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1.
Vascular ; 31(3): 564-572, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35226579

RESUMO

OBJECTIVES: We evaluated carotid artery stiffness in patients with coronary artery disease (CAD) using acoustic radiation force impulse (ARFI) elastography and investigated the relationship between stiffness and CAD. METHODS: This study examined 76 CAD patients (aged 60.7 ± 11) and 70 healthy individuals (aged 59.6 ± 9). The left common carotid artery mean shear wave velocity (LCmeanSWV) and the right common carotid artery mean shear wave velocity (RCmeanSWV) of the anterior walls were measured using ARFI elastography, and the results of the patient group and the healthy group were compared. The common carotid intima-media thickness (CIMT) was measured in both groups and compared with mean SWV. RESULTS: The RCmeanSWVs in the patient and healthy groups were 3.47 ± 1 m/s and 2.69 ± 0.90 m/s, respectively (p < 0.001). The LCmeanSWVs in the patient and healthy groups were 3.60 ± 0.9 m/s and 2.90 ± 0.80 m/s, respectively (p < 0.001). A significant correlation was found between the RCmeanSWV and the right CIMT values and between the LCmeanSWV and the left CIMT values (r = 0.231, p = 0.03 and r = 0.331, p = 0.002, respectively). CONCLUSIONS: The mean SWV values of carotid arteries of CAD patients measured with ARFI elastography were significantly higher than the mean SWV values of the carotid arteries of healthy individuals. Thus, measurement of the carotid artery SWV could be a potential tool in the risk evaluation of cardiovascular disease. Nonetheless, new studies are required to determine whether this method serves as a useful additional tool.


Assuntos
Doença da Artéria Coronariana , Técnicas de Imagem por Elasticidade , Humanos , Técnicas de Imagem por Elasticidade/métodos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Espessura Intima-Media Carotídea , Reprodutibilidade dos Testes , Artéria Carótida Primitiva/diagnóstico por imagem , Acústica
2.
Curr Med Imaging ; 2022 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-36305151

RESUMO

Background One of the greatest challenges in the diagnosis of acute mesenteric ischemia (AMI) is the lack of specific laboratory tests that support multidetector computed tomography (CT). Our aim is to investigate the diagnostic value of electrocardiographic QT parameters in AMI and their relationship with CT findings. Materials and methods Patients who were admitted to the emergency department with abdominal pain were recruited retrospectively from the hospital information system . Grouping was carried out on the basis of AMI(n=78) and non-AMI (n=78). In both groups, the corrected QT (QTc) and QT dispersion (QTD) were measured on electrocardiographs, and the qualitative and quantitative CT findings were evaluated on CT examinations. Results The QTc and QTD values were higher in the AMI group. The median QTc values were 456.16 (IQR: 422.88-483.16) for the AMI group and 388.83 (IQR: 359.74-415.83) for the control group (p<0.001), and the median QTD values were 58 (IQR: 50.3-68.25) for the AMI group and 46 (IQR: 42-50) for the control group (p<0.001). In the CT analysis, the QTc values were significantly higher among AMI patients, with images of paper thin bowel walls and the absence of bowel wall enhancement (p=0.042 and p=0.042, respectively). Meanwhile, the QTD values were significantly higher among patients with venous pneumatosis findings on CT (p=0.005). In the regression analysis, a significant relationship was found between the QT parameters and AMI (p<0.001). For QTc, an AUC of 0.903 (95% CI: 0.857-0.950, p<0.001), a sensitivity of 80.8%, and a specificity of 82.3% were found. For QTD, an AUC of 0.821 (95% CI: 0.753-0.889, p<0.001), a sensitivity of 73.1%, and a specificity of 82.3% were found. Conclusion We found the QTc and QTD values to be significantly higher among AMI patients. Furthermore, we found a significant relationship between the CT findings and QTc and QTD as well as a significant relationship between survival and QTc in the AMI group.

