Lütfi Akyol

Is there any relationship between RDW levels and atrial fibrillation in hypertensive patient

BACKGROUNDnAtrial fibrillation (AF) is the most common cardiac arrhythmia and increases the risk of stroke and death. Patients with hypertensive have an increased risk of developing atrial fibrillation. RDW (Red blood cell distribution width) levels are elevated in cardiovascular disorders including heart failure, stable coronary disease, acute coronary syndrome, slow coronary flow and stroke.nnnOBJECTIVEnWe aimed to investigate the relation between RDW and AF in patients with hypertensive.nnnMETHODnWe retrospectively examined 126 consecutive hypertensive patients (63 hypertensive patients with AF and 63 hypertensive patients without AF matched with age and sex.nnnRESULTSnThe mean age of the study population was 71,09± 8,50 (af group) and 70,97±8,24 (non-af group) years. RDW level was different among patients with atrial fibrillation and without atrial fibrillation.(15,13±1,58 and 14,05±1,15 p<001) . Logistic regression analysis showed that RDW and left atrial dimension were only independently risk factory associated with atrial fibrillation. (Rdw odds ratio:1,846 CI; 1,221-2,793 p<0,05). Roc curve analyses were applied to determine the cut-off point. Cut-off point was at 14,195 and Sensitive, specificity was %71,4, %56 respectively.nnnCONCLUSIONnRDW levels were higher in hypertensive patients with atrial fibrillation. An increased RDW level in the patient with hypertension may alert physician on developing or presence of atrial fibrillation.

Cardiometabolic risk factors in patients with erectile dysfunction.

Introduction. There is an increasing interest in the association between erectile dysfunction (ED) and cardiovascular risk factor. Epicardial adipose tissue (EAT) is associated with insulin resistance, increased cardiometabolic risk, and coronary artery disease. Our aim was to investigate relationships between epicardial fat thickness (EFT) as a cardiometabolic risk factor and erectile dysfunction. Method. We selected 30 erectile dysfunction patients without comorbidities and 30 healthy individuals. IIEF-5 score was applied to all patients, and IIEF-5 score below 22 was considered as erectile dysfunction. EFT was measured by echocardiography. Results. Body mass index (BMI) was higher in ED patients than those without ED (28.19 ± 4.45u2009kg/m2 versus 23.84 ± 2.36u2009kg/m2, P = 0.001, resp.). Waist circumstance (WC) was higher in ED patients than those without ED (106.60 ± 5.90 versus 87.86 ± 14.51, P = 0.001, resp.). EFT was higher in ED patients compared to non-ED patients (0.49 ± 0.09u2009cm versus 0.45 ± 0.03u2009cm, P = 0.016, resp.). There was positive correlation among BMI, WC, and EFT. There was negative correlation between EFT and IIEF-5 score (r : − 0.632, P = 0.001). Conclusion. EAT, BMI, and WC as cardiometabolic risk factors were higher in erectile dysfunction patients.

Detection of atrial electrical and mechanical dysfunction in non-dipper pre-hypertensive subjects.

Abstract Introduction: A relationship between atrial conduction time and hypertension was shown in previous studies. Increased atrial electromechanical intervals used to predict atrial fibrillation by measured tissue Doppler imaging (TDI). So we aimed to search if there was any association between the non-dipping status and atrial electromechanical intervals in pre-hypertensive patients. Methods: Forty-one non-dipper and 33 dipper pre-hypertensive subjects enrolled in the study. Systolic and diastolic blood pressures were measured with a mercury sphygmomanometer. Twenty-four hours blood pressure was measured with cuff-oscillometric method. All patients were evaluated by transthoracic echocardiography. Using tissue Doppler imaging (TDI), atrial electromechanical coupling (PA) was measured from the lateral mitral annulus (PA lateral), septal mitral annulus (PA septum) and right ventricular tricuspid annulus (PA tricuspid). Results: Systolic and diastolic blood pressures were significantly higher in subjects with non-dipper phenomenon than dipper ones at night. Twenty-four hours average systolic and diastolic blood pressures were higher in non-dipper pre-hypertensive subjects, but this elevation was not significant. Left and right intraatrial (PA lateral-PA septum and PA septum-PA tricuspid) and interatrial (PA lateral-PA tricuspid) electromechanical coupling intervals were measured significantly higher in non-dipper pre-hypertensive patients (31.3u2009±u20093.9 versus 24.1u2009±u20092.3, pu2009=u20090.001; 19.5u2009±u20094.3 versus 13.8u2009±u20092.1, pu2009=u20090.001; and 11.4u2009±u20092.8 versus 8.8u2009±u20091.5, pu2009=u20090.001). Also, interatrial electromechanical delay was negatively correlated with dipping levels. Conclusion: This study showed that prolonged atrial electromechanical intervals were related non-dipper pattern in pre-hypertensive patients. Prolonged electromechanical intervals may be an early sign of subclinical atrial dysfunction and arrhythmias’ in non-dipper pre-hypertensive patients.

