Association between androgenic hormone levels and left ventricular ejection fraction

Androgens have been shown to have diverse effects on the cardiovascular system. The aim of this study was to compare androgenic hormone levels in patients with different left ventricular ejection fractions [EF]. The study population consisted of 515 consecutive men who were referred for angiographic studies and whose results of echocardiography and coronary angiography were available. The patients were classified into four groups: EF < 35%, EF=35-45%, EF=45-54%, and EF >/= 55% to evaluate the trends of baseline characteristics and serum androgens, including free testosterone [fT], total testosterone [tT], and dehydroepiandrosterone sulfate [DHEAS]. To better elucidate the difference in the patients with severe heart failure, the patients were divided into two groups according to their EF level, and comparisons were repeated between those with EF < 35% and the ones with EF >/= 35%. There were statistically significant trends in some characteristics in the patients with different levels of EF. The subjects with higher EF levels were less likely to have diabetes [p value < 0.001], coronary artery lesion [p value < 0.001], or high levels of C-reactive protein [CRP] [p value < 0.001]. As regards the patients with severe heart failure, our regression analysis revealed that the fT level was significantly lower in those with EF < 35% than in the ones with EF >/= 35% [5.82 +/- 2.73 pg/mL vs. 6.88 +/- 3.34 pg/mL, p value < 0.05]. A significant association was found between the level of fT and EF < 35%. There is a need for further controlled prospective studies to delineate any possible causal relationship accurately

Clinical and angiographic characteristics of myocardial bridegs: a descriptive report of 19 cases and follow-up outcomes

Muscle fibers overlying the intramyocardial segment of an epicardial coronary artery are termed myocardial bridge [MB]. The aim of this study was to analyze the mid-term outcome of MB and to examine its possible association with angiographic findings and concomitant cardiac pathologies such as hypertrophic cardiomyopathy [HCM]. From a total of 3218 patients admitted for coronary angiography during 9 consecutive months, 28 [0.9%] were diagnosed with MBs with stenoses.50%. Of these, 19 referred for follow-up with a median duration of 18 months. HCM was present in 5 patients [26.3%], of whom 4 had MB as the sole finding in angiography. Of the 19 patients, 14 had diastolic dysfunction. In follow-up, 2 patients were treated with revascularization strategies due to the concomitant coronary artery disease and in 2, syncope occurred. For two patients, an intra-cardiac device and a permanent pacemaker were implanted. Three patients with MB as the sole finding in angiography were readmitted because of chest pain. Diastolic dysfunction may contribute to the presentation of symptoms of muscle bridging. Also, myocardial bridging as the only finding in coronary angiography is highly associated with hypertrophic cardiomyopathy and may help to detect this group of patients. The mid-term outcome of myocardial bridges is favorable

Periodontal Disease as a Risk Factor for Coronary Artery Disease

Coronary artery disease is recognized as one of the three major causes of mortality around the world. The role of inflammation in producing coronary artery disease has been established in previous studies. Since periodontal disease, which is highly prevalent, is considered as a cause of inflammation, its influence on producing coronary artery disease was investigated in the present study considering its four main indices. In this case-control study, 60 patients with angiographically proven coronary artery disease were selected as case group After matching for some baseline characteristics including educational level, age, sex, and some established risk factors for coronary artery disease, 60 healthy individuals were selected as control group from a population in whom coronary artery disease had been angiographically ruled out. Then, the existence of periodontal diseases was compared with statistical methods in these two groups, considering four different dental indices. The mean plaque index [PI] was 57.82 +/- 2.92% in cases vs. 35.73 +/- 2.53% in controls [p<0.05]. Mean bleeding on probing [BOP] was 36.3 +/- 3.38% in cases versus 18.6 +/- 2.6% in controls, while mean Attachment Loss>4mm was 35.14 +/- 3.89% and 15.48 +/- 2.79% in cases and controls, respectively [P<0.05]. The mean loss of teeth [LOT] was not significantly different in cases and controls [5.08 +/- 0.52 versus 5.38 +/- 0.53, P>0.05]. Therefore, except for the number of lost teeth, there was a statistically significant difference between these two groups. For an evaluation of independent variables, multiple logistic regression analysis was used. Odds ratio was 1.02 for attachment loss and 2.2 for BOP. Periodontal diseases may be counted as a risk factor for coronary artery disease and it is essential to study the effects of control and management of these diseases as primary and secondary prevention for coronary artery disease in future studies