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This article discusses the challenges of manually screening electroencephalogram (EEG) signals for emotion classification and proposes a novel automated method using Clefia pattern-based features. The proposed model achieves high accuracy in classifying arousal, dominance, and valence cases using two public databases. The Clefia pattern-based method offers low computational complexity and high accuracy for automated emotion classification using EEG signals. The text describes a database called DREAMER that contains EEG and ECG signals collected from 23 participants. The text also explains a proposed model for emotion classification using Clefia pattern and mRMR feature selection. The given text describes a method called Clefia pattern for extracting features from EEG signals. The method involves dividing the EEG signal into overlapping blocks and comparing each value in the signal with a corresponding value in a binary array. The resulting binary array is then divided into two groups and the decimal equivalent of each group is calculated. Finally, histograms of the EEG signal are generated using these decimal values and a feature vector is obtained by combining the histograms. The Clefia pattern is shown in a pseudocode algorithm and sample results of map generation and histogram operations are provided. The text describes a model for emotion classification that involves feature selection, classification using a support vector machine (SVM), and majority voting. The model is validated using two public databases and achieves high classification performance for arousal, valence, and dominance emotional states. The results are presented in tables, showing the performance metrics for each channel [Extracted from the article]

Bicuspid aortic valve is the most common congenital cause for the development of aortic valve calcification and stenosis. Calcification cause valvular stenosis or valvular insufficiency due to coaptation failure. We report a unique case of calcification of bicuspid valve was extending to left ventricular outflow tract and attached to interventricular septum which caused subvalvular stenosis. [ABSTRACT FROM AUTHOR]

Copyright of Kafkas Journal of Medical Sciences / Kafkas Tıp Bilimleri Dergisi is the property of Kafkas Journal of Medical Sciences, Kafkas Tip Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Kafkas Journal of Medical Sciences / Kafkas Tıp Bilimleri Dergisi is the property of Kafkas Journal of Medical Sciences, Kafkas Tip Bilimleri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

There are conflicting results about the early administration of beta-blockers (bb) on in-hospital mortality and arrhythmias. Here, we wanted to investigate the effects of chronic bb use on in-hospital Atrial Fibrillation (AF) development in ST-Elevation Myocardial Infarction (STEMI) patients. A total of 814 consecutive patients with STEMI were included in the study. They were divided into two groups according to whether they are using bb on admission or not. They were followed for AF development in-hospital and predictors of AF were determined by multivariable logistic regression analysis. Of the 814 patients, 103 (12.67%) patients were already using bb, while 711 (87.3%) were not. There were no significant differences in the frequency of AF development [3 (%2.9) vs 30 (%4.2), p =.788] between the groups. Multivariable logistic regression analysis showed that left atrial (LA) diameter is the only independent predictor of in-hospital AF development. Our study showed that chronic bb use does not have an effect on in-hospital AF development in STEMI patients. Nevertheless, LA diameter was found to be an independent predictor of AF. [ABSTRACT FROM AUTHOR]

Copyright of Gazi Medical Journal is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Vascular endothelial dysfunction leads to the emerging of free oxygen radicals, deficiency of antioxidant system, forming of oxidative stress, inflammatory processes and release of proinflammatory cytokines. These things play big role in the development of primary varicose veins. Prolidase has been reported as an indicator of oxidative stress in diabetes, diabetic neuropathy, non-ulcerous dyspepsia, osteoporosis, polycystic over syndrome and many other diseases. The aim of this study is to evaluate the oxidative stress at venous insufficiency and to provide preliminary knowledge about the role of prolidase enzyme in varicose vein formation. Methods Ninety patients aged between 22 and 80 (47.35 ± 17.69) were included in the study and divided into 3 groups. Group1(n:30)(Serum control group): Patients without venous insufficiency. Group 2(n:30)(Tissue control group(healthy vein group): Patients underwent coronary artery bypass surgery (the remaining portion of great saphenous vein used as coronary artery bypass graft used as normal tissue) . Group 3(n:30)(Varicose vein group): Patients underwent varicose vein surgery (varicose vein and serum of these patients were used for study). Total Oxidant Status (TOS), Total Antioxidant Status (TAS), Oxidative Stress Index (OSI) and Prolidase enzyme levels were detected in tissue and serum samples. Results No significant changes were detected between three groups' serum samples in oxidative stress parameters and in the prolidase enzyme activity. The tissue TOS and OSI were higher in varicose vein group according to normal vein group and this was found statistically significant. And TAC levels in varicose vein group were significantly lower than normal vein group. Prolidase enzyme activity in varicose vein group was found higher according to normal vein group. Conclusion Oxidative stress plays a role at the development of primary varicose veins at biochemical level. Prolidase enzyme related with oxidative stress may play an important role in the pathogenesis of primary varicose veins. [ABSTRACT FROM AUTHOR]

We investigated whether the lymphocyte-to-monocyte ratio (LMR) 48 hours after admission is related to 30-day and long-term mortality in patients with ST-elevation myocardial infarction (STEMI) who were treated with primary percutaneous coronary intervention (PCI). We evaluated 318 consecutive patients with STEMI who were undergoing primary PCI. The relationship between the LMR48h and all-cause mortality (30-day and long-term) was analyzed by categorizing the patients into tertiles (T) according to LMR48h—T1 (>2.46), T2 (1.67-2.46), and T3 (<1.67). The T3 group exhibited the highest risk of 30-day all-cause mortality (hazard ratio [HR]: 8.093 [1.006-65.074]; P = .049). For long-term mortality, a significantly higher mortality risk was observed in both T2 (HR: 2.005 [1.021-3.939]; P = .043) and T3 groups (HR: 2.374 [1.160-4.857]; P < .001) compared to the T1 group (reference group). In multivariate analysis, these associations remained unaltered even after adjusting for confounders. A low LMR at 48 hours after admission may be independently associated with both 30-day and long-term mortality in patients with STEMI who were treated with primary PCI. This marker may be used for identifying patients with STEMI at high risk. [ABSTRACT FROM AUTHOR]

