Most important cause of mortality in chronic obstructive pulmonary disease (COPD) patients is known to be cardiovascular disease (CVD). The objective of the present study was to evaluate the ...echocardiographic parameters in COPD patients with or without pre-diagnosed CVD and to investigate the relationship between echocardiographic parameters and systemic inflammation markers.
A total of 60 stable COPD patients (23 patients with CVD, group 1; 37 patients without CVD, group 2) and 21 healthy controls (group 3) were included in the study. Six-minute walking test (6MWT), COPD assessment test (CAT), and Body mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index results were recorded. High-sensitivity C-reactive protein (HsCRP), interleukin 8 (IL-8), fetuin-A, Clara cell protein (CCL-16), N-terminal pro-brain natriuretic peptide levels were studied in serum. Parameters of left and right ventricular systolic and diastolic function were measured by echocardiography.
Patients with COPD had higher levels of systemic inflammation markers and lower level of inflammation inhibitor fetuin-A. When three groups were compared, group 1 had lower 6MWT result. HsCRP was highest in group 2 while other inflammatory markers were similar in groups 1 and 2. Regarding echocardiographic parameters, left ventricular ejection fraction (LVEF) was lower and left ventricle end-diastolic diameter (LVED), left ventricle end-systolic diameter (LVES) diameters were higher in group 1. The aortic diameter was higher in COPD patients. Fetuin-A was correlated with diameter of aorta and LVES. LVEF, LVED, and LVES were found to be correlated with functional parameters of COPD cases.
In COPD, left ventricular functions are affected as well as right ventricle before prominent clinical findings of cardiac disease and these echocardiographic parameters correlate with functional parameters of COPD patients.
Aims. Cardiovascular diseases are the primary cause of premature morbidity and mortality in early breast cancer patients after treatment with cardiotoxic chemotherapeutic agents. Arterial stiffness ...is an independent risk factor for future cardiovascular diseases and can be used as a predictive marker of subclinical cardiac damage. The aim of this study is to analyze the arterial stiffness in breast cancer patients who are in the follow-up period after receiving anthracycline-based chemotherapy regimens with trastuzumab. Methods and Material. We enrolled 45 HER2-positive breast cancer patients who are on follow-up at least for six months after completion of adjuvant chemotherapy with trastuzumab, and cardiovascular risk matched 30 control volunteers. The measurements were done with pulse wave analyzing machine. Results. Mean pulse wave velocity was higher in breast cancer patients compared to controls. The pulse wave velocity was significantly higher in patients receiving aromatase inhibitors compared to patients under tamoxifen. It was also significantly higher in postmenopausal breast cancer patients than postmenopausal controls. Conclusions. Arterial stiffness measurements may predict the breast cancer survivors with higher risk for cardiovascular events earlier in the follow-up period, and necessary preventive approaches and/or treatments can be applied.
This study was conducted to investigate the prophylactic effects of carnitine against contrast-induced nephropathy (CIN) and its relation to oxidant/antioxidant status in kidney, liver, heart, spleen ...and lung tissues in a CIN rat model. Twenty-eight adult male Wistar rats were divided into 4 groups, the control, contrast media (CM), carnitine and contrast media+carnitine (CM+carnitine) groups. Animals were placed in individual metabolism cages, and on the 2nd day, rats were deprived of water for 24 hr. On the 3rd day, contrast media were administered to groups CM and CM+carnitine. L-carnitine was administered on days 2, 3 and 4. Histopathological changes were evaluated in the right kidney after euthanization. Superoxide dismutase (SOD) and catalase (CAT) activities and glutathione (GSH) and malondialdehyde (MDA) levels were measured in renal, liver, heart, spleen and lung tissues. The SOD activities in the renal (P<0.05), liver (P<0.001) and spleen (P<0.05) tissues were increased in the carnitine group. The CAT activities in the spleen tissue were decreased (P<0.01) only in the CM group. Renal (P<0.05), liver (P<0.001), spleen (P<0.001) and lung tissue (P<0.01) GSH levels were found to be higher in the carnitine group. In renal, liver and lung tissues, the MDA levels increased in the CM group (P<0.001). The histopathological findings showed that L-carnitine may have a preventative effect in alleviating the negative effects of CIN. Similar to this, L-carnitine may play a major role in the stability of the antioxidant status in the kidney, liver, spleen and lung of the CIN rat model.
