Search

OBJECTIVE Dynamic thiol-disulphide homeostasis is an indicator of the antioxidant system that interacts early with the oxidative environment. This study aimed to assess the dynamic thiol/disulphide balance in individuals with white-coat hypertension (WCH). METHODS This cross-sectional study included a total of 117 individuals who presented to our outpatient cardiology clinic. Seventy patients were diagnosed with WCH. All blood samples were obtained from the patients after a minimum of 8 h of fasting, centrifuged immediately, stored in Eppendorf tubes, and protected at -80°C. RESULTS The two groups were well-balanced in terms of age, gender, and BMI. Native thiol and total thiol levels were lower in the WCH group than in normotensive individuals. However, disulphide levels were higher in the former. Serum disulphide concentration positively correlated with 24-h SBP, and 24-h DBP. In backward stepwise logistic regression analysis, serum disulphide [odds ratio (OR) = 1.165 (1.089-1.245), 95% confidence interval (CI), P

Introduction and objectives: D-dimers are a determinant of hypercoagulable state and have been found to be related to acute coronary syndromes. We aimed to establish the association between increased D-dimer levels and coronary artery disease (CAD) severity using SYNTAX Score (SS) II in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Methods: This retrospective study included 300 consecutive patients (81.7% males, mean age 55±12 years) with STEMI who underwent a primary PCI. Patients were divided into two groups according to their median SSII [SSII

A high morning surge in systolic blood pressure poses a risk in people who have cardiovascular disease. We investigated the relationship between this phenomenon and the SYNTAX score I in patients who had stable coronary artery disease. Our single-center study included 125 consecutive patients (109 men and 16 women; mean age, 54.3 ± 9 yr) in whom coronary angiography revealed stable coronary artery disease. We calculated each patient's sleep-trough morning surge in systolic blood pressure, then calculated the SYNTAX score I. The morning surge was significantly higher in patients whose score was >22 (mean, 22.7 ± 13.2) than in those whose score was ≤22 (mean, 12.4 ± 7.5) (P To our knowledge, this is the first study to show an association between morning surge in systolic blood pressure and the SYNTAX score I in patients who have stable coronary artery disease.

Background: We aimed to investigate the association between morning surge (MS) of blood pressure (BP) and SYNTAX score (SS) which gives information regarding the complexity and extent of coronary a...

Objective: The expression of galectin-3 has been found to be increased in human atherosclerotic lesions, suggesting a role in atherogenesis. However, there is a lack of data regarding an association between galectin-3 and the extent, severity, and complexity of coronary artery disease (CAD). The aim of this study was to investigate the relationship between galectin-3 and SYNTAX Score I in patients with non-ST-segment elevation myocardial infarction (NSTEMI). Methods: This study included a total of 95 consecutive patients who were diagnosed with NSTEMI and underwent coronary angiography. The baseline galectin-3 level of each patient was measured. The SYNTAX Score I of each patient was calculated using the online calculator (www.syntaxscore.com). The study population was divided into 2 groups: SYNTAX Score I ≤22 group (n=55) and SYNTAX Score I >22 group (n=40). Results: The galectin-3 level was significantly higher in the SYNTAX Score I >22 group than in the SYNTAX Score I ≤22 group (22.1+-8.3 ng/mL vs. 13.5+-7.7 ng/mL; p

OBJECTIVE The renal resistive index (RRI) is the most described measure of renal hemodynamics. The myocardial performance index (MPI) is widely used to assess overall myocardial performance. In this study, we aimed to investigate the relationship between renal hemodynamics, assessed by the RRI, and cardiac functions, assessed by the MPI in the general population. METHODS This single-center, cross-sectional study included a total of 302 consecutive patients who presented to our outpatient cardiology clinic between October 2019 and February 2020. All patients underwent transthoracic echocardiography and renal Doppler ultrasonography. The study population was divided into two groups: low RRI group (RRI ≤ 0.7, n = 236) and high RRI group (RRI > 0.7, n = 66). RESULTS E/A ratio, left ventricular ejection fraction (LVEF), and the MPI were significantly higher in the high RRI group than in the low RRI group (61.3 ± 15.4 vs 55.3 ± 16.4, P = .010 for E velocity; 0.9 ± 0.3 vs 0.7 ± 0.2, P = .008 for E/A ratio; 57.7 ± 4.7 vs 53.2 ± 10.1, P = .029 for LVEF; 0.52 ± 0.1 vs 0.43 ± 0.1, P

Objective: Epicardial adipose tissue (EAT) secretes various pro-inflammatory and atherogenic substances that have several effects on the heart. The goal of this study was to evaluate the association between EAT thickness and both P-wave dispersion (Pd) and corrected QT interval (QTc), as simple, non-invasive indicators of arrhythmia on a surface electrocardiogram. Methods: This retrospective observational study included 216 patients who had normal coronary arteries observed on coronary angiography. Each patient underwent 12-derivation electrocardiography to measure Pd and QTc, and transthoracic echocardiography to measure EAT thickness. The patients were divided into 2 groups according to the median EAT value (EAT low group

Objective: Coronavirus disease 2019 (COVID-19) is an infectious disease that was first reported in December 2019 in Wuhan, China, and has since spread rapidly around the world, resulting in the ongoing COVID-19 pandemic. The CHA2DS2-VASc score is a well‐validated risk stratification tool for predicting stroke in atrial fibrillation (AFib), as well as morbidity and mortality in several entities. The aim of this study was to evaluate the relationship between the CHA2DS2-VASc score and in-hospital mortality in patients with COVID-19, regardless of AFib. Methods: This multicenter, retrospective study included a total of 349 patients with COVID-19 who were hospitalized between March 15 and April 15, 2020. The CHA2DS2-VASc score of each patient was calculated. Mortality outcomes were followed up until April 25, 2020. Results: The CHA2DS2-VASc score was significantly higher in non-survivor COVID-19 patients than in survivor COVID-19 patients (p

Aim Current literature lacks a definitive threshold of idiopathic premature ventricular complex (PVC) burden for predicting cardiomyopathy (CMP). The main objective of the present study was to evaluate relationship between the PVC burden and left ventricular ejection fraction (LVEF). Method This multicenter, cross‐sectional study included 341 consecutive patients with more than 1,000 idiopathic PVC in 24 hr of Holter monitoring admitted to the cardiology clinics between January 2019 and May 2019 in the nineteen different centers. The primary outcome was the LVEF measured during the echocardiographic examination. Result Overall, the median age was 50 (38–60) and 139 (49.4%) were female. Percentage of median PVC burden was 9% (IQR: 4%–17.4%). Median LVEF was found 60% (55–65). We used proportional odds logistic regression method to examine the relationship between continuous LVEF and candidate predictors. Increase in PVC burden (%) (regression coefficient (RE) −0.644 and 95% CI −1.063, –0.225, p

Objective: Epicardial fat thickness (EFth) is associated with both left ventricular hypertrophy (LVH) and diastolic dysfunction. However, the effect of EFth on myocardial performance is not known. The aim of this study was to investigate the relationship between EFth and tissue Doppler myocardial performance index (TD-MPI), which incorporates both systolic and diastolic left ventricular (LV) function, in newly diagnosed hypertension (HT) patients. Methods: A total of 314 consecutive, newly diagnosed HT patients were prospectively included (mean age: 51.9+-1.7 years). EFth was measured perpendicularly on the free wall of the right ventricle at the end of the systole in 2 echocardiographic views (parasternal short and long axis). Myocardial performance index (MPI) was calculated using tissue Doppler (TD) echocardiography. Patients were divided into 2 groups according to median TD-MPI levels (TD-MPIlow and TD-MPIhigh). Results: EFth values of the TD-MPIhigh group were higher than those of the TD-MPIlow group (p

OBJECTIVE Vitamin D deficiency is an independent risk factor for cardiovascular mortality. The relationship between vitamin D level and left ventricle (LV) myocardial performance index (MPI=Tei index), which incorporates both LV systolic function and diastolic function, was not investigated in previous studies. We hypothesized that vitamin D level may be associated with LV function and geometry. We aimed to investigate the association between serum 25-hydroxyvitamin D (25 [OH] D) levels and MPI and LV hypertrophy in hypertensive patients with newly diagnosed and preserved ejection fraction. METHODS We studied 151 sequential newly diagnosed hypertensive subjects who lived in the Cukurova region without known cardiovascular risk factors or overt heart disease (mean age: 62.8±10.4 years). Serum 25 (OH) D was measured using a direct competitive chemiluminescent immunoassay. The patients were divided into two groups according to serum 25 (OH) D level: vitamin D-non-deficient group (vitamin D≥ 20.00 ng/mL, n=53) and vitamin D-deficient group (vitamin D< 20.00 ng/mL, n=98). MPI was defined as the sum of isovolumic contraction and relaxation times divided by the ejection time. LV mass index (LVMI) was calculated by using the Devereux formula and body surface area. RESULTS MPI and LVMI values were lower and low-density lipoprotein (LDL) levels were higher in patients who were vitamin D-non-deficient than patients who were vitamin D-deficient (p