Background Pulmonary embolism (PE) is a common and life-threatening condition associated with considerable morbidity and mortality. Pleural effusion occurs in about one in three cases; however, data on its prognostic value are scarce. Purpose To investigate the association between pleural effusion and both 30-day and long-term mortality in patients with acute PE. Material and Methods We retrospectively evaluated 463 patients diagnosed with acute PE using computed tomography pulmonary angiography (CTPA). Echocardiographic, demographic, and laboratory data were collected. The study population was divided into two groups: patients with and without pleural effusions. Pleural effusion detected on CT was graded as small, moderate, and large according to the amount of effusion. The predictors of 30-day and long-term total mortality were analyzed. Results Pleural effusions were found in 120 patients (25.9%). After the 30-day follow-up, all-cause mortality was higher in acute PE patients with pleural effusions than in those without (23% versus 9%, P < 0.001). Also, patients with pleural effusions had significantly higher incidence of long-term total mortality than those without pleural effusions (55% versus 23%, P < 0.001). In a multivariate analysis, pleural effusion was an independent predictor of 30-day and long-term mortality (odds ratio [OR], 2.154; 95% confidence interval [CI], 1.186-3.913; P = 0.012 and OR, 1.591; 95% CI, 1.129-2.243; P = 0.008, respectively). Conclusion Pleural effusion can be independently associated with both 30-day and long-term mortality in patients with acute PE. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevation myocardial infarction (STEMI). Oxidative stress and inflammation may cause structural and electrical remodeling in the atria making these critical processes in the pathology of AF. In this study, we aimed to evaluate the association between total oxidative status (TOS), total antioxidative capacity (TAC) and high-sensitivity C-reactive protein (hs-CRP) in the development of AF in patients presenting with STEMI. This prospective cohort study consisted of 346 patients with STEMI. Serum TAC and TOS were assessed by Erel’s method. Patients were divided into two groups: those with and those without AF. Predictors of AF were determined by multivariate regression analysis. In the present study, 9.5% of patients developed AF. In the patients with AF, plasma TOS and oxidative stress index (OSI) values were significantly higher and plasma TAC levels were significantly lower compared to those without AF (p = .003,p = .002,p < .0001, respectively). Multivariate regression analysis results showed that, female gender (Odds ratio [OR] = 3.07; 95% Confidence Interval [CI] = 1.26–7.47;p = .01), left atrial diameter (OR =1.28; 95% CI =1.12–1.47;p < .0001), hs-CRP (OR =1.02; 95% CI =1.00–1.03;p = .001) and OSI (OR =1.10; 95% CI =1.04–1.18;p = .001) were associated with the development of AF in patients presenting with STEMI. The main finding of this study is that oxidative stress and inflammation parameters were associated with the development of AF in patients presenting with STEMI. Other independent predictors of AF were female gender, left atrial diameter and hs-CRP. [ABSTRACT FROM PUBLISHER]

Atrial fibrillation (AF) is the most common supraventricular arrhythmia following ST elevation myocardial infarction (STEMI). Oxidative stress and inflammation may cause structural and electrical remodeling in the atria making these critical processes in the pathology of AF. In this study, we aimed to evaluate the association between total oxidative status (TOS), total antioxidative capacity (TAC) and high-sensitivity C-reactive protein (hs-CRP) in the development of AF in patients presenting with STEMI. This prospective cohort study consisted of 346 patients with STEMI. Serum TAC and TOS were assessed by Erel's method. Patients were divided into two groups: those with and those without AF. Predictors of AF were determined by multivariate regression analysis. In the present study, 9.5% of patients developed AF. In the patients with AF, plasma TOS and oxidative stress index (OSI) values were significantly higher and plasma TAC levels were significantly lower compared to those without AF (p = .003, p = .002, p < .0001, respectively). Multivariate regression analysis results showed that, female gender (Odds ratio [OR] = 3.07; 95% Confidence Interval [CI] = 1.26-7.47; p = .01), left atrial diameter (OR =1.28; 95% CI =1.12-1.47; p < .0001), hs-CRP (OR =1.02; 95% CI =1.00-1.03; p = .001) and OSI (OR =1.10; 95% CI =1.04-1.18; p = .001) were associated with the development of AF in patients presenting with STEMI. The main finding of this study is that oxidative stress and inflammation parameters were associated with the development of AF in patients presenting with STEMI. Other independent predictors of AF were female gender, left atrial diameter and hs-CRP. [ABSTRACT FROM AUTHOR]

