Fetal sex and leptin concentrations in pregnant females.

BACKGROUND: Adult females have significantly more leptin than males. We investigated the effect of fetal sex on levels of leptin and other pregnancy hormones (progesterone, estradiol, FSH, LH and beta hCG) in pregnant females during different stages of pregnancy. PATIENTS AND METHODS: Serum leptin levels in pregnant females followed at King Khaled University Hospital, Riyadh, Saudi Arabia in the year 2001 were estimated at the first, second, and third trimester of pregnancy as well as after delivery. Progesterone, estradiol, FSH, LH and beta hCG levels were also measured. RESULTS: Leptin levels were significantly higher during all three trimesters in the pregnant females carrying female fetuses compared with those with male fetuses, while other hormones did not differ between the two groups. After delivery, the leptin levels decreased in both groups, and were still higher in the females who delivered baby girls, but the results were not statistically significant. CONCLUSION: These finding suggests that leptin might play a role in sex regulation during embryonic development.

Anatomical basis for acquired intracardiac shunt postaortic valve replacement: Doppler echocardiographic diagnosis.

We report a case of postoperative intracardiac shunts across the membranous septum detected by Doppler echocardiography and discuss the anatomical basis for the development of such a complication.

Predictors of left ventricular dysfunction in patients with Takayasu's or giant cell aortitis.

OBJECTIVES: The aim of this study was to determine the clinical and angiographic predictors of left ventricular systolic dysfunction (LVSD) from a relatively large and angiographically characterized Takayasu's or Giant Cell aortitis (TA/GCA) population. BACKGROUND: LVSD in patients with TA/GCA has been described in case reports and attributed variously to hemodynamic and immunologic factors. The predictors of LVSD in patients with angiographically confirmed TA/GCA are not known. METHODS: We identified 78 patients with angiographically confirmed TA/ GCA that underwent transthoracic echocardiography (TTE) at Mayo Clinic. Echocardiograms were then reviewed independently by reviewers blinded to clinical and angiographic data. LVSD was defined as an ejection fraction (LVEF) less than 50%. RESULTS: The study population was 84% Caucasian (54/78), 91% female (58/78), and had a mean age of disease onset of 30 years (+/- 15 years). LVSD was present in 14 of 78 patients (18%) with TA/GCA. The mean LVEF in the LVSD group (n = 14) was 37% +/- 7%, compared to an LVEF of 62% +/- 6% (p < 0.0001) in those without LVSD (n = 64). LVSD was not associated with hypertension or aortic regurgitation (p > 0.5). However, LVSD was found in 43% (9/21) of patients with aortic arch involvement, versus only 9% (5/57) of patients without aortic arch involvement (p = 0.0013). Patients with LVSD had a median of 2 (range 1-4) involved aortic segments compared to a median of 1 (range 1-4) among those without LVSD (p = 0.013). CONCLUSIONS: In TA/GCA aortitis, LVSD is associated with involvement of the aortic arch and with the greater extent of aortic involvement. The hemodynamic variables, aortic regurgitation and systemic hypertension, were not associated with LVSD, consistent with reports that cardiac inflammation is responsible for LVSD in a majority of cases. Ours is the first study to estimate an incidence of LVSD in patients with TA/GCA aortitis, which was 18%.