Red cell distribution width and neutrophilto- lymphocyte ratio predict left ventricular dysfunction in acute anterior ST-segment elevation myocardial infarction

Objectives: red cell distribution width [RDW] and neutrophil-to-lymphocyte ratio [NLR] are the two markers used to determine risk of mortality and adverse cardiovascular outcomes in patients with acute myocardial infarction. The relationship between RDW, NLR, and left ventricular [LV] systolic functions has not been reported. In this report, we aimed to investigate the relationship between RDW, NLR, and LV systolic function in anterior ST-segment elevation myocardial infarction [STEMI] patients who underwent primary percutaneous coronary intervention [PCI]

Methods: RDW and NLR were measured on admission in 106 STEMI patients treated with primary PCI. Patients were divided into two groups according to left ventricular ejection fraction [LVEF], as Group I [systolic dysfunction, LVEF <50%] and Group II [preserved global left ventricle systolic function, LVEF P50%]. The first group included 47 patients and the second group included 59 patients

Results: mean RDW and NLR were significantly higher in Group I compared to Group II [13.7 +/- 0.9% vs. 13.4 +/- 0.7%, p = 0.03 and 5.86 [range, 0.66-40.50] vs. 2.75 [range, 0.51-39.39], p = 0.013, respectively]

Conclusion: increased RDW and NLR on admission, in anterior STEMI patients treated with primary PCI are associated with LV systolic dysfunction

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

Atorvastatin given prior to electrical cardioversion does not affect the recurrence of atrial fibrillation in patients with persistent atrial fibrillation who are on antiarrhythmic therapy

In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation [AF] after electrical cardioversion [EC] in addition to antiarrhythmic therapy. 48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters [high-sensitivity C-reactive protein, white blood cell count and fibrinogen level] were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of>10 min. There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values [174 +/- 31 vs. 129 +/- 25 mg/dl, p=0.001, and 112 +/- 23 vs. 62 +/- 20 mg/dl, p=0.001, respectively], while no significant change occurred in control patients [168 +/- 26 vs. 182 +/- 29 mg/dl, p=0.07, and 99 +/- 18 vs. 108 +/- 26 mg/dl, p=0.1, respectively]. At the end of the 2-month follow-up period, 9 patients [20.5%] experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups [26 vs. 13%; p=0.2]. Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy