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Background: Heart failure (HF) is a complex disease and inflammation play a crucial role in its pathophysiology. The metabolism of energy substrate alters in HF and these changes may lead to the impairment in amino acid (AA) metabolism by increasing the heart's dependence on AAs. Limited studies evaluated the relationship between inflammation and AA profile in patients with HF. In this study, we aimed to evaluate the AA profile in patients with HF and to reveal its relationship with inflammation. Materials and Methods: Seventy-two patients with HF and 64 healthy controls were included in this study. C-reactive protein/albumin ratio (CAR) was used to assess inflammatory status of the patients. High performance liquid chromatography technique was used to evaluate the AA profile. Results: We detected that AAs profile was significantly changed in HF patients compared to controls. HF patients had also significantly higher CAR (p<0.001) level. The best cut-off value of CAR for predicting HF was 0.91, and patients were divided into 2 groups according to this cut-off value: CAR≥0.91 (high inflammation group) and CAR<0.91 (low inflammation group). When compared to low inflammation, patients with high inflammation had significantly different AAs profile. Correlation analysis showed that CAR was positively correlated with phenylalanine, tyrosine and asparagine whereas negatively correlated with valine, leucine and methionine levels. Conclusion: We found that AA profile was significantly changed in patients with HF. Also, the impairment in AA metabolism was more pronounced in patients with higher inflammation compared to patients with lower inflammation. We suggest that main mechanism underlying the impaired AA profile in HF may be increased inflammation. [ABSTRACT FROM AUTHOR]

Background and objectives: The frontal QRS-T angle is a novel parameter of myocardial repolarization. Weight gain during pregnancy and physiological changes during a cesarian section may affect the frontal QRS-T angle. We aimed to assess the effect of body mass index (BMI) on the frontal QRS-T angle in pregnant women undergoing cesarean section with spinal anesthesia. Method and materials: This study included 90 pregnant women. BMI was calculated for all pregnant women. The study population was divided into two groups: BMI < 30 (n = 66) and BMI ≥ 30 (n = 24). QT interval measurements and the frontal QRS-T angle were obtained from the report of an electrocardiography machine. Results: It was found that the pre-operative and post-operative frontal QRS-T angle (p = 0.045 and p = 0.007) and QTc interval (p = 0.037 and p < 0.001) were higher in pregnant women with a BMI ≥ 30 than in pregnant women with a BMI < 30. In addition, when compared to pre-operative values, the post-operative frontal QRS-T angle (from 24.0 [20.0–41.5] to 34.5 [19.5–50.0], p = 0.031) and QTc interval (from 420.6 ± 13.3 to 431.7 ± 18.3, p = 0.010) were increased in the BMI ≥ 30 group, whereas no significant post-operative increase was observed in the BMI < 30 group. In correlation analysis, BMI was positively correlated with the frontal QRS-T angle and QTc interval. Conclusions: The frontal QRS-T angle and QTc interval were importantly increased in pregnant women with a BMI ≥ 30 than in pregnant women with a BMI < 30. Also, after cesarean section operation with spinal anesthesia, the frontal QRS-T angle and QTc were increased significantly in the BMI ≥ 30 group, whereas no significant change was observed in the BMI < 30 group. Therefore, it is suggested to perform close post-operative monitoring in pregnant women with a BMI ≥ 30 undergoing cesarean section with spinal anesthesia. [ABSTRACT FROM AUTHOR]