3.
Acta Radiol ; 58(2): 156-163, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-27012278

RESUMO

Background Renal insufficiency may occur in patients with coronary artery disease (CAD). Acoustic radiation force impulse (ARFI) is a method for quantifying tissue elasticity, which could be used as an additional diagnostic test for renal insufficiency and provide an additional contribution to the determination of CAD. Purpose To evaluate ARFI elastography with shear wave velocity (SWV) measurements in the diagnosis of mild-to-moderate chronic kidney disease (CKD) in CAD patients, and to analyze the relationship between the severity of CAD assessed by the Gensini scoring system and kidney stiffness. Material and Methods The study included 76 CAD patients and 79 healthy volunteers. SWV was measured for each kidney in the both groups. The CAD group was divided into two subgroups based on Gensini score: mild CAD and severe CAD. SWV values of the CAD patients were compared to those of the healthy volunteers; values of subgroups were also compared with each other. Results The patient group had significantly lower renal mean SWV values than those of the healthy group (1.87 ± 0.58 vs. 2.34 ± 0.38, P < 0.01). The SWV value decreased as the eGFR level decreased. Mean SWV values for kidneys of the patients with severe CAD were lower than those of the mild CAD patients (1.64 ± 0.39 vs. 2.42 ± 0.60, P < 0.01). Conclusion renal mean SWV values of CAD patients decreased in proportion to the reduction in eGFR, and the SWV values decreased as the severity of CAD increased. ARFI elastography is a novel technique for diagnosing CKD and defining illness severity in CAD patients.


Assuntos
Doença da Artéria Coronariana/complicações , Técnicas de Imagem por Elasticidade/métodos , Insuficiência Renal/complicações , Insuficiência Renal/diagnóstico por imagem , Adulto , Idoso , Feminino , Humanos , Interpretação de Imagem Assistida por Computador/métodos , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença
4.
Clin Interv Aging ; 11: 377-82, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27069361

RESUMO

BACKGROUND: Many studies have shown that evidence supporting the relationship between low bone mineral density (BMD) and coronary artery disease (CAD) has been increasing. There is a significant increase of myocardial infarction in men with low BMD. PURPOSE: We aimed to detect the relationship between BMD and CAD in patients whose CAD was detected with coronary angiography, and its severity and prevalence was detected with Gensini score. METHODS: A total of 55 patients were selected who were found to have single or multiple infarctions through using coronary angiography in the cardiology clinic. The CAD severity was evaluated by calculating the Gensini score. These patients were divided into two groups: mild CAD and severe CAD groups. Femur bone mineral density (FBMD) was measured with dual energy X-ray absorptiometry. T score values were determined to be normal if the values were >-1.0 (n=22, 40%), and osteopenia-osteoporosis (osteopenic syndrome) if the T score values were ≤-1 (n=33, 60%). RESULTS: The FBMD of severe CAD according to the Gensini risk score was found to be significantly lower. FBMD values in patients decreased as their Gensini scores increased. CONCLUSION: There was a significant relationship between CAD and osteopenic syndrome. FBMD level in men with severe CAD is significantly low when compared with patients who have mild CAD.


Assuntos
Densidade Óssea , Doença da Artéria Coronariana/epidemiologia , Fêmur/diagnóstico por imagem , Osteoporose/epidemiologia , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Angiografia Coronária , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Fatores de Risco , Índice de Gravidade de Doença , Turquia
5.
J Obstet Gynaecol ; 36(5): 574-80, 2016 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26789488

