174G>C interleukin-6 gene polymorphism in Tunisian patients with coronary artery disease

A state of low-grade inflammation accompanies the pathogenesis of atherosclerotic events. Interleukin-6 [IL-6] is a pleotropic pro-inflammatory cytokine that modulates the development of acute coronary syndromes [ACSs], partly by destabilizing coronary atherosclerotic plaques. We have examined the contribution of the -174G>C IL-6 promoter variant on the risk of coronary artery disease [CAD] among Tunisians. Study subjects included 418 CAD patients and 406 age-and sex-matched controls. IL-6 genotyping was done by PCR-restriction fragment length polymorphism. The frequency of the -174C allele [mutant] was lower in Tunisians than in Europeans, and the distribution of -174 G>C genotypes was similar between CAD patients and control subjects. Moreover, compared to GG genotype carriers, -174C allele carriage did not increase the CAD relative risk [odds ratio and 95% confidence interval=1.09 and 0.80-1.49], which remained nonsignificant after adjusting for traditional risk factors for CAD [age, smoking, hypertension, diabetes and obesity]. The -174G>C IL-6 promoter variant is not associated with an increased risk of CAD among Tunisians

Doppler echocardiographic diagnosis of ventricular asynchrony. Present situation and future perspectives

Heart failure is among the most common chronic diseases in the modern era. It is the major cause of morbi - mortality and hospitalization in patients aged more than 60 years. Dilatation of left ventricle frequently induces intracardiac conduction delays resulting in asynchronous left ventricular motion. Showing as left bundle branch block in the surface EKG. Diagnosis of asynchrony based only on electrocardiogram criteria [wide QRS complex and left bundle branch block [LBBB]] proves to be non satisfactory considering the absence of parallelism between conduction unrests and cardiac dyssynchrony: 35% of LBBB are not associated with interventricular asynchrony and 20% without intraventricular asynchrony. So there is a necessity to define new criteria of asynchrony linked more directly to cardiac mechanical activity then EKG. Doppler Echocardiography brings more informative parameters concerning inter and intra ventricular asynchrony. Doppler tissue imaging can provide accurate information on electromechanical coupling and also assess interventricular and intraventricular dyssynchrony. It seems to be very promising for the prediction of the most satisfactory response to cardiac resynchronization therapy