Elevated neurofilament light chain (NFL) mRNA levels in prediabetic peripheral neuropathy.

Evidence suggests that peripheral nerve injury occurs during the early stages of disease with mild glycemic dysregulation. Two proteins, neuron-specific enolase (NSE) and neurofilament light chain (NFL), have been examined previously as possible markers of neuronal damage in the pathophysiology of neuropathies. Herein, we aimed to determine the potential value of circulatory NSE and NFL mRNA levels in prediabetic patients and in those with peripheral neuropathy. This prospective clinical study included 45 prediabetic patients and 30 age- and sex-matched controls. All prediabetic patients were assessed with respect to diabetes-related microvascular complications, such as peripheral neuropathy, retinopathy and nephropathy. mRNA levels of NSE and NFL were determined in the blood by real-time polymerase chain reaction. NSE mRNA levels were similar between prediabetic and control groups (pxa0>xa00.05), whereas NFL mRNA levels were significantly higher in prediabetics than in controls (pxa0<xa00.001). NSE mRNA levels did not significantly differ between prediabetic patients with and without peripheral neuropathy (pxa0>xa00.05), while NFL mRNA levels were significantly higher in prediabetics with peripheral neuropathy than in those without (pxa0=xa00.038). According to correlation analysis, NFL mRNA levels were positively correlated with the Douleur Neuropathique 4 questionnaire score in prediabetic patients (rxa0=xa00.302, pxa0=xa00.044). This is the first study to suggest blood NFL mRNA as a surrogate marker for early prediction of prediabetic peripheral neuropathy, while NSE mRNA levels may be of no diagnostic value in prediabetic patients.

Relationship between kidney volume and body indexes in the Turkish population determined using ultrasonography

OBJECTIVEnTo estimate the kidney volume of the healthy Turkish population using ultrasound and to evaluate the relationship between kidney volume and body indexes.nnnMATERIALS AND METHODSnKidney ultrasound evaluation was performed on 152 patients (mean age: 42 ± 13.7 years). Kidney length, width and thickness were measured using ultrasound. Mean total and parenchymal volume were also calculated. Patients age, sex, weight, height and body mass index (BMI) (kg/m²) were recorded.nnnRESULTSnAccording to ultrasound, kidney lengths were 10.3 ± 7.8 cm for the right and 10.4 ± 9 cm for the left. Volumes were 158 ± 39 cm3 for the right and 168 ± 40 cm3 for the left. Volumes in women were 151.8 ± 39 cm3 for the right and 159.8 ± 37 cm3 for the left, and 164.3 ± 38 cm3 for the right and 175.8 ± 41 cm3 for the left in men. Kidney measurements correlated with body height and weight. A strong correlation with total kidney volume and kidney measurements was determined for body weight for both kidneys (p<0.001). A significant correlation with kidney volume and width was determined for both kidneys (p<0.001). A positive correlation was also found between parenchymal and total kidney volume for both kidneys (p<0.001).nnnCONCLUSIONnThe most significant factors associated with kidney volume for both kidneys in the Turkish population are kidney width and body weight. Measuring kidney volume with ultrasound is a feasible modality and is widely available for daily clinical practice.