RESUMO

We conducted this study to determine demographic details, and clinical presentations in patients with peripartum cardiomyopathy (PPCMP) of Turkish origin. The study population consisted of 58 patients with PPCMP treated at 3 major hospitals in Turkey, retrospectively. In this study, demographic details and initial echocardiographic data were recorded and long-term clinical status was evaluated. The mean age for the patient cohort was 31.47 ± 6.31 years. Thirty-eight patients (73.1%) were multigravida and seven patients had multifetal pregnancy (13.7%). The mean follow-up left ventricular (LV) ejection fraction increased from 31 ± 7 to 38 ± 19. A minority of patients were defined as improvers according to our pre-specified criteria. The average survival period after diagnosis of PPCMP was 20.66 ± 14.44 months. Initial values for LV end-diastolic diameter and urea were higher in the deceased patients compared with the surviving patients, respectively. Twenty-eight (48%) patients with PPCMP showed improvement in the follow-up period. Of the 58 PPCMP patients, 9 (15%) died during a mean follow-up of 32 ± 22 months.


Assuntos
Cardiomiopatias/mortalidade , Período Periparto , Complicações Cardiovasculares na Gravidez/mortalidade , Transtornos Puerperais/mortalidade , Adulto , Cardiomiopatias/fisiopatologia , Ecocardiografia , Feminino , Seguimentos , Número de Gestações , Humanos , Gravidez , Complicações Cardiovasculares na Gravidez/fisiopatologia , Gravidez Múltipla , Transtornos Puerperais/fisiopatologia , Estudos Retrospectivos , Taxa de Sobrevida , Centros de Atenção Terciária , Turquia/epidemiologia , Função Ventricular Esquerda
6.
Clin Rheumatol ; 35(3): 701-8, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25744156

RESUMO

The etiology of Behçet's disease (BD) has not been fully elucidated. However, immunological and environmental factors, endothelial dysfunction (ED), and genetic susceptibility have been proposed to play a role. In this study, we aimed to evaluate epicardial fat thickness (EFT) together with serum asymmetric dimethylarginine (ADMA), carotid intima media thickness (CIMT), and neutrophil-to-lymphocyte ratio (NLR) in BD patients with ocular involvement. Thirty-six ocular BD patients (17 active and 19 inactive ocular involvement), and 35 age and sex-matched healthy controls were enrolled to this cross-sectional study. All patients underwent examinations with transthoracic echocardiography and carotid Doppler ultrasound. Serum ADMA levels, CIMT, EFT, and NLR were compared between groups, and their association with disease activity was evaluated. Behçet's disease patients had higher WBC counts, neutrophil counts, NLR, CIMT, EFT values, and serum ADMA levels than do healthy controls. The other biochemical, hematological, and echocardiographic parameters were comparable between the two groups. Behçet's disease duration was positively correlated with EFT and CIMT. Multivariate logistic regression analysis revealed that increased serum ADMA concentration and CIMT are independently associated with BD. Neutrophil counts, NLR, and serum ADMA level were higher, and lymphocyte count was lower in patients with active ocular BD compared to those of inactive ocular BD group. Carotid intima media thickness, serum ADMA level, EFT, and NLR were increased in ocular BD patients compared to healthy subjects. In addition, both serum ADMA level and NLR were associated with disease activity of ocular involvement. Increase in disease duration was associated with increase in CIMT and EFT which suggests that anatomical changes occur in time during the disease course. Increased CIMT, serum ADMA level, EFT, and NLR may provide new clues about the role of ED and inflammation in the etiopathogenesis of BD.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Arginina/análogos & derivados , Síndrome de Behçet/fisiopatologia , Endotélio Vascular/fisiopatologia , Olho/fisiopatologia , Inflamação/fisiopatologia , Linfócitos , Neutrófilos , Adulto , Arginina/sangue , Síndrome de Behçet/sangue , Síndrome de Behçet/diagnóstico por imagem , Biomarcadores , Espessura Intima-Media Carotídea , Estudos Transversais , Ecocardiografia , Feminino , Humanos , Inflamação/sangue , Inflamação/diagnóstico por imagem , Contagem de Leucócitos , Masculino , Pericárdio/diagnóstico por imagem
8.
Acta Cardiol ; 70(4): 409-13, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26455242