Objective The aim of this study was to investigate whether low thiol levels are associated with peri-procedural factors during primary percutaneous coronary intervention (pPCI) upon admission with ST-segment elevation myocardial infarction (STEMI), and the prognostic value at 6-month follow-up. Methods A total of 241 consecutive acute STEMI patients who underwent pPCI and a control group of 67 individuals with a normal coronary angiography were enrolled in the study. Results While age, contrast-induced nephropathy, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), stent length, and creatinine were related to native thiol, NT-proBNP, contrast-induced nephropathy, and creatinine were related to total thiol. NT-proBNP was also related to the disulphide level. The left ventricular ejection fraction (LVEF) and the levels of native thiol, total thiol, low-density lipoprotein, and serum albumin were found to be independent predictors of major adverse cardiovascular events (MACEs) during 6 months of follow-up. Conclusion Initial lower native thiol, total thiol, LVEF, LDL, and serum albumin may be used to identify patients with an increased long-term risk of unfavorable cardiac events in case of STEMI.

Objective: The aim of this study was to evaluate the potential relationship between 25-hydroxyvitamin D3 (25[OH]D3), the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score, and spontaneous reperfusion (SR) in patients with ST-elevation myocardial infarction (STEMI). Methods: A total of 148 consecutive patients with acute STEMI who underwent primary percutaneous coronary intervention were retrospectively enrolled in the study. Results: In all, 36 patients with a TIMI 3 flow score (spontaneous reperfusion [SR]) before coronary intervention constituted Group 1, and 112 patients with a TIMI flow score of 0-2 served as Group 2. The SYNTAX score and the in-hospital major adverse cardiovascular event (MACE) rate were significantly higher in Group 2 (p

OBJECTIVES Epicardial adipose tissue is related to coronary atherosclerosis, left ventricle hypertrophy, myocardial dysfunction, cardiomyopathy, and inflammation, which produces a variety of cytokines that influence key pathogenic mechanisms of atherogenesis. The main goal of this study is to examine the relationship between epicardial fat thickness (EFT) and cardiovascular risk markers as well as the complexity of coronary artery disease (CAD) in patients with stable CAD. MATERIALS AND METHODS We prospectively included 439 stable CAD patients undergoing coronary angiography in the present study (mean age: 62.2±10.7 years). Patients were divided into two groups (EFTlow and EFThigh groups) according to their median EFT values. EFT was evaluated by two-dimensional echocardiography before angiography. The SYNTAX score was calculated in all patients. N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP), high-sensitive cardiac troponin T (hs-cTnT), uric acid, and other biochemical markers were also measured. RESULTS Age, SYNTAX score, frequencies of diabetes, hyperlipidemia, and hypertension, NT-proBNP, hs-CRP, hs-cTnT, and uric acid levels were higher in EFThigh group compared with the EFTlow group (P

Increased aortic stiffness (AS) has been shown to be an independent risk factor for cardiovascular disease in renal failure and was also found to be associated with even mild renal insufficiency. We investigated the relationship between contrast-induced nephropathy (CIN) and AS parameters such as pulse wave velocity (PWV) and augmentation index (AIx). Patients (n = 440) with stable coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI) were included prospectively (mean age: 60.3 ± 10.3 years). The PWV and AIx were calculated using the single-point method. The PWV, age, diabetes, SYNTAX score, and contrast media dose were independent predictors for CIN ( P < .05, for all). The cutoff value for PWV obtained by the receiver–operator characteristic curve analysis was 10.35 m/s for the prediction of CIN (95% confidence interval: 0.838-0.916, sensitivity: 82.1%, specificity: 77.9%, and P < .001). In conclusion, a greater AS pre-PCI may predict CIN development in patients with stable CAD.

Both oxidative stress and morning surge (MS) of blood pressure (BP) were found to be closely related with cardiovascular and cerebrovascular diseases. We investigated the association between MS of BP and oxidative stress in newly diagnosed hypertensive patients.We prospectively included 237 newly diagnosed hypertensive patients in the present study (mean age: 51.6 ± 11.7 years). The patients were classified according to the extent of the sleep-through surge as follows: the top decile of sleep-through surge (47.2 mmHg, n = 27; EMShigh group), versus all others (n = 210, EMSlow group). Total antioxidant capacity (TAC) and total oxidant status (TOS) levels were determined by using an automated measurement method. The oxidative stress index (OSI) was calculated as the ratio of TOS to TAC. Serum paraoxonase 1 (PON-1) activity was measured spectrophotometrically.Patients in EMShigh group were found to have higher hs-CRP, TOS, and OSI values and lower TAC and PON-1 values (p0.01, for all). MS of BP was associated with hs-CRP, PON-1, TOS, TAC, and OSI levels in bivariate analysis. Multivariate linear regression analysis showed that MS of BP was significantly associated with PON-1(β = -0.206, p0.001), OSI (β = 0.602, p0.001) and hs-CRP (β = 0.210, p0.001).Present study shows that OSI is increased and antioxidant PON-1 activity is decreased in patients with enhanced MS of BP. There is a close association between high MS of BP and oxidative stress markers in newly diagnosed hypertensive patients.

