Galectin-3: A biochemical marker to detect paroxysmal atrial fibrillation?

PURPOSE: Atrial fibrillation (AF) is the most common form of arrhythmia. AF leads to electrical remodelling and fibrosis of the atria; however, the mechanism(s) remain poorly understood. Galectin-3 is a potential mediator of cardiac fibrosis. The present study aimed to examine the relationship between serum galectin-3 levels and paroxysmal AF. METHODS: Forty-six patients with paroxysmal AF and preserved left ventricular systolic function, and 38 age- and gender-matched control subjects, were involved in the study. Serum galectin-3 levels were analyzed with an enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum galectin-3 levels (median 1.38 ng/mL; 1.21 ng/mL-1.87 ng/mL; p< 0.001) were significantly elevated in patients with paroxysmal AF compared with the control. Left atrial diameter was significantly higher in patients with paroxysmal AF (41.2±3.0 mm vs. 39.6±3.3 mm). Left atrial diameter was found to be significantly correlated with serum galectin-3 levels in patients with paroxysmal AF (r= 0.378, p= 0.001). CONCLUSION: Serum galectin-3 levels are significantly elevated and significantly correlated with left atrial diameter in patients with paroxysmal AF.

Relation of red cell distribution width with dipper and non-dipper hypertension.

Aim Red cell distribution width (RDW), an index of erythrocyte size, is associated with high risk for cardiovascular disease. Nondipping hypertension (HT) is lack of nocturnal fall in blood pressure(BP). The association between RDW and non-dipping BP in normotensive and hypertensive patients was investigated. Methods A total of 170 patients were categorized into 4 groups: Normotensive-Dipper (NT-D), Normotensive-Non-dipper (NTND), Hypertensive-Dipper (HT-D) and Hypertensive-Non-dipper(HT-ND). RDW and hs-CRP levels were measured. Results Hypertensive patients had higher RDW and hs-CRP levels(14.5 ± 0.87 vs.12.7 ± 0.66, p<0.001 for RDW; 0.99 ± 0.52 vs.0.63 ± 0.43, p<0.001 for hs-CRP). Besides, the RDW levels were higher in non-dippers (13.0 ± 0.63 vs.12.4 ± 0.55, p<0.001 for NT-ND and NT-D; 14.9 ± 0.78 vs.14.2 ± 0.82, p<0.001 for HT-ND and HT-D) Conclusion RDW is elevated in non-dipping BP both in normotensive and hypertensive subjects, which may be related with increased inflammatory state.

Serum Paraoxonase Levels are Correlated with Impaired Aortic Functions in Patients with Chronic Kidney Disease.

BACKGROUND: The correlation between aortic functions and paraoxonase levels has been previously demonstrated by several earlier studies. In this study, we aimed to investigate the correlation between serum paraoxonase levels and aortic functions among patients with chronic kidney disease. METHODS: Our study enrolled 46 chronic kidney disease patients and 45 healthy controls. From these patients, serum cholesterol, creatinine, hemoglobin, and paraoxonase-1 levels were analyzed. RESULTS: Paraoxonase-1 levels were significantly lower in patients with chronic kidney disease compared to the controls (p < 0.001). Additionally, the extent of aortic stiffness index (%) was significantly higher in chronic kidney disease patients, but aortic strain and aortic distensibility were significantly higher in healthy controls (p < 0.001, p < 0.001, and p < 0.001, respectively). We further found that paraoxonase-1 levels were correlated with aortic stiffness index, aortic strain, and aortic distensibility (p < 0.001, p < 0.001, and p < 0.001, respectively). CONCLUSIONS: Our study demonstrated that serum paraoxonase-1 levels were significantly correlated with impaired aortic functions. The results of this study highlight the impact of serum paraoxonase-1 activity on atherosclerosis and cardiovascular adverse events. KEY WORDS: Aortic functions; Atherosclerosis; Chronic kidney disease; Echocardiography; Paraoxonase.