RESUMO

OBJECTIVE: Inflammation is involved in the pathogenesis of rheumatic mitral valve stenosis (RMVS). Pentraxin-3 (PTX3) indicates the inflammatory state of humans. However, circulating PTX3 levels in patients with RMVS, remain largely unknown. In this study, we investigated whether there is an association between the severity of RMVS and PTX3. METHODS: All patients diagnosed as rheumatic mitral valvular stenosis between December 2013 and April 2014 were included in the study. We investigated circulating PTX3 and high-sensitivity C-reactive protein (hsCRP) levels in patients with RMVS and healthy controls. RESUITS: The study population included 72 subjects (41 patients with RMVS and 31 healthy subjects, 56 female) with a mean age of 40 +/- 13 years. Patients with RMVS had higher left atrial diameters than healthy subjects. PTX3 and hsCRP were significantly higher in patients with RMVS when compared to control subjects and this difference was more significant in PTX3 compared to hsCRP (3.37 +/- 1.11 vs 2.86 +/- 0.59, P = 0.014 and 2.36 +/- 1.48 vs. 1.72 +/- 0.73, P = 0.019, respectively). PTX3 was positively correlated with Wilkins score, mitral valvular area, mitral pressure gradient and left atrium diameter. CONCLUSIONS: We demonstrated that plasma PTX3 and hsCRP levels were increased in patients with RMVS. Compared to hsCRP, PTX3 was more closely related with the severity of mitral valve stenosis. These findings suggest that PTX3 may participate in the pathophysiology of RMVS.


Assuntos
Proteína C-Reativa/análise , Átrios do Coração/patologia , Estenose da Valva Mitral , Cardiopatia Reumática/complicações , Componente Amiloide P Sérico/análise , Proteínas de Fase Aguda , Adulto , Biomarcadores/análise , Biomarcadores/sangue , Ecocardiografia/métodos , Feminino , Humanos , Inflamação/sangue , Masculino , Pessoa de Meia-Idade , Estenose da Valva Mitral/sangue , Estenose da Valva Mitral/diagnóstico , Estenose da Valva Mitral/etiologia , Estenose da Valva Mitral/fisiopatologia , Tamanho do Órgão , Índice de Gravidade de Doença , Estatística como Assunto , Turquia
9.
Korean Circ J ; 45(5): 386-90, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26413106

RESUMO

BACKGROUND AND OBJECTIVES: The etiopathogenesis of coronary artery ectasia (CAE) is not known completely. In most of the cases, CAE is associated with atherosclerosis; however, isolated CAE has a nonatherosclerotic mechanism. The association between atherosclerotic coronary artery disease and apelin has been examined in previous studies. However, the role of plasma apelin in isolated coronary artery ectasia has not been studied. In this study, we investigated the relationship between plasma apelin levels and isolated coronary artery ectasia. SUBJECTS AND METHODS: The study population included a total of 54 patients. Twenty-six patients had isolated CAE (53.6±8.1 years); 28 patients with normal coronary arteries (51.6±8.8 years) and with similar risk factors and demographic characteristics served as the control group. Apelin levels were measured using an enzyme-linked immunoassay kit. RESULTS: Apelin level in the CAE group was significantly lower (apelin=0.181±0.159 ng/mL) than that in the control group (apelin=0.646±0.578 ng/mL) (p=0.033). Glucose, creatinine, total cholesterol, triglyceride, low density lipoprotein cholesterol, and high density lipoprotein cholesterol levels were not significantly different between the two groups. CONCLUSION: In this study, we showed that patients with isolated CAE have decreased plasma apelin levels compared with the control group. Based on the data, a relationship between plasma apelin and isolated CAE was determined.

