Prognostic role of soluble suppression of tumorigenicity-2 on cardiovascular mortality in outpatients with heart failure.

OBJECTIVE: Soluble suppression of tumorigenicity-2 (sST2), a member of the interleukin 1 receptor family, is increased in mechanical stress conditions and is produced by cardiomyocytes and cardiac fibroblasts. Elevated sST2 level is associated with the prognosis of acute coronary syndrome, pulmonary arterial hypertension, and acute and chronic heart failure (HF). In this study, we aimed to investigate the relationship between sST2 levels and cardiovascular mortality in outpatients with HF. METHODS: This study used a prospective observational cohort design. A total of 130 consecutive outpatients with HF were prospectively evaluated. Clinical characteristics, laboratory results, cardiovascular risk factors, comorbidities, and medication use were recorded. The patients were followed up for a mean period of 12±4 months for the development of cardiovascular death. They were classified into two groups: those who survived and those who died. RESULTS: Mean age of patients was 67±11 years (69% males). After follow-up, 23 of 130 patients (18%) experienced cardiovascular death. sST2 levels were higher among those who died compared with among those who survived [51 (21-162) vs. 27 (9-198) ng/mL, p<0.001]. Optimal cut-off sST2 level to predict cardiovascular mortality was found to be >30 ng/mL with a sensitivity of 87% and a specificity of 67% (AUC =0.808, 95% CI=0.730 to 0.872). sST2 levels were negatively correlated with left ventricular ejection fraction and triglyceride, total cholesterol, LDL cholesterol, and hemoglobin levels and were positively correlated with left atrium size and the presence of right ventricular dilatation. In multiple Cox regression analysis, sST2 level of >30 ng/mL (HR=6.756, p=0.002, 95% CI=1.983-23.018), hemoglobin level (HR=0.705, p<0.001, 95% CI=0.587-0.847), age (HR=1.050, p=0.013, 95% CI=1.010-1.091), and HDL cholesterol level (HR=0.936, p=0.010, 95% CI=0.889-0.984) remained to be associated with an increased risk of mortality. CONCLUSION: sST2 measurement could help risk stratification in outpatients with HF. Moreover, this is the first study describing the impact of sST2 protein in Turkish patients with HF.

Chemical composition of Eastern Black Sea aerosol--preliminary results.

Trace element composition of atmospheric particles collected at a high altitude site on the Eastern Black Sea coast of Turkey was investigated to understand atmospheric transport of pollutants to this semi-closed basin. Aerosol samples were collected at a timber-storage area, which is operated by the General Directorate of Forestry. The site is situated at a rural area and is approximately 50 km to the Black Sea coast and 200 km to the Georgia border of Turkey. Coarse (PM2.5-10) and fine (PM2.5) aerosol samples were collected between 2011 and 2013 using a "stacked filter unit". Collected samples were shipped to the Middle East Technical University in Ankara, where Na, Mg, Al, Si, S, K, Ca, Ti, V, Cr, Mn, Fe, Ni, Cu, Zn, As, Ba, Pb were measured by Energy dispersive x-ray fluorescence technique (EDXRF). Comparison of measured concentrations of elements with corresponding data generated at other parts of Turkey demonstrated that concentrations of pollution derived elements are higher at Eastern Black Sea than their corresponding concentrations measured at other parts of Turkey, which is attributed to frequent transport of pollutants from north wind sector. Positive matric factorization revealed four factors including three anthropogenic and a crustal factor. Southeastern parts of Turkey, Georgia and Black Sea coast of Ukraine were identified as source regions affecting composition of particles at our site, using trajectory statistics, namely "potential source contribution function" (PSCF).

An approach to measure trace elements in particles collected on fiber filters using EDXRF.

A method developed for analyzes of large number of aerosol samples using Energy Dispersive X-Ray Fluorescence (EDXRF) and its performance were discussed in this manuscript. Atmospheric aerosol samples evaluated in this study were collected on cellulose fiber (Whatman-41) filters, employing a Hi-Vol sampler, at a monitoring station located on the Mediterranean coast of Turkey, between 1993 and 2001. Approximately 1700 samples were collected in this period. Six-hundred of these samples were analyzed by instrumental neutron activation (INAA), and the rest were archived. EDXRF was selected as an analytical technique to analyze 1700 aerosol samples because of its speed and non-destructive nature. However, analysis of aerosol samples collected on fiber filters with a surface technique such as EDXRF was a challenge. Penetration depth calculation performed in this study revealed that EDXRF can obtain information from top 150µm of our fiber filter material. Calibration of the instrument with currently available thin film standards caused unsatisfactory results since the actual penetration depth of particles into fiber filters were much deeper than 150µm. A method was developed in this manuscript to analyze fiber filter samples quickly with XRF. Two hundred samples that were analyzed by INAA were divided into two equal batches. One of these batches was used to calibrate the XRF and the second batch was used for verification. The results showed that developed method can be reliably used for routine analysis of fiber samples loaded with ambient aerosol.