ABSTRACT
Objective: The aim of this study was to evaluate the left [LV] and right [RV] ventricular function in euthyroid Hashimoto's thyroiditis [eHT] patients
Subjects and Methods:Forty-five patients diagnosed with eHT and 45 age- and gendermatched control subjects were enrolled in this study. Echocardiographic parameters reflecting RV and LV functions such as chamber dimensions, ejection fraction, fractional shortening, conventional and tissue Doppler-derived early and late filling velocities [E, A, E', A'], isovolumic relaxation [IVRT] and contraction [IVCT] times, ejection time [ET], deceleration time [DT], Tei index, pulmonary acceleration time [PAcT] and tricuspid annular plane systolic excursion [TAPSE] of patients with eHT were compared to those of control subjects using the paired-samples t test or Wilcoxon signedrank test
Results:Regarding the LV function, compared to the controls patients with eHT had a higher LV-Tei index [0.6 +/- 0.2 vs. 0.4 +/- 0.1, p < 0.001], higher DT [p < 0.001] and IVRT [p < 0.001] values, and higher E/E' ratios [p = 0.04]. In contrast, the peak E wave velocity [p = 0.02], E/A ratio [p = 0.01] and ET [p = 0.02] were significantly lower in the eHT group than amongst the controls. The RV, Tei index [0.40 +/- 0.11 vs. 0.28 +/- 0.07, p < 0.001], TAPSE [2.0 +/- 0.3 vs. 2.2 +/- 0.2 mm, p < 0.001], PAcT [124.3 +/- 22.6 vs. 149.4 +/- 18.3 ms, p < 0.001], A' [p = 0.007] and IVCT [p = 0.001] were significantly higher in patients with eHT than the controls. However, the tricuspid E/A ratio [p = 0.01], E' [p = 0.03] and E'/A' ratio [p = 0.001] were significantly lower in the eHT patients than the control group
Conclusions:This study demonstrated that both RV and LV functions were impaired in patients with eHT
ABSTRACT
Background and Objective: Diagnostic performance of troponin assays is affected by renal insufficiency. Neutrophil to lymphocyte ratio[NLR] is an independent predictor of acute coronary syndrome.Our objective was to evaluate performance of NLR in diagnosing acute myocardial infarction [AMI] among patients with elevated serum creatinine
Methods: Patients with elevated creatinine levels evaluated for coronary artery disease were included [n=284].Patients were divided into two groups according to having AMI or non-specific chest pain. AMI diagnosis was made based on clinical and laboratory data, including serial EKG and cardiac enzymes, ECHO and coronary angiography
Results: Troponin, neutrophil, and NLR were found to be higher in patients with AMI, compared to patients without AMI [P= 0.001, P= 0.001 and P=0.028, respectively]. ROC curve analysis for NLR in diagnosing AMI was significant[AUC:0.607; P=0.003]. Sensitivity, specificity, LR +, LR-, PPV and NPV for NLR>7.4 were found as 42.3%, 74.7%, 1.68%, 0.77%, 77% and 40%, respectively. Logistic regression analysis revealed that patients whose NLR>7.4 were 2.18 times as likely to have AMI
Conclusions: NLR can be used as an independent predictor of AMI in patients with renal insufficiency. This seems to get more important in the era of high sensitivity troponin assays. Our results might also help in early diagnosis of AMI in this high risk population while serial cardiac enzyme results are pending