The impact of diabetes on left ventricular diastolic function in patients with arterial hypertension.

OBJECTIVE: The aim of this study is to analyse the impact of diabetes mellitus on the left ventricular diastolic function in patients with arterial hypertension. METHODS: Between July 2007 and July 2008, we enrolled patients aged ≥40 years who had hypertension with or without type 2 diabetes mellitus and unknown history of coronary artery disease who applied to 7.-8. internal medicine polyclinics of Goztepe Education and Training Hospital. Transthoracic echocardiography was used to assess the diastolic function. If patients with positive treadmill exercise test and/or EF ≤%50 in transthoracic echocardiography were excluded from the study. A total of 110 patients (males, n=42 38.2%, and females, n=68; 61.8%) with a mean age of 60.78 (±10.627) years were included in the study. For statistical analysis, SPSS 12.0 program and for the comparison of data chi-square test was used. RESULTS: Diastolic dysfunction was significantly more prevalent in diabetes (81.25%) than those without diabetes group (62.9%) (p<0.05). In men, 35.9% in the DM(+) group and 41.1% in the DM(-) group had diastolic dysfunction. In women, 64.1% in the DM(+) group and 58.29% in the DM(-) group had diastolic dysfunction. In the evaluation based on gender, the difference male and female patients was not significant (p>0.05). CONCLUSION: Diabetes in association with hypertension has a negative effect on left ventricular diastolic function. This effect appears similar in men and women.

Cardiac changes with subclinical hypothyroidism in obese women.

OBJECTIVES: Obesity has been linked to a spectrum of minor cardiovascular changes. The aim of this study was to determine the effect of obesity on cardiac functions and its relations with subclinical hypothyroidism in healthy women. STUDY DESIGN: Eighty-eight consecutive "healthy" females (mean age: 31.2±6.6 years) were included in the study. Thyroid function tests and echocardiography studies were performed in all patients. Height, weight, and waist and hip circumference were also measured. A body mass index (BMI) above 30 kg/m2 was considered obese. RESULTS: Left ventricular mass (LVM) was higher in obese subjects (p<0.001). Doppler-derived indices of LV diastolic filling showed clear abnormalities of myocardial relaxation in obese subjects with higher E/e' (p=0.001) and larger left atrial volume (LAV) (p<0.001). LV myocardial performance index was also significantly higher in obese subjects (p=0.033). Thyroid-stimulating hormone (TSH) levels were significantly higher in obese subjects (p=0.011) and were positively correlated with BMI, waist circumference, LAV, and LVM. The prevalence of abnormal systolic and diastolic functions showed stepwise increases with higher TSH levels in obese subjects. Multiple regression analysis was used to evaluate the association of E/e' with anthromorphometric and biochemical parameters, and waist circumference was found to be the strongest independent variable correlated with the E/e' ratio. CONCLUSION: Cardiac structural and functional deteriorations may be related with subclinical hypothyroidism in obese subjects.

The role of pentraxin 3 as diagnostic value in classification of patients with heart failure.

OBJECTIVE: Pentraxin 3 (PTX3) is a new inflammatory marker that is the prototype of the long pentraxin group, while C-reactive protein (CRP) is the short pentraxin group. The aim of the present study was to investigate the clinical significance of plasma PTX3 and CRP levels in heart failure (HF). MATERIALS AND METHODS: The study included 22 male and 37 female patients with HF, and 23 healthy volunteers as the control group. Patients were divided into 4 groups (class I, II, III and IV) according to New York Heart Association functional class. RESULTS: Plasma PTX3 and CRP levels were significantly elevated in HF patients compared to healthy controls. Comparing PTX3 levels in patient groups, statistically significant difference was found between class-I and class-II, class-III and class-IV patients (p=0.009, p=0.001, p<0.001, respectively). There was a positive correlation between PTX3 and CRP levels (r=0.369, p=0.004). In receiver-operating characteristic (ROC) curves, area under the curve (AUC) values for PTX3 and CRP were 0.928 (p=0.001) and 0.834 (p=0.001), respectively. CONCLUSIONS: Plasma PTX3 levels are elevated in HF and might be used as diagnostic value in classification of patients with HF. It is still debated whether inflammation may be just a cause or a consequence of the disease. Therefore further work is needed to better understand in large populations of patients with HF.

Prolonged QT dispersion in inflammatory bowel disease.

AIM: To investigate the frequency and factors of prolonged QT dispersion that may lead to severe ventricular arrhythmias in patients with inflammatory bowel disease (IBD). METHODS: This study included 63 ulcerative colitis (UC) and 41 Crohn's disease (CD) patients. Forty-seven healthy patients were included as the control group. Heart rate was calculated using electrocardiography, corrected QT dispersion (QTcd) and the Bazett's formula. Homeostasis model assessment (HOMA) was used to determine insulin resistance (IR). HOMA values < 1 were considered normal and values > 2.5 indicated a high probability of IR. RESULTS: Prolonged QTcd was found in 12.2% of UC patients, and in 14.5% of CD patients compared with the control group (P < 0.05). A significant difference was found between the insulin values (CD: 10.95 ± 6.10 vs 6.44 ± 3.28, P < 0.05; UC: 10.88 ± 7.19 vs 7.20 ± 4.54, P < 0.05) and HOMA (CD: 2.56 ± 1.43 vs 1.42 ± 0.75, P < 0.05; UC: 2.94 ± 1.88 vs 1.90 ± 1.09, P < 0.05) in UC and CD patients with and without prolonged QTcd. Disease behavior types were determined in CD patients with prolonged QTcd. Increased systolic arterial pressure (125 ± 13.81 vs 114.09 ± 8.73, P < 0.01) and age (48.67 ± 13.93 vs 39.57 ± 11.58, P < 0.05) in UC patients were significantly associated with prolonged QTcd. CONCLUSION: Our data show that IBD patients have prolonged QTcd in relation to controls. The routine follow-up of IBD patients should include determination of HOMA, insulin values and electrocardiogram examination.

The prevalence of giardia intestinalis in dyspeptic and diabetic patients.

Background and Aims. We aimed to investigate the prevalence of Giardiasis in patients with dyspepsia and patients with diabetes mellitus. Methods. 400 patients and 100 healthy persons were included in this clinical prospective study. The number of patients in each group was equal, 200 dyspeptic and 200 diabetic, respectively. The antigen of G. lntestinalis was determined in the stool specimens by ELISA method. Results. The frequency of Giardiasis was 7% in dyspeptic and 15% in diabetic patients. There was no positive results in any of the healthy persons. There was a significant difference in prevalence rate of Giardiasis between patients with dyspepsia and diabetes mellitus (P < 0.05). Conclusions. These results revealed that the prevalence of Giardiasis in dyspepsia and with diabetes mellitus was high in our country. This is the first study investigating the prevalence of Giardiasis in diabetic patients. To investigate Giardiasis in diabetic patients, who have dyspepsia or not, may be a good approach for public health.