[Show abstract][Hide abstract] ABSTRACT: To compare the mean platelet volume (MPV; a general marker of platelet activation) in groups of patients with and without hypertension and to analyse its relationship with left ventricular mass index (LVMI).
This cross-sectional, observational study enrolled newly diagnosed patients with untreated stage I-II hypertension and healthy control subjects without hypertension. MPV was measured using a haematology analyser. Echocardiography was performed on all of the study participants.
A total of 50 newly diagnosed patients with hypertension and 50 healthy control subjects were enrolled in the study. The majority of the demographic characteristics and laboratory findings were not significantly different between the two groups. The mean ± SD MPV was significantly higher in the hypertensive group compared with the control group (10.3 ± 1.4 fl versus 9.2 ± 1.8 fl, respectively). The mean ± SD LVMI was significantly higher in the hypertensive group compared with the control group (115.9 ± 23.0 g/m(2) versus 95.7 ± 23.4 g/m(2), respectively). There was no significant correlation between MPV and LVMI.
In patients with untreated hypertension, despite elevated MPV levels there was no correlation between LVMI and MPV.
Preview · Article · Apr 2014 · The Journal of international medical research
[Show abstract][Hide abstract] ABSTRACT: Elevated plasma levels of asymmetric dimethylarginine (ADMA) are prevalent in patients with hypercholesterolemia and coronary artery disease. A total of 83 patients with hypercholesterolemia and angiographically documented mild coronary artery stenosis were randomized to rosuvastatin treatment (20 mg) or atorvastatin treatment (40 mg) once daily for 6 weeks after a 4-week dietary lead-in phase. Both statins decreased total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglyceride levels effectively. Only rosuvastatin increased high-density lipoprotein cholesterol (HDL-C) levels. Both rosuvastatin and atorvastatin decreased plasma ADMA levels; rosuvastatin had a significantly greater effect. The reduction in ADMA levels were correlated with the reduction in TC and LDL-C levels as well as LDL-C-HDL-C ratio. Treatment with rosuvastatin or atorvastatin in patients with hyperlipidemia with mild coronary artery stenosis may lead to a decrease in ADMA levels, which may contribute to improved endothelial function.
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to study time indices of heart rate variability (HRV) in patients with mitral annular calcification (MAC).
A cross-sectional observational study was performed. Fifty patients with echocardiographic evidence of MAC and 50 age- and gender-matched control subjects without echocardiographic evidence of MAC were included. All the study participants underwent 2-dimensional echocardiographic examinations and 24-hour Holter monitoring for HRV analysis. Student-t, Mann-Whitney U and Chi-square tests were used for statistical analysis.
Hypertension and coronary artery disease were more common in the MAC group than in the control group. All HRV parameters including mean RR interval, SDNN, SDANN, SDNN index, pNN50 and RMSSD were reduced in the MAC group when compared with the control group (p<0.05 for all). In hypertensive subgroup, all HRV parameters except mean RR interval were diminished in patients with MAC when compared with those without MAC (p<0.05 for all). In non-hypertensive subgroup, all HRV parameters were also diminished in patients with MAC when compared with those without MAC. In the subgroup of patients with coronary artery disease, patients had lower HRV parameters except mean RR interval, pNN50 and RMSSD in comparison to those without MAC (p<0.05 for all). In the subgroup of patients without coronary artery disease, all HRV parameters were depressed in patients with MAC in comparison to those without MAC (p<0.05 for all).
Our findings indicate that MAC was associated with reduced heart rate variability which possibly reflects decreased parasympathetic tone with a predominant activity of the sympathetic tone.
Preview · Article · Jul 2013 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
[Show abstract][Hide abstract] ABSTRACT: Objectives:
Red blood cell distribution width (RDW) has been reported to be a marker of morbidity and mortality for some cardiovascular and pulmonary diseases. We aimed to evaluate RDW values in otherwise healthy smokers.
Two hundred and twenty consecutive subjects with current smoking and 230 age- and gender-matched healthy subjects without smoking history were enrolled. Number of cigarettes smoked per day and duration of smoking, evaluated as pack years, were recorded. Complete blood count, high-sensitivity C-reactive protein (hs-CRP) levels and lipid profile were analyzed in all study participants.
