Assessment of bank financial health in Latvia

Financially strong, trustworthy and reliable banks form the basis of every economy and are a vital precondition for the stable economic development of every country. The financial health of banks is important for different stakeholders, including bank clients, correspondent banks, state and others. Therefore, lack of appropriate measures for bank financial health can cause a number of risks for the bank stakeholders. Traditionally the assessment of bank financial health and reliability is done by the international rating agencies as Standard & Poor’s, Moody’s and Fitch. These ratings are widely recognized worldwide; however, due to different reasons ratings assigned by the international rating agencies historically are not available for the majority of European banks. Besides, after the global financial crisis of 2008 the number of banks with a rating by an international rating agency has substantially decreased. Therefore, the aim of the paper is to design a model allowing to assess bank financial health using publicly available information. The proposed model is based on the analysis of financial statements data of Latvian commercial banks in the period from 2003 till 2017, key macroeconomic indicators, and aggregate statistical data of Latvian commercial banks managed by the Financial and Capital Market Commission (FCMC). The methodology is based on the design of multiple choice model ordered logit using eViews 7.0. The paper determines the main factors affecting the bank financial health based on the Moody`s Investors Service Long Term Bank Deposit Ratings. According to the developed model, the main factors involve bank assets structure, level of credit risk, profitability, bank capitalization, stability of resource base as well as macroeconomic factors, including investment and unemployment

The interrelationship between arterial markers alterations and left ventricular diastolic dysfunction in metabolic syndrome patients

Objective. To evaluate the relationship between arterial stiffness and left ventricular diastolic dysfunction(LVDD) in metabolic syndrome(MetS) patients. Methods. The cross-sectional study was carried among 1208 MetS subjects (64,8% men, 93,3% hypertensive). 573 subjects were evaluated after 3,8±0,6yr. Arterial stiffness was assessed by applanation tonometry. LVDD was defined according to the 2016 ESC Guidelines for the diagnosis and treatment of heart failure. Results. Subjects with LVDD (75,7%) were older (54,7±6vs 52±6yr), had higher cfPWV (9,0±1,6vs 8,2±1,3 m/s), AIxHR75 (25,4±9,9vs 21,1±10,8 %), mean arterial pressure(mAP) (108,6±12,8vs 103,4±10,1mmHg), HR (66,4±9,4vs 63,8±8,2 bpm), LV mass index(LVMI) (109,8±24vs 101,9±21,5 g/m2) all p<0.05. We found significant correlations between arterial stiffness and E/A (rcfPWV=-0,19, rAIxHR75=-0,15), e' (rcfPWV=-0,25, rAIxHR75=-0,18), E/e' (rcfPWV=0,17, rAIxHR75=0,14, all p<0,05). In multiple regression analysis cfPWV, gender, mAP, LVMI, HR, BMI remained significant determinants of E/e' (p<0,05). During the observation LV diastolic function didn’t change in 337, deteriorated in 110 and improved in 126 participants. We found significant alterations of arterial and diastolic function parameters(mean): cfPWV 8,55±1,4vs 8,7±1,6m/s; Aix/HR75 22,8±10,4vs 24,3±10,8%; mAP 105,3±10,4vs 101,5±14,8mmHg; LVMI 105±22,7vs 99±24,1 (all p<0,05). To clarify the relation between LVDD and arterial stiffness the conditional inference trees analysis was used. Only cfPWV, mAP, HR and BMI remained significant for presence of LVDD. Conslusion. Arterial stiffness is significant determinant of LV diastolic dysfunction and can be a possible causal link to development of left ventricular diastolic dysfunction

Arterijų funkcijos ir struktūros rodiklių pokyčio ir kairiojo skilvelio diastolinės disfunkcijos sąsajų tyrimas metabolinį sindromą turinčių asmenų grupėje

Objective. To evaluate the relationship between arterial stiffness and left ventricular diastolic dysfunction(LVDD) in metabolic syndrome(MetS) patients. Methods. The cross-sectional study was carried among 1208 MetS subjects (64,8% men, 93,3% hypertensive). 573 subjects were evaluated after 3,8±0,6yr. Arterial stiffness was assessed by applanation tonometry. LVDD was defined according to the 2016 ESC Guidelines for the diagnosis and treatment of heart failure. Results. Subjects with LVDD (75,7%) were older (54,7±6vs 52±6yr), had higher cfPWV (9,0±1,6vs 8,2±1,3 m/s), AIxHR75 (25,4±9,9vs 21,1±10,8 %), mean arterial pressure(mAP) (108,6±12,8vs 103,4±10,1mmHg), HR (66,4±9,4vs 63,8±8,2 bpm), LV mass index(LVMI) (109,8±24vs 101,9±21,5 g/m2) all p<0.05. We found significant correlations between arterial stiffness and E/A (rcfPWV=-0,19, rAIxHR75=-0,15), e' (rcfPWV=-0,25, rAIxHR75=-0,18), E/e' (rcfPWV=0,17, rAIxHR75=0,14, all p<0,05). In multiple regression analysis cfPWV, gender, mAP, LVMI, HR, BMI remained significant determinants of E/e' (p<0,05). During the observation LV diastolic function didn’t change in 337, deteriorated in 110 and improved in 126 participants. We found significant alterations of arterial and diastolic function parameters(mean): cfPWV 8,55±1,4vs 8,7±1,6m/s; Aix/HR75 22,8±10,4vs 24,3±10,8%; mAP 105,3±10,4vs 101,5±14,8mmHg; LVMI 105±22,7vs 99±24,1 (all p<0,05). To clarify the relation between LVDD and arterial stiffness the conditional inference trees analysis was used. Only cfPWV, mAP, HR and BMI remained significant for presence of LVDD. Conslusion. Arterial stiffness is significant determinant of LV diastolic dysfunction and can be a possible causal link to development of LVDD

