Effect of hyoertension om aortic root size and prevelance of aortic regurgitation

Although early reports suggested that hypertension predisposed to aortic root enlargement and consequent aortic regurgitation, more recent pathological and M-mode echocardiographic studies have not found an association between hypertension and aortic root enlargement when age is considered. Objective: The aim of this study is to asses the effect of hypertension on aortic root size and to estimate the prevalence of aortic regurgitation. Methods: Measurement of two-dimensional echocardiographic diameters of the aortic root at four locations and compared findings with resting blood pressures and measures of body BMI in 110 normotensive and 110 hypertensive men and women matched for age and sex. Colour and continuous wave Doppler study are used to diagnose and assess severity of aortic regurgitation. Results:Aortic diameters at the annulus [2.40 plus or minus 0.29] versus 2.33 plus or minus 0.24 cm, P=06] and sinuses [3.45 plus or minus 0.43 versus 3.35 plus or minus 0.35, p=08] were marginally higher, whereas diameters at the supra-aortic ridge [2.93 plus or minus 0.39 versus 2.73 plus or minus 0.33 cm, P less than 01] were significally increased in hypertensive subjects. Aortic diameters increased with increasing quartiles of diastolic and systolic pressures, particularly at the supra-aortic ridge and ascending aorta. In multivariate analyses, blood pressure remained an independent determinant of distal aortic diameters after body size and age were considered. Aortic regurgitation was seen in 6 normotensive and 8 hypertensive subjects and did not differ in severity. Conclusion: Hypertension is associated with a slight increase in aortic root size, most notably of the supra-aortic ridge and proximal ascending aorta. Although dilation at the commissural attachment might be expected to predispose to an increase in aortic regurgitation, we did not detect such a difference in this population of, asymptomatic hypertensive individuals

Realtionship netween Tei index and left ventricular geometric patterns in hypertensive patients

Various left ventricular geometric patterns occur in hypertension and may affect the cardiovascular risk profile of hypertensive subjects. Tei index is a combined index of systolic and diastolic functions and has been shown to be a predictor of cardiovascular outcome in heart diseases. Objective: The aim of this study was to investigate the relationship between Tei index and left ventricular [LV] geometry in hypertensive patients. Methods: Two dimensional-guided M-mode echocardiography and Doppler study were performed in 122 hypertensive patients and 67 control subjects. This study was conducted at Baghdad Medical city/ Teaching Hospital and Alshahed Mohammed B. Alhakem Hospital in Alshulla city. According to the value of relative wall thickness [RWT] and left ventricular mass index [LVMI], hypertensive patients were subdivided into four geometric patterns. The Tei index was obtained from the summationof isovolumic relaxation time [IVRT] and isovolumic contraction time [IVCT], divided by the ejection time. Statistical analysis was done using SPSS 17.0. Results: This study shoes that the Tei index was significantly higher among the hypertensive patients with concentric hypertrophy [CH], eccentric hypertrophy [EH], concentric remodeling and normal geometry compared with the control group [0.8 plus or minus 1.1, 0.78 plus or minus 0.3, 0.59 plus or minus 0.5 respectively]. Tei index was correlated to the left ventricular ejection fraction [LVEF], left ventricular fractional shortening [LVFS], mitral E/A ratio, heart rate[HR], LVMI and RWT. Conclusion: The Tei index are impaired in all subgroups of hypertensive patients according to their LV geometry compared to control group. This impairment is more advanced in patients with concentric and eccentric hypertrophy

Evaluation of the complement [C3] in patients with acute coronary syndrome

To evaluate complement activation [C3] levels in all forms of acute coronary syndrome [AC S] and to find whether there is any significant changes in C3 concentration at the 1[st] and 4[th] day after admission and its relation to clinical outcome. Comparing the degree of complement activation [C3 level] between ACS and stable pectoris. To know whether there is any significant difference between the level C3 at first and fourth day. Any correlation between CRP and C3 in patients with ACS. 129 subjects [94 male and 35 female] age range [41-72 years, mean age 57 + 10.6] were admitted in this study over the period of Feb 2009-Jan 2010 categorized into three groups; 76 patients with acute coronary syndrome [group A], 25 patients with stable angina [group B] and 28 healthy control [group C]. Full clinical, biochemical, electrocardiographic and echocardiographic studies liveredone. All patients were followed to the fourth day of admission, Blood samples from peripheral veins were collected centrifuged and Serum C3 levels were measured using immunokit based on single immunodiffision. The sample of patients was [129] subjects [94 male 72.9%] and [35 female 27.1%]. TropoIlin [I] was positive in 35.7% and negative in 64.3% of the study sample [p. value 0.0005]. C-reactive protein [CRP] was significantly correlated with different groups [p. value 0.0004].the same with diabetes mellitus [p. value 0.0003] but not in hypertensive and smokers [p. value 0.486 and 0. 368 respectively].C3 levels was significant in correlation to clinical status in both STEMI and NSYEMI 1[st] and 4[th] day. Correlation between C3 and C-reactive protein level was insignificant with different groups. C3 levels was significantly elevated in correlation between ACS compared to patient with stable angina and healthy control subjects. Also C3 level was significant at the fourth day of admission in patients with NSTEMI in correlation to its level at the first day. However no significance associations between C3 levels and CRP in different studied groups