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1.
Korean Circulation Journal ; : 929-938, 2017.
Article in English | WPRIM | ID: wpr-90201

ABSTRACT

BACKGROUND AND OBJECTIVES: Functional capacity varies significantly among patients with heart failure with reduced ejection fraction (HFrEF), and it remains unclear why functional capacity is severely compromised in some patients with HFrEF while it is preserved in others. In this study, we aimed to evaluate the role of pulmonary artery stiffness (PAS) in the functional status of patients with HFrEF. METHODS: A total of 46 heart failure (HF) patients without overt pulmonary hypertension or right HF and 52 controls were enrolled in the study. PAS was assessed on parasternal short-axis view using pulsed-wave Doppler recording of pulmonary flow one centimeter distal to the pulmonic valve annulus at a speed of 100 mm/sec. PAS was calculated according to the following formula: the ratio of maximum flow velocity shift of pulmonary flow to pulmonary acceleration time. RESULTS: PAS was significantly increased in the HFrEF group compared to the control group (10.53±2.40 vs. 7.41±1.32, p < 0.001). In sub-group analysis of patients with HFrEF, PAS was significantly associated with the functional class of the patients. HFrEF patients with poor New York Heart Association (NYHA) functional capacity had higher PAS compared those with good functional capacity. In multivariate regression analysis, NYHA class was independently correlated with PAS. CONCLUSION: PAS is associated with functional status and should be taken into consideration as an underlying pathophysiological mechanism of dyspnea in patients with HFrEF.


Subject(s)
Humans , Acceleration , Dyspnea , Heart Failure , Heart , Hypertension, Pulmonary , Pulmonary Artery , Stroke Volume , Vascular Stiffness
2.
Medical Principles and Practice. 2015; 24 (4): 369-375
in English | IMEMR | ID: emr-175087

ABSTRACT

Objectives: To evaluate the role of pentraxin-3 [PTX-3] in determining the presence and severity of coronary atherosclerosis in patients with coronary artery disease [CAD]


Subjects and Methods: Ninety-five patients [77 males and 18 females] who underwent elective coronary angiography were enrolled in this study. Patients with heart failure, renal failure, diabetes and thyroid disease were excluded. The study population was divided into 3 groups: individuals with normal coronary arteries, patients with critical CAD [n = 35] and patients with noncritical CAD [n = 36]. The association of PTX-3 levels with the presence and severity of CAD and the number of involved vessels were analyzed


Results: The mean age was 53.40 +/- 10.25 years. The PTX-3 levels were significantly higher in patients with CAD than without CAD [146.48 +/- 48.52 vs. 109.83 +/- 49.06 pg/ml, p < 0.001]. A statistically significant difference was found among the 3 groups regarding the severity of CAD [165.66 +/- 49.10, 127.83 +/- 40.51 and 109.83 +/- 49.06 pg/ml, p < 0.001, respectively]. The serum PTX-3 levels in normal arteries were 110.4 +/- 48.11 pg/ml, in single-vessel disease 132.35 +/- 32.96 pg/ml, in 2-vessel disease 142.57 +/- 55.88 pg/ml, in 3-vessel disease 156.07 +/- 50.53 pg/ml, and in 3-vessel disease 160.50 +/- 30.41 pg/ml. After adjusting for baseline confounders, older age [OR = 1.107, 95% CI = 1.027-1.193, p = 0.008] and higher PTX-3 levels [OR = 1.017, 95% CI = 1.003-1.032, p = 0.021] were detected as significant predictors for the presence of CAD


Conclusions: Higher PTX-3 levels were associated with the presence of CAD and its increased severity in clinically stable patients. Higher PTX-3 levels may be regarded as a novel diagnostic predictor and may offer therapeutic options in the clinic


Subject(s)
Humans , Male , Female , Middle Aged , Adult , C-Reactive Protein , Coronary Artery Disease , Coronary Angiography , Atherosclerosis
3.
Medical Principles and Practice. 2015; 24 (3): 263-268
in English | IMEMR | ID: emr-171524

ABSTRACT

We aimed to examine the relationship between serum uric acid levels and left atrial appendage [LAA] peak flow velocity, an indicator of the mechanical functions of the LAA, and atrial fibrillation [AF]. Transesophageal echocardiography was performed before cardioversion in 153 patients with AF. The patients were categorized into 2 groups based on their LAA blood flow velocity. Group 1 included 87 patients with a low LAA flow velocity [<35 cm/s], and group 2 comprised 66 patients with a normal LAA flow velocity [>/=35 cm/s]. The chi[2]and Student's t tests were used to compare categorical and quantitative data between the groups. Linear regression analyses were performed to demonstrate the independent association between serum uric acid levels and LAA peak flow velocity. The LAA blood flow velocity was 24.62 +/- 5.90 cm/s in group 1 and 49.28 +/- 13.72 cm/s in group 2, respectively [p < 0.001]. The serum uric acid levels were 6.88 +/- 1.85 mg/dl in group 1 and 5.97 +/- 1.51 mg/dl in group 2, and the difference was statistically significant [p = 0.001]. There was a negative correlation between serum uric acid levels and LAA blood flow velocity [r = -0.216, p = 0.007]. Multivariate regression analysis showed that serum uric acid levels, age and gender differences were significant predictors of the LAA peak flow velocity. High serum uric acid levels were associated with a low contractile function of the LAA and could provide additional prognostic information on future thromboembolic events in patients with AF


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Atrial Appendage , Atrial Fibrillation , Blood Flow Velocity , Atrial Function, Left , Retrospective Studies
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