Nesfatin-1 levels predict angiographic no-reflow in patients with st-segment elevation myocardial infarction

Background: Nesfatin-1 is a novel peptide possessing pleiotropic metabolic effects. No-reflow phenomenon (NR) is a poor prognostic indicator occurring in around 30% of all patients undergoing primary percutaneous coronary interventions (pPCI). Inflammation and complexity of coronary artery disease (CAD) play pivotal roles in the pathogenesis of NR. In this study, we investigated the relationship between admission serum nesfatin-1 level, NR and complexity of CAD assessed by SYNTAX-1 (SS-1) and SYNTAX-2 (SS-2) scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing pPCI. Methods: A total of 174 STEMI patients who underwent pPCI were included in the study and divided into NR (n = 36) and normal flow (n = 138) groups. Serum nesfatin-1 was measured by enzyme-linked immunosorbent assay. Seventy-eight consecutive age-, gender-and co-morbidity-matched patients undergoing coronary angiography with < 50% stenosis comprised the control group. Results: Nesfatin-1 levels were significantly lower in the NR group compared to the normal flow and control groups (10.8 ± 6.6 ng/mL vs. 34.9 ± 24 ng/mL vs. 43.6 ± 23.2 ng/mL, respectively, p < 0.001). Nesfatin-1 was significantly and inversely correlated with SS-1 and SS-2 scores (r =-0.709 and r =-0.655, respectively, both p < 0.001). Multivariate logistic regression analysis showed that nesfatin-1 [odds ratio (OR) = 0.81, 95% confidence interval (CI) = 0.708-0.936, p = 0.004] and glomerular filtration rate (OR = 0.94, 95% CI = 0.892-0.989, p = 0.018) were independently associated with NR. In the receiver operating characteristic analysis, nesfatin-1 < 15.21 ng/mL predicted NR with 78.4% sensitivity and 72.2% specificity (area under the curve = 0.809, 95% CI = 0.701-0.918, p < 0.001). Conclusions: Admission nesfatin-1 level is a potent predictor of NR in STEMI patients undergoing pPCI. Additionally, nesfatin-1 has a robust and negative correlation with the complexity of CAD. © 2020, Republic of China Society of Cardiology. All rights reserved

Wet Cupping Therapy Improves the Parameters of Ventricular Repolarization

Background: Cupping therapy (CT) is an ancient medical treatment since antiquity and is used for the treatment of such various disease states as contagious diseases, chronic or acute inflammatory disease, and autoimmune disorders. Ventricular repolarization is represented by QT and corrected-QT (QTc) intervals from surface electrocardiography.Objectives: As novel repolarization parameters, Tpeak-toTend (Tp-Te) interval, and Tp-Te/QT and Tp-Te/ QTc ratios are suggested to correlate better with ventricular arrhythmia risk in various clinical conditions than sole QT and QTc intervals. In this study, we aimed to determine whether these parameters changed significantly after CT in healthy individuals.Methods: One hundred and twenty participants (57 women and 63 men; mean age: 49.0 +/- 13.0 years) participated in this study. ECGs strips were recorded 1 hour before and 1 hour after CT from each participant, and relevant ECG parameters were compared.Results: Tp-Te interval [69.51 +/- 11.54 msec vs 63.15 +/- 10.89 msec, p = 0.001], Tp-Te/QT ratio [0.191 +/- 0.030 vs 0.174 +/- 0.031, p = 0.002] and Tp-Te/QTc ratio [0.175 +/- 0.030 vs 0.159 +/- 0.026, p = 0.001] were found to be significantly decreased 1 hour after the procedure compared with the pre-procedure values. However, no statistically significant change was observed in mean heart rate, QT and QTc intervals, QT/ QRS and cQT/QRS, and frontal QRS/T angle after the procedure compared with the same parameters before the procedure (p > 0.05).Conclusions: In accordance with the results of our study, it is plausible to conclude that CT may exert cardioprotective effect. However, larger scale prospective studies are needed to support our findings. (c) 2020 Medical Association of Pharmacopuncture Institute, Publishing services by Elsevier B.V

İntrakranial lipomlar: Yerleşim yerleri ile birlikte bilgisayarlı tomografi ve manyetik rezonans görüntüleme bulguları

