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Amaç: Bu çalışmada immünglobulin A vasküliti İmmünoglobulin A vasküliti (IgAV; eski adıyla Henoch Schonlein Purpurası) olan çocuklarda böbrek tutulumunun zamanını etkileyen faktörlerin ortaya konulması amaçlanmıştır. Yöntemler: Ocak 2015- Haziran 2022 arasında IgAV tanısı ile en az 1 yıl takip edilen hastaların verileri geriye dönük olarak incelendi. Hastaların demografik, klinik, laboratuar verileri ve uygulanan tedaviler kaydedildi. Bulgular: Çalışmaya 372 IgAV hastası dahil edildi, bu hastaların 81’inde IgAV böbrek tutulumu vardı. Hastaların 46’sı (%56,8) erkek, 35’i (%43,2) kızdı. Hastaların tamamında cilt tutulumu, 32’sinde (%39,5) eklem, 44’ünde (%54,3) gastrointestinal sistem (GİS), 2’sinde (%2,5) nörolojik tutulum vardı. 3 hastada tanı anında hipertansiyon vardı. Böbrek tutulumu, 45 hastada (%55,5) tanı anında, 10 hastada (%12,4) ilk 2 hafta içinde, 12 hastada (%14,8) 2-4. haftalar arasında, 14 hastada (%17,3) 1 ay-3 ay arasında saptandı. 3 aydan sonra böbrek tutulumu olmadı. Tanı anında böbrek tutulumu ile tanı yaşının büyük ve albümin düzeyinin düşük olması; 1-3 ayda böbrek tutulumu gelişmesi ile eklem ve GİS tutulumu arasında ilişki bulundu. Böbrek tutulumu olan hastalar içinde iyileşme süresi en uzun olanlar, tanı anında böbrek tutulumu saptananlar ve nefrotik düzeyde proteinüri olan hastalardı. İyileşme süresi en kısa olanlar ise, 1-3 ay arası böbrek tutulumu olan ve hematüri saptananlardı. Sonuç: Büyük yaştaki çocuklarda ve düşük albümin düzeyi olanlarda IgAV-böbrek tutulumunun gelişimi dikkatle takip edilmelidir. Özellikle ilk 3 ay böbrek tutulumunun saptanması için riskli dönemdir.

Objectives: The aim of our study was to evaluate the association between the presence and severity of CAD and NAFLD. Methods: The study group consisted of 153 patients who underwent coronary angiographies. Patients were categorized into CAD and non-CAD groups. CAD severity was determined by the number of CAD-involved arteries and the vessel score multiplied by Gensini score, the latter judging CAD severity. Fatty liver was diagnosed by abdominal ultrasonography (USG), with the patients being categorized by the degree of hepatosteatosis, as Grade 0, Grade 1, and Grade 2-3. Results: Among the whole study population, 47.1% of patients (n=72) were female and 52.9% of patients (n=81) were male. Forty-three patients had normal coronary arteries; 27 patients had non-critical CAD and side branch disease; and 83 patients had clinically significant CAD (stenosis>50%). The rate of CAD and Gensini score were significantly different between Grade 0, 1 and 2-3 hepatosteatosis groups (p

This research was performed to detect tissue fatty acid (FA) composition and conjugated linoleic acid (CLA) content in Anatolian buffaloes at different muscle types (MTs) and slaughter weights (SWs). The research was carried out on a private commercial livestock farm in Tokat. The research's animal material comprised 20 Anatolian buffalo calves with approximately 100 kg body weights, weaned at about 150 days of age. Before the experiment started, the calves were randomly divided into two slaughter groups (SW) as low weight (LW=225 kg) and high weight (HW=325 kg). Ten calves from each of the two experimental groups, which were intensively fed, were slaughtered in two different weights. After the slaughtering, FA composition and CLA content of the Semimembranosus (SM), Semitendinosus (ST), and Triceps brachii (TB) muscle tissues of the animals were examined. The study determined that palmitoleic acid (C16:1) and stearic acid (C18:0) were affected by MTs and oleic acid (C18:1) and alpha-linolenic acid (C18:3 n-3) were affected by SW (P < 0.05). The highest CLA was in the ST muscle type (0.298) and the LW group (0.289) of the SW groups (P > 0.05). With the increase of SW (in LW and HW groups), n-6/n3 (SM: 7.783 and 6.533; ST: 8.115 and 7.859; TB: 8.416 and 8.215) (P > 0.05) and PUFA ratio decreased (P < 0.05). The SW increase raised the SFA ratio in the SM muscle (P < 0.05) while lowering it in the TB muscle (P > 0.05). Again, with the increase in SW, AI and TI values increased in SM and ST muscles, while the same index values decreased in TB muscle (P> 0.05). In conclusion, when considering the PUFA/SFA ratio and the beneficial effects of CLAs on human health, ST in the MT and LW groups in SW, and thus ST and LW in MT and SW were prominent in Anatolian buffaloes.

This research was done to detect some meat quality traits and tissue fatty acid combination of the longissimus dorsi thoracis (LT) muscle of Brown Swiss bulls at the different slaughter weights (SW). The animal material of the study comprised 20 Brown Swiss bulls. In the study, Brown Swiss bulls were divided into two groups according to their SW as low (LSW (n = 10); 431–503 kg) and high (HSW (n = 10); 504–583 kg). In the study, the LSW group showed the lowest final pH value (pHF) (5.44) (P 0.05). In the research, the differences observed between the SW groups considering a* (redness) and C (chroma) values were found significant (P 0.05). Freeze–thaw loss (FL) and ether extract (PEE) were found 4.35% and 1.01% higher, respectively, in the HSW group than the LSW group (P 0.05) in the LT muscle decreased with the increase of SW. As a result, when LSW and HSW slaughter weight groups were evaluated considering the water losses causing financial losses in meat and fatty acids having beneficial effects on human health, it was seen that the LSW group came to the fore.