Several laboratory parameters have been used to assess inflammatory process and determine cardiovascular risk. The C-reactive protein to albumin ratio (CAR) is a novel marker of inflammation and its clinical importance has not been clearly elucidated in coronary artery disease (CAD). We compared the diagnostic value of CAR with other inflammatory parameters in detecting significant CAD. Patients (n = 421) with stable angina pectoris who underwent coronary angiography for the suspected CAD were included. Neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), platelet to lymphocyte ratio, uric acid, monocyte to high-density cholesterol (HDL-C) ratio, mean platelet volume to lymphocyte ratio (MPVLR), and platelet to mean corpuscular volume (MCV) ratio were measured. Patients with significant CAD had a significantly higher NLR (P =.043), MLR (P =.004), uric acid (P <.001), monocyte to HDL-C ratio (P =.004), and CAR (P <.001) compared to patients without significant CAD. However, MPVLR and platelet to MCV ratio weren't different between 2 groups. The area under the curve (AUC) of CAR was the highest AUC among all inflammatory parameters for predicting significant CAD. Multivariate analysis showed that age (odds ratio [OR]: 1.046, 95% confidence interval [CI], 1.020-1.072, P <.001) and CAR (OR: 1.175, 95% CI, 1.126-1.226, P <.001) were the only independent predictors of significant CAD. In conclusion, CAR had the strongest diagnostic value in detecting significant CAD among the inflammatory parameters evaluated in this study. [ABSTRACT FROM AUTHOR]

What is known and objective: Propofol is a most commonly used anaesthetic drug for conscious sedation in outpatient procedures. Previous studies have shown that propofol may affect ventricular repolarization based on QT and Tp‐e intervals. Frontal QRS‐T angle is a marker of ventricular depolarization and repolarization difference. However, there is no study investigating the effect of propofol on frontal QRS‐T angle. In this study, we aimed to investigate the effect of propofol on frontal QRS‐T angle in patients undergoing colonoscopy procedure. Method: A total of 56 patients (53.5% females) who underwent colonoscopy procedure were included in this study. All patients underwent 12‐lead surface electrocardiograms (ECGs) just before colonoscopy and 15 minutes after colonoscopy. QT interval, QTc interval, Tp‐e interval, Tp‐e/QT, Tp‐e/QTc and frontal QRS‐T angle were calculated from 12‐lead ECGs. Results and discussion: The frontal QRS‐T angle was significantly increased 15 minutes after colonoscopy compared to basal value (36.2 ± 24.3 vs. 29.5 ± 23.6, P =.003). In addition, repolarization parameters including QT, QTc and Tp‐e intervals were significantly prolonged at 15 minutes after colonoscopy compared to basal value, except Tp‐e/QT and Tp‐e/QTc. Significant ventricular or supraventricular arrhythmias were not observed in any patient during the procedure. What is new and conclusion: In this study, we found that propofol administration increased the frontal QRS‐T angle in patients undergoing colonoscopy procedure. Given that a prolonged frontal QRS‐T angle is associated with ventricular arrhythmias, it may be safer to monitor those patients receiving propofol during colonoscopy procedures. [ABSTRACT FROM AUTHOR]

Background: Frontal QRS-T angle is a novel marker of myocardial repolarization, and an increased frontal QRS-T angle associated with adverse cardiac outcomes. Non-dipper hypertension is also associated with adverse cardiac outcomes. This study aimed to investigate the relationship between frontal QRS-T angle and non-dipper status in hypertensive patients without left ventricular hypertrophy (LVH). Methods: This study included 122 hypertensive patients without LVH. Patients were divided into two groups: dipper hypertension and non-dipper hypertension. The frontal QRS-T angle was calculated from 12-lead electrocardiography. Results: Frontal QRS-T angle (47.9° ± 29.7° vs. 26.7° ± 19.6°, P < 0.001) was significantly higher in patients with non-dipper hypertension than in patients with dipper hypertension. In addition, frontal QRS-T angle was positively correlated with sleeping systolic (r = 0.211, P = 0.020), and diastolic (r = 0.199, P = 0.028) blood pressures (BP), even if they were weak. Multivariate analysis showed that the frontal QRS-T angle was independent predictor of non-dipper status (QR: 1.037, 95% CI: 1.019-1.056, P < 0.001). Conclusion: Frontal QRS-T angle is independent predictor of non-dipper status in hypertensive patients without LVH. [ABSTRACT FROM AUTHOR]