Cardio-ankle vascular index represents the best surrogate for 10-year ASCVD risk estimation in patients with primary hypertension

Background: Identification of target organ damage and/or risk-enhancing factors help treatment decisions in hypertensive and hyperlipidaemic patients who reside in borderline to an intermediate risk category based on 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimates. Aim: In the present study, we aimed to investigate the comparative efficacy of certain hypertension-mediated organ damage markers (HMOD) for the prediction of 10-year ASCVD risk ≥10%, in patients with primary hypertension without established CVD. Methods: One-hundred thirty-seven asymptomatic hypertensive patients ≥40 years of age were enrolled in the present study. Ten-year ASCVD risks were estimated by Pooled Cohort Equations. The following HMOD markers; pulse pressure (PP), left ventricular mass index (LVMI), carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI) and estimated glomerular filtration rate (eGFR) were evaluated with respect to efficacy for predicting ≥10% ASCVD risk with ROC analysis. Results: CAVI gave the greatest Area Under Curve (AUC = 0.736, p < .000), and followed by CIMT (AUC = 0.727, p < .000), LVMI (AUC = O.630, p = .01), and PP (AUC = 0.623, p = .02). ABI and eGFR were not found to be predictive. CAVI correlated best with estimated 10-year ASCVD risk (r = 0.460, p < .000). A CAVI value ≥8 was found 71% sensitive and 72% specific for predicting ≥10% risk in 10-year ASCVD risk scale. CAVI gave the best graded response to increments in 10-year ASCVD risk categories. Conclusion: We suggest that CAVI is the best surrogate for 10-year ASCVD risk, among several HMOD markers

Aşikar kardiyovasküler hastalığı olmayanlarda koroner arter kalsifikasyonu ile ortalama trombosit hacmi arasındaki ilişki: Gözlemsel bir çalışma

dolaylı bir parametredir. Koroner arter kalsifikasyonunun (KAK) aterosklerotik proçesin bir parçası olduğu uzun zamandır bilinmektedir. Bu çalışmamızda aşikar kardiyovasküler hastalığı olmayan hastalarda KAK ile OTH arasındaki ilişkiyi inceledik. Yöntemler: Bu gözlemsel çalışmada, bilinen kardiyovasküler hastalığı olmayan ve en az bir kardiyovasküler riski olan 259 hasta çalışmaya alındı. KAK çok kesitli tomografi ile değerlendirildi. OTH ise etilen diamin tetra asetik asit (EDTA)’li tüplere alınan kanda ölçüldü. İstatistiksel analiz Kruskal-Wallis, Ki-kare, korelasyon testleri ve çoklu regresyon analiz ile yapıldı. Bulgular: Kalsiyum skoru 0 ile 735 arasında idi. Tek yönlü analizde KAK ile OTH (r0.24, p0.02), yaş (r0.32, p0.001), hipertansiyon (r0.19, p0.03), diyabet (r0.16, p0.005) ve sigara içimi (r0.17, p0.001) arasında anlamlı bir ilişki vardı. Çok yönlü analizde ise OTH (?0.4, %95GA 19.8- 31.1, p0.001), yaş (?0.13, %95GA 0.23-2.4 p0.01) ve sigara içimi (?0.12, %95GA 3.2-15.1, p0.02) KAK’ın bağımsız belirleyicileri idi. Ayrıca anlamlı KAK’ı olanlarda minimal ya da KAK’ı olmayan hastalara göre OTH anlamlı olarak yüksek idi (10.22.4 karşı 8.10.9 ve 7.61.3; R252.7, p0.001). Sonuç: Çalışmamızda OTH ile KAK arasında anlamlı bir ilişki bulduk. Her ne kadar çalışmamız bir korelasyon çalışması olduğu için neden- sonuç ilişkisi açısından bir sonuç çıkarmak zor olsa da yüksek OTH’nin artmış aterosklerotik yükü ve kardiyovasküler riski gösterebileceği söylenebilir. (Anadolu Kardiyol Derg 2012; 12: 35-9)Objective: Platelets have an important role in the pathogenesis of atherothrombosis. It has been shown that platelet size measured by mean platelet volume (MPV), correlates with their reactivity and is still regarded as an easy, useful tool for indirect monitoring of platelet activity in different situations. Coronary artery calcification (CAC) has long been known to occur as a part of the atherosclerotic process. The aim of this study was to determine whether an association exists between MPV and CAC. Methods: In this observational study, we enrolled 259 participants with at least one cardiac risk factor but with unknown cardiovascular disease. Coronary calcification was assessed by multislice computerized tomography and MPV was measured in a blood sample collected in EDTA tubes. Statistical analysis was performed using Kruskal-Wallis, Chi-square, correlation tests and multiple regression analysis. Results: Calcium scores ranged from 0 to 735. There was a significant relation between CAC and MPV (r0.24, p0.02), age (r0.32, p&lt;0.001), hypertension (r0.19, p0.03), diabetes (r0.16, p0.005), smoking (r0.17, p0.001). In linear regression analysis, MPV (&amp;#946;0.4, 95%CI 19.8- 31.1, p&lt;0.001), age (&amp;#946;0.13, 95%CI 0.23-2.4, p0.01) and smoking (&amp;#946;0.12, 95%CI 3.2-15.1, p0.02) independently associated with CAC. In addition, there were significant differences in MPV between significant CAC group compared to the minimal and none (10.2&plusmn;2.4 versus 8.1&plusmn;0.9 and 7.6&plusmn;1.3; p&lt;0.001). Conclusion: We have found significant association between MPV and CAC. Although this study is purely correlative and no causative conclusions can be drawn, it may suggest that higher MPV may reflect increased atherosclerotic burden and cardiovascular risk. (Anadolu Kardiyol Derg 2012; 12: 35-9