Aksoy, Yuksel/0000-0001-5709-937X WOS: 000456658700004 This investigation was conducted to estimate the breeding values and genetic trends for body weight (BW), scanning fat depth (SFD) and scanning muscle depth (SMD) of Karayaka lambs (n= 1059) at 140 +/- 3.36 day of age. Experiments were conducted in a nucleus flock of Karayaka sheep under a selective breeding program to increase productivity at research farm of Gaziosmanpasa University between the years 2006 - 2011. Breeding values were estimated with ASREML software. While genetic trend for BW and SMD showed a smooth ascending trend, SFD exhibited a descending trend throughout the experimental period. The genetic trend for BW, SFD and SMD of Karayaka lambs were observed as 0.433 kg / year, 0.00686 mm / year and 0.00786 mm / year, respectively. The results showed that applying of a selection program on BW, SMD and SFD characteristics would increase BW and SMD values and decrease SFD value in Karayaka lambs. Scientific and Technological Research Council of Turkey "TUBITAK"Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [104O329]; General Directorate of Agricultural Research and Policy of Turkey [60KYK2005-01] The authors wish to thank The Scientific and Technological Research Council of Turkey "TUBITAK" (Project number: 104O329) and General Directorate of Agricultural Research and Policy of Turkey (Project number: 60KYK2005-01) for their financial support for the present research.

Bu çalışmada, Türkiye’de yetiştirilen 7 yerli koyun ırkında kalpastatin (CAST) gen polimorfzmi PCR-RFLP metodu kullanılarak araştırılmıştır. CAST geninin M ve N allelleri frekansları; Kangal (n= 31), İvesi (n= 26), Güney Karaman (n= 23), Akkaraman (n= 21), Morkaraman (n= 34), Karayaka (n= 33) ve Karakaş (n= 22) koyun ırklarında sırasıyla 0.92- 0.08, 0.59-0.41, 0.67-0.33, 0.69-0.31, 0.87-0.13, 0.86-0.14, 0.89-0.11 olarak tespit edilmiştir. Ki-kare testi CAST geni bakımından Morkaraman, İvesi ve Karayaka populasyonlarının Hardy-Weinberg dengesinden önemli düzeyde (P, In this study, calpastatin (CAST) gene polimorphism was investigated in 7 native sheep breeds reared in Turkey by using PCR-RFLP method. The frequencies of M and N alleles of CAST gene in Kangal (n= 31), Awassi (n= 26), Güney Karaman (n= 23), Akkaraman (n= 21), Morkaraman (n= 34), Karayaka (n= 33), and Karakas (n= 22) sheep breeds were determined as 0.92-0.08, 0.59-0.41, 0.67-0.33, 0.69-0.31, 0.87-0.13, 0.86-0.14, 0.89-0.11 respectively. According to chi-square test, all the other populations were consistent with Hardy-Weinberg equilibrium, whereas Morkaraman, İvesi and Karayaka populations showed signifcant (P

Background: Recent clinical observations have demonstrated that the beneficial effects of statins are not limited to LDL lowering effect. They have also favourable effects on platelet activation, endothelial function, inflammation, and coagulation cascade. Aim: To investigate the effects of statins on mean platelet volume (MPV) which is a simple measure of platelet activation volume in patients who have been prescribed statins. Atorvastatin and rosuvastatin were also compared in respect to effects on MPV. Methods: One hundred and forty five patients were retrospectively included in the study from the outpatient cardiology clinic. Patients who had been given statin treatment were recruited based on the records. Baseline and 4–8 weeks biochemical analysis and haematological measurements and cardiovascular risk factors were recorded. Results: Both statins significantly decreased the MPV. MPV of patients did not show any significant correlation with lipid parameters. Linear regression analysis revealed that there were no statistically significant associations of ∆ MPV with the ∆ LDL-cholesterol (beta coefficient = 0.13; p = 0.24), ∆ DL-cholesterol (beta coefficient = 0.17; p = 0.18) or ∆ triglyceride (beta coefficient = –0.11; p = 0.21) after statin treatment. Both statins had comparable effects on lipid parameters at the end of the one month follow up period. Conclusion: Statins significantly reduce MPV irrespective of cholesterol levels, and atorvastatin and rosuvastatin have comparable effects in this regard.

The underlying mechanism by which osteoporosis and cardiovascular disease may be linked is not fully understood. However studies mainly focused on the association between bone mineral density (BMD) and cardiovascular risk factors or atherosclerosis itself by only assessing the presence of vascular calcification. In this study we aimed to evaluate both cardiovascular risk factors, and presence of coronary artery disease (CAD) in post-menopausal women patients with and without low BMD.Study population consisted of post menopausal women who were scheduled to coronary angiography. Two hundred and twenty seven consecutive female patients were included in the study and evaluated for the presence of cardiovascular risk factors and CAD. Bone mineral density was measured in all patients either the day before or the day after coronary angiography. Low BMD was defined as T score-1 and normal BMD was defined as T scoreor = -1. For statistical analysis patients were divided into two groups: patients with low BMD and patients with normal BMD.There were not statistically significant differences between two groups in respect to body mass index, presence of diabetes mellitus, hypercholesterolemia, and smoking status. Age and presence of CAD was found to be statistically different between two groups being higher in patients with low BMD. Logistic regression analysis revealed that age was positively and independently associated with low BMD in post menopausal female patients (Odds ratio=1.072 CI: 1.036-1.11, p=0.001).Age is found to be an independent predictor of decreased BMD in our study population recruited from the coronary angiography laboratory. However, neither cardiovascular risk factors, nor coronary artery disease itself has been found to be associated with low BMD.

