial fat tissue thickness in patients with multiple sclerosis

Aim: Multiple sclerosis (MS), which is inflammatory in its pathogenesis, damages the myelin sheath in the central nervous system (CNS) and causes axonal loss. Epicardial fat tissue (EFT), located between the myocardium and the visceral layer of the pericardium, surrounds the heart and several inflammatory cytokines is secreted from this tissue. In this study, we aimed to investigate EFT thickness in MS patients and compared with that of volunteer non-MS subjects. Methods: A total of 154 subjects comprising 61 MS patients and 93 volunteers matched for gender and age were included in our study.  Epicardial fat tissue thickness was measured by echocardiography. All values were compared between groups. Results: Echocardiographic parameters were similar in both groups. However, the mean EFT thickness was significantly higher in the MS group than in the control group (p<0.001). Epicardial fat tissue thickness was also significantly correlated with the presence of MS (r=0.33, p<0.001). Conclusion: The results of our study suggest that the increase in epicardial adipose tissue thickness in MS patients may be a predictive factor for cardiovascular disease. However, the clinical significance of this finding and its relevance to MS pathogenesis should be investigated in further studies

Evaluation of electrocardiographic ventricular repolarization parameters in stable coronary artery disease

Aim: To examine the relationship between the SYNTAX score (SS) and cardiac repolarization parameters such as cQTd and Tp-e values, and Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios in patients who have stable angina pectoris. Methods: 12-lead resting electrocardiograms (ECGs) and SS of 160 patients (51 female and 109 male) undergoing coronary angiography with the pre-diagnosis of stable angina pectoris were evaluated. Patients with a SS below 22 were classified as Group 1 (low-SYNTAX), and those above 22 (high-SYNTAX) as Group 2. Forty-four patients with normal coronary angiography were included in Group 3. Results: Mean age of the patients was 62.4±9.1 years. The heart rate, QRS, QT, cQT and JT durations between the groups were similar. In addition, relatively recent ventricular repolarization indices such as Tp-e interval and Tp-e/QT, Tp-e/JT, Tp-e/QTc, and Tp-e/JTc ratios were also not substantially different between groups. Conclusion: Several surface ECG predictors of ventricular arrhythmias, including QTd, JT and Tp-e intervals and their ratios to QT and JT, are not significantly correlated with SYNTAX score-assessed CAD severity in patients with stable angina pectoris

Evaluation of electrocardiographic ventricular and atrial repolarization markers in patients with high grade varicocele

Aim: Varicocele is abnormal dilation of testis veins without unclear pathophysiology. Morphological studies showed imbalance between vasoconstrictor and vasodilator mechanisms. We aimed to determine the relationship between varicocele and cardiovascular system disorders with electrocardiography (ECG) parameters. Methods: This is a prospective study which was conducted in a University Hospital between February and June 2018. Thirty patients (18-45 years old) with high grade varicocele from urology outpatient clinic and 32 healthy volunteers for the control group were recruited to the study.  Results: P-min. value was significantly higher in control group than patients with high grade varicocele (p= 0.03). PR, QT and QTc intervals, PWD and P-max values were similar. Also, there were no significant differences in terms of the other ECG parameters between the groups. Conclusions: In this small prospective study we have found no association between high grade varicocele and potential electrocardiographic arrhythmia predictors namely OTd, QTc interval, PWD, Tp-e interval, Tp-e/QT ratio and Tp-e/QTc ratio. Long-term follow-up and large-scale prospective studies are needed to confirm our results

The relationship between epicardial fat thickness and high-grade varicocele

Background: Varicocele is abnormal dilation of testis veins. The precise mechanism of varicocele is not fully understood despite some hypothesis were suggested in the literature. Disequilibrium between constrictor and dilatator mechanism of the veins have been shown to cause varicocele. High-grade varicoceles have been also linked to endothelial dysfunction and increased vasoconstriction. Objectives: We hypothesized that epicardial fat thickness (EFT), flow-mediated dilatation (FMD) and aortic stiffness (AS) could be associated with varicocele. In the present study, we aimed to compare vascular parameters such as FMD, EFT and AS in healthy subjects and high-grade varicocele patients. Methods: The study population consisted of 35 men with high-grade varicocele and 32 age- and sex-matched control subjects younger than 45 years old. This is a cross-sectional study conducted at Bolu Abant Izzet Baysal University Hospital between May to October 2018. Results: EFT, aortic diastolic diameters (AoDD) and EFT/BMI ratio were significantly higher in control group than in patients with high-grade (p=0.012, p=0.044, p=0.026, respectively). EFT and EFT /BMI ratio were significantly and inversely correlated with presence of varicocele (r=-0.422, p=0.009; r=-0.38, p=0.026, respectively). Conclusion: The present study suggests that high-grade varicocele may be associated with decreased echocardiographic EFT but not with aortic stiffness and FMD