Soluble ST2 levels and left ventricular structure and function in patients with metabolic syndrome

Background: A biomarker that is of great interest in relation to adverse cardiovascular events is soluble ST2 (sST2), a member of the interleukin family. Considering that metabolic syndrome (MetS) is accompanied by a proinflammatory state, we aimed to assess the relationship between sST2 and left ventricular (LV) structure and function in patients with MetS. Methods: A multicentric, cross-sectional study was conducted on180 MetS subjects with normal LV ejection fraction as determined by echocardiography. LV hypertrophy (LVH) was defined as an LV mass index greater than the gender-specific upper limit of normal as determined by echocardiography. LV diastolic dysfunction (DD) was assessed by pulse-wave and tissue Doppler imaging. sST2 was measured by using a quantitative monoclonal ELISA assay. Results: LV mass index (β=0.337, P<0 .001, linear regression) was independently associated with sST2 concentrations. Increased sST2 was associated with an increased likelihood of LVH [Exp (B)=2.20, P=0.048, logistic regression] and increased systolic blood pressure [Exp (B)=1.02, P=0.05, logistic regression]. Comparing mean sST2 concentrations (adjusted for age, body mass index, gender) between different LV remodeling patterns, we found the greatest sST2 level in the group with concentric hypertrophy. There were no differences in sST2 concentration between groups with and without LV DD. Conclusions: Increased sST2 concentration in patients with MetS was associated with a greater likelihood of exhibiting LVH. Our results suggest that inflammation could be one of the principal triggering mechanisms for LV remodeling in MetS

Analysis of factors influencing Cu(II) sorption by clinoptiolite

Experimental design methodology represents a powerful tool for the analysis and optimization of various processes. Immobilization of toxic substances by sorption onto low-cost materials has gained a lot of attention in the last decade. Fundamental knowledge about sorption processes and their practical use can be improved by experimental planning and statistical analysis. In this study, the effects of initial metal concentration and pH, as well as the sorbent mass and particle size, on Cu(II) sorption by natural clinoptilolite were evaluated and compared. Full factorial experimental design at two levels was applied. Statistically significant factors were determined considering residual Cu(II) concentrations as a system response. The Pareto graphs of standardized effects, Main effect plots and Interaction plots were created using statistical software. Initial sorbate concentration, sorbent mass and their interaction were recognized as statistically significant, at 95% confidence level. Main effect plot approved that sorbent mass increase and initial Cu(II) concentration decrease caused reduction of residual Cu(II) concentration in solution. On the other hand, the change of initial solution pH and sorbent particle size didnt provoke significant response changes. Bearing in mind that pH is a factor with high effect on heavy metal sorption, the insignificant influence of initial pH detected in this study can be explained by buffering properties of the applied clinoptilolite and relatively narrow pH range chosen in order to prevent sorbent dissolution on one side and sorbate precipitation on the other. By regression analysis, the mathematical model for process description was derived. The correlation between predicted and experimental values was high (R-2 GT 0.99). In the investigated ranges of parameters, the obtained empirical equation can be applied for the prediction of system response

Association between right ventricle two- and three-dimensional echocardiography and exercise capacity in patients with reduced left ventricular ejection fraction.

INTRODUCTION:Echocardiography represents the most commonly performed noninvasive cardiac imaging test for patients with heart failure (HF). The aim of this study was to assess the relationship between exercise capacity parameters (peak oxygen consumption (VO2) and the minute ventilation-carbon dioxide production relationship (VE/VCO2)), two-dimensional speckle-tracking echocardiography (2D-STE) and three-dimensional echocardiography (3DE) imaging of right ventricular (RV) function in HF patients with reduced ejection fraction (EF). MATERIAL AND METHODS:This cross-sectional study included 54 patients with diagnosed ischemic LV systolic dysfunction (HF with reduced EF 15 ml/kg/min, VE/VCO2 slope < 36 and VE/VCO2 slope ≥ 36. All patients underwent a physical examination, laboratory testing, conventional echocardiography, 2D-STE, 3DE, and CPET. RESULTS:RV fractional area change (FAC), 2D RV global longitudinal strain (GLS), 3D RV EF were significantly decreased, and RV basal diameter (BD), systolic pulmonary artery pressure (SPAP), tricuspid annular plane systolic excursion (TAPSE), ratio between tricuspid flow and tissue Doppler derived e' of the lateral tricuspid annulus (TV E/e') were significantly increased in the subgroups of subjects with a worse VO2 peak and VE/VCO2 slope values. There was a significant positive correlation between the peak VO2 values and TAPSE, 2D RV GLS, 3D RV SV, and 3D RV EF as well as a significantly inverse correlation with VE/VCO2 slope. CONCLUSIONS:The observed significant correlation between the examined parameters suggests that 2D RV GLS and 3D RV EF, SV are associated with exercise capacity in patients with reduced HF

Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the peak VO2 values.

<p>Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the peak VO2 values.</p

Two–and three-dimensional speckle tracking echocardiography parameters in the investigated groups.

<p>Two–and three-dimensional speckle tracking echocardiography parameters in the investigated groups.</p

Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the VE/VCO2 slope values.

<p>Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the VE/VCO2 slope values.</p

Correlation between the parameters of cardiopulmonary exercise testing and echocardiographic parameters.

<p>Correlation between the parameters of cardiopulmonary exercise testing and echocardiographic parameters.</p

Demographic characteristics and clinical parameters of the study population.

<p>Demographic characteristics and clinical parameters of the study population.</p

Conventional two-dimensional echocardiography parameters in the investigated groups.

<p>Conventional two-dimensional echocardiography parameters in the investigated groups.</p

Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the peak VO2 values.

<p>Receiving operating characteristics (ROC) curve for the selected echocardiographic parameters in relation to the peak VO2 values.</p