Uyku Apne Sendromlu Hastalarda Otonomik Fonksiyonların Değerlendirilmesi

Aim Obstructive sleep apnea is a highly prevalent disease, affecting 4% of adult in western countries. Heart rate variability is decreased in obstructive sleep apnea patients, and it is associated with poor cardiovascular outcome. We aimed to evaluate autonomic function in obstructive sleep apnea patients with heart rate variability. Material and Method We selected 30 obstructive sleep apnea patients without comorbidity and 30 healthy individual. All patients underwent 24 hours holter monitoring to assess heart rate variability. Results Age and gender were not different in two groups. Body mass index was higher in obstructive sleep apnea patients compared to the control group (36.43±6.8 and 27.21±36.4, p=0.001 respectively). SDNN was lower in obstructive sleep apnea patients than the control group (128.73±31.27 and 144.80±37.74, p=0.021 respectively). LF and LF/HF value were higher in patients with obstructive sleep apnea compared to those with control (680.76±319.47 vs. 524.87±348.78, p=0.02 and 4.745±2.16 vs. 2.9583±1.79, p=0.001 respectively). HF was lower in obstructive sleep apnea patients compared to control group (238.00±96.07 and 167.57±75.09, p=0.007 respectively). Conclusion We detected reduced heart rate variability and impaired balance between sympathetic-parasympathetic systems in OSAS patients. OSAS patients should be closely followed for developing arrhythmias.

Mean platelet volume is associated with myocardial perfusion defect in diabetic patients.

Summary Aim Our aim was to evaluate whether there was a relationship between mean platelet volume and myocardial perfusion defect in diabetic patients using myocardial perfusion imaging. Method Forty-four diabetic patients with myocardial perfusion defect (group 1) and 44 diabetic patients without myocardial perfusion defect (group 2), matched for age and gender, were retrospectively examined. Levels of mean platelet volume (MPV) in the two groups were assessed. Results MPV was higher in group 1 than group 2 patients (8.76 ± 0.76 and 8.25 ± 0.78 fl), respectively, p = 0.003). Levels of glucose, triglycerides (TG), total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, haemoglobin (Hb) and glycosylated haemoglobin (HbA1c), and body mass index (BMI) in the two groups were not statistically significantly different. Multivariate logistic regression analyses showed that MPV was the only variable independently associated with myocardial perfusion defects (OR: 2.401, 95% CI: 1.298–4.440, p = 0.013). Conclusion This study showed that higher MPV was associated with myocardial perfusion defects. Higher MPV in diabetic patients was independently related to myocardial perfusion defects and may be an indicator of myocardial ischaemia.

UYKU APNE SENDROMU OLAN HASTALARDA KARDİYOVASKÜLER HASTALIĞIN BİR GÖSTERGESİ OLAN AORTİK SERTLİĞİN EKOKARDİYOGRAFİ İLE DEĞERLENDİRİLMESİ

Aim:Obstructive characterized with intermittant obstruction of upper air tracts and leading to somnolence during all day. Aortic stiffness is associated with poor cardiovascular outcome and an early indicator of mortality and morbidity. In the present study we aimed to investigate aortic stiffness and aortic dispensability in OSAS patients. Material and methods: We selected 30 obstructive apnea syndrome patients without co-morbidities and 30 healthy individuals. All patients underwent echocardiography to measure aortic stiffness and compared to between groups. Results: There is no difference in term of age and sex in two groups. There were no difference in ejection fraction, thickness of interventiculer septum and posterior wall in between groups. Aortic strain was higher in OSAS patients compared to healthy individuals (8.64±3.41 and 5.92±2.43, p=0.024). Also, aortic dispensability was lower in OSAS patients than those with control groups (2.30±1.98 and 3.35±1.38, p=0.021). Conclusion: Aortic stiffness was increased where as aortic dispensability was decreased in obstructive sleep apnea patients without co-morbidities. Arterial stiffness could be easily evaluated by transthoracic echocardiography in OSAS patients and these patients should be evaluated in detail to follow up and threat in terms of cardiovascular disease