It is unclear whether changes in mean platelet volume (MPV) are associated with total mortality in acute coronary syndromes. We investigated whether the change in MPV predicts total mortality in patients with non–ST-segment elevation myocardial infarction (NSTEMI). We retrospectively analyzed 419 consecutive patients (19 patients were excluded). The remaining patients were categorized as survivors (n = 351) or nonsurvivors (n = 49). Measurements of MPV were performed at admission and after 24 hours. The difference between the 2 measurements was considered as the MPV change (ΔMPV). The end point of the study was total mortality at 1-year follow-up. During the follow-up, there were 49 deaths (12.2%). Admission MPV was comparable in the 2 groups. However, both MPV (9.6 ± 1.4 fL vs 9.2 ± 1.0 fL, P = .044) and ΔMPV (0.40 [0.10-0.70] fL vs 0.70 [0.40-1.20] fL, P < .001) at the first 24 hours were higher in nonsurvivors than survivors. In multivariate analysis, ΔMPV was an independent predictor of total mortality (odds ratio: 1.84, 95% confidence interval: 1.28-2.65, P = .001). An early increase in MPV after admission was independently associated with total mortality in patients with NSTEMI. Such patients may need more effective antiplatelet therapy. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to evaluate the efficacy of nebivolol, carvedilol or metoprolol succinate on the outcome of patients presenting with acute myocardial infarction (AMI) complicated by left ventricular dysfunction.Subjects and Methods: Patients (n = 172, aged 28-87 years) with AMI and left ventricular ejection fraction ≤0.45 were randomized to the nebivolol (n = 55), carvedilol (n = 60) and metoprolol succinate (n = 57) groups. Baseline demographic and clinical characteristics and composite event rates of nonfatal MI, cardiovascular mortality, hospitalization due to unstable angina pectoris or heart failure, stroke or revascularization during the 12-month follow-up were compared among the groups using the x03C7;2 test, t test or log-rank test as appropriate.Results: Baseline demographic and clinical characteristics were similar in the three groups. The composite end point during follow-up was lower in the patients treated with nebivolol than those treated with metoprolol (14.5 vs. 31.5%; p = 0.03). However, event rates were similar between the patients treated with carvedilol and those treated with the metoprolol (20.3 vs. 31.5%, p > 0.05) and between the patients treated with nebivolol and carvedilol (14.5 vs. 20.3%, p > 0.05).Conclusion: The patients treated with nebivolol experienced 12-month cardiovascular events at a lower rate than those treated with metoprolol succinate. However, event rates were similar between the carvedilol and the metoprolol succinate groups and between the nebivolol and the carvedilol groups. [ABSTRACT FROM AUTHOR]

Familial hypercholesterolemia (FH) is a genetic disorder of lipoprotein metabolism and increases the risk of premature cardiovascular diseases. In patients with FH, platelet function may be activated; however, the extent of this activation and its etiology are unclear. We aimed to evaluate the mean platelet volume (MPV), a marker of platelet activation, in patients with FH. The study group consisted of 164 patients with FH and 160 control patients. Controls were matched for age, gender, hypertension, and smoking. The MPV was significantly higher in patients with FH than in controls (9.2 ± 0.4 vs 7.9 ± 0.6 fL, respectively; P < .001). Platelet count was significantly lower among patients with FH when compared to control patients (259 ± 51 vs 272 ± 56 × 103/L, respectively; P = .03). In linear regression analysis, MPV was independently associated only with total cholesterol (β = .6, 95% confidence interval: 0.004-0.008, P < .001). We have shown that MPV was increased in patients with FH and that it was independently associated with total cholesterol level. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to determine the effect of oral cholecalciferol treatment on vascular calcification, left ventricular mass index (LVMI) and other cardiac functions in dialysis patients. Design and methods: A six-month course of oral cholecalciferol treatment was recommended to dialysis patients with vitamin D insufficiency. While 26 patients were given cholecalciferol treatment, 17 patients who could not tolerate to therapy received standard therapy. Initial biochemical parameters were measured, and they were measured again after 6 months of treatment. Echocardiographic measurements were also performed, and the vascular calcification score (VCS) was calculated at baseline and at the 6th month. Results: The cholecalciferol replacement group showed no significant change in LVMI and VCS values ( p > 0.05). However, while LVMI was similar between groups at initial evaluation, it was lower in the cholecalciferol group at the 6th month when compared to the standard treatment group (141.8 ± 40.2 g/m2 vs. 166.3 ± 31.4 g/m2; p = 0.04). Likewise, left ventricular diastolic diameters (48.8 ± 5.1 mm vs. 47.5 ± 4.6 mm; p = 0.023) and left atrial diameters (41.2 ± 8.9 mm vs. 38.9 ± 8.1 mm; p = 0.006) decreased in the cholecalciferol group. Additionally, significant increases were observed in serum 25-hydroxyvitamin D (25(OH)D) and albumin levels, with a significant decrease in serum C-reactive protein levels. Conclusion: A lesser increase in left ventricular mass and better diastolic functions was observed in dialysis patients after 6 months of cholecalciferol treatment. [ABSTRACT FROM AUTHOR]

