Aortic Flow Propagation Velocity in Patients with Familial Mediterranean Fever: an Observational Study

BACKGROUND AND OBJECTIVES: Systemic inflammation has an important role in the initiation of atherosclerosis, which is associated with arterial stiffness (AS). Aortic flow propagation velocity (APV) is a new echocardiographic parameter of aortic stiffness. The relationship between systemic inflammation and AS has not yet been described in patients with familial Mediterranean fever (FMF). We aimed to investigate the early markers of AS in patients with FMF by measuring APV and carotid intima-media thickness (CIMT). SUBJECTS AND METHODS: Sixty-one FMF patients (43 women; mean age 27.3±6.7 years) in an attack-free period and 57 healthy individuals (36 women; mean age 28.8±7.1 years) were included in this study. The individuals with atherosclerotic risk factors were excluded from the study. The flow propagation velocity of the descending aorta and CIMT were measured to assess AS. RESULTS: APV was significantly lower (60.2±16.5 vs. 89.5±11.6 cm/sec, p<0.001) and CIMT was significantly higher (0.49±0.09 vs. 0.40±0.10 mm, p<0.001) in the FMF group compared to the control group. There were significant correlations between APV and mean CIMT (r=-0.424, p<0.001), erythrocyte sedimentation rate (ESR) (r=-0.198, p=0.032), and left ventricle ejection fraction (r=0.201, p=0.029). APV and the ESR were independent predictors of FMF in logistic regression analysis (OR=-0.900, 95% CI=0.865-0.936, p<0.001 and OR=-1.078, 95% CI=1.024-1.135, p=0.004, respectively). Mean CIMT and LVEF were independent factors associated with APV in linear regression analysis (β=-0.423, p<0.001 and β=0.199, p=0.017, respectively). CONCLUSION: We demonstrated that APV was lower in FMF patients and is related to CIMT. According to our results, APV may be an independent predictor of FMF.

Effect of weight loss induced by intragastric balloon therapy on cardiac function in morbidly obese individuals: a pilot study

The aim of the study was to investigate the effect of intragastric balloon therapy on left ventricular function and left ventricular mass in a cohort of morbidly obese patients. A prospective trial was performed in a cohort of 17 class II and class III morbidly obese individuals. The intragastric balloon was retained in the stomach for an average of 6 months. Conventional and tissue Doppler echocardiography were performed in all patients before and after the procedure. The mean age of the study participants was 36 +/- 10 years [range: 18-55]. The mean body mass index was significantly decreased following the intragastric balloon insertion procedure [44 +/- 8 vs. 38 +/- 5, p < 0.001]. The left ventricular mass index and left atrial volume index were significantly decreased following the procedure [112 +/- 21 vs. 93 +/- 17, p = 0.001 and 20 +/- 6 vs. 14 +/- 5, p = 0.02, respectfully]. In addition, the ratio of mitral peak early diastolic velocity to tissue Doppler-derived peak diastolic velocity and tissue Doppler echocardiography-derived left ventricular myocardial performance index were decreased significantly following the procedure [9.5 +/- 1.9 vs. 7.7 +/- 1.5, p = 0.002 and 0.57 +/- 0.11 vs. 0.46 +/- 0.06, p= 0.001, respectively].Intragastric balloon therapy resulted in significant weight reduction in morbidly obese patients. This weight reduction was associated with improved left ventricular function

Coronary ectasia is associated with impaired left ventricular myocardial performance in patients without significant coronary artery Stenosis

To determine both ventricular functions and tissue Doppler echocardiography [TDE]-derived myocardial performance index [MPI] in patients with coronary artery ectasia [CAE]. Twenty-five patients with CAE [13 men; mean age 57 +/- 9 years] and 25 age- and sex-matched controls without CAE [8 men; mean age 54 +/- 10 years] were enrolled in the study. Left and right ventricular functions were detected using conventional echocardiography and TDE. Left ventricle-lateral wall [0.61 +/- 0.17; 0.50 +/- 0.10, p = 0.02], interventricular septum [0.66 +/- 0.17; 0.52 +/- 0.10, p = 0.007] and mean MPI [0.63 +/- 0.15; 0.51 +/- 0.09, p = 0.004] were increased in the CAE group compared to the control group. Right ventricular MPI was similar in both the CAE and control groups [0.58 +/- 0.18; 0.52 +/- 0.19, p > 0.05]. The findings show that left ventricular MPI is different in CAE patients without obstructive coronary artery disease compared to the normal control group. Also in these patients, right ventricular MPI was similar to the control group

Cardiac Autonomic Function Evaluated by the Heart Rate Turbulence Method was not Changed in Obese Patients without Co-morbidities

Obese subjects are more prone to sudden deaths and arrhythmias than non-obese subjects. Heart rate turbulence (HRT) impairment reflects cardiac autonomic dysfunction, in particular impaired baroreflex sensitivity and reduced parasympathetic activity. Our aim was to evaluate the cardiac autonomic function in obesity by the HRT method. Ninety obese subjects and 112 healthy subjects were included in the study. Twenty-four hours ambulatory electrocardiograms were recorded and Holter recordings were analyzed. HRT parameters, turbulence onset (TO) and turbulence slope (TS), were calculated with HRT View Version 0.60-0.1 software program. HRT were calculated in 43 obese and 43 control subjects who had at least one ventricular premature beat in their Holter recordings. We excluded 47 obese patients and 69 control subjects who showed no ventricular premature beats in their Holter recordings from the statistical analysis. There were no significant differences in TO and TS between obese and control subjects (TO obese: -1.6+/-2.2%, TO control: -2.1+/-2.6%, p>0.05; TS obese: 8.2+/-5.2, TS control: 10.1+/-6.7, p>0.05, respectively). HRT parameters seem to be normal in obese patients without comorbidities.