The mean RDW values were higher in smokers than in nonsmokers (13.9±1.2 vs. 13.1±0.8, p<0.0001). The mean leukocyte count, mean platelet volume and hs-CRP levels were also significantly greater in smokers when compared to nonsmokers (8440±1.750 vs. 7090±1550, p<0.0001; 8.7±0.8 fL vs. 8.3±0.6 fL, p<0.0001; 2.42±0.53 mg/L vs. 1.46±0.52 mg/L, p<0.0001, respectively). Significant positive correlations between RDW and number of cigarettes smoked per day and between RDW and duration of smoking were identified (r=0.565 and r=0.305, respectively).
Elevated RDW is associated with cigarette smoking and may be a useful indicator of inflammatory activity in smokers.
Preview · Article · May 2013 · Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir
[Show abstract][Hide abstract] ABSTRACT: Purpose:
The purpose of the present study was to evaluate the effects of different loading doses of clopidogrel on ST segment resolution on ECG, changes in cardiac enzyme levels and serum levels of high-sensitivity C-reactive protein (Hs-CRP) in patients with ST elevated myocardial infarction (STEMI) treated with fibrinolytic therapy.
Patients admitted to our cardiology clinic with a diagnosis of STEMI and treated with fibrinolytic therapy were included: Group 1 (n=58) received a 300 mg loading dose of clopidogrel, Group 2 (n=55) a 450 mg loading dose and Group 3 (n=59) a 600 mg loading dose. A 75 mg/d maintanence dose of clopidogrel was given in all groups.
All demographic characteristics and baseline laboratory parameters were statistically similar among three groups (p > 0.05). When ST resolution periods were compared, most patients in Group 3 had ST resolution at 30 minutes; Group 2 at 60 minutes and Group 1 at 90 minutes (p < 0.05). Peak levels of creatine kinase (CK) and CK-MB were as follows: Group 3, 8(th) hour, Group 1 and 2, 12(th) hour. Peak levels of those enzymes were significantly lower in Group 3 than in Group 1 and 2 ( < 0.05). Although basal hs-CRP levels of all groups were similar, the increase in hs-CRP levels at 48 hours was lower with higher clopidogrel loading doses (p < 0.05).
In this study comparing three different clopidogrel loading doses, the higher doses provided earlier ECG resolution, earlier and lower peak CK and CK-MB levels and lower levels of hs-CRP.
No preview · Article · Feb 2013 · Clinical and investigative medicine. Medecine clinique et experimentale
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to show the prolonged P Wave Dispersion (PWD) in patients with acute ischemic stroke. Researchers compared PWD in patients with acute ischemic stroke (n = 50) with age-matched healthy subjects (n = 46) as controls. Twelve-lead electrocardiograms of all patients were obtained and PWDs were measured. Left ventricular diameters and functions were also obtained by transthoracic echocardiography. The demographic properties of the study population were similar between two groups. P wave dispersions were significantly longer in patients with acute ischemic stroke than control subjects (77±26 and 63±21 m sec, respectively p = 0.007). The left ventricular end-systolic, end-diastolic diameters and ejection fraction were similar between two groups. The interventricular septal diameter and left atrial diameter were significantly higher in patients with acute ischemic stroke than those in control group. This study demonstrates that prolonged PWD has a relationship with acute ischemic stroke. Prolonged PWD may be a predictor of ischemic stroke.
[Show abstract][Hide abstract] ABSTRACT: There are limited clinical data revealing the relationship between mitral annular calcification (MAC) and systemic inflammation. The goal of the present study was to compare high-sensitivity C-reactive protein (hs-CRP) levels in patients with and without MAC and investigate the relationship between MAC and hs-CRP.
One hundred patients with MAC who underwent transthoracic echocardiography (TTE) and 100 age-matched controls without MAC who underwent TTE were included in our study. Hs-CRP levels were compared between groups.
Prevalence of female gender, hypertension, and coronary artery disease were significantly higher in the MAC group than in the control group (64% versus 45%, P = 0.007, 42% versus 28%, P = 0.03 and 37% versus 18%, P = 0.003, resp.). On multivariate analysis, age, gender, and coronary artery disease were the only independent predictors of MAC. The levels of hs-CRP were higher in the MAC group than in the control group (2.02 ± 0.35 versus 1.43 ± 0.47 mg/dl, P < 0.001). This increase in hs-CRP levels in the MAC group persisted in patients without hypertension, coronary artery disease, and in male patients when compared to the control group.
Our study demonstrated that hs-CRP, which is a sensitive marker of systemic inflammation, increased in patients with MAC.
Full-text · Article · Feb 2012 · Mediators of Inflammation
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study is to evaluate the importance of tenascin-C ( TNC), N-terminal pro brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) on LV remodelling after myocardial infarction (MI).
