The effect of propofol on frontal QRS-T angle in patients undergoing elective colonoscopy procedure.

WHAT IS KNOWN AND OBJECTIVE: Propofol is a most commonly used anaesthetic drug for conscious sedation in outpatient procedures. Previous studies have shown that propofol may affect ventricular repolarization based on QT and Tp-e intervals. Frontal QRS-T angle is a marker of ventricular depolarization and repolarization difference. However, there is no study investigating the effect of propofol on frontal QRS-T angle. In this study, we aimed to investigate the effect of propofol on frontal QRS-T angle in patients undergoing colonoscopy procedure. METHOD: A total of 56 patients (53.5% females) who underwent colonoscopy procedure were included in this study. All patients underwent 12-lead surface electrocardiograms (ECGs) just before colonoscopy and 15 minutes after colonoscopy. QT interval, QTc interval, Tp-e interval, Tp-e/QT, Tp-e/QTc and frontal QRS-T angle were calculated from 12-lead ECGs. RESULTS AND DISCUSSION: The frontal QRS-T angle was significantly increased 15 minutes after colonoscopy compared to basal value (36.2 ± 24.3 vs. 29.5 ± 23.6, P = .003). In addition, repolarization parameters including QT, QTc and Tp-e intervals were significantly prolonged at 15 minutes after colonoscopy compared to basal value, except Tp-e/QT and Tp-e/QTc. Significant ventricular or supraventricular arrhythmias were not observed in any patient during the procedure. WHAT IS NEW AND CONCLUSION: In this study, we found that propofol administration increased the frontal QRS-T angle in patients undergoing colonoscopy procedure. Given that a prolonged frontal QRS-T angle is associated with ventricular arrhythmias, it may be safer to monitor those patients receiving propofol during colonoscopy procedures.

Serum prolidase activity in patients with left ventricular diastolic dysfunction.

OBJECTIVES: Prolidase is an important factor in collagen metabolism, matrix remodelling and cell growth. Increased collagen turnover leading to increased ventricular stiffness plays an important role in the pathophysiology of left ventricular diastolic dysfunction (LVDD). This study aims to investigate whether serum prolidase activity is related to left ventricular diastolic function. METHODS: We studied 144 participants, and divided them into four groups according to the phase of diastolic dysfunction (66 with normal function, 46 with impaired relaxation, 19 with pseudonormalization, and 13 with restrictive-like filling). Assessment of diastolic filling was carried out with the measurements of E wave, A wave, E-wave deceleration time, isovolumic relaxation time, lateral tissue Doppler E S, E and A wave. Serum prolidase activity was measured by spectrophotometrical methods. RESULTS: Serum prolidase activity level was higher in patients with left ventricular diastolic dysfunction (LVDD) than without LVDD (P = 0.004). Also, prolidase activity values gradually increased from stage I through stage III in patients with LVDD. Multivariate analysis shows that LVDD is independently associated with age (ß = 0.066, SE = 0.017, P = 0.006), hypertension (ß = -1.252, SE = 0.354, P = 0.037) and prolidase activity (ß = 0.021, SE= 0.088, P= 0.045). CONCLUSION: Our data have shown that, in a selected group of patients, serum prolidase activity was positively and independently associated with the presence and severity of LVDD.

Mean platelet volume is not associated with coronary slow flow: a retrospective cohort study.

OBJECTIVE: To investigate mean platelet volume (MPV) levels in patients with coronary slow flow (CSF). METHODS: 465 stable angina pectoris cases with angiographically normal coronary arteries were recruited [coronary slow flow group (n=76), control group (n=389)] in the observational retrospective cohort study. Clinical, biochemical and demographic variables including MPV were noted and coronary blood flow was assessed with TIMI frame count (TFC). RESULTS: Gender, smoking, height, serum creatinine, uric acid levels, hemoglobin, waist/hip ratio, systolic blood pressure but not MPV were significantly different among groups. Independent predictors of CSF were height (p=.029) and serum uric acid level (p=.045). Gender, height, weight, hip circumference, systolic blood pressure, fasting blood glucose, serum urea, creatinine, uric acid levels, hemoglobin and platelet count were associated with mean TFC whereas independent predictors of mean TIMI frame count were height (p=.010) and serum uric acid level (p=.041). CONCLUSION: Height and serum uric acid level but not MPV were independent predictors of both CSF and mean TFC.

Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients.

Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results.

Relation between P-wave dispersion and left ventricular geometric patterns in newly diagnosed essential hypertension.

AIM: P-wave durations and P-wave dispersion (PD) are considered to reflect the heterogeneous conduction in atria. The aim of this study was to investigate PD and P-wave duration in different left ventricle geometric patterns of hypertensive patients. METHODS: One hundred forty-nine consecutive patients with newly diagnosed essential hypertension and 29 healthy control groups were included in the study. The maximum and minimum P-wave duration (Pmax and Pmin, respectively) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed in all subjects. Four different geometric patterns were identified in hypertensive patients according to left ventricular mass index (LVMI) and relative wall thickness. RESULTS: P-wave dispersion was longer in concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH) groups when compared with the control group (P = .009, P < .001, P < .001, respectively). P-wave dispersion of normal left ventricle (NLV) geometric pattern was not different from that of the control group. Patients with NLV geometric pattern had shorter PD than patients who had CH and EH (NLV vs CH, P < .001; NLV vs EH, P = .025). P-wave dispersion of the NLV group was not different from that of the CR group. Patients with CR had also shorter PD than patients who had CH (P = .002). In bivariate analysis, there was a significant correlation between PD with left ventricle geometry, body surface area, LVMI, and relative wall thickness. In multiple linear regression analysis, PD was independently correlated only with LVMI (beta = .425, P < .001). CONCLUSIONS: P-wave dispersion is independently associated with LVMI rather than left ventricle geometry and relative wall thickness in hypertensive patients. Thus, it is increased particularly in patients with CH and EH.