Background: Although previous studies have documented a variety of electrocardiogram (ECG) abnormalities in obesity, P-wave alterations, which represent an increased risk for atrial arrhythmia, have not been studied very well in these patients. The aim of the present study was to evaluate P-wave duration and P dispersion (Pd) in obese subjects, and to investigate the relationship between P-wave measurements, and the clinical and echocardiographic variables. Methods: The study population consisted of 52 obese and 30 normal weight control subjects. P-wave duration and P-wave dispersion were calculated on the 12-lead ECG. As echocardiographic variables, left atrial diameter (LAD), left ventricular end-diastolic, and end-systolic diameters (LVDD and LVSD), left ventricular ejection fraction (LVEF), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular mass (LVM) of the obese and the control subjects were measured by means of transthoracic echocardiography. Results: There were statistically significant differences between obese and controls as regards to Pmax (maximum P-wave duration) and Pd (P dispersion) (P < 0.001 and P < 0.001, respectively). Pmin (minimum P wave duration) was similar in both groups. Correlation analysis showed that Pd in the obese patients was related to any the clinical and echocardiographic parameters including BMI, LAD, LVDD, IVST, LVPWT, and LVM. Conclusion: Our data suggest that obesity affects P-wave dispersion and duration, and changes in P dispersion may be closely related to the clinical and the echocardiographic parameters such as BMI, LAD, IVST, LVPWT, and LVM.

Prevalences of mitral annular calcium (MAC), osteoporosis, and coronary artery disease (CAD) increase with aging and often usually coexist. Correlates of MAC including cardiovascular risk factors and bone mineral density (BMD) have never been evaluated in men and women undergoing coronary angiography. Accordingly, we assessed the association between cardiovascular risk factors, BMD, and MAC in patients undergoing coronary angiography. The study population consisted of 484 consecutive patients (180 women, mean 60 +/- 10 years of age; 304 men, mean 60 +/- 10 years of age) who underwent coronary angiography. Complete transthoracic echocardiographic studies were performed in all patients. Diagnosis of MAC was made by M-mode and cross-sectional transthoracic echocardiography. All patients were referred to the nuclear medicine department to measure BMD (T score) using dual-energy x-ray absorptiometry. The following clinical and demographic parameters were recorded: age, gender, body mass index, hypertension, diabetes mellitus, CAD, hypercholesterolemia, and smoking status. Prevalence of MAC in our study population was 20%. There were no statistically significant differences between groups with respect to body mass index, diabetes mellitus, hypercholesterolemia, and presence of CAD (p0.05 for all comparisons). Prevalence of hypertension and mean age were significantly higher in patients with MAC than in those without MAC (hypertension 74% vs 52%, p0.001; age 68 +/- 9 vs 58 +/- 10 years, p0.001, respectively). Age and hypertension were found to be independent positive risk factors for MAC, whereas T score and age-gender adjusted T score were found to be negatively and independently associated with MAC. In conclusion, we found that MAC in patients undergoing coronary angiography is independently and positively associated with age and hypertension and negatively associated with T-score measurement of BMD.

Coronary artery ectasia has been defined as localized or diffuse nonobstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Although coronary artery disease is supposed to be responsible for more than 50% of coronary ectasia, the precise pathology of coronary artery ectasia is not clearly understood. The brachial artery ultrasound test for flow-mediated endothelial-dependent vasodilatory function includes administration of sublingual nitrates to examine the vasodilating effect of an exogenous source of nitric oxide. In the present study, we aimed to compare flow-mediated and nitrate-mediated responses of brachial artery in patients with coronary artery ectasia and patients with coronary artery disease.Thirty-six consecutive patients with coronary artery ectasia in combination with coronary artery disease and 42 age-matched and sex-matched patients with coronary artery disease alone were included in the study. Flow-mediated and nitrate-mediated dilatations were measured in all patients using a high-resolution B-mode ultrasonographic system.Baseline brachial artery diameters in patients with coronary artery ectasia were not statistically different from those in patients with coronary artery disease (4.2+/-0.6 vs. 4.0+/-0.6 mm, respectively, P=0.16). Although the forearm flow-mediated dilatation of the patients with coronary artery ectasia did not differ from that of patients with coronary artery disease alone (5.5+/-3.8 vs. 4.8+/-3.6%, respectively, P=0.41), nitrate-mediated dilatation was significantly lower than that of patients with coronary artery disease alone (7.9+/-5.2 vs. 10.9+/-5.4%, respectively, P=0.02).We have shown that patients with coronary artery ectasia have decreased nitrate-mediated response of brachial artery compared with patients with coronary artery disease alone, suggesting more severe dysfunction or, possibly, destruction of the media layer in coronary artery ectasia than in coronary artery disease.

BACKGROUND Migraine is a common neurovascular disorder characterized by attacks of severe headache, autonomic and neurological symptoms. We hypothesized that patients with migraine had abnormal endothelial function. The vascular theory of migraine assumes that the major pathophysiological events that initiate the migraine attack occur in the perivascular nerves of the major cerebral vessels. Accordingly, we aimed to measure endothelium-dependent vasodilatation in migraineurs by means of flow-mediated dilatation, which reflects endothelium-dependent vasodilatation capacity. MATERIALS AND METHODS Forty-five patients who fulfilled the diagnostic criteria for migraine and 45 age and sex-matched healthy participants were enrolled in the study. Flow-mediated dilatation of the brachial artery was determined using a high-resolution B-mode ultrasonographic system. Flow-mediated vasodilatation was expressed as the change in post-stimulus diameter as a percentage of the baseline diameter. RESULTS Mean ages of the patients were 33+/-10 years in migraineurs (range: 18-52 years, 36 female, 9 male) and 33+/-9 years in non-migraineurs (range: 17-50 years, 36 female and 9 male). Flow-mediated dilatation of patients with migraine is significantly lower than that of the controls (8.02+/-4.095% vs. 10.72+/-3.52%, respectively, P=0.001). CONCLUSION We have shown that migraineurs have decreased endothelium-dependent vasodilatation capacity compared with non-migraineurs. Migraine may be a local manifestation of systemic vascular vasomotion abnormalities.