Abstract Background Contrast-induced nephropathy (CIN) is an important complication of vascular interventions. Ozone therapy can induce tolerance to ischemic insults, a phenomenon known as ozone ...oxidative preconditioning (OOP). The aim of this study was to investigate the effects of OOP on CIN. Materials and methods Thirty-two Wistar rats were randomized into four groups ( n = 8). The control group had intravenous saline injection. The contrast media (CM) group had intravenous meglumine/sodium diatrizoate injection to form CIN. The ozone (O3 ) group received intraperitoneal ozone for 5 d before the induction of CIN. The oxygen (O2 ) group was given an equal amount of oxygen for 5 d before the induction of CIN. The animals were sacrificed 48 h after the administration of contrast agent or saline. Kidneys were harvested, and blood samples were obtained. Renal function tests, serum and renal tissue malondialdehyde (MDA), and nitric oxide (NO) levels and renal oxidant system parameters were determined. Histologic examination was performed for renal injury. Results Serum blood urea nitrogen (BUN), creatinine, and serum and renal MDA were increased after contrast exposure. Renal NO was decreased, and there was prominent tubular necrosis in the CM group. Serum BUN, creatinine, serum and renal MDA, and grade of tubular necrosis were decreased in the O3 group as compared with those in the CM group. The levels of serum and renal NO and renal total antioxidant system in O3 group were higher than the levels in the CM group. Conclusions OOP attenuates experimental CIN. This effect is suggested to be mediated by reinforcement of renal antioxidant defenses and maintenance of renal NO levels.
...to the best of our knowledge there is not any study comparing preventive effects of these three beta blockers with each other against contrast induced nephropathy (CIN).Aım We aimed to investigate ...and compare the probable prophylactic effects of three beta blocker agents, carvedilol, nebivalol and metoprolol against CIN.Method 184 patients who were hospitalized for further evaluation with coronary angiography and have been using beta blocker agent (50 mg metoprolol, 25 mg carvedilol or 5 mg nebivolol) at least for a week were enrolled to the study. Exclusion criteria included dialysis patients, recent exposure to contrastmedia or a nephrotoxic agent within 7 days before the study, urgent percutaneous coronary intervention (PCI), requiring loop diuretics, theophylline/ aminophylline, dopamine throughout the study, hemodynamically unstable patients. Changes in mean Cr level from baseline to day 2 and day 5 were not statistically significant in all groups.Conclusıon If there is indication for a beta blocker therapy before the coronary angiography procedure, although the comperative results with metoprolol and nebivolol did not reach statistical significance, this study demonstrated a weak evidence favouring against carvedilol prescription as it would be a better choice for the prevention of CIN. metoprolol nebivalol carvedilol p Male 38 (59.4%)a 21 (35%)b 32 (53.3%)a.b 0,02 Female 26 (40.6%)a 39 (65%)b 28 (46.7%)a.b 0.02 Diabetes Mellitus 17 (26.6%) 20 (33.3%) 14 (23.3%) 0.494 Hypertension 51 (79.7%)a 33 (55%)b 36 (60%)b 0.008 Hyperlipidemia 29 (45.3%)a 9 (15%)b 14 (23.3%)b 0.001 Family History of coronary heart disease 9 (14.1%) 3 (5%) 5 (8.3%) 0.228 Smoking 29 (45.3%)a 14 (23.3%)b 25 (41.7%)a.b 0.023 Statin 33 (51.6%) 25 (41.7%) 28 (46.7%) 0.532 ACE 27 (42.2%) 16 (26.7%) 16 (26.7%) 0.114 ARB 18 (28.1%) 14 (23.3%) 16 (26.7%) 0.871 Tiazide 5 (7.8%) 6 (10%) 6 (10%) 0.902 Trimetazidin 3 (4.7%) 4 (6.7%) 3 (5%) 0.925 Metformine 10 (15.6%) 12 (20%) 7 (11.7%) 0.466 CIN 7 (10.9%) 5 (8.3%) 2 (3.3%) 0.283 Table 1 Metoprolol Nebivolol Carvedilol p Age y 59.8±9.74a 58.23±10.6a.b 54.55±10.23b 0.014 BMI kg/m2 30.51±4.68 31.28±14.18 29.93±4.77 0.711 EF % 58.14±9.88 60.45±9.96 57.75±10.1 0.107 Mehran score 3.53±2.86 3.85±2.93 3.37±3.02 0.515 Total contrast dose ml 127.97±73.66a 99.67±39.44a 104.67±79.86b 0.009 Creatinine clearance 89.12±20.46 94.64±25.98 96.69±26.20 0.2 Basal creatinine 0.89±0.21a 0.8±0.2b 0.8±0.16b 0.023 Second day creatinine 0.92±0.26a 0.84±0.22a 0.82±0.17b 0.029 Fifith day creatinine 0.90±0.19a 0.81±0.20b 0.81±0.14b 0.008 HB 13.29±1.48 12.86±1.34 12.9±2.17 0.290 LDL 116.54±34.5 115.52±34.3 119.21±41.1 0.855 TG 161.23±89.2 168.27±151.5 180.38±122.3 0.753 Glukose 114.72±37.3 118.97±57.8 116.87±53.9 0.652 Table 2