Commercial Banking System Stability Assessment Problems

Over time several economists of the world have tried to find a model that would determine the security of commercial banks as well as stability of the commercial bank system and would help forecast potential problems in commercial banks and prevent their insolvency. Nowadays the development of the commercial bank assessment is topical and important not just for the potential customer and credit institutions themselves that are interested in early detection of likely problems and adequate assessment of bank contractors, but also for the supervisory institutions. Over recent 10 years the world has achieved a significant progress in strengthening the commercial bank stability and in decreasing the likelihood of crises and their consequences. This has been ensured by work of both national central banks and supervisory institutions as well as international organizations – the World Bank and IMF on developing new methods for the bank stability assessment, including rating systems, stress testing and macroprudential indicators. Nowadays the development of the commercial bank assessment system is topical and important not just for the potential customers and credit institutions themselves interested in early detection of the possible problems and adequate assessment of the contractor banks, but also for the supervision institutions as they will provide for the possibility to forecast the likely problems in commercial banks and prevent the insolvency of commercial banks

Association of cardio-ankle vascular index with cardiovascular risk factors and cardiovascular events in metabolic syndrome patients

Objectives: We aimed to investigate the association between arterial stiffness assessed as cardio-ankle vascular index (CAVI) and cardiovascular (CV) risk factors and CV events in the middle-aged metabolic syndrome (MS) patients. Materials and methods: A follow-up study was carried out in 2106 middle-aged (53.83+-6.17 years old, 62% women) MS subjects without overt atherosclerotic disease. Patients were initially recruited in 2009–2011 as participants of the Lithuanian High Cardiovascular Risk (LitHiR) primary prevention program and followed up for 3.8+-1.7 years for CV events. Thorough cardiometabolic risk assessment was carried out at inclusion. Results: Subjects with higher CAVI had worse lipid and glucose metabolism profile: elevated total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), decreased highdensity lipoprotein cholesterol (HDL-C), higher fasting and oral glucose tolerance test (OGTT) glucose levels (all P < 0.001), and lower fasting insulin (P = 0.021). Greater age (P < 0.001), heart rate (P = 0.016), and mean arterial pressure (P < 0.001) were also associated with higher CAVI. Over the follow-up period, 93 (4.4%) patients developed a cardiovascular event: 55(2.6%) patients had myocardial infarction and 38 (1.8%) suffered a cerebrovascular event. Fatal CV events comprised 6.5% (n = 6) of all CV events. CAVI was statistically significantly associated with occurrence of myocardial infarction (P = 0.027) and total cardiovascular events (P = 0.045), but not cerebrovascular events (P = 0.65). However, this association was dependent on age and gender

Detection of early heart failure with preserved ejection fraction (HFpEF) in metabolic syndrome patients detected as part of a National Screening Programme in middle aged subjects

Background We wished to investigate if community detected Metabolic Syndrome (MetS) is associated with the burden of incipient HFpEF in the community. Methods and Results We prospectively studied 148 consecutive MetS patients identified from the Lithuanian High Cardiovascular Risk primary prevention programme and investigated them further for unknown HFpEF through cardiopulmonary stress testing as well as assessment of BNP levels and of arterial stiffness. Subjects with a peak VO2 value lower than 90% of predicted and/or BNP≥35 ng/l were categorized as having early phase HFpEF. For comparison of this early phase HFpEF with others already clinically diagnosed with HFpEF, patients with both established HFpEF and MetS were selected retrospectively from patients attending our cardiopulmonary stress testing laboratory (n=38). Two thirds of the screening programme-derived MetS population (n=96) demonstrated a reduced exercise capacity and/or an elevated BNP, indicating signs of early HFpEF. Both the clinically diagnosed HFpEF and the screening programme detected MetS group with early HFpEF demonstrated similarly decreased exercise tolerance evaluated by peak oxygen uptake (79.8 ± 22.1% vs 82.7 ± 14.0%, p>0.05). Analysis of arterial markers in the screening programme group revealed statistically significant differences of augmentation index values between groups with and without signs of early HFpEF (p=0.016). Conclusions A considerable proportion of patients having MetS may be diagnosed with previously undetected early stage HFpEF. The use of objective parameters of exercise capacity and neurohormonal activation might be effectively used for the early detection of HFpEF. Also early HFpEF in this setting is found to be associated with increased arterial stiffnes

Primary prevention strategy for cardiovascular disease in Lithuania

Cardiovascular diseases are the main cause of premature death worldwide. More than half of deaths were caused by cardiovascular diseases in 2017 in Lithuania. Primary prevention programmes encourage both medical staff and general population to pay attention to potential health issues as well as attempt to eradicate risk factors causing cardiovascular diseases. “A Funding Programme for the Screening and Preventive Management of the High Cardiovascular Risk Individuals” published in Lithuania has been implemented as of 2006. Analysis of the results of the programme shows that the prevalent cases of arterial hypertension are gradually declining. However, the prevalence of dyslipidaemia is still not decreasing. The prevalence of other modifiable cardiovascular disease risk factors has erratic trends with a slight overall decline. Consequently, mortality rate of cardiovascular diseases has decreased by more than one third among middle-age population over the past 10 years. Having higher availability of the anti-hypertensive and anti-lipid medications already achieved, the future plans include the aim of further reducing elevated blood pressure and effectively treating dyslipidaemia. In order to implement a strategy that focuses on smoking prevention, promotion of healthy nutrition and physical activity, a significant contribution is required from the state authorities