Epicardial adipose tissue thickness in patients with chronic obstructive pulmonary disease having right ventricular systolic dysfunction.

OBJECTIVE: The aim of the present study was to evaluate epicardial fat thickness (EFT) in patients with chronic obstructive pulmonary disease (COPD) having right ventricular systolic dysfunction (RVSD). PATIENTS AND METHODS: This study was comprised of 98 patients with COPD and 40 healthy controls. All the study participants underwent 2-dimensional, pulsed and tissue-doppler transthoracic echocardiographic examination for the measurements of EFT and parameters of right and left ventricular functions. Patients with COPD were divided into mild and severe RVSD groups according to right ventricular fractional area changes (RVFACs). RESULTS: Age, gender, prevalence of diabetes mellitus, hypertension, body-mass-index (BMI) and dyslipidemia were similar between COPD patients and controls, as were between mild, and severe RVSD groups. Prevalence of smoking were higher in COPD patients than in controls. Right ventricular end-diastolic diameter, myocardial performance index and peak pulmonary systolic pressure were found to be higher in COPD patients, while tricuspid annular plane systolic, excursion, isovolumic accelerating time, EFT and EFT/BMI were found to be lower in COPD patients. COPD patients with severe RVSD had thinner EFT and lower EFT/BMI values than those with mild RVSD (4.10 ± 0.77 vs 5.48 ± 1.28 mm, p < 0.001, respectively). CONCLUSIONS: The present study shows that the EFT decreases in patients with COPD and it is also associated with the degree of RVSD. Therefore, evaluating EFT in patient with COPD may provide information about the severity of the disease.

Effects of transcatheter closure of atrial septal defects on heart rate variability.

This study evaluated heart rate variability and its changes in 30 patients before and after transcatheter closure of secundum atrial septal defects. Heart rate variability data from 30 healthy volunteers with normal echocardiographic parameters and no history of atrial septal defects were included as controls. Values for the SD of all the normal RR intervals (SDNN), the SD of the means of all the 5-min segment normal RR intervals (SDANN), and the mean of all the 5-min SDs of normal RR intervals during the 24-h period (SDNN index) in patients with atrial septal defects before transcatheter closure were statistically significantly different from controls. At 6 months after closure of the defects these values were not statistically different from controls. It is concluded that transcatheter closure of secundum atrial septal defects had positive effects on heart rate variability and, consequently, may contribute to less mortality and morbidity.

Apolipoprotein B gene polymorphisms in people in the east Mediterranean area of Turkey.

Point mutations in the receptor binding domain of low density lipoprotein may increase cholesterol levels in blood. Three mutations of Apo B-100 protein result in defective binding (Arg 3500 ----> [corrected] Gln, Arg 3500 ----> [corrected] Trp and Arg 3531 ----> [corrected] Cys). We estimated the frequency of Apo B point mutations (codon 3500) C9774T (Arg 3500 ----> [corrected] Trp) and G9775A (Arg 3500 ----> [corrected] Gln) in 179 atherosclerotic, 145 hyperlipidaemic individuals and 272 healthy individuals in the east Mediterranean region of Turkey. Lipid and lipoprotein levels were measured with routine biochemical analyser and Apo B mutation was detected using real-time PCR. Neither mutation was found. In this region, Apo B-100 protein mutations are rare and causes of hyperlipidaemia and atherosclerosis may therefore be unrelated to them.

Apolipoprotein B gene polymorphisms in people in the East Mediterranean area of Turkey

Point mutations in the receptor binding domain of low density lipoprotein may increase cholesterol levels in blood. Three mutations of Apo B-100 protein result in defective binding [Arg 3500 ----> [corrected] Gln, Arg 3500 ----> [corrected] Trp and Arg 3531 ----> [corrected] Cys]. We estimated the frequency of Apo B point mutations [codon 3500] C9774T [Arg 3500 ----> [corrected] Trp] and G9775A [Arg 3500 ----> [corrected] Gln] in 179 atherosclerotic, 145 hyperlipidaemic individuals and 272 healthy individuals in the east Mediterranean region of Turkey. Lipid and lipoprotein levels were measured with routine biochemical analyser and Apo B mutation was detected using real-time PCR. Neither mutation was found. In this region, Apo B-100 protein mutations are rare and causes of hyperlipidaemia and atherosclerosis may therefore be unrelated to them

The relationship between leptin and lipids in atherosclerosis.

BACKGROUND: This study aimed to examine the extent to which leptin, alone or in combination with other risk factors, may be an independent marker for myocardial infarction in a region with a high incidence of cardiovascular disease. METHODS AND RESULTS: Leptin levels were measured by the ELISA method, while plasma lipids and lipoproteins were measured by conventional methods. Leptin levels were significantly higher in the patient than in the control group. Serum total cholesterol, low-density lipoprotein, lipoprotein (a) and apolipoprotein B showed a significant correlation with leptin, while high-density lipoprotein showed an inverse relation. CONCLUSIONS: Our results suggest that leptin may be one factor operating in the metabolic alteration taking place during myocardial infarction, and is a possible risk factor.

