Serum Irisin: Pathogenesis and Clinical Research in Cardiovascular Diseases

Recently, muscular function/dysfunction has gained importance in the maintenance of metabolic homeostasis in cardiovascular diseases. Skeletal muscle plays a vital role in coordinating the activity and metabolism of endocrine organs by secreting many myokines, especially irisin. Irisin is a polypeptide hormone consisting of 112 amino acids secreted into the blood from muscle and adipose tissues. Serum irisin levels are associated with cardiometabolic risk factors such as obesity and insulin resistance as defined by homeostatic model assessment. Irisin reduces endothelial damage by inhibiting inflammation and oxidative stress, thus playing a key role in maintaining endothelial cell function. Unsurprisingly, low irisin levels cause endothelial dysfunction and increase the incidence of atherosclerosis. We aimed to summarize the studies on this issue since we have not found any review in the literature on the role of serum irisin levels in the process of atherosclerosis and other cardiovascular events in cardiovascular diseases

Association between red blood cell distribution width and aortic valve sclerosis

RDW is a simple and inexpensive parameter, which reflects the degree of anisocytosis. Evidence from recent studies indicates that anisocytosis is common in most of the cardiovascular diseases and is related to their prognosis. Relation between red blood cell distribution width (RDW) levels and aortic valve sclerosis (AVSc) has not been investigated so far. Our aim is to investigate the relation between RDW and AVSc. This is a single center, retrospective cohort study. A total of 250 patients, 136 patients (mean age 65.4±7.7 years) with AVSc and 114 patients (mean age 68.5±6.8 years) as control group were enrolled. The serum RDW levels of two groups were compared. RDW levels were higher and statistically significant in patients with aortic sclerosis compared to the control group [14.1 (12.4-19 .1) vs 14.0 (11.7-17.1) p=0.044]. In multivariate regression analysis, high levels of RDW were associated with aortic sclerosis (OR=1.474, p=0.005), while hs-CRP was excluded from the analysis. To the best of our knowledge, this is the first study to demonstrate the correlation between RDW and Aortic valve sclerosis. Exploring the causes of RDW increment may contribute to our knowledge about pathogenesis of aortic sclerosis and our treatment strategies. [Med-Science 2020; 9(2.000): 485-91

Trombüs aspirasyonu yapılan akut anteriyor miyokard infaktüsünde reperfüzyon başarısının TIMI Frame sayımıyla değerlendirilmesi

Aim: Achieving reperfusion is the key target in the treatment of myocardial infarction with acute ST elevation. In our study,we aimed to compare the improvement in coronary blood flow using corrected TIMI frame score (cTFC) in patients, whopresented with acute anterior ST elevated myocardial infarction (AASTEMI), underwent primary percutaneous coronaryintervention (PPCI) with manual thrombus aspiration (MTA) and those, who underwent PPCI alone.Material and Methods: We included 30 patients with acute AASTEMI, who underwent PPCI with MTA and 60 patients,who underwent PPCI alone, between June 2009 and August 2013. Coronary angiography images were reviewed afterthe procedure to evaluate distal embolization, TIMI scores and the corrected TIMI frame scores in both groups. Allcause mortality and stent thrombosis were recorded at hospital admission. All-cause mortality, stent thrombosis, andhospitalization due to cardiac failure, occurring within a month of discharge, were investigated.Results: The mean age was 56.50 ± 16.45 among patients undergoing thrombus aspiration; there were 22 males and8 females. Among those who did not undergo MTA, the mean age was 56.57 ± 13.21; and there were 44 males and 16females. The rate of previous myocardial infarction (MI) (23.3 % vs 6.6 %; p = 0.019) and history of percutaneous coronaryintervention (PCI) (20.0 % vs 6.7 %, p = 0.040) was higher in patients, who underwent MTA. The mean TIMI frame scorewas 28.33 ± 7.24 and 26.68 ± 8.22, respectively in the patients, who underwent and did not undergo MTA; however, nostatistically significant difference was detected (p = 0.389). Overall time to ischemia was longer in the groups of patients,who underwent MTA (8.23 ± 9.68 vs 3.68 ± 8.22 hours, p = 0.003). Three patients, who underwent MTA (10 %, p = 0.007) diedbefore discharge and 1 patients (13.1 %, p = 0.003) died within a month. No cases of death were detected in the group ofpatients, who did not undergo MTA, in the hospital and within a month. There were no statistically significant differencesbetween these two groups with respect to hospitalization due to cardiac failure and occurrence of stent thrombosis.Conclusion: The use of MTA in AASTEMI did not have a favorable impact on reperfusion compared to not using MTA.Amaç: Akut ST yükselmeli miyokard enfarktüsü tedavisinde reperfüzyonun sağlanması temel hedeftir. Bizim çalışmamızda amacımız; akut anteriyor miyokard infarktüsü ile başvuran, manuel trombüs aspirasyonu ile primer perkütan koroner girişim yapılan ve yalnızca primer perkütan koroner girişim yapılan hastalarda, koroner kan akımındaki iyileşmeyi, düzeltilmiş TİMİ frame sayımı ( dTFS ) kullanarak kıyaslamaktır. Gereç ve Yöntemler: Çalışmaya retrospektif olarak akut anteriyor miyokard in-farktüsü olup manuel trombüs aspirasyonu ile birlikte primer perkütan koroner giri-şim uygulanmış 30, yalnızca primer perkütan koroner girişim uygulanmış 60 hasta alındı. Gruplar yaş ve cinsiyet açısından eşleştirdi. Koroner anjiografi filmleri tekrar izlenerek her iki grubta distal embolizasyon, TİMİ skoru ve dTFS değerlendirildi. Hastane yatışı esnasında tüm nedenli ölümler, stent trombozu kaydedildi. Taburcu-luk sonrası bir ay içinde meydana gelen tüm nedenli ölümler, stent trombozu ve kalp yetersizliği nedenli yatışları incelendi. Bulgular: Trombüs aspirasyonu yapılanların, ortalama yaşı 56.50±16.45. Tombüs aspirasyonu yapılmayanların ortalama yaşı 56.57±13.21 idi. Manuel trombüs aspi-rasyonu yapılan grupta dTFS ortalama 28.33±7.24, yapılmayan grupta ortalama 26,68±8.22, olarak tespit edildi. Ancak istastistiksel olarak fark tespit edilmedi (p=0.389). İşlem sonrası her iki grupta da EKG‘de benzer oranlarda ST segment rezolüsyonu tespit edildi. Manuel trombüs aspirasyonu yapılan 3 hasta (%10, p= 0.007) taburculuk öncesi, 1 hasta (%13.1, p=0.003) bir ay içinde ölmüştür. Trombüs aspirasyonu yapılmayan grupta hastane içinde ve bir ay içinde ölüm izlenmemiştir. Gruplar arasında bir ay içinde kalp yetersizliği nedenli hastane yatışı ve stent trom-bozu görülme oranları açısından istastistiksel fark tespit edilmedi. Sonuç: Çalışma grubumuzda akut anteriyor miyokard infarktüsünde manuel trom-büs aspirasyonun kullanılması, kullanılmamasına göre reperfüzyon üzerine olumlu etki göstermemiştir