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1.
Murat Akcay 《Journal of electrocardiology》2018,51(6):929-933
Introduction
Long-time exposure to high altitude leads to changing at the respiratory, cardiovascular and hematological systems. There is no sufficient study about cardiovascular changes in moderate altitude. The distance between the peak and the end of the T wave (Tp-e) is a measure of transmyocardial distribution of repolarization and may be associated to dangerous rhythm disorders and ventricular arrhythmias. Again, P-wave dispersion (PWD) described as the extension of interatrial and intraatrial conduction time and inhomogeneous spread of sinus pulses are well recognized electrophysiologic features in patients with atrial fibrillation. We aimed to compare repolarization parameters (Tp-e interval, Tp-e/QT ratio, QT, cQT) and P wave dispersion between healthy people living at moderate altitude and sea level.Methods
In this study included 80 healthy people living at moderate altitude (1600?m, Group I) and 90 people living at sea level (0–4?m, Group II). All people were born and grew up at the same altitude area. Being migrant to living area, people with structural heart disease, rhythm disorders, pulmonary diseases or any systemic chronic disease were excluded criteria in the study. Tp-e interval, QT interval, cQT, Tp-e/QT ratio, P wave durations and PWD were measured from D2 and V5 leads with 20?mm/mV amplitude and 50?mm/s rate. All the measurements were repeated three times and were evaluated manually with a magnifying glass.Results
There were no differences in baseline demographic, laboratory, echocardiographic parameters and coronary artery risk factors. The QRS duration (94.2?±?14.8 msn and 90.2?±?9.3 msn, p?=?0.05) and corrected QT time (415.8?±?20.1 msn and 403.9?±?20.5 msn; p?=?0.001), Tp-e interval (86.5?±?11.7 msn and 80.5?±?10.4 msn p?=?0.001) and Tp-e/QT ratio (0.23?±?0.03 msn and 0.22?±?0.03 msn p?=?0.011) were statistically significantly higher in the moderate altitude group. P wave maximum, minimum time and PWD were similar in both groups (p?>?0.05).Conclusion
Moderate altitude leads to subclinical electrocardiographic changes in healthy individuals such as high altitude. Repolarization parameters (Tp-e interval, Tp-e/QT ratio, and cQT) are prolonged without cardiac structural changes. It should be kept in mind that people living in moderate altitude may be more susceptible to arrhythmia in the future, and findings should be supported in large randomized trials. 相似文献2.
Mehmet Demir Umut Uyan 《Clinical and experimental hypertension (New York, N.Y. : 1993)》2014,36(5):285-288
Aims: Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. Several studies have suggested that the interval from the peak to the end of the electrocardiographic T wave (Tp-e) may correspond to the transmural dispersion of repolarization and that increased Tp-e interval and Tp-e/QT ratio are associated with malignant ventricular arrhythmias. The aim of this study was to evaluate ventricular repolarization by using Tp-e interval and Tp-e/QT ratio in patients with non-dipper hypertension.Materials and method: This study included 80 hypertensive patients. Hypertensive patients were divided into two groups: 50 dipper patients (29 male, mean age 51.5?±?8 years) and 30 non-dipper patients (17 male, mean age 50.6?±?5.4 years). Tp-e interval and Tp-e/QT ratio were measured from the 12-lead electrocardiogram. These parameters were compared between groups.Results: No statistically significant difference was found between two groups in terms of basic characteristics. In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QTd were significantly increased in non-dipper patients compared to the dippers (39.4?±?11.5 versus 27.3?±?7.5?ms and 37.5?±?9.5 versus 29.2?±?6.5?ms, p?=?0.001 and p?=?0.01, respectively). Tp-e interval and Tp-e/QT ratio were also significantly higher in non-dipper patients (97.5?±?11.2 versus 84.2?±?8.3?ms and 0.23?±?0.02 versus 0.17?±?0.02, all p value <0.001).Conclusion: Our study revealed that QTd, Tp-e interval and Tp-e/QT ratio are prolonged in patients with non-dipper hypertension. 相似文献
3.