Amaç: Bu çalışmanın amacı, nadir doğumsal malformasyonlardan olan intrakranial lipomların bilgisayarlı tomografi BT ve manyetik rezonans görüntüleme MRG bulgularını incelemek, klinik bulgularını ve birliktelik gösterdikleri malformasyonları tespit etmek ve lezyon yerleri ile hem semptomlar hem de kalfikasyon varlığı arasındaki ilişkiyi tespit etmektir. Gereç ve yöntem: Mart 2010-Mart 2015 tarihleri arasında tanı alan intrakranial lipoma sahip 57 hastanın 22 erkek ve 35 kadın, ortalama yaş 50, 2-89 arası yaş BT ve MRG bulgularını geriye dönük değerlendirdik. 25 hastanın BT, 32 hastanın MRG incelemesi mevcuttu. Lezyonların BT dansiteleri ölçüldü, görüntüleme bulguları, lezyon hacimleri, semptomlar ve birliktelik gösterdikleri lezyonlar tespit edildi. Lezyon yerleri ile hem semptomlar hem de kalsifikasyon varlığı arasındaki ilişki kikare testi kullanılarak araştırıldı. Bulgular: Lezyonların yerleşim yerleri şu şekilde izlendi; interhemisferik fissür n=22 , sol kuadrigeminal sistern n=10 , korpus kallozum n=10 , interserebellar fissür n=4 , sağ kuadrigeminal sistern n=3 , interpedinküler sistern n=3 , silvian fissür n=2 , koroid pleksus n=2 , sol akustik kanal n=1 . Ortalama lipom hacmi 4±3,047 mm3 idi. En sık semptom 9 hastada görülen baş ağrısı idi. Lezyon yerleri, ne semptomlar p=0,394 ile ne de kalsifikasyon varlığı p=0,552 ile anlamlı ilişki göstermedi. Sonuç: BT ve MRG tipik özellikleriyle intrakranial lipomlara tanı koyabilmektedir ve de bu lezyonların birliktelik gösterdikleri diğer malformasyonları da ortaya koyabilmektedir. BT ve MRG özelliklerinin bilinmesi ayırıcı tanıyı kolaylaştırmaktadı

Association between aortic stiffness and left ventricular function in inflammatory bowel disease

Background: Recent studies have reported an increased incidence of both aortic stiffness and left ventricular (LV) systolic and diastolic dysfunction in patients with inflammatory bowel disease (IBD). However, the association between aortic stiffness and the LV function has not been fully defined. We aimed to investigate the relationship between aortic stiffness and the LV function in IBD patients. Methods and Results: Seventy-two patients with IBD (56 cases of ulcerative colitis and 16 cases of Crohn’s disease) and 50 healthy controls were consecutively enrolled in this study. The LV systolic and diastolic functions were assessed using conventional echocardiographic techniques, including tissue Doppler echocardiography. The degree of aortic strain and distensibility were calculated based on the aortic diameters measured on M-mode echocardiography at the level of 3 cm above the aortic valve and the blood pressure values obtained on sphygmomanometry. There were significant differences between the IBD and control group in the degree of aortic strain and distensibility. Significant differences were also observed between the patient and control groups in the parameters of the LV systolic and diastolic functions. Moreover, aortic stiffness was found to be associated with the LV function in the patient group. Conclusions: There is a significant relationship between aortic stiffness and LV systolic and diastolic dysfunction in patients with IBD, based on the findings of this study. The parameters of aortic elasticity measured according to 2-dimensional echocardiographic methods can be beneficial for predicting early cardiovascular risk in cases of IBD. (

The Effect of Lower and Higher Calorie Meal on the Parameters of Ventricular Repolarization in Healthy Subjects

BACKGROUND: Cardiovascular modulation following meal consumption has been known. Little and conflicting data is present regarding electrocardiographic QT and QTc intervals after a meal, and status of ventricular repolarization following meal is not known comprehensively. AIM: To inquire the electrocardiographic status of ventricular repolarisation thoroughly after lower and higher calorie meal consumption in a comparative manner. METHODS: A group of 61 healthy individuals were studied before and after lunch. They were divided into two groups according to the calorie consumed (higher calorie and lower calorie; median 1580 and 900 kcals, respectively). Calorie consumed was estimated using dietary guidelines. Data was collected from 12-lead ECG both in a fasted state and 2nd postprandial hour for each participant. Parameters of ventricular repolarization, namely, JTp, Tp-e, QT, QTc intervals and their ratios, as well as RR intervals, were compared between fasted and postprandial states for every participant. RESULTS: Tp-e and QTc intervals, and Tp-e/QTc ratio do not significantly change after both higher- and lower-calorie meals. JTp and QT intervals significantly shorten in both groups, regardless of the calorie consumed. While JTp shows a positive correlation with RR interval both before and after a meal in lower calorie intake group, no correlation was found with RR interval after a meal in higher calorie group. Logistic regression analysis revealed that higher calorie intake during a meal is a predictor for greater shortening in JTp and QT, compared to lower calorie meal. CONCLUSION: Our study may guide future studies on ventricular repolarisation, particularly those conducted on various disease conditions or drug effect of cardiac electrophysiology