Coronary artery ectasia is a variant of coronary atherosclerosis. Hyperhomocysteinemia has emerged as a major, independent risk factor for cardiovascular diseases. The purposes of this study were to determine plasma hyperhomocysteine levels in patients with coronary artery ectasia, and to compare patients with coronary artery ectasia, coronary artery disease, and controls with normal coronary angiogram.The study population included 37 patients with coronary artery ectasia and 36 patients with coronary artery disease. The control group consisted of 32 patients with angiographically proven normal coronary arteries. Plasma hyperhomocysteine levels were measured in all study patients with an enzyme-linked immunosorbent assay.Plasma homocysteine levels were significantly higher in patients with both coronary artery ectasia and coronary artery disease than in the controls (14.8+/-1.1 and 15.9+/-0.8 vs. 2.5+/-0.6 micromol/l; P0.001 and P0.001, respectively). No significant differences in plasma homocysteine levels were found among CAE and CAD groups (P0.05).We have demonstrated that patients with coronary artery ectasia and coronary artery disease have increased plasma hyperhomocysteine levels compared with the controls. These findings suggest that hyperhomocysteinemia may play an important role in the pathogenesis of coronary artery ectasia as in coronary artery disease.

Recent evidence suggests that the activation of platelets and their interaction with circulating cells are important independent risk factors for atherosclerosis. In non-uremic patients with symptomatic peripheral vascular disease, a relationship between serum homocysteine (Hcy) levels and platelet activity had been reported. The purposes of this study were to evaluate of effects of dialysis modality on platelet activity in patients with end-stage renal failure and to investigate the relationship between platelet activity, Hcy, and left ventricular hypertrophy (LVH).In age and sex matched 19 healthy subjects, 20 hemodialysis (HD) patients, and 18 continuous ambulatory peritoneal dialysis (CAPD) patients, the expression of platelet surface receptors CD41, CD61, CD42a, and CD62P were investigated. CD62P expression was statistically significantly increased in HD patients compared with CAPD patients and controls (34.4 +/- 22.5%; 17.3 +/- 19.6%, 12.0 +/- 15.6%, respectively, p0.05), but not in CAPD patients compared with controls. There was a positive correlation between CD62 expression and duration of dialysis in HD patients (r = 0.498, p = 0.026). Mean plasma Hcy levels in dialysis patients were higher than reference levels. However, we could not find any relationship between CD62 expression, Hcy, and LVH in both groups (p0.05).Hemodialysis and peritoneal dialysis (PD) have a different impact on the expression of CD62: peritoneal dialysis seems to have a more favorable effect. It may be possible that the differences in biocompatibility between PD and HD potentially contribute to differences in CD62 expression.

An increase of brain natriuretic peptide (BNP) levels is commonly observed in patients on dialysis. Increased circulating levels of BNP are related to future cardiac events and associated with shorter survival in patients on chronic hemodialysis (HD). During the first 1 or 2 years on dialysis, patients on peritoneal dialysis (PD) have been shown to have an improvement in left ventricular hypertrophy, blood pressure, and volume status. This study compares BNP levels and cardiac status of PD and HD patients without cardiovascular disease and on dialysis for less than 36 months. The correlation between plasma BNP concentration and findings of echocardiography before HD scans were examined and compared with findings of PD. Twenty-two HD patients (15 men, 7 women; mean age, 52.5 +/- 13.9 years) and 19 PD patients (10 men, 9 women; mean age, 47.6 +/- 11.3 years) were studied. There were no significant differences between HD and PD patients with regard to age, gender, duration of dialysis, left ventricular mass, left ventricular mass index (p0.05). Plasma BNP levels were markedly greater in HD patients (467.8 +/- 466.5 pg/ mL) than those of PD patients (143.1 +/- 165.2 pg/mL). Urine output was significantly higher in PD patients compared with HD patients (p0.05). A positive correlation between systolic blood pressure, diastolic blood pressure, and plasma BNP in HD patients (r: 0.653, p: 0.001; r: 0.493, p: 0.023, respectively) was detected. Additional studies are needed to investigate whether lower BNP level in PD patients is an advantage.

OBJECTIVE Alterations in aortic stiffness may reflect the elastic properties of the larger arteries. In many diseases, aortic elastic properties have been investigated to show whether the larger arteries are involved. The elastic properties of aorta in patients with coronary artery ectasia, however, have not been studied yet. We aimed to investigate aortic stiffness parameters in patients with coronary artery ectasia and to compare patients with coronary artery ectasia and coronary artery disease with the control group. METHOD Thirty-three patients with coronary artery ectasia, 31 patients with coronary artery disease and 30 patients with angiographically normal coronary arteries were included in this study. Aortic diameters were measured on the M-mode tracing obtained at a level 3 cm beyond the aortic valve at parasternal long-axis view. Aortic diameter change, aortic strain, aortic distensibility and stiffness parameters were measured as aortic stiffness parameters. RESULTS Aortic diameter changes were fewer in the coronary artery ectasia and coronary artery disease group than in the control group (0.4 +/- 0.1 and 0.3 +/- 0.1 vs. 0.8 +/- 0.2; P < 0.001). Aortic distensibility and aortic strain were significantly lower in patients with coronary artery ectasia and coronary artery disease than in the controls (for aortic distensibility P < 0.001 and for aortic strain P < 0.001, < 0.001, respectively). In contrast, a significantly higher aortic stiffness index was observed in patients with coronary artery ectasia and coronary artery disease than in the control group (14.2+/-2.6 and 18.1 +/- 2.9 vs. 5.9 +/- 1.8; P < 0.001, respectively). CONCLUSIONS The impairment in aortic elastic properties in patients with coronary artery ectasia indicates that this disease is a generalized disease rather than a localized disease of the coronary arteries.

