Publications (2)1.81 Total impact
-
Article: The relationship between flow-mediated dilatation and left ventricular function in type 2 diabetic patients with microalbuminuria.
[show abstract] [hide abstract]
ABSTRACT: The aim of this study was to assess the relationship between flow-mediated dilatation (FMD) and left ventricular (LV) systolic and diastolic function in type 2 diabetic patients with or without microalbuminuria. We prospectively evaluated 68 consecutive patients (36 women, 32 men; mean age 57 +/- 11 yr) with type 2 diabetes mellitus (DM). Patients were divided into two groups according to whether or not they had microalbuminuria: group 1 (n = 29, mean age 58 +/- 10 yr) with microalbuminuria and group 2 (n = 39, mean age 56 +/- 10 yr) without microalbuminuria. LV function was assessed by classical methods and Doppler tissue imaging (DTI). Left ventricular ejection fraction (EF), interventricular (IVS) and posterior wall (PW) thickness, peak early (E) and late (A) transmitral filling velocities, their ratio (E/A) and deceleration time of the mitral E wave (DT), LV isovolumetric relaxation time (IVRT), flow propagation of velocity (Vp), and E/Vp were evaluated by conventional echocardiography. Early diastolic (Em), late diastolic (Am), and peak systolic (Sm) mitral annular velocities were measured. Em/Am and the ratio of early diastolic mitral inflow velocity to Em (E/Em), which is a reasonably good index for predicting elevated LV filling pressure, were calculated by DTI. Endothelial function, measured as flow-mediated dilatation of the brachial artery using ultrasound, was calculated in two groups. FMD was lower in those with microalbuminuria than those without (8.8 +/- 6.44% vs 12.6 +/- 7.24%, p = 0.03). Group 1 had longer DT (223 +/- 39 ms vs 199 +/- 37 ms, p = 0.01) and longer IVRT (109 +/- 13 ms vs 100 +/- 13 ms, p = 0.03) than that of group 2 with conventional echocardiography. Group 1 had significantly lower Em/ Am (0.79 +/- 0.27 cm/s vs 1.02 +/- 0.44 cm/s, p = 0.01), lower Vp (40.4 +/- 9.98 vs 50.4 +/- 19.01 cm/s, p = 0.01) than that of group 2. Group 1 had significantly higher serum creatinine (1 +/- 0.33 mg/dL vs 0.7 +/- 0.19, p = 0.001). In logistic regression analysis, FMD was the only variable independently related to microalbuminuria. FMD was positively correlated with EF (r = 0.43, p = 0.02) and E/A (r = 0.40, p = 0.03), and negatively correlated with E/Em (r = 0.41, p = 0.04) and E/Vp (r = 0.41, p = 0.04) only in patients with microalbuminuria. It was found that left ventricular diastolic function and FMD are impaired in type 2 diabetic patients with microalbuminuria. FMD may be related to LV diastolic dysfunction only in patients with microalbuminuria.Endocrine 11/2006; 30(2):197-202. · 1.42 Impact Factor -
Article: Factor V Leiden mutation and its relation to left atrial thrombus in chronic nonrheumatic atrial fibrillation.
[show abstract] [hide abstract]
ABSTRACT: The genetic defect of coagulation factor V, known as factor V Leiden, produces a resistance to degradation by activated protein C and increased venous thrombosis. However, the role of factor V Leiden in the formation of left atrial thrombus with nonrheumatic atrial fibrillation has not been studied. We investigated whether factor V Leiden is a risk factor for left atrial thrombus in patients with nonrheumatic atrial fibrillation. We analyzed clinical, echocardiographic, and biochemical data in 105 consecutive patients with nonrheumatic atrial fibrillation. These patients were divided into two groups: group A (n = 37) with left atrial thrombus and group B (n = 68) without left atrial thrombus. The study also included 42 control subjects. Left atrial thrombus was investigated by using both transthoracic echocardiography and transesophageal echocardiography. Blood samples from the patients and controls were analyzed for the factor V Leiden mutation by DNA analysis, using the polymerase chain reaction. There was no significant difference in the prevalence of factor V Leiden between the patients and control subjects. The prevalence of factor V Leiden mutation was 8.1% (3/37) in patients with left atrial thrombus, and 8.8% (6/68) in patients without left atrial thrombus. The prevalence of factor V Leiden was 7.1% (3/42) in control subjects. The prevalance of factor V Leiden was 10% (2/20) in patients with spontaneous echo contrast and 8% (7/85) in patients without spontaneous echo contrast. Multivariate analyses showed that left ventricular ejection fraction was an independent predictor of left atrial thrombus. Factor V Leiden mutation is not a risk factor for left atrial thrombus formation and spontaneous echo contrast in patients with nonrheumatic atrial fibrillation.Japanese Heart Journal 08/2003; 44(4):481-91. · 0.40 Impact Factor