The relationship between coronary collateral circulation and neutrophil/lymphocyte ratio in patients with coronary chronic total occlusion.

OBJECTIVES: To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion. SUBJECTS AND METHODS: Our study population consisted of 275 consecutive patients with chronic total occlusion. One hundred and thirty-eight patients with chronic total occlusion were included in the study. They were classified into 2 groups as follows: impaired CCC (group 1: Rentrop grades 0-1) and good CCC (group 2: Rentrop grades 2-3). The NLR was calculated from the complete blood count. RESULTS: The NLR values of the patients with impaired CCC (4.5 ± 0.7) were significantly higher than of those with good CCC (2.7 ± 0.6, p < 0.001). In the multivariate logistic regression test, NLR (OR 33.36, 95% CI 8.189-135.7, p < 0.001), high-sensitivity C-reactive protein (hs-CRP; OR 2.152, 95% CI 1.226-3.777, p = 0.008), estimated glomerular filtration rate (OR 1.167, 95% CI 1.049-1.298, p = 0.004) and systolic blood pressure (OR 1.068, 95% CI 1.009-1.1310, p = 0.025) were independent predictors of impaired CCC. The NLR value >3.55 yielded an area under the curve value of 0.957 (95% CI 0.921-0.992, p < 0.001) and demonstrated a sensitivity of 95% and a specificity of 90% for the prediction of CCC. A moderate correlation between NLR and hs-CRP was observed (r = 0.443; p < 0.001). CONCLUSION: Our findings reveal that NLR correlates with the impaired development of coronary collaterals.

Is there a relationship between serum paraoxonase level and epicardial fat tissue thickness?

OBJECTIVE: This study aimed to show the relationship between serum paraoxonase 1 level and the epicardial fat tissue thickness. METHODS: Two hundred and seven patients without any atherosclerotic disease history were included in this cross-sectional observational study. Correlation analysis was performed to determine the correlation between epicardial fat tissue thickness, which was measured by echocardiography and serum paraoxonase 1 level. Also correlation analysis was performed to show correlation between patients' clinical and laboratory findings and the level of serum paraoxonase 1 (PON 1) and the epicardial fat tissue thickness. Pearson and Spearman test were used for correlation analysis. RESULTS: No linear correlation between epicardial fat tissue thickness and serum PON 1 found (correlation coefficient: -0.127, p=0.069). When epicardial fat tissue thickness were grouped as 7 mm and over, and below, and 5 mm and over, and below, serum PON 1 level were significantly lower in ≥7 mm group (PON1 : 168.9 U/L) than <7 mm group (PON 1: 253.9 U/L) (p<0.001). Also hypertension prevalence was increased in ≥7 mm group (p=0.001). Serum triglyceride was found to be higher in ≥7 mm group (p=0.014), body mass index was found higher in ≥5 mm group (p=0.006). CONCLUSION: Serum PON 1 level is not correlated with the epicardial fat tissue thickness. But PON 1 level is lower in patients with epicardial fat tissue thickness 7 mm and over. Therefore, increased atherosclerosis progression can be found among patients with 7 mm and higher epicardial fat tissue thickness.

Penetrating atherosclerotic aortic ulcer mimicking acute inferior myocardial infarction.

Penetrating atherosclerotic ulcers (PAU), aortic dissection, and intramural hematoma are the three most important diseases involving the aorta which are classified as acute aortic syndromes. Penetrating atherosclerotic aortic ulceration is characterized by ulceration of atheromatous plaque disrupting the internal elastic lamina. These aortic ulcers may penetrate through the media to cause aortic pseudoaneurysms or less often through the adventitia to cause transmural aortic rupture. We described a case of penetrating atherosclerotic ulcer of ascending aorta mimicking ST elevation myocardial infarction. To our knowledge, this is the first case reported in the literature of such a complication from PAU.