In the present study, we aimed to investigate whether tissue Doppler imaging could provide more information than standard echocardiography about left and right ventricular functions and their relations to homocysteine and C-reactive protein (CRP) levels in the course of Behcet's disease (BD). In the right ventricle, patients with BD had lower early diastolic tricuspid annular velocity and early diastolic/late diastolic tricuspid annular velocity ratios than the control group. Mitral and tricuspid annular systolic velocities did not significantly differ; however, diastolic velocities were correlated with duration of the disease. In addition, early/late diastolic mitral annular velocity ratio and early/late diastolic tricuspid annular velocity ratios showed an inverse relation with ocular involvement, serum homocysteine, and CRP levels in patients with BD.

Coronary blood flow was quantified using the thrombosis in myocardial infarction (TIMI) frame-count method. This measurement has been significantly correlated with flow velocity measured invasively by use of a Doppler flow wire. Coronary artery ectasia or aneurysm (CEA) is thought to be present in patients with a slow blood flow. In this study, we aimed to assess the relationship between the ectasia size or ectasia ratio and TIMI frame count in patients with CEA. The study population included 58 patients with isolated CEA of the right coronary artery. In patients with CEA, an ectasia ratio was calculated as diameter of the ectatic segment/diameter of the adjacent normal segment. According to the ectasia ratio, ectatic vessels were divided into two groups: ectasias with a 1.5- to 2.0-fold increase (group A) and more than 2.0-fold increase (group B) in normal vessel diameter. Patients with a significant stenotic lesion (>50%) in the ectatic vessel were excluded. The control group was formed from a matched population of 35 patients with angiographically proven normal coronary arteries. Characteristics of the ectasia and control groups are similar. The TIMI frame counts for the right coronary artery (RCA) were significantly higher in the ectasia group as compared with the control group (43 ± 12 vs 23 ± 8, P < 0.001). The ectasia group had 38 patients in group A and 20 patients in group B. The TIMI frame counts were significantly higher in group B than in group A (43 ± 10 vs 51 ± 15, P < 0.05). The TIMI frame count of the RCA showed a significant correlation with the ectasia ratio and the maximum diameter of the ectatic segment (r = 0.578, P < 0.001 and r = 0.435, P < 0.001, respectively). Our data suggest that TIMI frame count measurement depends on the ectasia size or ectasia ratio, and an increased ectasia ratio is markedly associated with decreased TIMI frame counts in patients with CEA.

Background Coronary artery ectasia (CAE) is defined as localized or diffuse non-obstructive lesions of the epicardial coronary arteries with a luminal dilation exceeding the 1.5-fold of normal adjacent segment or vessel diameter. Varicocele is the dilatation of the pampiniform plexus. Recently increased prevalence of peripheral varicose veins has been shown in patients with CAE. In this study we aimed to assess the prevalence of varicocele, which is dilatation of another venous system, in patients with CAE. Materials and methods Thirty-five male consecutive patients with coronary artery ectasia in combination with or without coronary artery disease (CAD) and 63 male, age-matched patients with coronary artery disease were included in the study. All patients were evaluated for the presence of varicocele. Results Twenty-one patients with CAE were found to have varicocele (62% of group I patients). In patients with CAD, 24 patients (38%) were found to have varicocele. The difference between the two groups in respect to presence of varicocele was statistically significant (P=0.02; odds ratio=1.57; 95% confidence interval 1.05- 2.3). Conclusion We have shown that patients with coronary artery ectasia have an increased prevalence of varicocele compared to those with coronary artery disease. The mechanism underlying coronary artery ectasia might further increase the prevalence of varicocele in susceptible patients.

Objectives : The potential role of common infectious agents in the pathogenesis and progression of atherosclerosis has been studied increasingly over the last decade. The evidence for Chlamydia pneumoniae as a potential causative agent is strong and is based on the findings of numerous sero-epidemiological studies, examination of atheromatous plaque specimens, in vitro animal models. We performed a prospective study in percutaneous transluminal coronary angioplasty (PTCA) patients to investigate whether the angioplasty procedure influenced the specific humoral immune response reaction against C. pneumoniae antigens. Methods : We studied 76 patients who successfully underwent PTCA for de novo lesions. Blood samples were drawn immediately before PTCA and 1 month after PTCA. IgG and IgA antibodies against C. pneumoniae (strain CDC/CWL-029) were determined by an in-house developed enzyme immunoassay. Results : At the time of angioplasty 75% and 34% of the patients had seropositive antibodies to elementary bodies (EBs) of classes IgG and IgA, respectively. Mean titers of IgG antibodies before and 1 month after PTCA were 46±31 and 50±28 relative units (RU/ml) ( P >0.05). One month after PTCA, 97% and 34% of the patients had seropositive antibodies to EBs of classes IgG and IgA, respectively. We divided our patients into two groups on the basis of IgG seropositivity (group I: Chlamydia antibody IgG seronegative patients, group II: Chlamydia antibody IgG seropositive) before PTCA. Significant increase in the antibody titers of IgG (12±5 vs. 40±18, P P =0.007) was observed in group I patients 1 month after PTCA and 88% of them gained IgG seropositivity. There were no significant changes in IgG and IgA antibody levels in group II after PTCA. Conclusion : We have demonstrated a statistically significant rise in C. pneumoniae antibodies (especially IgG) induced by PTCA in patients previously seronegative.

Background: Although previous studies have documented a variety of electrocardiogram (ECG) abnormalities in obesity, P‐wave alterations, which represent an increased risk for atrial arrhythmia, have not been studied very well in these patients. The aim of the present study was to evaluate P‐wave duration and P dispersion (Pd) in obese subjects, and to investigate the relationship between P‐wave measurements, and the clinical and echocardiographic variables. Methods: The study population consisted of 52 obese and 30 normal weight control subjects. P‐wave duration and P‐wave dispersion were calculated on the 12‐lead ECG. As echocardiographic variables, left atrial diameter (LAD), left ventricular end‐diastolic, and end‐systolic diameters (LVDD and LVSD), left ventricular ejection fraction (LVEF), interventricular septum thickness (IVST), left ventricular posterior wall thickness (LVPWT), and left ventricular mass (LVM) of the obese and the control subjects were measured by means of transthoracic echocardiography. Results: There were statistically significant differences between obese and controls as regards to Pmax (maximum P‐wave duration) and Pd (P dispersion) (P < 0.001 and P < 0.001, respectively). Pmin (minimum P wave duration) was similar in both groups. Correlation analysis showed that Pd in the obese patients was related to any the clinical and echocardiographic parameters including BMI, LAD, LVDD, IVST, LVPWT, and LVM. Conclusion: Our data suggest that obesity affects P‐wave dispersion and duration, and changes in P dispersion may be closely related to the clinical and the echocardiographic parameters such as BMI, LAD, IVST, LVPWT, and LVM.