Creating a functional model for conceptual design

Bu çalışmanın amacı, standart fonksiyonel dil yapısını kullanarak kavramsal tasarımın en kritik aşaması olan fonksiyonel modeli oluşturmaktır. Günümüz sanayisindeki uygulamalarda tasarımcılar tasarım süreci hakkındaki bilgi eksikliğinden dolayı doğrudan ayrıntılı tasarıma geçmektedirler. Bu durum tasarım verimliliği ve süresini olumsuz yönde etkileyebilir. Fonksiyonel dil yapısı, tasarımın sistematik aşamalardan geçmesini sağlayarak tasarımın tecrübe ve bireysel yeteneklere bağlı olmasını engeller. Bu çalışma, mekanik ya da makine tasarımı ile ilgilenen birimlerin ve kişilerin kavramsal tasarım sürecinde, fonksiyonel model oluşturmalarında yardımcı olmak amaçlı hazırlanmıştır. Fonksiyonel model oluşturmak için ihtiyaç duyulan standart fonksiyon sınıfları ve akış sınıfları detaylı bir şekilde ele alınmıştır. Ayrıca soyut bir kavram olan fonksiyonel model yapısını gerçek örneklerle destekleyerek uygulanabilirliği gösterilmiştir.The goal of this study is creating a functional model by using functional basis tool which is the most critical stage of the conceptual design. Nowadays designers are missing the design stages due to lack of information about the design processes in industrial applications. This case can affect the design efficiency and design time negatively. Since the functional basis lets the systematic design stages, it prevents the needed individual experiences and capabilities for design. This study is prepared for supporting a functional model for mechanical or machine designers and related departments in conceptual design processes. Function and flow classes are also discussed here to create a functional model. Furthermore a functional model structure, which is an intangible concept, is supported with verified examples. As a result, the applicability is proved of the functional model structure

Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease

WOS: 000471737700016PubMed ID: 30928820Background: Ventricular arrhythmias and sudden cardiac deaths are the most common cause of mortality in patients with end-stage renal disease (ESRD). Index of cardiac-electrophysiological balance (iCEB) (QT/QRS) may predict malignant ventricular arrhythmias. In this study, we investigated whether iCEB value is increased in ESRD patients and whether it changes before and after hemodialysis. Methods: The study included 52 ESRD patients and 53 control subjects matched for age and comorbidities. Biochemical, electrocardiographic and echocardiographic values of all participants were recorded. QRS, QT, Tp-e were measured manually. QTC was calculated using Bazett's formula. Then, Tp-e/QT, Tp-e/QTc, QT/QRS, and QTc/QRS ratios were calculated. The changes in ECG parameters of the ESRD patients before and after HD were compared using paired t-test. Results: Mean age and male sex ratio was comparable in both groups (p = 0.448 and p = 0.777, respectively). Comorbidity incidences, and biochemical parameters except eGFR (p < 0.001), albumin (p < 0.001), HDL cholesterol (p = 0.03) and platelet counts (p < 0.001) were comparable in both groups. Compared to the control group, QT, QTc, Tp-e, Tp-e/QT, Tp-e/QTc, QT/QRS, and QTc/QRS ratios were higher in the ESRD group (p < 0.05 for each). While QT and QTc intervals did not change after HD in ESRD patients, Tp-e, Tp-e/QT, Tp-e/QTc, QT/QRS, and QTc/QRS parameters increased significantly. Conclusion: In addition to ventricular repolarization dispersion indices in ESRD patients, iCEB elevation and increasing values after HD session indicate the increased risk of TdP-mediated ventricular arrhythmia after HD. Larger studies are needed to confirm our results. (C) 2019 Elsevier Inc. All rights reserved

Role of calcium–albumin ratio in severity of coronary artery disease assessed by angiographic SYNTAX score

Aim: Numerous studies have reported a relationship between serum calcium or albumin levels and acute coronary syndromes and coronary artery disease. The present study investigated the relation between serum albumin, calcium or albumin-corrected calcium levels or calcium/albumin ratio (CAR) and extensiveness and severity of atherosclerosis. Methods: This prospective study included patients with non-ST elevation myocardial infarction (NSTEMI, n=120) and a control group (n=109). We used the SYNTAX score to evaluate the association between CAR and severity and extent of coronary artery disease. Results: There were higher, but statistically nonsignificant, levels of calcium in patients with NSTEMI (p=0.058). However, serum albumin-corrected calcium levels were significantly higher in NSTEMI group (p=0.001). Yet, albumin levels did not differ between the groups (p=0.093). CAR and corrected calcium–albumin ratio (cCAR) were significantly higher in NSTEMI group (p=0.001). A positive correlation existed between CAR (r=0.235, p=0.010), cCAR (r=0.259, p=0.004), and SYNTAX score, whereas albumin and SYNTAX score (r=−0.259, p=0.004) showed a negative correlation. Conclusion: Calcium/albumin ratio has been found to be associated with an increased coronary atherosclerotic burden as calculated by SYNTAX score. Further large-scale studies are warranted to confirm our findings