The significance of adiponectin as a biomarker in metabolic syndrome and/or coronary artery disease

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Adiponectin exerts profound protective actions during insulin resistence or prediabetes progression towards more severe clinical entities such as metabolic syndrome and/or cardiovascular disease. Since hypoadiponectinaemia contributes to the pathophysiology of the metabolic syndrome and coronary artery disease the level of circulating adiponectin may be an early marker of cardiovascular events. The aim of this study was to determine the relationships between serum adiponectin levels and parameters of both insulin sensitivity and obesity in patients with the metabolic syndrome and/or coronary artery disease, as well as to assess predictive value of adiponectin serum levels as a biomarker of these entitetis. Methods. The study included 100 patients with metabolic syndrome and/or coronary artery disease with different degree of insulin resistance and healthy, normoglycemic individuals. The control group comprising healthy, normoglycemic individuals was used for comparison. Serum level of adiponectin, fasting glucose, fasting insulinemia Homeostasis Model Assessment of Insulin Resistance (HOMAIR) index and anthropometric parameters were determined in all the subjects. Adiponectin was measured by using the ultrasensitive ELISA method. Insulinemia was measured by the radioimmunoassay (RIA) method. The presence of glycemic disorders was assessed on the basis of oral glucose tolerance test (OGTT). Results. Adiponectin level was inversely correlated with age (ϱ = - 0.015), parameters of both obesity (R = 0.437; p < 0.001) and insulin resistance (R = 0.374; p < 0.01). Decreasing in the level of adiponectin was strongly implicated in the development of insulin resistance. Most importantly, a statistically significant rapid decrease in adiponectin was in the prediabetic stages (p < 0.01). The predictor value of adiponectin was 1,356.32 ± 402.65 рg/mL. Conclusions. The obtained resultats suggest that adiponectin may be a useful marker in identification of individuals with risk of developing metabolic syndrome and coronary artery disease, as well as a predictor of prediabetes

Multithreaded Aapplication for Real-Time Visualization of ECG Signal Waveforms and Their Spectrums

By using concept of virtual instrumentation, signals from human body can be digitized and transferred to computer for further processing. Software in a computer enables use of modern tools for digital signal processing that can be improved easily with emergence of new knowledge and with increasing of computer performances. Presenting the ECG signal in both: Time and Time-Frequency domains enables to cardiologist to obtain more reliable diagnosis. In order to present simultaneously the waveform and spectrogram of ECG signal in the real time we use Fast Fourier and Discrete Wavelet transform in the multithreading environment of a standard personal computer. The synchronization of accessing the signal data by threads according to the principle one thread a time is performed by controlling the state of event type variables

Relation between QT dispersion, left ventricle systolic function and frequency of ventricular arrhythmias in coronary patients

Introduction QT dispersion (QTd) is a measure of non-homogeneous repolarisation of the myocardium and is used as an indicator of arrhythmogenicity. Objective The aim of this study was to assess the relation between QT dispersion, left ventricle systolic function and frequency of ventricular arrhythmias in coronary patients. Method We studied 290 coronary patients, 72 with angina pectoris and 218 after myocardial infarction. Eighty-one coronary patients had frequent and complex ventricular arrhythmias (out of them 19 had ventricular tachycardia) and 209 were without arrhythmias or with infrequent ventricular premature contractions (VPC≤10/h). In all patients, QT dispersion, exercise test, 24-hour Holter monitoring and echocardiographic examination were performed. Results Patients with frequent and complex ventricular arrhythmias had significantly higher values of QTd (71.8±25.5 vs 55.6±21.7 ms; p&lt;0.001), corrected QT dispersion (QTdc: 81.3±31.5 vs. 60.3±26.1 ms; p&lt;0.001), left ventricular end-diastolic diameter (LVEDd: 56.2±6.9 vs. 53.4±6.2 mm; p&lt;0.001) and left ventricular end-systolic diameter (LVESd: 39.5±6.2 vs. 36.0±6.3 mm; p&lt;0.001), and significantly lower values of left ventricular ejection fraction (LVEF: 47.7±13.9 vs. 55.9±11.6%; p&lt;0.001) in comparison to those without arrhythmias or with infrequent VPC. Patients with VT had significantly higher values of QTd and QTdc in comparison to other patients with frequent and complex ventricular arrhythmias (83.8±17.1 vs. 69.4±26.2 ms; p&lt;0.02 for QTd; 101.1±23.9:77.6±31.4 ms; p&lt;0.005 for QTdc). There is a significant negative correlation of QTd and QTdc with LVEF, and a significant positive correlation of QTd and QTdc with inside dimensions of the left ventricle, in patients with frequent and complex ventricular arrhythmias. Conclusion The study demonstrated that patients with frequent and complex ventricular arrhythmias had significantly higher values of QTd and QTdc, as well as a higher degree of left ventricle systolic dysfunction in comparison to those without arrhythmias or with infrequent VPC

The Association Between Obesity and Visit-to-Visit Variability in Systolic Blood Pressure: A Prospective Study

