Relationship between Pulmonary Artery Diameter and Pulmonary to Aortic Artery Diameter Ratio in High Risk Individuals for Obstructive Sleep Apnea without Pulmonary Artery Hypertension Based on the Berlin Questionnaire.

BACKGROUND: A significant association has been found between the pulmonary artery (PA) diameter and obstructive sleep apnea (OSA) in patients with pulmonary artery hypertension (PAH). We aimed to evaluate the relationship between the diameters of the PA trunk and aortic artery with their ratio as PAH markers in high risk cases for OSA based on the Berlin questionnaire without PAH. MATERIALS AND METHODS: This case-control study included 161 non-PAH patients admitted to a multi-slice CT scan ward. Filling out the Berlin questionnaire, the patients were divided into high and low risk cases for OSA. The diameters of the PA trunk and aortic ascending aorta and their ratio were assessed using the multi-slice CT scan. RESULTS: The PA to aortic ratios in the case and control groups were 0.89±0.17 and 0.88±0.17, respectively, which all were non-significant. With regard to gender, the PA diameter was significantly lower among males in the control group than in the case group (P=0.034). The mean PA to aortic ratio was slightly higher but statistically non-significant in the case group than in the control group. The aortic diameter showed a statistically significant increase by age in the case group (r=0.374, P=0.003) compared to the other group. However, the PA diameter increased significantly by age in both groups (r=0.184, P=0.020). CONCLUSION: The PA diameter can be considered as a predicting factor for future cardiovascular diseases in high risk males for OSA based on the Berlin questionnaire without PAH. More studies are required to confirm these findings.

Cardiovascular disease risk prediction among Iranian patients with diabetes mellitus in Isfahan Province, Iran, in 2014, by using Framingham risk score, atherosclerotic cardiovascular disease risk score, and high-sensitive C-reactive protein.

BACKGROUND: Risk assessment in clinical practice plays an important role in classifying population for appropriate preventive medicine for each category. Several multivariable risk predictor algorithms and inflammatory biomarkers are developed for assessing risk for cardiovascular diseases (CVDs). We aimed to depict a picture of the cardiovascular risk profiles in the Iranian population with diabetes mellitus (DM) through three risk predictors for the first time, as the patients with DM have an increased risk for CVDs. METHODS: In this cross-sectional study, the sample size consisted of 418 patients with DM from Diabetes Clinic of Shariati hospital, Isfahan, Iran, in February to July, 2014. We collected the latest information, and then calculated the 10-year CVD risk using Framingham risk score (FRS) and atherosclerotic cardiovascular disease (ASCVD) risk score; while high-sensitivity C-reactive protein (hs-CRP) was measured for them based on their physicians' prescription. Finally, all data were analyzed using SPSS software. RESULTS: The mean 10-year risk prediction of CVDs in the 30- to 74-year-old Iranian patients with DM was high in all three predictors based on their cut-off points, 16.31%, 12.39%, and 3.46 mg/l for FRS, ASCVD risk score, and hs-CRP level, respectively. Although the mean FRS and ASCVD risk scores were significantly higher among men than women (P < 0.0500), the mean hs-CRP level was slightly lower in men than women (P > 0.0500). CONCLUSION: Mean FRS and ASCVD risk scores and hs-CRP in patients were high, and a considerable proportion of patients with DM in our study were at intermediate and high risk for CVDs in the next 10 years. Future cohort studies would investigate the accuracy of different predictors in upcoming years, and also help to derive a specific model or recalibrate existing predictors with characteristic of Iranian populations and specific target groups.

The association between epicardial fat thickness in echocardiography and coronary restenosis in drug eluting stents.

BACKGROUND: The association between epicardial fat and coronary in-stent restenosis has not been evaluated. The objective of the present study was to evaluate the relationship of echocardiographic epicardial fat thickness (EFT) with restenosis in drug eluting stents (DES). METHODS: In this study, 117 patients who underwent coronary angiography due to recurrent clinical symptoms or findings of non-invasive cardiac tests one year after stent implantation were selected. According to angiographic results, they were divided into two groups, 65 patients with in-stent restenosis (case group) and 52 patients without such finding (control group). EFT was measured perpendicularly on the free wall of the right ventricle at the end of systole in two echocardiographic views (parasternal short and long axis) at least in three cardiac cycles. The average of obtained values was determined and recorded as EFT. Furthermore, the history of hypertension, smoking and diabetes, age and sex were investigated and body mass index (BMI) of each patient was also calculated. RESULTS: There were no significant differences in the baseline characteristics (P=0.812). Patients with in-stent restenosis did not have statistically significant difference (4.6±1.8 mm) in EFT compared to subjects with patent stents (4.5±1.8 mm; P=0.88). The above results were also confirmed using multiple linear regressions. No significant correlation was found between EFT and other clinical variables (P >0.05). CONCLUSION: In this selected population, the risk of restenosis was not correlated with epicardial fat thickness. Future studies for determining the role of epicardial fat in development of in-stent restenosis are warranted.