Lior Yankelson Aviram Hochstadt Ben Sadeh Benley Pick Ariel Finkelstein Raphael Rosso Sami Viskin 《Journal of electrocardiology》2018,51(3):481-486
Objectives
To predict the QT interval in the presence of normal QRS for patients with left bundle branch block (LBBB).Background
There is no acceptable method for simple and reliable QT correction for patients with bundle branch block (BBB).Methods
We measured the QT interval in patients with new onset LBBB who had a recent electrocardiogram with narrow QRS for comparison. 48 patients who developed in-hospital LBBB were studied. Patients who had similar heart rate before and after LBBB were included. We used linear regression, the Bogossian method, and our new fixed QRS replacement method to evaluate the most reliable correction method.Results
JTc (QTc-QRS) interval was preserved before and after LBBB (328.9?±?25.4?ms before LBBB vs. 327.3?ms post LBBB (p?=?0.550). Mean predicted preLBBB QTc difference was 1.3?ms, ?21.3?ms and 1.6?ms for the three methods respectively (p?<?0.001 for Bogossian comparison with the other methods). Coefficients of correlation (R) between actual preLBBB QTc with predicted preLBBB QTc were 0.707, 0.683 and 0.665 respectively (p?>?0.3 for R comparisons between all methods). The average absolute difference in preLBBB QTc was 15.5?ms and 16.7?ms for the regression and fixed-gender methods (p value between the two?=?0.321) and 25.5?ms for the Bogossian method, which was found to be significantly underperforming.Conclusions
In patients with LBBB, replacing of the QRS duration after deriving the QTc interval with a fixed value of 88?ms for female and 95?ms for male provides a simple and reliable method for predicting the QTc before the development of LBBB. 相似文献4.
Background
Coronary artery disease is one of the main causes of death in diabetes mellitus (DM). Egypt was listed among the world top 10 countries regarding the number of diabetic patients by the International Diabetes Federation (IDF).Aim of work
Assessment of the extent of coronary atherosclerotic disease and lesion tissue characterization among diabetic compared to non-diabetic Egyptian patients.Methodology
IVUS studies of 272 coronary lesions in 116 patients presented with unstable angina were examined. The patients were divided into two groups: diabetic group (50 patients with 117 lesions) and non-diabetic group (66 patients with 155 lesions).Results
As compared to the non-diabetic group, the diabetic patients were more dyslipidemic (84% vs 39.4%, p?=?0.001) with higher total cholesterol level (194.6?±?35.3 vs 174.4?±?28.5?mg/dl, p?=?0.001) and higher LDL-C (145.3?±?27.1 vs 123.2?±?31.4, p?=?0.001). Regarding lesions characteristics, the diabetic group had longer lesions (19.4?±?7.4 vs 16.3?±?7.9?mm, p?=?0.002) with higher plaque burden (60.8?±?15.3 vs 54.8?±?14.0, p 0.002) and more area stenosis percentage (60.8?±?15.6 vs 55.6?±?14.1, p?=?0.008). Structurally, the diabetic group lesions had more lipid content (19.8?±?8.8 vs 16.8?±?8.7, p?=?0.008) and more necrotic core (17.6?±?7.4 vs 14.7?±?4.8, p?=?0.008) but less calcification (6.9?±?3.6 vs 11.8?±?6.3, p?=?0.001). The RI was negative in both groups, 0.95?±?0.13 in the diabetic group vs 0.98?±?0.19 in non-diabetic group (p?=?0.5). Within the diabetic group lesions, the dyslipidaemic subgroup had more lipid content (23.?±?5.2 vs 14.6?±?8.6, p?=?0.01) but less fibrotic component (48.6?±?4.7 vs 59.1?±?13.6%, p?=?0.01) and less calcification (10.9?±?6.8% vs 14.07?±?3.8%, p?=?0.02) as compared to the nondyslipidaemic subgroup.Conclusions
Diabetic patients with coronary atherosclerosis in Egypt have longer lesions with higher plaque burden and more percent area stenosis with negative remodeling index. The diabetic lesions had more lipid content and more necrotic core but less calcification. 相似文献5.
Objective
Abnormalities in ventricular repolarization (VR) parameters have been associated with sudden cardiac death (SCD) in patients with rheumatoid arthritis (RA). The benefits of cardiac rehabilitation (CR) in patients with RA are well recognized. We aimed to assess its impact on VR indexes in patients with RA.Methods
This study included 45 patients with RA (36 female, age 58?±?5.5?years) and 50 age- and sex-matched otherwise healthy controls. Baseline electrocardiogram (ECG) recordings were used to compare VR parameters such as maximum and minimum QT intervals, and corrected, and dispersion (QTmax, QTmin, cQTmax, cQTmin, QTd, cQTd, respectively), JT and cJT intervals, Tp-e and cTp-e intervals, and Tp-e/QT and Tp-e/cQT ratios in patients with RA and healthy individuals. The effects of 6-week CR in patients with RA were also evaluated by comparing pre- and post-CR ECGs, exercise tolerance test (MET and VO2max) and RA characteristics (C-reactive protein (CRP), Disease Activity Score 28 (DAS28) and Health Assessment Questionnaire(HAQ)).Results
In comparison with the healthy individuals, the patients with RA had significantly higher cQTmax and QTmin intervals, QTd, cQTd, Tp-e and cTp-e intervals, and Tp-e/QT and Tp-e/cQT ratios. At the end of CR, all VR indexes (p?<?005), except QTd, were significantly decreased as did the results for CRP, DAS28, and HAQ (all p?<?0.05), and MET and VO2max (p?<?0.05 for both) were significantly increased in patients with RA.Conclusions
CR may provide an improvement in the majority of VR indexes which are related with ventricular arrhythmia and SCD in patients with RA. Changes in ETT parameters and RA characteristics may contribute to improvement of several VR indexes such as cQTd, cJT and Tp-e intervals at the end of CR. 相似文献6.