Clinical hypothyroidism (HT) is often associated with cardiovascular disorders, such as endothelial and myocardial dysfunction. Previous studies have explored left ventricular (LV) function using pulsed-wave tissue Doppler echocardiography (TDE) in HT. However, no study has utilized this technique in the assessment of right ventricular (RV) function in HT. Accordingly, we investigated the effects of clinical HT on LV and RV function by TDE. The study subjects included 35 newly diagnosed HT patients and 32 healthy normal controls. For each subject, serum FT3, FT4, TT3, TT4, and thyroid stimulating hormone (TSH) levels were measured, and standard echocardiography and TDE were performed. No statistically significant difference was found between patients and controls with regard to age, gender, body mass index, heart rate, and blood pressure. Compared to controls, TSH levels were significantly higher, and TT4 and FT4 levels were significantly lower. TDE showed that patients had significantly lower early diastolic tricuspid annular velocity (Ea) and early/late (Ea/Aa) diastolic tricuspid annular velocity ratio (P < 0.001 and P < 0.001, respectively), and significantly longer isovolumetric relaxation time (P < 0.001) than those of the controls. Aa, Sa, isovolumetric contraction time, and ejection time did not significantly differ. In addition, a significant relationship between some TDE indexes, and thyroid hormones (TT4 and FT4) and TSH was observed. We showed that patients with clinical HT are associated with impaired RV diastolic function, in addition to impaired LV diastolic function using TDE.

It has been previously proposed that electrocardiographic abnormalities may be associated with acute pancreatitis. However, there is a lack of data on the QT interval and dispersion value in patients with acute pancreatitis, and no data are also available concerning QT interval and QT dispersion in acute biliary pancreatitis (ABP).: We aimed to investigate the QT parameters in patients with ABP, to compare them with those of healthy controls, and to analyze the relationship between QT parameters and Ranson score.The present study included 32 patients with acute biliary pancreatitis and 35 healthy controls. The severity of the pancreatitis was determined by Atlanta criteria: fewer than 3 Ranson criteria or fewer than 8 APACHE II (the Acute Physiology and Chronic Health Evaluation) points indicated the mild disease (group 1); 3 or more Ranson criteria or 8 or more APACHE II points or organ failure or systemic complications or local complications indicated the severe disease (group 2). On admission, all patients underwent a standard 12-lead electrocardiogram, and corrected maximum QTc interval (QTcmax), corrected minimum QT interval (QTcmin), and corrected QTc dispersion (QTcd) values of the subjects were measured according to the Bazett formula in this study.QTcmax and QTcd were significantly longer in patients with ABP than in healthy controls (442 +/- 38 milliseconds versus 413 +/- 34 milliseconds, P0.05; and 67 +/- 21 milliseconds versus 42 +/- 18 milliseconds, P0.001, respectively). Similarly, QTcmax and QTcd were significantly longer in group 2 than in group 1 (440 +/- 38 milliseconds versus 450 +/- 34 milliseconds, P0.01; and 66 +/- 9 milliseconds versus 71 +/- 11 milliseconds, P0.01, respectively). Correlation analysis showed that there is a significant positive relationship between Ranson scores of patients and QTcmax and QTcd (P0.01 and P0.001, respectively).The effect of acute biliary pancreatitis on QT intervals and dispersion appears to be dependent not only on the disease but also on its severity, and these parameters may give additional prognostic information in ABP patients, even in the initial evaluation.

Plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM)-1, vascular cell adhesion molecule-1 (VCAM-1) and E-selectin leves of patients with isolated coronary artery ectasia (CAE), patients with obstructive coronary artery disease without CAE and subjects with angiographically normal coronary arteries were evaluated. Patients with isolated CAE were detected to have significantly higher levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive coronary artery disease without CAE (ICAM, 673 +/- 153 versus 381 +/- 106, respectively, P0.001; VCAM-1, 2366 +/- 925 versus 1136 +/- 208, respectively, P0.001; E-selectin, 74 +/- 21 versus 61 +/- 18, respectively, P = 0.01) and subjects with normal coronary arteries (ICAM-1, 673 +/- 153 versus 303 +/- 131, respectively, P0.001; VCAM-1, 2366 +/- 925 versus 729 +/- 231, respectively, P0.001; E-selectin, 74 +/- 21 versus 49 +/- 9, respectively, P0.001), suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in patients with isolated CAE.The common coexistence of coronary artery ectasia (CAE) with coronary artery disease (CAD) suggests that it may be a variant of CAD. However, it is not clear why some patients with obstructive CAD develop CAE whereas most do not. Inflammation has been reported to be a major contributing factor to both obstructive and aneurysmatic vascular disorders and therefore, in the present study, the plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin levels in isolated CAE were investigated.The study population consisted of three groups: the first consisted of 32 patients with isolated CAE without stenotic lesion; the second of 32 patients with obstructive CAD without CAE; and the third group of 30 control subjects with normal coronary arteries. Coronary diameters were measured as the maximum diameter of the ectasic segment by use of a computerized quantitative coronary angiography analysis system. According to the angiographic definition used in the Coronary Artery Surgery Study, a vessel is considered to be ectasic when its diameter isor =1.5 times that of the adjacent normal segment in segmental ectasia. Plasma soluble ICAM-1, VCAM-1 and E-selectin levels were measured in all patients and control subjects using commercially available enzyme-linked immunosorbent assay kits.Patients with isolated CAE were found to have significantly higher levels of plasma soluble ICAM-1, VCAM-1, and E-selectin in comparison with patients with obstructive CAD without CAE (ICAM, 673 +/- 153 versus 381 +/- 106, respectively; P0.001; VCAM-1, 2366 +/- 925 versus 1136 +/- 208, respectively; P0.001; E-selectin, 74 +/- 21 versus 61+/-18, respectively; P = 0.01) and control subjects with normal coronary arteries (ICAM-1, 673 +/- 153 versus 303 +/- 131, respectively;, P0.001; VCAM-1, 2366 +/- 925 versus 729 +/- 231, respectively; P0.001; E-selectin, 74 +/- 21 versus 49 +/- 9, respectively; P0.001). In addition, we detected statistically significant positive correlation between the total length of ectasic segments and the levels of plasma soluble ICAM-1 (r = 0.625; P0.001), VCAM-1 (r = 0.548; P = 0.001) and E-selectin (r = 0.390; P = 0.027). Multivariate logistic regression analysis revealed a significant independent relation between isolated CAE and ICAM-1 [odds ratio (OR) = 1.023; 95% confidence interval (CI) = 1.0048-1.0414; P = 0.0129] and VCAM-1 (OR = 1.0057; 95% CI = 1.0007-1.0106; P = 0.0240).We have shown that patients with isolated CAE have raised levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive CAD without CAE and control subjects with normal coronary arteries, suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in these patients.