Assessment of ventricular repolarization in deaf-mute children.

The long QT syndrome is a congenital disease with frequent familial transmission, characterized primarily by prolongation of the QT interval and by the occurrence of life-threatening arrhythmias. The syndrome may be familial, with or without congenital deafness, or it may be idiopathic. We attempted to assess ventricular repolarization and to identify patients with the Jervell and Lange-Nielsen syndrome among 132 deaf-mute school children. Five deaf-mute subjects had Jervell and Lange-Nielsen syndrome. The deaf-mute subjects were divided into two subgroups according to the length of their QT intervals: group 1 included 5 cases with the long QT interval (>440 msec), and group 2 included 127 subjects with the normal QT interval (< or =440 msec). Group 3 was composed of 96 control subjects. The mean QT, QTc, JT, and JTc intervals (418+/-70, 500+/-38, 302+/- 65, and 389+/-36 msec, respectively) in group 1 were significantly longer than those of group 2 (344+/-23, 408+/-22, 249+/-34, and 291+/-28 msec, respectively) and group 3 (325+/-11, 383+/-26, 228 +/-36, and 269+/-46 msec, respectively). The dispersion (d) values (QT-d, QTc-d, JT-d, and JTc-d; 63+/-10, 73+/-8, 60+/-8, and 62+/-11 msec, respectively) of group 1 were significantly longer than those of group 2 (49+/-16, 43+/-11, 48+/-21, and 45+/-18 msec, respectively) and group 3 (33+/-13, 33+/-14, 28+/-16, and 27+/-14 msec, respectively) at similar mean RR intervals. Also, the mean QT, QTc, JT, and JTc intervals and the dispersion values (QT-d, QTc-d, JT-d, and JTc-d) in group 2 were significantly longer than those of group 3 at similar mean RR intervals. Consequently, in this study, we determined that the deaf-mute children who did not meet the criteria for Jervell and Lange-Nielsen syndrome still had evidence of subtle derepolarization abnormalities evidenced by intermediate prolongation of QTc, JTc, and the corresponding measures of dispersion, and we believe an electrocardiogram examination of deaf-mute subjects will reveal this potentially life-threatening syndrome.

Effect of trimetazidine on late potentials after acute myocardial infarction.

The purpose of this study was to evaluate the effect of trimetazidine on late potentials in patients with acute myocardial infarction. A total of 60 patients (52 males, mean age 55 +/- 2 years, and 8 females, mean age 54 +/- 1.8 years) with the diagnosis of acute myocardial infarction were included in this study. The study was designed as a randomized, double-blinded, and placebo-controlled trial. Signal-averaged electrocardiography and echocardiography were performed during the first 2 days of acute myocardial infarction and were repeated between days of 8 and 15 (mean 11). Patients were treated with trimetazidine (n = 30) or placebo (n = 30). In the placebo group, the total filtered QRS duration and low-amplitude terminal signal duration increased (from 102.7 +/- 1.8 ms to 113.3 +/- 1.8 ms, and from 32.2 +/- 0.9 ms to 38.3 +/- 1.1 ms; P < 0.001), the root mean square voltage of the terminal 40 ms of the QRS decreased (from 28.6 +/- 2.1 microV to 21.4 +/- 1.3 microV; P < 0.001), and the incidence of late potentials increased (from 30% to 46%; P < 0.01) significantly. In the trimetazidine group, these measurements were a decrease from 102.9 +/- 1.9 ms to 100 +/- 2.0 ms (NS), an increase from 31.6 +/- 0.9 ms to 32.5 +/- 0.9 ms (NS), a decrease 9.3 +/- 2.0 microV to 27.3 +/- 1.8 microV (P < 0.01), and a decrease from 33% to 30% (NS), respectively. The ejection fraction was 47.1 +/- 1.3% to 50.8 +/- 1.2% in the placebo group (P = 0.05), and 48.1 +/- 1.1% to 53.4 +/- 1.2% (P < 0.01) in the trimetazidine group. It is concluded that trimetazidine reduces late potentials after acute myocardial infarction without changing blood pressure and heart rate.

Impact of hemodialysis on comprehensive ventricular repolarization.

Cardiac arrhythmia are one of the most important problems in haemodialysis patients. An important cause of the arrhythmias is inhomogenous myocardial repolarization. In this study, the ventricular repolarization parameters (QT, QTc, JT and JTc) and dispersions (d) of the parameters (QT-d, QTc-d, JT-d and JTc-d) were evaluated. Also were recorded the right-sided leads (RV3-6) and posterior leads (V7-9) in addition to the standard 12 lead ECG to assess comprehensive ventricular repolarization. The leads were divided in three groups: Group A (Standard ECG leads), Group B (Right-sided leads) and Group C (All of the leads). Among the above mentioned parameters, only JT and JTc intervals decreased significantly in all groups. There was no significant difference between the groups in evaluation of the parameters. It was concluded that in assessment of ventricular repolarization, the most important ECG intervals may be JT and JTc intervals, and the standard 12 lead ECG record is sufficient in evaluation of ventricular repolarization in hemodialysis patients.