10.
Ther Adv Cardiovasc Dis ; 9(5): 257-66, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25784498

RESUMO

OBJECTIVE: The prognostic value of the Global Registry of Acute Coronary Events (GRACE) risk score (GRS) and the Thrombolysis in Myocardial Infarction (TIMI) risk index (TRI) have been reported in patients with coronary artery disease (CAD). In this study, we sought to evaluate the association between TRI and the extent and severity of CAD evaluated by SYNTAX score (SS) and Gensini score in patients with ST elevation myocardial infarction (STEMI). METHODS: A total of 290 patients with STEMI were included in the study. GRS and TRI were calculated on admission using specified variables. The extent and severity of CAD were evaluated using the SS and Gensini scores. The patients were divided into low (TRI ⩽19), intermediate (TRI 19-30), and high (TRI ⩾30) risk groups. A Pearson correlation analysis was used for the relationship between TRI, GRS, Gensini score and SS. RESULTS: There were significant differences in the mean age (p < 0.001), admission heart rate (p < 0.001), admission systolic blood pressure (p = 0.009), SS (p < 0.001), GRS (p < 0.001) and in-hospital major adverse cardiac events (MACE) in all patients between the low, intermediate and high TRI risk groups. There was a positive significant correlation between TRI and SS (r = 0.24, p < 0.001), Gensini score (r = 0.18, p = 0.002), GRS (r = 0.74, p = 0.001) and in-hospital MACE (r = 0.29, p < 0.001). CONCLUSION: TRI is significantly related to SS and Gensini score in predicting the extent and severity of CAD in patients with STEMI.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Infarto do Miocárdio/fisiopatologia , Intervenção Coronária Percutânea , Adulto , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea/fisiologia , Feminino , Frequência Cardíaca/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Medição de Risco/métodos , Índice de Gravidade de Doença
11.
Turk Kardiyol Dern Ars ; 43(2): 157-65, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25782120

RESUMO

OBJECTIVES: In patients with heart failure, a variety of hemogram parameters are known to be of prognostic significance. This study aimed to investigate which of these parameters is/are useful in predicting one-year all-cause mortality in patients with acute decompensated heart failure (ADHF). STUDY DESIGN: Patients who were hospitalized between September 2012-March 2013 in our hospital with systolic-ADHF with ejection fraction ≤40%, symptoms, and findings of congestion were enrolled retrospectively in the study. The study population was divided into two groups based on one-year-mortality. RESULTS: 119 patients with ADHF (mean-age 67±14 years; 55% male) were enrolled in the study. One-year-mortality occurred in 29% of patients. Hemoglobin levels, platelet, basophil and lymphocyte counts were significantly lower, while red-cell distribution width (RDW) was found to be significantly higher in the one-year-mortality group. Neutrophil, monocyte, and eosinophil counts were similar in the two groups. Furthermore, lower estimated glomerular-filtration-rate (eGFR) and unused angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) were associated with mortality. Age, presence of hypertension, right-ventricular diameter, eGFR, ACE/ARB treatment, hemoglobin levels, RDW and platelet, leukocyte, lymphocyte, basophil, neutrophil, monocyte, and eosinophil-counts were found to have prognostic significance in univariate analysis. In multivariate analysis, decreased platelet, lymphocyte-counts and hemoglobin level on admission and unused ACE/ARB treatment at discharge (p<0.05) were found to be independent factors predicting one-year-mortality. CONCLUSION: Among hematological indices; hemoglobin level, platelet and lymphocyte counts are readily available, useful and inexpensive markers for the prediction of one-year all-cause mortality in ADHF patients.


Assuntos
Insuficiência Cardíaca Sistólica/sangue , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Anemia/sangue , Anemia/fisiopatologia , Contagem de Células Sanguíneas , Feminino , Insuficiência Cardíaca Sistólica/fisiopatologia , Hemodinâmica , Hemoglobinas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco
12.
Turk Kardiyol Dern Ars ; 43(2): 169-77, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25782122