In the present study we examined retrospectively the coronary anatomy pathology of 78 consecutive patients with coronary artery disease (CAD) who underwent permanent pacemaker implantation in order to find a common pathological anatomic basis for conduction disturbances and to compare them with a group of matched patients with angiographically proven CAD.Study group consists of seventy-eight patients with angiographically documented CAD and permanent pacemaker implantation. Control group included comparable patients with CAD and without a pacemaker implantation. Coronary angiography was performed using standard Judkins approach in all patients within 2 months before pacemaker implantation. The locations of narrowings in the left anterior descending (LAD) and right (RCA) coronary arteries, as the arteries supplying the conduction system, were documented accurately and further classified as follows. Type I: Anatomy not compromising blood supply to the conduction system, namely, either the absence of significant narrowing in the LAD, RCA, left circumflex, posterolateral, or posterior descending arteries or the presence of mid-distal LAD lesions beyond the septal branches. Type II: Pathological coronary anatomy involving septal branches emerging from the LAD (and without significant lesions in the RCA). Type III: Pathological coronary anatomy compromising blood supply to the sinoatrial (SAN) or atrioventricular (AVN) nodes but not compromising blood flow to the septal branches. This subset included patients with distal LAD lesions after the septal branches. Type IV: Combination of types II and III pathological coronary anatomy that compromises blood supply both to the septal branches and SAN and AVN arteries.Occurrence of the type IV coronary anatomy (45%) was significantly higher than type I (19%), type II(24%) and type III (11%) in the study group (p0.02). Statistically significant differences were found between the two groups (p0.05): more patients in the study group had type II (24%) and IV(45%) coronary anatomy (p0.02) while type I (35%) and III (37%) anatomy were more frequently observed in control group (p0.05). Analysis of flow quality of septal perforators, SAN and AVN arteries, in the study group demonstrated a significant tendency for reduced blood flow in the conduction system.Presence of first perforator lesions with poor quality of flow and right coronary artery lesions shown angiographically should be considered as the risk factors requiring permanent pacemaker implantation in patients with coronary artery disease.

Recently, Raddino et al. [1] have reported a 19-year-old woman with acute anterior myocardial infarction (MI) giving a history of cocaine abuse with last exposure 4 days before symptom onset. Her coronary angiographic evaluation has revealed the thrombotic occlusion of anterior descending coronary artery without atherosclerotic plaques, and complete recanalization of the vessel after anticoagulation with enoxaparine. She has been normotensive, nondiabetic, non-smoker, with normal lipid profile and normal body mass index, without familial history of coronary artery disease. Laboratory analysis has shown the presence of antiphospholipid antibodies. Raddino at al. [1] have suggested that cocaine-induced endothelial activation and synergic prothrombotic activity of cocaine and antiphospholipid antibodies may be the possible factors in the development of acute MI in this patient. Cocaine has been shown to be associated with myocardial ischemia and MI independently of the administration route, the amount ingested and the frequency of use [2,3]. Most patients with cocaine-related acute MI are young and male and have a low coronary risk factor profile for atherosclerosis and have previously normal epicardial coronary arteries [3,4]. The pathogenesis of cocaine-related MI has been reported to be multifactorial including increased myocardial oxygen demand, marked vasoconstriction of the coronary arteries, enhanced platelet aggregation and thrombus formation and accelerated atherosclerosis [2–5]. Cocaine-related acute MI due to

It has been reported that deep breathing at 6 breaths/min is associated with reduction of premature ventricular complexes. The beneficial effect of deep breathing is supposed to be due to vagal modulation of sinoatrial and atrioventricular node. Beside the modulating effects of deep breathing, we believe that deep breathing, which is also used in yoga training, might have additional effects via decreasing QT dispersion.