With the prevalence of obesity and all accompanying health risks, both prevention and health education, as well as identifying predictors for the development of obesity-related diseases are primary. The pathophysiological relationship between obesity and visit-to-visit variability in systolic blood pressure (SBPV) has not been completely resolved. To investigate the association between obesity and SBPV in hypertensive patients. The prospective study comprised three visits was performed at the hypertension outpatient clinic during the follow up period of 22-months between March 2014 and January 2016. This study included 300 randomly selected hypertensive patients (average 67.76±9.84 years), who were divided in groups of obese/non-obese examinees. SBPV was defined as the standard deviation (SD) from three values of SBP. The values of SBP and SBP-SD were significantly higher in the group of obese hypertensive patients than in the group of non-obese patients (127.06±8.30 vs. 120.37±7.75; 11.29±5.67 vs. 7.37±3.94 mmHg; p<0.01). The highest SBPV was recorded in the 4th quartile in obese patients (43.13±7.50 mmHg). SBPV was strongly correlated with BMI and Waist cirumferences (WC) (ρo=0.425, ρo=0.356, p<0.01). During 22-months follow up there was a significant decrease of SBPV for 8.2 mmHg, BP for 31/5 mmHg, BMI for 3.8 kg/m2, WC for 10 cm and body weight for 8.24 kg. During 22-months follow-up, reduction of body weight was associated with reduction of blood pressure variability in hypertensive patients. Persistently decrease both body weight and long term visit-to-visit variability may explain lower cardiovascular risk in obese-related disease

Similarities and Differences in Epidemiology and Risk Factors of Cerebral and Myocardial Ischemic Disease

Ischemic heart disease and cerebral ischemia represent the leading causes of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. The autors aimed to investigate differences and similarities in epidemiology and risk factors that could be found between both entities. In a retrospective sudy 403 patients were included and divided into two groups: group of 289 patients with history of myocardial infarction (AMI), and group of 114 patients with history of ischemic stroke (IS). All patients were evaluated for nonmodifiable risk faktors, which included age and sex, and modifiable, such as hypertension, dyslipidemia, diabetes, obesity, physical activity and smoking. Diff erences in some epidemiological aspects were also considered: occupation, marital status, alcohol consumption, exposure to stress. Patients with history of IS were significantly older then AMI patients (64.0 ± 9.9 vs 64.0 ± 9.9, p=0,028), with higher diastolic blood pressure (87,1 ± 10,2 vs 83,6 ± 10,4, p=0,003) and higher Sokolow-Lyon index in ECG, an also index of left ventricular hypertrophy (19,2 ± 9,1 vs 14,7 ± 6,5). Th ere were no significant differences between groups in the estimated body mass index and waist circumference. Differences between groups in stress exposure, occupation, alcohol consumption or physical activity were no significant. Patients in AMI group were more frequently male (199 (69%) vs 59 (52%), p=0,001), married (252 (87%) vs 88 (77%), p=0,037), smokers (162 (56%) vs 50 (44%), p=0,018) and with higher incidence od dyslipidemia (217 (75%) vs 73 (64%), p=0,019) compared with IS group. Incidence of arterial hypertension and diabetes was similar in both groups. Both entities share similar pathophysiological mechanisms and, consequently, main traditional risk factors. However, incidence of myocardial infarction increases with male sex, dyslipidemia, smoking and marital status, while incidense of ischemic stroke increases with age, higher diastolic blood pressure and also with ECG signs of left ventricular hypertrophy

The possibilities of the application of some species of sage (Salvia L.) as auxiliaries in the treatment of some diseases

The chemical composition of four essential oils of four species of sage (Salvia officinalis L., Salvia pratensis L., Salvia glutinosa L. and Salvia aethiopis L.) are examined by GC-FID and GC-MS analysis. The presence of some components in the essential oil (mono- and sesquiterpene) determines the pharmacological effects and therapeutical application of a plant species. Salvia officinalis L. gives the highest yield of oil (1.1 %), while the lowest is in Salvia pratensis L. (0.1 %). The investigations included the determination of the antimicrobic activities of the essential oils by the diffusion method and the oil of Salvia pratensis L. proved to have the highest activity

CARDIAC RESYNCHRONIZATION THERAPY WITH OR WITHOUT AN IMPLANTABLE CARDIOVERTER DEFIBRILLATOR IN DIFFERENT GROUPS OF HEART FAILURE PATIENTS

Aim. Patients with heart failure have poor prognosis and mortality rate is between 15–60% per year. Implantable cardioverter-defibrillators and cardiac resynchronization therapy have been shown to improve survival, decrease hospital readmissions and mortality, and improve functional status and quality of life in patients with heart failure and left ventricular systolic dysfunction. Aim of the study was to examine the effects of different CRT devices in carefully selected heart failure patients during 1 year.Material and methods. We included 98 heart failure patients. First group (n=60) received CRT-P, while in second group (n=38) were patients with CRT-D pacemaker (with an additional cardioverter-defibrillator option).Results. Data gathered in our the study showed that both CRT-P and CRT-D in adequately selected heart failure patients improve different clinical parameters: symptoms, echocardiographic parameters, decrease QRS duration, increase 6 min walk test distance, decrease mortality rate.Conclusion. Patients with both CRT-P and CRT-D showed improvement in heart failure symptoms and CRT had significant influence on disease prognosis during 1 year of follow up. Nevertheless we do not have the perfect criteria for selection of patients and their follow up after the device implantation. In patients with the rhythm disturbances CRT-D option is the right choice only if the patient has the indications for resynchronization therapy as well. This choice however depends on clinical judgment of the operator more than on strict protocols and guidelines which are necessary but we need more clinical trials to support current hypothesis