RESUMO

OBJECTIVES: Atrial fibrillation (AF) is one of the most common causes of preventable ischemic stroke and is related to increased cardiovascular morbidity and mortality. There is a lack of data in Turkey on the use of new oral anticoagulants (NOACs), and time in therapeutic INR range (TTR) in vitamin K antagonist users and AF management modality. In this multi-center trial, we aimed to analyze, follow and evaluate the epidemiological data in non-valvular AF patients. STUDY DESIGN: Four thousand one hundred consecutive adult patients from 42 centers with at least one AF attack identified on electrocardiography will be included in the study. Patients with rheumatic mitral valve stenosis and prosthetic valve disease will be excluded from the study. At the end of one year, the patients will be evaluated in terms of major cardiac end points (death, transient ischemic attack, stroke, systemic thromboembolism, major bleeding and hospitalization). RESULTS: First results are expected in June 2015. Data about major cardiovascular end-points will be available in January 2016. CONCLUSION: The rates and kind of oral anticoagulant use, TTR in vitamin K antagonist users and main management modality applied in non-valvular AF patients will be determined by AFTER-2 study. In addition, the rate of major adverse events (MACEs) and the independent predictors of these MACEs will be detected (AFTER-2 Study ClinicalTrials.gov number, NCT02354456.).


Assuntos
Anticoagulantes/administração & dosagem , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/epidemiologia , Vitamina K/antagonistas & inibidores , Humanos , Turquia/epidemiologia
13.
Anatol J Cardiol ; 15(8): 640-7, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25550173

RESUMO

OBJECTIVE: In this study, we aimed to explore the association between platelet-to-lymphocyte ratio (PLR) and the severity of atherosclerosis in coronary artery disease (CAD). METHODS: Clinical and laboratory data of 388 patients who underwent coronary angiography were evaluated retrospectively. Gensini score, which indicates the severity of atherosclerosis, was calculated for all of the patients. Patients with CAD were categorized as mild and severe atherosclerosis, according to their Gensini score. Eighty patients with normal coronary arteries formed the control group. Mean PLR values of the three study groups were compared. Also, PLR value was tested for whether it showed a positive correlation with Gensini score. RESULTS: The mean PLR of the severe atherosclerosis group was significantly higher than that of the mild atherosclerosis and controls groups (p<0.001). Also, PLR was positively correlated with Gensini score in CAD patients. A cut-off value of 111 for PLR predicted severe atherosclerosis with 61% sensitivity and 59% specificity. Pre-procedural PLR level was found to be independently associated with Gensini score, together with WBC, age, and low HDL level, in the multivariate analysis. CONCLUSION: Our study suggests that high PLR appears to be additive to conventional risk factors and commonly used biomarkers in predicting severe atherosclerosis.


Assuntos
Plaquetas/fisiologia , Doença da Artéria Coronariana/sangue , Linfócitos/fisiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença
14.
Anatol J Cardiol ; 15(8): 648-56, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25550174

RESUMO

OBJECTIVE: The neutrophil/lymphocyte ratio (NLR), the platelet/lymphocyte ratio (PLR), and uric acid (UA) are inflammatory markers in cardiovascular disease. However, there are not enough data on infarct-related artery (IRA) patency in ST-segment elevation myocardial infarction (STEMI). We aimed to investigate the association of NLR, PLR, and UA with IRA patency before percutaneous coronary intervention (PCI) in STEMI. METHODS: The study was designed as a retrospective study. Three hundred and twenty-four consecutive patients with STEMI were divided into two groups according to pre-PCI Thrombolysis in Myocardial Infarction flow grade (TIMI). Patients with a TIMI flow grade of into the spontaneous reperfusion (SR) group, while patients with TIMI flow grade of 0, 1 and 2 were placed into the non-SR group. The χ2 and independent-samples t-test, Mann-Whitney U test, multivariate logistic regression analysis, and receiver-operator characteristic (ROC) curve analysis were used for the statistical analysis. RESULTS: PLR, NLR, and UA values in the SR group were lower than in the non-SR group (p<0.004, p<0.001, p<0.001, respectively). In the multivariate analysis, serum UA level and PLR were found to be independent predictors of pre-PCI IRA patency. In the ROC curve analysis, PLR >190, UA>5.75 mg/dL, and NLR>4.2 predicted non-SR. The sensitivity and specificity of the association between low IRA TIMI flow grade and PLR were 88% and 84%, 72% and 66% for UA, and 74% and 44% for NLR, respectively. CONCLUSION: We determined that PLR and UA are novel predictors of IRA patency before PCI. We suggest that PLR and UA may be used in risk-stratifying STEMI.


Assuntos
Contagem de Linfócitos , Infarto do Miocárdio/sangue , Contagem de Plaquetas , Ácido Úrico/sangue , Plaquetas/fisiologia , Feminino , Humanos , Linfócitos/fisiologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/fisiologia , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Grau de Desobstrução Vascular
17.
J Stroke Cerebrovasc Dis ; 23(9): 2328-34, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25200242

RESUMO

BACKGROUND: The role of epicardial fat thickness (EFT) in ischemic stroke (IS) has not been previously investigated. The aim of the present study was to evaluate EFT and neutrophil/lymphocyte ratio (NLR) among patients with IS and to examine the relationship between these inflammatory markers and the incidence of IS. METHODS: The cross-sectional design includes 38 patients with IS and 47 age- and sex-matched healthy controls. Echocardiographic measurement of EFT was conducted according to previously published methods. An automated hematology analyzer was used to generate total and differential leukocyte counts from patient blood samples. RESULTS: Mean EFT was 4.86 ± .68 mm in the control group and 5.95 ± 1.14 mm in the IS group. EFT was significantly greater in the IS patients in relation to the control group (P < .001). Mean NLR was significantly greater among IS patients in relation to the control group (2.5 ± .6 vs. 1.8 ± .4, P < .001). No significant confounding factors were identified in the data set. Spearman's correlation analysis revealed a mild, but highly significant correlation between EFT and NLR (r = .293, P = .006). CONCLUSIONS: This study demonstrates for the first time the association between EFT and cerebral IS. Echocardiographic EFT was significantly correlated with NLR. NLR and echocardiographic EFT represent inexpensive and readily available clinical markers that maybe useful in estimating risk of IS.


Assuntos
Tecido Adiposo/diagnóstico por imagem , Contagem de Células Sanguíneas , Isquemia Encefálica/sangue , Isquemia Encefálica/diagnóstico por imagem , Inflamação/sangue , Inflamação/diagnóstico por imagem , Linfócitos , Neutrófilos , Pericárdio/diagnóstico por imagem , Acidente Vascular Cerebral/sangue , Acidente Vascular Cerebral/diagnóstico por imagem , Adulto , Idoso , Estudos de Casos e Controles , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Ultrassonografia
18.
Artigo em Inglês | MEDLINE | ID: mdl-25061454

RESUMO

INTRODUCTION: Previous studies have reported a relationship between serum bilirubin levels and coronary artery disease (CAD). However, data are rare up to now regarding the relation of bilirubin levels with infarct-related artery (IRA) patency in the setting of ST-segment elevation myocardial infarction (STEMI). Moreover, previous studies reported that increased bilirubin was related to impaired post-intervention coronary flow. To our knowledge, the association between serum total bilirubin (TB) levels and pre-primary percutaneous coronary intervention (PCI) with patency of IRA flow in STEMI patients has not been investigated. AIM: To evaluate the association of TB with pre-primary PCI, coronary flow and in-hospital major adverse cardiac events (MACE) in patients with STEMI. MATERIAL AND METHODS: A total of 360 consecutive patients with STEMI (mean age = 61.4 ±13.7 years) admitted within 12 h from the time of symptom onset were enrolled. Patients were divided into 2 groups based on the serum TB levels. We defined normal flow as pre-PCI TIMI 3 flow, while impaired flow was defined as pre-PCI TIMI ≤ 2 flow. RESULTS: Pre-PCI impaired flow was higher in the TB group than pre-PCI normal flow (p < 0.001). In-hospital mortality and MACE were significantly higher in the high TB group (p = 0.002, p < 0.001 respectively). In the receiver operating characteristic curve analysis, TB > 0.825 mg/dl predicted impaired IRA flow before p-PCI with a sensitivity of 79% and specificity of 71%. CONCLUSIONS: The TB is an inexpensive and readily available marker for STEMI patients undergoing PCI. It can be used for risk stratification in this patient population.