In their recently published original article, Frick et al. [1] have reported for the first time that patients with metabolic syndrome develop transient impairment of flow-mediated dilatation (endothelium-dependent vasodilatation) at moderate altitude (1700 m) using high resolution ultrasonographic examination of the brachial artery. The findings of this study are interesting and clinically significant when considering the high risk of atherosclerotic and atherothrombotic cardiovascular disease and its poor morbidity and mortality in patients with metabolic syndrome. A few previous studies have also investigated the impact of high altitude on coronary circulation in various clinical situations. Recently, Berger et al. [2] have shown that hypoxia markedly impairs vascular endothelial function in the systemic circulation in subjects who are susceptible to high altitude pulmonary edema. Besides, Wyss et al. [3] have evaluated the impact of high altitude on coronary flow reserve in patients with coronary artery disease. Patients with coronary artery disease have been shown to have impaired coronary flow reserve in response to high altitude, suggesting the development of microvascular vasoconstriction or impaired microvascular vasodilator response. Metabolic syndrome is characterized with the constellation of atherosclerotic and atherothrombotic risk factors [4,5]. The combination of various coronary risk factors comprising the metabolic syndrome interacts synergistically causing or accelerating the progression of atherosclerosis [6,7]. Endothelial dysfunction, an earliest stage of atherosclerotic process, is a well defined consequence of metabolic

Recently, we read the paper of Yamashita et al. [1] with a great interest. In their study, they evaluated the effects of experimental hyperhomocysteinemia (oral methionine load) on coronary flow velocity reserve (CFR) in healthy individuals and the impact of addition of oral vitamin C to oral methionine load. They have measured CFR before and 4 h after administration of placebo, oral methionine and oral methionine+vitamin C. Experimentally induced hyperhomocysteinemia by oral methionine load has been reported to be associated with impaired CFR and this impairment has been shown to be reversed with vitamin C administration. Previously, Tawakol et al. [2] have investigated the effect of acute hyperhomocysteinemia on coronary microvascular dilator function and detected an impaired microvascular dilator function in subjects with acute hyperhomocysteinemia as a result of decreased nitric oxide bioavailability. In addition Coppola et al. [3] have shown that acute hyperhomocysteinaemia reduces CFR and pretreatment with antioxidant vitamin E and ascorbic acid has been detected to prevent the effects of hyperhomocysteinaemia, suggesting an oxidative mechanism. Besides, Ascione et al. [4] have also found a significant association between acute hyperhomocysteinemia and reduced CFR. All these studies have reported a significant negative correlation between postload homocysteine levels and CFR. CFR represents the regulatory ability of coronary microcirculation to increase its blood flow during hyperemic

Neurohormones have drawn particular attention in the recent years possiblyduetotheirpotentialdiagnosticandprognosticvalues inavarietyof clinical conditions includingcongestiveheart failure(CHF), acutemyocardial infarction (AMI), etc. Among neurohormones, arginine vasopressin (AVP) has been known to be secreted by hypothalamus in response to hypovolemia and increased plasma osmolality [1], and was also demonstrated to be a marker of the presence and severity of CHF [2]. However as described below, the potential association between AVP system and arrhythmogenesis may also confer some important therapeutic and prognostic implications in arrhthmia-prone patients. In the recent years, due to the instability and rapid clerance [1], the clinical utility of AVP has beengraduallyabandonedtosomedegree, andcopeptin(CP), anothernovel neurohormone of the AVP system, has come into use in the clinical practice. CP, the C-terminal portion of provasopressin [1], is co-released with AVP from hypothalamus. CP is structurally more stable, and hence may mirror the stable levels of AVP associated with the severity of the related disease [1]. CP was recently demonstrated to be a strong predictor of mortality and morbidity in patients suffering heart failure after an AMI [1]. In another study [3], CP was found to be associated with left ventricular dysfunction (inverse correlation between copeptin levels and left ventricular ejection fraction (LVEF)) in the early (at discharge) and late stages (on follow-up) of AMI indicating that hyperactivation of the AVPsystemseems tobea contributor (via inducing remodelling) and/or a consequence in the process of heart failure development. However, as an absolute clinical implication inCHF, substantial levels of CPmay indirectly denotepoor systemicperfusionassociatedwithdepressed left ventricular systolic function (a notion consistent with a previous study that demonstrated a negative correlation between AVP and cardiac index [2]). CHF is a well known trigger for malign ventricular arrhythmias through various mechanisms including structural alterations of myocardium, increased myocardial wall tension, adrenergic activation, enhanced effects of the AVP system on the heart, etc. AVP (co-secreted with CP) was suggested to induce protein synthesis, cardiac hypertrophy [4] and collagen synthesis in cardiac fibroblasts [5] in rats that may not only induce myocardial remodelling but may also create an arrhythmogenic substrate for malign ventricular arrhythmias indicating direct arrhythmogenic effects of AVP on myocardium in patients with CHF. It may be suggested that the association between CP levels and arrhythmogenesis may be dependent on left ventricular function, to some extent. However, this association may still persist even after adjustment for parameters of left ventricular function (LVEF, etc.) suggesting CP as an arrhythmogenic marker in arrhythmia-prone patients without heart failure as well. In the absence of heart failure, CP may still remain associated with arrhythmogenesis through various potentialmechanisms: CPwas found to be associatedwith the individual stress level [6]. In a very recently published study, CP was reported to have an additional diagnostic value in AMI (for rapid rule out) as an endogenous stress marker [7]. Hyperactivation of the adrenergic system is generally suggested to trigger malign ventricular arrhythmias and sudden cardiac death (SCD) in arrhythmia-prone subjects [8], and iswell known to be associated with the endogenous stress level. Therefore, CP may be regarded as a promising biochemical marker of arrhythmogenesis in arrhytmia-prone patients with and without heart failure. It may be suggested that besides conventional indices of arrhythmogenesis (QT dispersion, T wave alternance (TWA), heart rate variability (HRV), etc.), clinicians are in need of novel biochemicalmarkers thatmay rapidly and reliably predict the risk for arrhythmogenesis and arrhythmic mortality in arrhythmia-prone patients. CP, the novel and promising marker with strong predictive values, may help predict arrhythmia risk, and may help determine the therapeutic strategy in these patients. However, future large scale studies particularly focusing on the link between arrhythmogenesis and CP in arrhythmia-prone subjects are still warranted to confirm the clinical utility of CP in these patients. The authors of this manuscript have certified that they comply with the Principles of Ethical Publishing in the International Journal of Cardiology [9].