Xanthelasma is associated with an increased amount of epicardial adipose tissue

Objective: In the present study, we aimed to compare the amount of epicardial adipose tissue in subjects with and without xanthelasma

Subjects and Methods:Fifty-two subjects with xanthelasma and 52 age- and gender-matched control subjects were enrolled in this study. Epicardial adipose tissue was assessed by measuring epicardial fat thickness [EFT] with echocardiography. Participants were dichotomized according to median EFT, which was 4 mm. The group with EFT >4 mm was defined as the supramedian group. Body mass index [BMI] was calculated by weight [kilograms] divided by height [meters] squared. Conditional logistic regression analysis was performed to find independent factors associated with supramedian EFT [>4 mm]

Results: Subjects with xanthelasma had higher BMI [31.2 +/- 5.6 vs. 28.6 +/- 5.7, p = 0.01] and higher levels of total cholesterol [216 +/- 54 vs. 181 +/- 42 mg/dl, p < 0.001], LDL cholesterol [142 +/- 45 vs. 115 +/- 36 mg/dl, p = 0.003] and triglycerides [median, 154 vs. 101 mg/dl, p = 0.01] than control subjects. EFT was significantly higher in subjects with xanthelasma than in controls [5.04 +/- 2.02 vs. 3.81 +/- 2.03 mm, p = 0.002]. In the conditional logistic regression analysis, the presence of xanthelasma [OR, 3.55; 95% CI, 1.43-8.78, p = 0.006] and lower HDL cholesterol level [OR, 0.96; 95% CI, 0.92-0.99, p = 0.023] were independently associated with supramedian EFT

Conclusion:The amount of epicardial adipose tissue found in subjects with xanthelasma was higher than in subjects without xanthelasma. In addition, the presence of xanthelasma was independently associated with supramedian EFT

A New Method for Patent Foramen Ovale Closure: Delivering Sheath Over Coronary Sinus Catheter into Left Atrium

Patent foramen ovale (PFO) is a frequent condition. It usually does not pose any threat to life, but in certain circumstances, it can open and serve as a conduit for thrombi causing paradoxical embolism. Herein, we report a case of PFO in a patient with ischemic cerebrovascular accident, due to paradoxical embolism, which could not be passed via general practice; hence it was crossed with coronary sinus catheter, through which the delivery sheath was placed into the left atrium, and it was successfully closed.

A New Method for Patent Foramen Ovale Closure: Delivering Sheath Over Coronary Sinus Catheter into Left Atrium

Patent foramen ovale (PFO) is a frequent condition. It usually does not pose any threat to life, but in certain circumstances, it can open and serve as a conduit for thrombi causing paradoxical embolism. Herein, we report a case of PFO in a patient with ischemic cerebrovascular accident, due to paradoxical embolism, which could not be passed via general practice; hence it was crossed with coronary sinus catheter, through which the delivery sheath was placed into the left atrium, and it was successfully closed.

Impairment in flow-mediated vasodilatation of the brachial artery in acromegaly

The aim of this study was to assess flow-mediated dilatation [FMD] of the brachial artery in patients with acromegaly. We prospectively evaluated 25 patients with acromegaly [14 females, 11 males; aged 42 +/- 12 years; growth hormone [GH] levels 34 +/- 14 ng/ml] and 27 control subjects [15 females, 12 males; aged 45 - 8 years; GH levels 3 +/- 1.5 ng/ml]. The patients and controls were matched for age, gender, body mass index, cigarette smoking, blood pressure, lipid levels, diabetes mellitus, hypertension, and its duration. Endothelial function, measured as FMD of the brachial artery using ultrasound, was calculated in the 2 groups. The endothelial function was evaluated by assessing 1-min postischemic FMD of the brachial artery. The FMD was lower in patients with acromegaly [9.97 +/- 3.5%] than in controls [16.1 +/- 3.4%], and the difference was statistically significant [p = 0.0001]. Endothelial dysfunction may develop in the preclinical phase of atherosclerosis in patients with acromegaly. Endothelium-dependent FMD may be impaired in acromegalic patients, and measurement of endothelial function may identify high-risk individuals earlier

Coagulation and fibrinolysis parameters in type 2 diabetic patients with and without diabetic vascular complications

To investigate the markers of endogenous coagulation/fibrinolysis and vascular endothelial cell function, and to assess the relationships between hemostatic parameters and diabetic vascular complications in type 2 diabetic patients. Materials and Coagulation and fibrinolysis parameters were measured in 92 type 2 diabetic patients [43 male, 49 female, mean age 50.1 ' 13.4 years] with [n = 44] and without [n = 48] vascular diabetic complications, and in 40 nondiabetic healthy subjects [20 male, 20 female, mean age 49.8 ' 15.1 years]. Common lipid parameters were also measured. The plasma levels of fibrinogen, antithrombin III [AT III], plasminogen activator inhibitor-1 [PAI-1], von Willebrand factor [vWF] activity and prothrombin time were found to be significantly increased in the type 2 diabetic patients compared with the healthy subjects. Glycosylated hemoglobin lc was inversely correlated with plasma protein S and activated prothrombin time. Protein C and S activities were positively correlated with plasma vWF activity, and were negatively correlated with plasma t-PA levels. vWF activity was negatively correlated with plasma t-PA levels. AT III levels were positively correlated with plasma total cholesterol levels, plasma low density lipoprotein cholesterol levels, plasma triglycerides and D-dimer levels. Plasma PAI-1 levels and factor V activity in diabetic patients with microvascular complications were significantly higher than those of the diabetic patients without microvascular complications. The plasma PAI-1 and platelet count were increased in patients with diabetic retinopathy compared with the diabetic patients without retinopathy. Plasma PAI-1 levels and factor VII activity were significantly higher in the diabetic patients with nephropathy than in diabetic patients without nephropathy. Plasma concentrations of fibrinogen and PAI-1 were significantly higher in the diabetic patients with neuropathy than the diabetic patients without neuropathy. The data demonstrated that patients with type 2 diabetes mellitus had a hypercoagulable state and hypofibrinolysis, thereby indicating that activation of coagulation with a reduced fibrinolytic activity may contribute to the increased risk of vascular disease in type 2 diabetic patients