Apelin, Omentin-1, and Vaspin in patients with essential hypertension: association of adipokines with trace elements, inflammatory cytokines, and oxidative damage markers

Background Hypertension (HT) is a disease associated with endothelial dysfunction which is related to some adipokines and pro- and anti-inflammatory cytokines. Aims Our aim was to investigate roles of apelin, omentin-1, and vaspin in essential HT and to evaluate their relationships with other pro- and anti-inflammatory cytokines, trace elements, and oxidative stress. We also investigated these parameters to determine asymptomatic target organ damage period and grading essential hypertension. Methods One hundred fifty-three patients diagnosed with essential hypertension and 45 healthy controls were included in the study. Hypertension was defined as a systolic blood pressure > 140 mmHg and/or a diastolic blood pressure > 90 mm Hg or current use of an antihypertensive medication. The patients who had secondary HT, other chronic metabolic, cardiovascular, cerebrovascular diseases were excluded. History and physical exam including detailed cardiovascular examination were performed in all participants. Adipokines, cytokines, trace elements, lipid peroxidation, and ischemia-modified albumin levels were measured in blood samples by biochemical methods. Results Vaspin, IL-4, IL-8, IL-10, selenium, and zinc levels were significantly lower in the HT group compared to healthy controls while omentin-1, TNF-alpha, copper, iron, MDA, SOD, and IMA-C levels were significantly higher in HT patients compared to controls. Multiple ordinal regression revealed that TNF-alpha, IL-10, and body mass index of patients were statistically significant independent predictors (P =0.024,P= 0.019, andP= 0.032, respectively) for grading of HT. IL-4 and IL-10 were significantly higher in patients with asymptomatic target organ damage, compared to patients without asymptomatic target organ damage (P= 0.032 andP= 0.015, respectively). Our findings suggest that adipokines apelin, omentin, and vaspin may be involved in hypertension by a complex interaction with the anti- and pro-inflammatory cytokines, trace elements, and oxidative stress pathways

Age-related Changes in the Left Ventricular Twist

Introduction: Left ventricular (LV) rotation and twist play important roles in LV contraction and relaxation. Systolic function is usually preserved with aging, but diastolic function deteriorates. The aim of this study was to establish a reference value for LV twist and examine the effect of aging on it. Patients and Methods: We enrolled 75 healthy subjects who were divided into two groups according to age: < 40 and > 40 years. LV rotation and twist were assessed with two-dimensional speckle tracking imaging at the basal and apical levels of the parasternal short axis. LV twist was defined as an apical rotation relative to the baseline. Exclusion criteria included a history of ischemic and valvular disease, arrhythmia, use of a pacemaker, and systolic dysfunction. Results: Peak A wave velocity (70.6 ± 13.7 vs. 57.7 ± 10.6, p< 0.001) and E/E’ratio (7.7 ± 2.2 vs. 6.1 ± 1.3, p< 0.001) were higher and peak E wave velocity (52.4 ± 16 vs. 76.8 ± 11, p< 0.001) and E/A ratio (0.75 vs. 1.34, p< 0.001) were lower in old patients than in young patients. There was an increase in apical rotation (4.4 ± 2.9° vs. 3.3 ± 2.4°, p= 0.075) and a decrease in basal rotation (−4.1 ± 2.7° vs. −5.2 ± 3.7°, p= 0.185) in old patients, but these changes indicated no significant difference. With aging, the twist increased (8.6 ± 3.3° vs. 8.5 ± 4.1°, p= 0.890), but not significantly. LV apical rotation (5 ± 3.2 vs. 2.4 ± 1.1, p= 0.004) and twist (9.4 ± 3.4 vs. 6.9 ± 2.4, p= 0.64) decreased in the old group with an increasing degree of LV diastolic dysfunction. Conclusion: LV twist slightly increased with age, but this effect was reversed with increased diastolic dysfunction even in the presence of normal systolic function

Unusual Vascular Complications Associated with Transradial Coronary Procedures Among 10,324 Patients: Case Based Experience and Treatment Options

ConclusionsHemorrhagic and vascular complications are rarely seen during TRC. However, majority of these complications could be managed conservatively without a requirement for surgical reconstruction. (J Interven Cardiol 2015;28:305-312

Relationship of aortic knob width with cardio-ankle vascular stiffness index and its value in diagnosis of subclinical atherosclerosis in hypertensive patients: a study on diagnostic accuracy

Conclusion: Observation of aortic knob on chest X-ray in hypertensive patients may provide important predictive information of subclinical atherosclerosis. (Anadolu Kardiyol Derg 2012; 12: 102-6