Fifty-seven stable patients with subacute anterior MI who had total or subtotal occlusion in the infarct-related left anterior desending artery in coronary angiography were enrolled the study. 18 of patients who had total occlusion received only medical theraphy, 19 of patients who had total occlusion received successful PCI+ medical theraphy and 20 of patients who had subtotal occlusion received successful PCI+ medical theraphy. Left ventricular volumes and ejection fractions (EF) were measured with echocardiography. Serum TNC, NT-proBNP and CRP levels were measured at admission and a month after treatment.
There was significant increase in LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) baseline to follow-up in total-PCI group. Baseline to follow-up; a borderline significant increase was observed in LVEDV in the total-medical group. No significant difference was seen in LV volumes and EF in the subtotal-PCI group. NT-proBNP, TNC and CRP levels were decreased in all groups. The decrease in NT-proBNP and CRP values were significant in the total-medical and subtotal-PCI group but in the total-PCI group they were not significant. The decrease of TNC was significant in all groups but the lowest decrease was seen in the total-PCI group.
TNC, NT-proBNP and CRP reflect LV remodelling in accordance with echocardiography after MI.
Tenascin-C; NT-pro BNP; CRP; Remodelling; Myocardial infarction.
Full-text · Article · Feb 2012 · Journal of Clinical Medicine Research
[Show abstract][Hide abstract] ABSTRACT: Objective: It has been accepted that slow coronary flow (SCF) is a variant of coronary artery diesease (CAD). It is not known that leptin plays an important role in the etiopathogenesis of CAD. We aimed to evaluate whether there was a significant difference in serum leptin levels between patients with normal coronary flow and those with SCF. Method: The study population consisted of a total of 80 subjects, 40 patients with SCF and 40 healty subjects with normal coronary arteries (NCA). Serum leptin levels were determined by a radioimmunoassay technique. Results: Age, Gender, hypertension, diabetes mellitus (DM), body mass index (BMI), systolic blood pressure, and levels of total cholesterol, creatinine, C-reactive protein and other biochemical parameters were not different between SCF group and NCA group, as were serum leptin levels (32.6±40.9 versus 44.2±43.8, p>0.05). When SCF and NCA groups were divided into two groups according to the presence or absence of DM, leptin levels were again did not differ between those with DM in SCF and those with DM in NCA, as were between those without DM in SCF group and those without DM in NCA group (p>0.05). It was found that leptin levels correlated with BMI, height and levels of serum CRP, LDL-cholesterol, trigliseride, white blood cells and platelets (p< 0.05). Conclusion: We did not find any statistically significant differences in leptin levels between SCF and NCA groups. Correlation of leptin levels with LDL-C, trigliseride, CRP and BMI may suggest that leptin may play an important role in the atherosclerotic process.
[Show abstract][Hide abstract] ABSTRACT: We aimed to compare heart-type fatty acid-binding proteins (H-FAB) and other cardiac biomarkers to determine the most reliable cardiac marker in hemodialysis (HD) patients without acute coronary syndrome (ACS).
Sixty HD patients without ACS were included the study. Blood samples were taken before HD session for measurement of H-FAB, troponin I, troponin T, creatine kinase-MB (CK-MB) isoforms.
Mean age of patients was 55 ± 15 years. Males were 55%. Mean serum level of blood urea nitrogen was 75 ± 15 mg/dL, mean serum level of creatinine was 8.3 ± 2.5 mg/dL, mean serum level of hematocrit was 33 ± 5%, mean ejection fraction was 54 ± 9%, and mean left ventricular mass index (LVMI) was 136 ± 54 g/m(2). H-FAB was positive in 32%, troponin T in 20%, troponin I in 12%, and CK-MB in 5% of all patients. Three or four of all parameters were not positive together in any patient. While 5% of patients had positive troponin T with H-FAB, 3% of patients had positive troponin T with troponin I and 2% of patients had positive troponin I with H-FAB.
Our study found that CK-MB had the lowest positivity in the HD patients without ACS. H-FAB had the highest rate of positivity in all markers. If only one marker is assessed it should be CK-MB. But using two parameters in HD patients in ACS diagnosis increases the reliability of diagnosis. If we use two biomarkers it should be CK-MB and troponin I.
[Show abstract][Hide abstract] ABSTRACT: Numerous studies have shown an increase in NT-pro BNP, troponin I and D-dimer levels with right ventricular dysfunction on echocardiography in patients with acute pulmonary thromboembolism (PTE). We found no data about the relation between tenascin-C and acute PTE in the litera-ture. The aim of this study was to evaluate tenascin-C levels in acute PTE and correlate them with NT-pro BNP, troponin I and D-dimer.
