Sympathetic Activity Index Should Be Kept in Mind When Assessing Autonomic Tonus

No abstract available.

Endocan and Non-Dipping Circadian Pattern in Newly Diagnosed Essential Hypertension

BACKGROUND AND OBJECTIVES: Non-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension. SUBJECTS AND METHODS: Twenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded. RESULTS: Despite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern. CONCLUSION: Elevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.

Do All Antioxidant Supplements Have the Same Potential Effect on Preventing Myringosclerosis?

OBJECTIVES: Myringosclerosis is an irreversible pathological healing mechanism of the tympanic membrane which can result in the formation of sclerotic plaques. Antioxidant treatment is a recognised prevention therapy and coenzyme Q10 (CoQ10), lycopene, and grape seed extract (GSE), were used in this manner. METHODS: Forty-four Wistar rats were used in this experiment, and, following myringotomies, the animals were randomly divided into four groups. CoQ10, lycopene or GSE was administered orally to the respective groups, starting from the day of surgery. Otomicroscopy examination was performed on the 14th day. All tympanic membrane lesions were evaluated and compared otomicroscopically and histopathologically. RESULTS: The otomicroscopy and histopathological findings, compared against a control (saline) group, showed the CoQ10, lycopene, and GSE groups had statistically significant differences of degree of sclerosis (P<0.001). CONCLUSION: CoQ10, lycopene, and GSE were compared against a saline group and their antioxidative and anti-inflammatory effects were similar. The formation of myringosclerotic plagues after experimental myringotomy in rats significantly decreased and diminished after systemic administration of the three different antioxidant supplements.

RE: Anomalous Cardiac Venous Connection to the Left Atrium Associated with Coronary Sinus Atresia

No abstract available.

CHA[2]DS[2] -VASc score as a predictor of left atrial thrombus in patients with non-valvular atrial fibrillation

To investigate whether or not the CHA[2]DS[2] -VASc score predicts left atrial [LA] thrombus detected on pre-cardioversion transoesophageal echocardiography [TEE]. The medical records of patients who had undergone TEE were reviewed to assess the presence of LA thrombus prior to direct-current cardioversion for atrial fibrillation [AF]. The CHA[2]DS[2] -VASc score was calculated for each patient. Clinical TEE reports were reviewed for the presence of LA thrombus. Patients with a valve prosthesis or rheumatic mitral valve disease were excluded from this study. A total of 309 patients were identified. The mean age was 70.1 +/- 9.8 years and 151 [49%] patients were males and 158 [51%] were females. LA thrombus was seen in 32 [10.3%] of the 309 patients. Fifty [16.2%] patients had a low CHA[2]DS[2] -VASc score [0-1], 230 [74.4%] had an intermediate score [2-4] and 29 [9.4%] had a high score [5-9]. The incidence of LA thrombus in the low, intermediate and high CHA[2]DS[2] -VASc score groups was 0, 4.4 and 68.7%, respectively. The LA thrombus risk increased with increasing CHA[2]DS[2] -VASc scores. On multivariate logistic analysis, the CHA[2]DS[2] -VASc score [OR 3.26, 95% CI 2.3-4.65; p = 0.001] and age [OR 0.93, 95% CI 0.88-0.98; p = 0.004] were independent risk factors for LA thrombus in patients with non-valvular AF. A high CHA[2]DS[2] -VASc score was independently associated with the presence of LA thrombus in patients with non-valvular AF

Infliximab; an Anti-TNF-Alpha Agent; Improves Left Atrial Abnormalities in Patients with Rheumatoid Arthritis: Preliminary Results : Cardiovascular Topic

Background : Rheumatoid arthritis (RA) is associated with increased cardiovascular morbidity and mortality. In the current prospective study; we addressed the impact of RA on left atrial (LA) function and electrical remodelling. Further; we tried to demonstrate the effects of infliximab; an anti-TNF-alpha agent; on echocardiographical LA abnormality in RA patients with preserved left ventricular (LV) ejection fraction. Methods: We compared 38 female RA patients without clinical evidence of heart disease and 30 female controls without RA and clinical evidence of heart disease. Further; we compared RA patients receiving infliximab and increasing doses of prednisolone over a three-month period. At baseline and post treatment; this study assessed (1) LA and LV parameters using conventional and speckle tracking echocardiography (STE); and (2) electrocardiographic P-wave changes. Results: The values of C-reactive protein (CRP); isovolumic relaxation time (IVRT); A wave; and deceleration time (DT) were significantly higher in RA patients compared to the control group (p 0.05); whereas E/E' and E/A values were found to be lower (p 0.05) in RA patients. E/E' values were lower in prednisolone- compared to infliximab-treated patients (p 0.05). After three months of infliximab and prednisolone treatment; CRP and disease activity score (DAS 28) values decreased in both groups (p 0.05); and Duke activity status index (DASI) increased (p 0.05). Maximal left atrial volume index (LAVImax); pre-contraction left atrial volume index (LAVIpreA) and maximum P wave (Pmax) of the RA patients were higher compared to the control group (p 0.05); whereas LA global strain was found to be lower (p 0.05). There was no difference in Pmax values between groups before and after the treatment period. E/E'; LAVImax and LAVIpreA values of infliximab-treated patients decreased and LA global strain increased after three months of therapy compared to baseline (p 0.05). At baseline in both treatment groups; E/E' and LA global late diastolic strain rate were lower in prednisolone- compared to infliximab-treated patients (p 0.05). Conclusion: There was echocardiographic LA abnormality in these RA patients. In this patient group there was also a meaningful increase in maximum P wave assessed by