19.
Clin Invest Med ; 37(3): E186, 2014 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-24895992

RESUMO

PURPOSE: Response to infliximab treatment diminishes as body mass index (BMI) increases in patients with ankylosing spondylitis (AS). The purpose of the study was to determine if diminished response to infliximab treatment in patients with AS could be associated with increased visceral adipose tissue rather than increased BMI. METHODS: Twenty six AS patients (21 males and five females) who fulfilled the modified New York criteria and who were currently receiving infliximab treatment were enrolled in the study. Pain was measured by the visual analogue scale (VAS). The disease activity and functional status were assessed by the Bath AS Disease Activity Index (BASDAI) and the Bath AS Functional Index (BASFI). The Bath AS Metrology Index (BASMI) was used to evaluate mobility restrictions. Weight and visceral body composition were measured without shoes in light indoor clothes using a bio-impedance meter. RESULTS: There was a significant correlation between visceral adipose tissue amount and disease activity under infliximab treatment. In correlation analysis, visceral fat showed significant correlations between BASDAI (r=0.545, p=0.004) and VAS (r=0.458, p=0.019). Total body fat also showed a significant correlation with BASDAI (r=0.463, p=0.017). CONCLUSION: A significant correlation was found between visceral adipose tissue amount and disease activity in patients with AS.


Assuntos
Gordura Intra-Abdominal/metabolismo , Espondilite Anquilosante/metabolismo , Espondilite Anquilosante/patologia , Tecido Adiposo/metabolismo , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Adulto Jovem
20.
Clin Exp Hypertens ; 36(8): 531-7, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24786588

RESUMO

BACKGROUND: Arterial stiffness (AS), the term describes the rigidity of arterial walls, and its hemodynamic results have been shown to be associated with increase in future cardiovascular events. Women with pre-eclampsia in their past pregnancies have a higher risk of developing cardiovascular disease later in life. The goal of this study was to assess AS using a non-invasive and simple oscillometric method in pregnant women with and without pre-eclampsia. METHODS: Ninety pregnant women, forty-five of which had pre-eclampsia, were included in the study. The vascular measurements were performed with a Mobil-O-Graph 24 h PWA Monitor, an automatic oscillometric device. Statistical analysis was performed using the Chi-square, independent sample t-test or the Mann-Whitney U test, Pearson correlation, and linear regression tests. RESULTS: All the vascular function parameters were significantly higher in the patients with pre-eclampsia. The pulse wave velocity (PWV) values found in the pre-eclampsia group were positively correlated with gestational age, maternal age, glucose level, creatinine level, augmentation index, and central blood pressure. Using linear regression analysis, the PWV values were confirmed to be positively correlated with gestational age, maternal age, and central systolic blood pressure. The women with severe pre-eclampsia had significantly higher blood pressures, PWV values, augmentation indices, and cardiac outputs when compared with the patients with mild pre-eclampsia. CONCLUSION: Oscillometric PWV measurement is already accepted as the most reproducible quick, simple, and inexpensive non-invasive method for the assessment of large artery stiffness. It can be applied to evaluate the AS and also aid in detecting future cardiovascular risk of patients with pre-eclampsia.


Assuntos
Pré-Eclâmpsia/fisiopatologia , Análise de Onda de Pulso/métodos , Rigidez Vascular , Adulto , Pressão Sanguínea , Débito Cardíaco , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Estudos de Casos e Controles , Feminino , Humanos , Gravidez , Fatores de Risco , Adulto Jovem
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