The innominate and subclavian arteries are the most common locations for stenotic lesions in the upper extremities (1). Innominate artery occlusive disease is often associated with cerebrovascular symptoms such as subclavian steal syndrome, arm claudication, distal embolization, and stroke. In some patients, subclavian steal syndrome can present with symptoms of arterial insufficiency afflicting the brain, typically manifesting as transient brain ischemia (2). Percutaneous interventions have evolved as an effective and safe treatment modality for occlusive lesions of the subclavian and innominate arteries (3). Current guidelines recommend the endovascular-first strategy in patients with atherosclerotic lesions of the upper extremities (1). Herein we report a case of successful percutaneous stent implantation to innominate artery in a symptomatic patient.

In the pathogenesis of atherosclerosis, oxidative stress plays a major role in plaque instability, rupture, and erosion, which subsequently leads to thrombus formation and causes total infarct-related artery (IRA) occlusion. We investigated the relationship between spontaneous reperfusion (SR) of IRA and oxidative stress in patients with anterior ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. A total of 341 consecutive patients with anterior STEMI were prospectively included in the present study. Patients were divided into 2 groups according to their thrombolysis in myocardial infarction (TIMI) flow grade: SR group (66 patients, TIMI flow 3) and non-SR group (275 patients, TIMI flow 0-2). On multivariate logistic regression analysis, oxidative stress index (β = 0.868, 95% confidence interval [CI] = 0.806-0.934, P < .001), neutrophil to lymphocyte ratio, uric acid, mean platelet volume, Killip 2 to 4 class, and initial SYNTAX score were independently associated with SR. Oxidative stress as well as inflammation may play a pivotal role in the pathogenesis of SR in patients with STEMI.

Percutaneous closure of atrial septal defect (ASD) has become the preferred method in treatment of the majority of cases. The aim of this study was to evaluate the echocardiographic effects of percutaneous closure of secundum ASD in adults and assess which parameters predict good response to closure.We prospectively included 42 patients with secundum ASD treated successfully with percutaneous device closure. All patients underwent transthoracic echocardiography examination with tissue Doppler imaging before, 24 hours after and within 3 months of intervention. Measurements of arterial stiffness were carried out using a Mobil-O-Graph arteriography system.Remodeling of heart chambers occurred immediately and persisted at 3 months after ASD closure. Significant decreases were observed in right ventricle (RV) end-diastolic diameter, right atrium volume index, and tricuspid annular plane systolic excursion both after the procedure and at 3 months (P.01 for all). The RV and left ventricle (LV) tissue Doppler-myocardial performance index demonstrated to decline during follow up (P = .0001). Significant correlations were found between pulse-wave velocity, augmentation index, pulmonary artery stiffness, and LV-RV tissue Doppler-myocardial performance index at third month. Linear regression analyses showed that pulse-wave velocity is the most effective parameter of LV and pulmonary artery stiffness is the most effective parameter of RV functional recovery, respectively, assessed by tissue Doppler-myocardial performance index.Percutaneous closure of secundum ASD in adults has various sustained benefits on multiple echocardiographic parameters within 3 months. The changes in RV and LV function after device closure were significantly correlated with the degree of pulmonary artery stiffness and pulse-wave velocity, respectively.

We aimed to evaluate the association between serum vitamin D status and elastic properties of aorta in patients with diabetes mellitus (DM). We studied 136 patients with newly diagnosed DM (mean age: 62.9 ± 10.6 years). Serum 25-hydroxyvitamin D was measured using a direct competitive chemiluminescent immunoassay. Aortic distensibility was calculated from the echocardiographically derived ascending aorta diameters and haemodynamic pressure measurements. Left ventricle mass index (LVMI) was determined according to the Devereux formula. Multiple linear regression analysis showed that vitamin D level is independently associated with LVMI (β = −0.259, p = 0.001), aortic distensibility (β = 0.369, p < 0.001), high-sensitive C-reactive protein (hs-CRP) (β = −0.220, p = 0.002) and body mass index (β = −0.167, p = 0.015) in patients with DM. In diabetic patients, serum 25-hydroxyvitamin D level is independently associated with aortic distensibility. Vitamin D may play a role on pathogenesis of impaired elastic properties of aorta in type 2 DM.