Background Outcomes in patients requiring coronary artery bypass graft （CABG） surgery have been improved with devices such as the intra-aortic balloon pump （IABP）.Good coronary collateral circulation ...（CCC） has been shown to reduce mortality in patients with coronary artery disease （CAD）.We aimed to investigate whether poor preoperative CCC grade is a predictor of in-hospital mortality in CABG surgery requiring IABP support.Methods Fifty-five consecutive patients who were undergoing isolated first time on-pump CABG surgery with IABP support were enrolled into this study and CCC of those patients was evaluated.Results Twenty-seven patients had poor CCC and 28 patients had good CCC.In-hospital mortality rate in poor CCC group was significantly higher than good CCC group （14 （50％） vs.4 （13％）,P=0.013）.Preoperative hemoglobin level （OR：0.752; 95％ CI,0.571-0.991,P=0.043）,chronic obstructive pulmonary disease （OR：6.731; 95％ CI,1.159-39.085,P=0.034） and poor CCC grade （OR：5.750; 95％ CI,1.575-20.986,P=0.008） were associated with post-CABG in-hospital mortality.Poor CCC grade （OR：4.853; 95％ CI,1.124-20.952,P=0.034） and preoperative hemoglobin level （OR：0.624; 95％ CI,0.476-0.954,P=0.026） were independent predictors of in-hospital mortality after CABG.Conclusion Preoperative poor CCC and hemoglobin are predictors of in-hospital mortality after CABG with IABP support.
Objectives: Fabry's disease is an X-linked inherited, rare, progressive, lysosomal storage disorder, affecting multiple organs due to the deficient activity of α-galactosidase A (α-Gal A) enzyme. The ...prevalence has been reported to be 0.15-1% in hemodialysis patients; however, the information on the prevalence in chronic kidney disease not on dialysis is lacking. This study aimed to determine the prevalence of Fabry's disease in chronic kidney disease.
Methods: The patients older than 18 years, enclosing KDIGO 2012 chronic kidney disease definitions, not on dialysis, were enrolled. Dried blood spots on Guthrie papers were used to analyze α-Gal A enzyme and genetic analysis was performed in individuals with enzyme activity ≤1.2 μmol/L/h.
Results: A total of 1453 chronic kidney disease patients not on dialysis from seven clinics in Turkey were screened. The mean age of the study population was 59.3 ± 15.9 years. 45.6% of patients were female. The creatinine clearance of 77.3% of patients was below 60 mL/min/1.73 m
2
, 8.4% had proteinuria, and 2.5% had isolated microscopic hematuria. The mean value of patients' α-Gal A enzyme was detected as 2.93 ± 1.92 μmol/L/h. 152 patients had low levels of α-Gal A enzyme activity (≤1.2 μmol/L/h). In mutation analysis, A143T and D313Y variants were disclosed in three male patients. The prevalence of Fabry's disease in chronic kidney disease not on dialysis was found to be 0.2% (0.4% in male, 0.0% in female).
Conclusion: Fabry's disease should be considered in the differential diagnosis of chronic kidney disease with unknown etiology even in the absence of symptoms and signs suggestive of Fabry's disease.
Coronary collateral circulation (CCC) helps to protect and preserve myocardium from episodes of ischemia, and reduce angina symptoms, arrhythmia, and cardiovascular events. Atrial fibrillation (AF) ...is the most frequent form of arrhythmia after coronary artery bypass graft (CABG) surgery. The aim of this study was to investigate the association between CCC and the development of AF in patients undergoing CABG surgery.
A total of 165 patients (mean age 63±10 years, 74% men, 26% women) who were undergoing CABG surgery at our department were enrolled into this study. Patients were categorized into two groups according to preoperative CCC using the Rentrop method.
Of the patients, 79 had poor CCC and 89 had good CCC. The AF incidence rate in the poor collateral group was significantly higher than that in the good collateral group 37 (49%) vs. 12 (14%), P<0.001. In univariate analysis, age, left atrium size, and poor CCC grade were associated with AF after CABG surgery. Multivariate analysis showed that only poor CCC grade (odds ratio: 11.500; 95% confidence interval 3.977-33.253, P<0.001) was an independent predictor of the development of AF after adjustment of other potential confounders in patients undergoing CABG surgery.
The present study showed that preoperative poor CCC is a powerful predictor of the development of AF after CABG surgery.
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