Objective: It was the aim of this study to investigate the serum oxidative stress level in nonischemic patients with heart failure (HF). Subjects and Methods: The study included 37 patients who presented to the Department of Cardiology, Suleyman Demirel University, Isparta, Turkey, with a diagnosis of asymptomatic HF (New York Heart Association class I-II). The patients had a left ventricular (LV) ejection fraction (EF) of ≤40% and normal coronary arteries or nonsignificant stenosis (stenosis <40%). In addition, 30 age- and sex-matched normal patients were selected as the control group. Clinical and laboratory characteristics presumed to be associated with oxidative stress were evaluated. Results: Demographic characteristics were comparable. However, creatinine and potassium levels were higher in the HF than in the control group. Total oxidative status [2.42 μmol H2O2 Eq/l (range 0.74-5.86) vs. 1.81 μmol H2O2 Eq/l (range 0.42-3.45); p < 0.01], oxidative stress index [2.24 (range 0.63-5.33) vs. 1.53 (range 0.28-2.51); p < 0.01] and uric acid (6.1 ± 1.8 vs. 4.4 ± 1.1 mg/dl; p < 0.01) levels were significantly higher in the HF than in the control group. The total antioxidant capacity was similar in both groups [1.22 mmol Trolox Eq/l (range 0.61-1.99) vs. 1.18 mmol Trolox Eq/l (range 0.82-1.80); p = 0.77]. The γ-glutamyltransferase levels were also comparable in both groups [32 U/l (range 11-106) vs. 23 U/l (range 11-72); p = 0.10]. Conclusion: The oxidative stress levels were higher in HF patients, and hence, oxidative stress may play an important role in poor prognosis of HF. Therefore, antioxidant treatment might be reasonable. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Platelets may be activated in hypertension (HT). Hypertensive crisis is an extreme phenotype of HT and HT-related thrombotic complications. We aimed to assess mean platelet volume (MPV) in patients with hypertensive crises. This study included 215 hypertensive urgency (HU) patients (84 male, mean age = 66 ± 15 years) and 60 hypertensive emergency (HE) patients (26 male, mean age = 68 ± 13 years), who were admitted to the emergency department with a diagnosis of hypertensive crises. Control group was composed of age- and sex-matched 39 normotensive patients. Blood samples were withdrawn for whole blood count and routine biochemical tests. Systolic blood pressure (BP) was significantly higher in the HE group than in the HU group ( p < 0.001). Median mean platelet volume (MPV) was higher in the HE group compared with HU and control groups [9.5 (Interquartile range, IQR: 8.7-10.1), 8.4 (IQR: 7.7-9.1), and 8.3 (IQR: 7.7-8.7) fl, each p < 0.001, respectively). In linear regression analysis, systolic BP ( β = 0.18, 95% confidence intervals (CI): 0.002-0.015, p = 0.007) and diabetes mellitus ( β = 0.24, 95% CI: 0.28-0.95, p < 0.001) were independently associated with MPV levels. Our findings show that MPV can be elevated in patients with HE and HU. It can be independently associated with systolic BP and diabetes mellitus. These findings imply that platelet activation contribute to the pathogenesis of thrombotic complications in hypertensive crises. [ABSTRACT FROM AUTHOR]

It is unclear whether carvedilol and nebivolol will produce different effects on platelet function and prothrombotic state in heart failure (HF). Thus, we compared their effects on these functions in patients with nonischemic HF. We included 61 patients with symptomatic nonischemic HF having ejection fraction ≤40%. The patients were randomized to carvedilol (n = 31) or nebivolol (n = 30). Analyses were made at baseline, 3, and 6 months. At 6 months, mean platelet volume (MPV) was significantly lowered by both carvedilol and nebivolol therapy. However, MPV tended to be lower in the carvedilol group (7.7 ± 1.0 vs 8.0 ± 0.7 fL, P = .05). Fibrinogen and d-dimer levels were significantly decreased in but comparable in both the groups. Carvedilol and nebivolol have similar beneficial effects on platelet function and prothrombotic state in patients with nonischemic HF. [ABSTRACT FROM AUTHOR]

Thromboembolic events may be seen in patients with hypertrophic cardiomyopathy (HCM). We investigated the mean platelet volume (MPV), an indicator of platelet activation in patients with HCM. This study included 112 patients with HCM, in which 40 were patients with hypertrophic obstructive cardiomyopathy (HOCM), and 106 were control participants. The MPV was significantly higher in patients with HCM than in controls (9.1 ± 0.3 vs 7.9 ± 0.3 fL, P = .01). In the subgroup analyses, MPV was also higher in patients with HOCM compared to those with hypertrophic nonobstructive cardiomyopathy (HNCM; 9.3 ± 0.3 vs 9.0 ± 0.2 fL, P = .01). Similarly, patients with HNCM had higher MPV values than controls (9.0 ± 0.2 vs 7.9 ± 0.3 fL, P = .01). The MPV was significantly and positively correlated with left ventricular outflow tract (LVOT) obstruction (r = .42, P = .001) and septal thickness (r =.62, P = .001). In linear regression analysis, MPV was independently associated only with septal thickness (β = .07, 95% confidence interval: 0.04-0.09, P = .001). The MPV can be elevated in patients with HCM regardless of the obstruction of LVOT and may be associated with the severity of septal thickness. [ABSTRACT FROM PUBLISHER]

Thromboembolic events can be seen in patients with mitral valve prolapse (MVP). It is unclear whether platelet activation may contribute to these events in patients with MVP. Thus, we aimed to evaluate mean platelet volume (MPV) in patients with MVP and its association with the severity of MVP. This study included 312 patients with MVP and 240 control participants. Mean platelet volume was significantly higher in patients with MVP than in controls (8.9 ± 0.7 vs 7.9 ± 0.6 fL, P = .001). In linear regression analysis, MPV was independently associated with the degree of mitral regurgitation (β = .23, 95% confidence interval (CI): 0.14-0.32, P = .001), maximal leaflet displacement (β = .24, 95%CI: 0.17-0.31, P = .001), and mean thickness of the anterior (β = .47, 95%CI: 0.27-0.61, P = .001) and posterior leaflets (β = .22, 95%CI: 0.03-0.41, P = .02). Our findings show that MPV can be elevated in patients with MVP and may be independently associated with severity of mitral regurgitation, leaflet displacement, and thickness of the leaflets. [ABSTRACT FROM PUBLISHER]

Failure to decrease blood pressure (BP) normally during nighttime (non-dipping) in hypertension is associated with higher cardiovascular morbidity and mortality. In addition, non-dipping BP is associated with increased platelet activity and inflammatory response; however, there has been no study to evaluate the relationship of non-dipping BP to indices of platelet activity and inflammation in uncontrolled hypertensive patients. In the present study, hypertensive subjects with uncontrolled office BP were firstly divided into three groups: 84 subjects with white coat effect and 365 subjects with true uncontrolled hypertension. Then, true uncontrolled hypertensive patients were divided into two groups: 158 patients with dipping and 207 patients with non-dipping. Mean platelet volume (MPV), uric acid (UA), γ-glutamyltransferase (GGT), C-reactive protein (CRP), and high-sensitivity CRP (hs-CRP) levels were studied. The general characteristics and risk factors for coronary artery disease (CAD) of the study population were similar among the groups. MPV, UA, GGT, CRP, and hs-CRP levels were significantly higher in non-dipper group than both dipper and white coat effect groups, and were significantly higher in dipper group than in white coat effect group (MPV: 9.1 ± 1.3, 8.7 ± 1.1, and 8.0 ± 0.9 fL; UA: 6.9 ± 1.2, 5.9 ± 1.4, and 4.1 ± 0.8 mg/dL; GGT: 38.9 ± 11.1, 33.6 ± 14.9, and 25.2 ± 9.2 U/L; CRP: 7.1 ± 2.4, 6.2 ± 1.9, and 3.9 ± 0.8 mg/dL; hs-CRP: 3.8 ± 1.5, 3.3 ± 1.2, and 2.0 ± 0.6, non-dipper, dipper, and white coat effect groups, respectively, all p values <0.01). All study parameters strongly correlated with each other. In conclusion, in hypertensive patients with uncontrolled office BP, presence of non-dipping BP is associated with increased platelet activity and inflammation, which can be one of the underlying plausible mechanisms of non-dipping BP status. [ABSTRACT FROM AUTHOR]

Introduction: Slow coronary flow (SCF) is a microvascular disorder characterized by delayed opacification of coronary vessels with normal coronary angiogram. It may be due to endothelial dysfunction and diffuse atherosclerosis. Lipoprotein(a) [Lp(a)] is related to cardiovascular events. Plasma Lp(a) levels have not been studied previously in SCF patients. Aim: We investigated plasma Lp(a) and fibrinogen levels, and their relation to coronary flow rate in patients with SCF. Material and methods: This cross-sectional study included 50 patients with SCF and 30 age- and sex-matched controls who had normal coronary arteries and normal flow. Coronary flow rates of patients and controls were counted with the thrombolysis in myocardial infarction (TIMI) frame count. Plasma Lp(a) and fibrinogen levels were measured in SCF patients and controls, with routine biochemical tests. Results: There were no significant differences between the two groups with respect to plasma Lp(a) (21 mg/dl vs. 14 mg/dl, p = 0.11) and fibrinogen (278 mg/dl vs. 291 mg/dl, p = 0.48) levels. The TIMI frame count was not correlated with plasma Lp(a) (r = 0.13, p = 0.25) or fibrinogen (r = -0.14, p = 0.28) levels. Conclusions: Our results show that there is no significant association between SCF and Lp(a) and fibrinogen levels. [ABSTRACT FROM AUTHOR]

The aim of this study was to assess the values of mean platelet volume (MPV) in regular smokers and the effect of smoking cessation on MPV. The study group consisted of 116 regular smokers (57 females and 59 males; mean age 46.3 ± 12.7 years) and the control group was composed of 90 healthy volunteers (49 females and 41 males; mean age 47.7 ± 8.3 years). Platelet indices were assessed in regular smokers and control participants. Platelet indices were measured at 3 months after smoking cessation in these 101 participants. The MPV values were significantly higher in smokers than those of controls (8.8 ± 0.9 vs 8.0±0.8 fL, respectively; P < .001). The MPV values decreased significantly at 3 months when compared with the baseline values (8.9 ± 1.0 vs 7.9 ± 0.7 fL, respectively; P < .001). We have found that serum MPV values were significantly higher in regular smokers than in controls. Serum MPV values decreased significantly at 3 months after smoking cessation. [ABSTRACT FROM PUBLISHER]

The objective of the present study was to determine the heart rate recovery index (HRRI), a marker of autonomic nervous system function in patients with endemic fluorosis. Forty patients with endemic fluorosis (16 men/24 women) and 40 age-, sex-, and body mass index-matched healthy controls (16 men/24 women) with normal fluoride intake were enrolled in this study. HRRI was calculated by subtracting the heart rate values at the first, second, and third minutes of the recovery phase from the peak heart rate (HRRI 1, HRRI 2, HRRI 3). Urine fluoride levels of fluorosis patients were significantly ( P < 0.001) higher than control subjects as expected. HRRI 2 was significantly lower in fluorosis patients than in the controls. The incidence of abnormal HRRI 1 was significantly higher in fluorosis patients than in the controls ( P < 0.05). We observed that HRRI, a marker of autonomic nervous system function, is impaired in patients with chronic fluorosis. [ABSTRACT FROM AUTHOR]

Aims Carvedilol and N-acetyl cysteine (NAC) have antioxidant and anti-inflammatory properties. Aim was to evaluate the efficacy of metoprolol, carvedilol, and carvedilol plus NAC on the prevention of post-operative atrial fibrillation (POAF). Methods and results Patients undergoing cardiac surgery (n = 311) were randomized to metoprolol, carvedilol, or carvedilol plus NAC. Baseline characteristics were similar. The incidence of POAF was lower in the carvedilol plus NAC group compared with the metoprolol group (P < 0.0001) or the carvedilol group (P = 0.03). There was a borderline significance for lower POAF rates in the carvedilol group compared with the metoprolol group (P = 0.06). Duration of hospitalization was lower in the carvedilol plus NAC group compared to the metoprolol group (P = 0.004). Multivariate independent predictors of POAF included left-atrial diameter, hypertension, bypass duration, pre-randomization and pre-operative heart rates, carvedilol plus NAC group vs. metoprolol group, and carvedilol plus NAC group vs. carvedilol group. Conclusion Carvedilol plus NAC decreased POAF incidence and duration of hospitalization compared with metoprolol and decreased POAF incidence compared with carvedilol. [ABSTRACT FROM PUBLISHER]

Although fluoride induced inflammatory reactions have been shown in animals and in vitro humans, there are few studies about fluoride induced inflammatory reactions in human beings at clinical setting. We aimed to measure the plasma neopterin, a marker of activation of the monocyte/macrophage system, and high sensitivity C-reactive protein (hs-CRP) levels in patients with endemic fluorosis to investigate the possible role of inflammatory processes (monocyte/macrophage activity) in the underlying pathophysiology of fluoride toxicity at clinical level. Plasma neopterin and hs-CRP levels were determined in endemic fluorosis patients and control subjects. Plasma neopterin levels were significantly higher among patients with endemic fluorosis when compared with control group (2.40 ± 0.66 vs. 1.63 ± 0.27 ng/mL respectively; p < 0.001) and plasma hs-CRP levels were also significantly higher among patients with endemic fluorosis when compared with control group (2.41 ± 1.23 vs. 1.93 ± 0.64 mg/L respectively; p < 0.001). Plasma neopterin levels were positively correlated with urine fluoride levels (r = 0.67, p < 0.001) and serum hs-CRP levels were positively correlated with urine fluoride levels (r = 0.36, p < 0.001). We have found that plasma neopterin and hs-CRP levels are increased in patients with endemic fluorosis. We have concluded that inflammation play an important role in the pathophysiology of fluoride toxicity in patients with endemic fluorosis. [ABSTRACT FROM AUTHOR]

Objectives. Slow coronary flow (SCF) is slow progression of contrast agent in the coronary arteries in the absence of stenosis in epicardial coronary vessels. Endothelial dysfunction and diffuse atherosclerosis have been proposed for the etiology of SCF. Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthesis, levels are associated with an increased risk of endothelial dysfunction and atherosclerosis. ADMA levels may be increased by homocysteine. The aim of this study was to evaluate the relationship between ADMA, nitric oxide and homocysteine in patients with SCF. Methods. The study group consisted of 50 patients with SCF. An age- and gender-matched control group was composed of 30 patients with normal coronary arteries and normal coronary flow on coronary angiography. We measured ADMA, nitric oxide and homocysteine plasma concentrations in all patients. Results. Plasma nitric oxide concentrations were significantly lower in the SCF group than in the control group (11.4 ± 6, 16.1 ± 9, p = 0.02). Plasma ADMA concentrations (0.9 ± 0.3, 0.7 ± 0.3, p = 0.01) and plasma homocysteine concentrations (12.4 ± 5, 9.8 ± 2, p = 0.03) were significantly higher in the SCF group than control group. The mean TIMI frame count (TFC) was significantly correlated with plasma ADMA (r = 0.26, p = 0.02) and homocysteine (r = 0.28, p = 0.02) concentrations, but not with nitric oxide concentrations (r = − 0.18, p = 0.13). In linear regression analysis, plasma ADMA concentrations (β = 4.6, p = 0.005) and homocysteine concentrations (β = 0.2, p = 0.03) were independently and positively associated with mean TFC. Conclusion. Our results suggest that plasma concentrations of ADMA and homocysteine are increased in SCF and also that these are independent predictors of SCF. [ABSTRACT FROM AUTHOR]

Background. Rheumatic mitral stenosis (RMS) is associated with increased thromboembolic event, especially in the presence of concomitant atrial fibrillation. In addition, increased platelet activity including elevated mean platelet volume (MPV) has been demonstrated in patients with RMS. It has also been reported that percutaneous mitral balloon valvuloplasty (PMBV) attenuates platelet activity. However, the impact of PMBV on MPV has never been studied. Accordingly, we aimed to investigate whether PMBV decreases MPV in patients with RMS. Methods. In the present study, MPV was measured in 20 patients with RMS planned for PMBV just before and 1 month after the procedure. Twenty sex- and age- matched apparently healthy controls were used for comparison. Mitral valve area (MVA), transmitral gradient (TMG) and pulmonary artery pressure (PAP) were measured using transthoracic echocardiography. Results. As compared to apparently healthy controls, patients with RMS had higher MPV (9.05 ± 1.26 vs. 7.56 ± 0.74 fl, p < 0.001). All patients with RMS underwent successful PMBV. One month after the procedure, MVA, TMG and PAP were reduced significantly ( p < 0.0001). As compared to values obtained before the procedure, white blood cell count, hemoglobin concentration and hematocrit remained unchanged. However, 1 month after the procedure platelet count had increased ( p < 0.05) and MPV decreased significantly (to 7.78 ± 0.59, p < 0.0001). PMBV induced an absolute decrease in MPV more than 0.2 fl in 19 of 20 patients (95%). Conclusions. As compared to apparently healthy controls, patients with RMS have higher MPV reflecting increased platelet activity, and PMBV is associated with a significant decrease in MPV 1 month after the procedure. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the prognostic role of mean platelet volume (MPV) in patients with coronary artery ectasia (CAE). The baseline MPV values of 258 patients with CAE were screened. The mean time of follow-up was 49 ± 21 months for major adverse cardiac events (MACEs) defined as the combination of cardiac death, nonfatal myocardial infarction (MI), rehospitalization due to cardiac disorders, and readmission due to chest pain. During follow-up period, 63 (24%) MACEs developed. There were 4 (2%) cardiovascular deaths, 0 nonfatal MI, 14 (5%) rehospitalization, and 45 (17%) readmission. Mean platelet volume values were significantly higher in patients with CAE with MACEs than in patients with CAE without MACEs (9.5 ± 1.2 fL vs 8.9 ± 1.1 fL, respectively, P = .002). The rate of MACE was higher in CAE patients with MPV of >9 fL than those with MVP of ≤9 fL (33% vs. 15%, P = .001). Mean platelet volume has a prognostic value for MACEs in patients with CAE. [ABSTRACT FROM PUBLISHER]

Attenuated coronary flow reserve (CFR) has been reported in patients with idiopathic dilated cardiomyopathy (IDC). On the other hand increased platelet activity has been demonstrated in patients with congestive heart failure and left ventricular dysfunction. Accordingly, we aimed to investigate whether mean platelet volume (MPV) is increased in patients with IDC and increased MPV correlates with the degree of coronary microvascular dysfunction. MPV was measured in 37 patients with IDC. Each patient with IDC also underwent echocardiographic examination including CFR measurement. Patients with IDC were divided into two groups based on median CFR value (lower CFR group and normal CFR group). MPV was significantly higher in the lower CFR group than in the normal CFR group (9.00 ± 0.56 vs. 8.25 ± 0.76 flfl; respectively, p == 0.001). CFR correlated significantly and inversely to MPV (r == −0.475, p == 0.003). Logistic regression analysis revealed that MPV level was the independent predictor of lower CFR (ββ == −0.750, p == 0.002). Furthermore, MPV was an accurate predictor of low CFR ( p == 0.001); Area under the curve was 82%% (95%% CI 0.67-0.96). The best cut-off value of MPV to predict low CFR was 8.3 fl with 95%% sensitivity and 69%% specificity. In conclusion, the present study showed a negative correlation between MPV and CFR in patients with IDC. [ABSTRACT FROM AUTHOR]

Previous studies have reported increased platelet activation and aggregation in patients with obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) treatment has been shown to decrease platelet activation. We aimed to study the effects of nasal CPAP therapy has on MPV values in patients with severe OSA. Thirty-one patients (21 men; mean age 53.8 ± 9.2 years) with severe OSA (AHI > 30 events/hour) constituted the study group. An age, gender and body mass index (BMI) matched control group was composed 25 subjects (14 men; mean age 49.6 ± 8.5 years) without OSA (AHI < 5 events/hour). We measured MPV values in patients with severe OSA and control subjects and we measured MPV values after 6 months of CPAP therapy in severe OS patients. The median (IQR) MPV values were significantly higher in patients with severe OSA than in control group (8.5 [8.3-9.1] vs. 8.3 [7.5-8.8] fL; p == 0.03). The platelet counts were significantly lower in patients with severe OSA than in control group (217.8 ± 45.9 vs. 265.4 ± 64.0 × 109/L; p == 0.002). The six months of CPAP therapy caused significant reductions in median (IQR) MPV values in patients with severe OSA (8.5 [8.3-9.1] to 7.9 [7.4-8.2] fL; p < 0.001). Six months of CPAP therapy caused significant increase in platelet counts when compared with baseline values (217.8 ± 45.9 to 233.7 ± 60.6 × 109/L; p < 0.001). We have found that the MPV values of patients with severe OSA were significantly higher than those of the control subjects and 6 months CPAP therapy caused significant reductions in the MPV values in patients with severe OSA. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the factors associated with the development of atrial fibrillation (AF) in patients with rheumatic mitral stenosis (MS). A total of 146 consecutive patients with rheumatic MS were screened. They were accepted to be in AF group and sinus rhythm group according to their rhythm in the baseline ECG. After screening, 38 patients were excluded due to hyperthyroidism ( n = 13), chronic obstructive pulmary disease ( n = 22), malignancy ( n = 2) and romatoid arthritis ( n = 1). Therefore, remaining 108 patients, 74 of whom in sinus rhythm (MS-SR) and 34 of whom in AF (MS-AF) constituted study population. Forty age- and gender-matched patients constituted control group. Factors associated with development of AF in multivariable analysis included High sensitivity C reactive protein ( P = 0.005; odds ratio, 3.44; 95% confidence interval, 1.44-8.22), N-terminal of brain natriuretic peptide precursor ( P < 0.0001; odds ratio, 1.03; 95% confidence interval, 1.02-1.06) and left atrial diameter ( P < 0.0001; odds ratio, 1.68; 95% confidence interval, 1.32-2.14). Present study suggests that High sensitivity C reactive protein, N-terminal of brain natriuretic peptide precursor and left atrial diameter are associated with development AF in patients with MS. [ABSTRACT FROM AUTHOR]

Arrhythmias have been reported to occur frequently in symptomatic patients with mitral valve prolapse (MVP). The mechanisms causing ventricular arrhythmias in patients with MVP have not been fully investigated. The purpose of this study was to determine the clinical, echocardiographic and heart rate variability parameters, and plasma concentrations of electrolytes and inflammatory markers in predicting ventricular arrhythmias in patients with MVP. A total of 58 consecutive patients with MVP were included in this study. We performed electrocardiography, echocardiography, holter analysis, routine biochemical tests including plasma concentrations of electrolytes and inflammatory markers, and evaluated the clinical characteristics. Ventricular arrhythmia defined as occurrence of any of the followings: ventricular premature contractions (VPCs), VPC couplets, and ventricular tachycardia documented by holter analysis, continuous monitoring or by electrocardiography. Twenty patients (34%) had ventricular arrhythmias, and 38 (66%) patients had no ventricular arrhythmias. Seventeen patients had VPC, 2 patients had VPC couplets and 1 patient had ventricular tachycardia. Univariable predictors of ventricular arrhythmias included isovolumetric relaxation time and the occurrence of moderate to severe mitral regurgitation. Multivariable logistic regression analysis showed that occurrence of moderate to severe mitral regurgitation was the only independent predictor of ventricular arrhythmias (relative risk: 8.42, 95% confidence interval: 1.49–47.64, p = 0.01). Present study showed that the only independent predictor of ventricular arrhythmias in patients with MVP is the occurrence of moderate to severe mitral regurgitation. [ABSTRACT FROM AUTHOR]

Objective: Atrial and/or appendage stunning (AS) usually occur after successful cardioversion of atrial fibrillation (AF). Several parameters except mitral annular velocity were previously evaluated to determine AS. We investigated whether mitral annular velocity was useful for determining of AS.Methods: This study consisted of 52 consecutive patients with AF <3 months who converted to the sinus rhythm. Mitral inflow and annular velocities were measured before and after cardioversion. Left atrial appendage (LAA) size and flow were assessed. The average velocity of septal and lateral segments of mitral annulus was considered as the final annular velocity. Thrombus and/or spontaneous echo contrast (SEC) were also investigated.Results: Of 52 patients, 29 (56%) had AS but 23 did not. There was no significant difference in age, gender, and cardioversion type between two groups. Hypertension was more prevalent in patients without AS compared to those with AS (P = 0.02). Mitral annular systolic and E-wave velocities were comparable in both groups (P > 0.05). Mitral annular A-wave velocity (3.1 +/- 2.9 vs. 7.1 +/- 2.2 cm/s, P < 0.001), and its velocity-time integral (0.27 +/- 0.22 vs. 0.74 +/- 0.19 cm, P < 0.001) were significantly lower in patients with AS compared with those without AS. The annular A-wave velocity < or =3.3 cm/s predicted AS with a sensitivity of 59% and specificity of 76%. It was correlated with mitral inflow A velocity (r = 0.85, P < 0.001), LAA emptying velocity (r = 0.41, P = 0.003) and presence of SEC (r = -0.52, P < 0.001).Conclusion: After cardioversion of AF, mitral annular A-wave velocity may be a new marker to determine AS. [ABSTRACT FROM AUTHOR]

Background: β-thalassemia major (β-TM) is a congenital hemolytic disorder characterized by impaired left ventricular and endothelial function. However, elastic properties of the aorta have not been sufficiently investigated in patients with β-TM. We investigated whether β-TM is related to impaired ascending aortic elastic properties. Methods: We studied 36 patients with β-TM (age: 15.8 ± 2.6 years) and 30 age- and sex-matched control subjects by echocardiography. Aortic elastic indexes, aortic strain (%), distensibility (cm2 dyn−1 10−3), and stiffness index were calculated from the echocardiographically derived thoracic aortic diameters (mm/m2), and the measurement of pulse pressure obtained by cuff sphygmomanometry. Results: Patients versus control subjects had increased aortic diameters (P < 0.001), lower mean aortic strain (9 ± 3.6 vs. 14.9 ± 3.2, P < 0.001) and distensibility (0.6 ± 0.36 vs. 0.8 ± 0.2, P < 0.012), and higher mean stiffness index (5.3 ± 2.4 vs. 2.8 ± 0.6, P < 0.001). Aortic elastic indexes were significantly associated with ferritin level, while stiffness index was significantly related to platelet count. Conclusion: Elastic properties of ascending aorta are impaired in patients with β-TM. Impaired functions of aorta may lead to deterioration of left ventricular function. [ABSTRACT FROM AUTHOR]

Backround: The aim of the present observational study is to search the incidence of postoperative atrial fibrillation (AF) in patients with or without preoperative statin treatment. Methods andResults: The population consisted of 362 consecutive patients (267 on and 95 not on statin). Diabetes mellitus was more frequent in statin group (p = 0.03). Other demographic and procedural variables were similar in the both groups (All p > 0.05). Postoperative AF was less frequent and its duration was shorter in statin group compared to non-statin group (p = 0.03 and 0.0001, respectively). The Kaplan-Meier analysis showed the protective effect of statins against the risk of developing AF (p = 0.01). Conclusion: Statin treatment before the by-pass surgery decreases the incidence and shortens the duration of postoperative AF. Copyright © 2007 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]