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We aimed to evaluate the diagnostic accuracy of the proinflammatory monocyte chemotactic protein-1 (MCP-1) in the diagnosis of asymptomatic diastolic dysfunction (DD) in patients with psoriatic arthritis (PsA). The disease activity in psoriatic arthritis (DAPSA) was determined using clinical and laboratory parameters, and echocardiography was performed to estimate DD. Serum MCP-1 concentrations were elevated in PsA patients with DD diagnosed with ultrasound (median (25th percentile, 75th percentile): 366.6 pg/mL (283, 407.1 pg/mL) vs. 277.5 pg/mL (223.5, 319.1 pg/mL) in controls; P < 0.0017 ). PsA patients with serum MCP-1 concentration higher than the cut-off value of 347.6 pg/mL had a 7.74-fold higher chance of developing DD than PsA patients with lower serum MCP-1 concentrations (controls), with a specificity of 86.36% and sensitivity of 55%, as verified using ultrasound. The group with MCP-1 concentrations above the cut-off value also showed a higher late peak diastolic mitral inflow velocity, A-wave value ( P = 0.000005 ), E/E ′ ratio ( P = 0.00005 ), and a lower E/A ratio ( P = 0.000002 ), peak systolic left atrial reservoir strain, SA value ( P = 0.0066 ), early peak diastolic displacement of the mitral septal annulus, E ′ wave value ( P = 0.003 ), than controls. Systolic blood pressure ( P = 0.01 ), LDL cholesterol concentration ( P = 0.012 ), glucose concentration ( P = 0.011 ), and DAPSA ( P = 0.0000 ) increased in the PsA group with higher MCP-1 concentrations, although there were no differences in comorbidities and therapy between the groups compared. Thus, the serum MCP-1 concentration was a significant and independent prognostic indicator for asymptomatic DD in PsA patients ( area under the curve = 0.730 , P = 0.001 ). The DAPSA score in PsA patients might indicate the need for echocardiography and adjustment of anti-inflammatory treatment in terms of DD prevention.

Introduction: Double outlet right ventricle (DORV) is congenital cardiac malformation which occurs 1-3% of individuals with congenital heart defects1. The echocardiography is a method of choice to detect the regional acceleration of flow and in most cases is sufficient for diagnosis and surgical planning1. When the findings at the imaging examination are inconclusive, cardiovascular MR imaging may play an important role in anatomy of the ventricuar septal defect, functional status of both ventricles, and to identify any residual stenosis or regurgitation or coexistent anomalies2. In DORV both great arteries come from the same pumping chamber2. These patients require long-term follow up and may present for surgical or catheter-based interventions3. Possible complications may include heart failure, high blood pressure in the lungs or death3. Case report: We report 43-year-old men with Blalock-Taussig shunt. He visited hospital for cardiac evaluation after he had respiratory infection with shortness of breath and palpitation. Electrocardiography showed right axis deviation and right ventricular hypertrophy. Laboratory examination revealed polycythemia and hypoxemia. This patient has associated ventricular and atrial septal defect and hypoplastic pulmonary artery. The heart showed dilatation of the bilateral ventricles, right ventricular hypertrophy with reduced systolic function (39%). Above the right ventricle is left atrium with pulmonic veins. Conclusion: MR imaging provides accurate additional anatomic information in patients with DORV, which is helpful in presurgical planning as well as during follow up.