Thirty-four patients who have massive or submassive PTE on spiral thorax CT (PTE group) and twenty healthy volunteers (non-PTE group) were evaluated. In all patients, right ventricular functions were obtained on transthoracic echocardiography and plasma tenascin-C, NT-pro BNP, troponin I, and D-dimer levels were measured.
The left ventricular systolic diameter, left ventricular diastolic diameter and left ventricular ejection fraction were similar in the two groups. The right heart chamber sizes and main pulmonary artery diameter were significantly larger in the PTE group and systolic pulmonary artery pressures were also significantly higher in this group. Tenascin-C, NT-pro BNP, and D-dimer levels were also significantly higher in the PTE group than in the non-PTE group (p< 0.001). The troponin I levels did not differ between the two groups (p=0.4). Tenascin-C was found to be highly correlated with sPAP and NT-pro BNP and correlated with D-dimer; however, troponin I was not correlated with tenascin-C.
This study demonstrates that tenascin-C may be an indicator of acute PTE.
No preview · Article · Feb 2011 · Journal of atherosclerosis and thrombosis
[Show abstract][Hide abstract] ABSTRACT: The aim of this study is to investigate the relationship between the duration of clopidogrel use and the inflammation process after acute coronary syndrome in patients who received bare metal stent (BMS) or drug eluting stent (DES).
Sixty patients with acute coronary syndrome who received a stent were divided into three groups: 20 patients with BMS receiving clopidogrel for one month (BMS1 group), 20 patients with BMS receiving clopidogrel for 6 months (BMS6 group), and 20 patients with DES receiving clopidogrel for 6 months (DES group). High sensitive C-reactive protein (hsCRP, mg/dL) was measured at baseline, and then at first, third and sixth post-operative month.
The inital hsCRP levels were similar and decreased significantly in all groups by one month of clopidogrel treatment (from 7.1±1.9 to 3.8±2.3 in BMS1 group, p=0,002, from 6.5±2.8 to 4.3±2.5 in BMS6 group, p= 0,01 and from 7.7±2 to 3.6±2.4 in DES group, p < 0.001). In the BMS1 group, after termination of the clopidogrel therapy after the first month, hsCRP levels increased again at the third and sixth months. In the BMS6 and DES groups, hsCRP levels continued to show a decrease at the third month and sixth months.
Clopidogrel decreases hsCRP levels in patients with acute coronary syndrome. It might be desirable to lengthen the duration of the clopidogrel therapy to maintain its anti-inflammatory effects.
Full-text · Article · Jan 2011 · Clinical and investigative medicine. Medecine clinique et experimentale
[Show abstract][Hide abstract] ABSTRACT: We aimed to investigate the relation of brachial artery intima-media thickness (IMT) with endothelial function and left ventricular mass (LVM).
Fifty-four stage I-II hypertensive patients according to JNC VII who were not taking any medication and 27 age and sex-matched healthy controls were included to this cross-sectional observational study. IMT was measured by the same radiologist who was unaware of the patient's clinical status by using high resolution ultrasound machine. Endothelial function was evaluated by flow mediated dilation (endothelium-dependent vasodilatation, FMD). LVM was calculated by using Devereux method. LVM index (LVMI) was obtained by dividing LVM to body surface area. Mann-Whitney U test was used to compare continuous variables, qualitative variables were compared by Chi-square test and the relations of parameters were evaluated by multiple linear regression analysis.
Both groups (hypertensive and control) were similar with respect to age, sex, left ventricular ejection fraction. IMT was significantly higher in hypertensive group (0.43+/-0.09 vs 0.33+/-0.06 mm; p<0.001). FMD values were also significantly different between hypertensive and control groups (4+/-4% vs 13+/-12%; p<0.001). LVMI was significantly different between hypertensive and control groups LVMI (124 +/- 5 vs 99+/-6 gr/m2, p=0.002). The correlation between IMT and FMD (r=0.260; p=0.026) and IMT and LVMI (r =0.348; p=0.004) were statistically significant. A correlation was found between IMT and LVMI independently of other variables (beta=105; p=0.004) when LVMI was accepted as dependent variable in multivariate linear regression analysis (R2=0.570, p<0.001). According to this finding, the 105 units increase in LVMI occurs when IMT increases by 1 mm.
Brachial artery IMT is related to endothelial function and LVM. According to these data, any negative changes of the IMT may reflect the similar negative changes in other parameters.
Preview · Article · Jun 2010 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology