Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus.

INTRODUCTION: It is known that mean platelet volume (MPV) increases during acute coronary syndrome. However, there are conflicting data about the importance of MPV in patients with stable coronary artery disease (CAD). This study aimed to assess relationship between MVP and the severity of coronary atherosclerosis in patients with diabetes mellitus (DM), stable CAD and normal left ventricular ejection fractions. METHODS: Thirty-three DM and 46 nonDM patients with stable CAD diagnosed by selective coronary angiography were included in the study. All angiographic variables pertinent to Gensini score (GS) and Syntax score (SS) calculation were computed by two experienced interventional cardiologists. All patients underwent echocardiographic examination. MPV and other biochemical markers were measured on admission. RESULTS: All patients were evaluated and it was found that both scoring systems are correlated with MPV (GS: r = 0.373, p < 0.001; SS: r = 0.385, p < 0.001). DM and nonDM groups were severally evaluated, it was found that the correlation between MPV and GS and SS increased in DM patients (GS: r = 0.638, p < 0.001; SS: r = 0.624, p < 0.001); however, no differences were identified in nonDM patients (GS: r = 0.124, p = 0.410; SS: r = 0.124, p = 0.411). CONCLUSION: It is thought that high MPV levels may be an effective marker in determining the severity of CAD in patients with DM. And the high MPV level may be related with CAD pathophysiology in DM patients.

Utility of c2 monitoring in prediction of diastolic dysfunction in renal transplant recipients.

BACKGROUND: A number of experimental studies have suggested that cyclosporine (CsA) toxicity induces cardiac modifications which may cause diastolic dysfunction over the course of time. Doppler echocardiography with tissue Doppler imaging (TDI) could consistently detect diastolic dysfunction. The purpose of this study was to assess diastolic dysfunction using C2 monitoring of CsA exposure in stable renal transplant patients. PATIENTS AND METHODS: Seventy-eight kidney recipients including 42 men and 36 women of overall mean age of 52 +/- 9 years were obtained in 47 living and in 31 cases from cadaveric donations over 12 or more months after transplantation using cases from CsA, mycophenolate mofetil, and steroid. C2 levels were measured by an enzyme multi-immune assay technique. The patients underwent conventional and Doppler echocardiography with TDI. RESULTS: The patients were divided into 2 groups according to C2 levels less than 500 mug/L (group 1, n = 40) versus greater than 500 mug/L (group 2, n = 38). The demographic parameters, serum creatinine and lipid levels, systolic and diastolic blood pressures, number and type of antihypertensive medications, and conventional echocardiographic parameters did not differ significantly between the groups. However, group 1 patients showed significantly higher isovolumic relaxation time (109 +/- 27 vs 86 +/- 14 ms), early diastolic deceleration time (189 +/- 52 vs 137 +/- 59 ms), and lower values of E velocity (56 +/- 32 vs 92 +/- 27 cm/s) and E/A ratios (0.81 +/- 0.23 vs 1.15 +/- 0.46) than group 2. TDI studies revealed significantly lower E'/A' (0.76 +/- 0.25 vs 1.09 +/- 0.32, P < .05) in group 1 versus group 2. CONCLUSION: The data suggested that the higher C2 levels may induce diastolic dysfunction in the hearts of kidney recipients without impairment of contractile performance.

Quantification of the weakness and fatigue in thoracic outlet syndrome with isokinetic measurements.

OBJECTIVES: Patients with thoracic outlet syndrome (TOS) complain of many subjective symptoms that are difficult to measure and quantify. In this study we have tried to assess the weakness (muscle strength) and fatigue (endurance) of these patients with an objective measurement method, isokinetic muscle testing. METHODS: Twenty three TOS patients and 15 age matched healthy controls were enrolled in the study. Detailed histories of the patients were taken and the patients underwent complete physical examinations. Cervical radiographies, Doppler ultrasonography, electromyography, and isokinetic measurements were carried out. The isokinetic measurements were carried using the Biodex System 3 dynamometer during concentric shoulder flexions and extensions at velocities of 60 degrees /s, 180 degrees /s, and 240 degrees /s. RESULTS: Although the muscle strengths of both groups seemed to be similar, the fatigue ratios of TOS patients at 60 degrees /s and 180 degrees /s were found to be higher compared with those of healthy controls (p = 0.029, p = 0.007). CONCLUSIONS: TOS patients were found to have muscular performance similar to controls, but their upper extremities developed fatigue more easily than those of healthy individuals.