Viral N. Shah Mengdi Wu Sarit Polsky Janet K. Snell-Bergeon Jennifer L. Sherr Eda Cengiz Linda A. DiMeglio Rodica Pop-Busui Kara Mizokami-Stout Nicole C. Foster Roy W. Beck 《Journal of diabetes and its complications》2018,32(10):961-965
Aims
To evaluate gender differences in diabetes self-care components including glycemic, blood pressure and lipid control, utilization of diabetes technologies and acute diabetes complications in adults with type 1 diabetes.Methods
A total of 9,481 participants >18 years were included in the analysis, 53% were female. Variables of interest included glycemic control measured by HbA1c, systolic/diastolic blood pressures, presence of dyslipidemia, insulin delivery modality, and rates of acute complications.Results
Glycemic control was similar in women and men (mean HbA1c in both groups: 8.1%?±?1.6% (64?±?16 mmol/mol), (p?=?0.54). More women used insulin pump therapy (66% vs. 59%, p?<?0.001) but use of sensor technology was similar (p?<?=?0.42). Women had higher rates of diabetic ketoacidosis (DKA) (5% vs. 3%, p?<?0.001) and eating disorders (1.7% vs. 0.1%, p?<?0.001). Severe hypoglycemia rates were not different between men and women (p?=?0.42). Smoking (6% vs 4%, p?<?0.001), systolic (125?±?14.2 vs. 121?±?14.4, p?<?0.001) and diastolic blood pressure (73.3?±?9.5 vs. 72.2?±?9.3, p?<?0.001) and rate of dyslipidemia (28% vs. 23%, p?<?0.001) were higher in men.Conclusion
While glycemic control in type 1 diabetes was similar regardless of gender, rates of DKA and eating disorders were higher in women while rates of smoking, hypertension and dyslipidemia were higher in men. 相似文献7.
Alin O. Stirban Cosmina I. Bondor Bogdan Florea Ioan A. Veresiu Norina A. Gavan 《Journal of diabetes and its complications》2018,32(9):851-856
Objective
Advanced glycation end products (AGE) contribute to the development of diabetes complications. Their accumulation in skin can be non-invasively assessed by measurement of skin autofluorescence (SAF). Our study investigated whether SAF correlates with measures of diabetic peripheral neuropathy (DPN).Methods
In a multi-center study (8 centers), 497 consecutive individuals with diabetes mellitus were investigated.Forearm SAF was measured using the AGE Reader (Groningen, The Netherlands). DPN was assessed using the Toronto Clinical Neuropathy Score (TCNS), the Neuropathy Symptoms Score (NSS) and the Neuropathy Disability Score (NDS).Results (mean?±?SD)
According to the TCNS, SAF (arbitrary units - AU) was increased in individuals with DPN (TCNS?>?5): 2.59?±?0.56?AU compared with those without DPN (TCNS?≤?5): 2.45?±?0.53?AU, (p?=?0.04) and significantly increased with the severity of DPN (p?=?0.028).Higher SAF was detected in individuals with neuropathic deficits (NDS?>?2): 2.58?±?0.56?AU vs. those without deficits (NDS?≤?2): 2.45?±?0.53?AU, (p?=?0.009) as well as in individuals with symptoms (NSS?>?2): 2.54?±?0.56?AU vs. those without symptoms (NSS?≤?2): 2.40?±?0.47?AU, (p?=?0.022).Conclusions
Accumulation of AGE in skin is increased in individuals with DPN and progresses with the severity of DPN. Therefore, SAF measurement, an easy-to-use, quick and non-invasive method, might help in identifying subjects at high risk for having DPN. 相似文献8.
Samia Salah-El-Din Mahmoud Doaa Ghaith Yomna Farag Bishoy Ibrahim 《The Egyptian Rheumatologist》2018,40(4):273-276
Introduction
Ferritin is an acute-phase reactant that is elevated in several autoimmune disorders. Serum ferritin levels have been correlated with disease activity scores of juvenile systemic lupus erythematosus (JSLE). Furthermore, enhanced levels of ferritin have also been described in lupus nephritis (LN).Aim of the work
To evaluate serum ferritin as a cheap and available marker of disease activity and renal involvement in Egyptian children with JSLE.Patients and methods
Forty-eight JSLE cases recruited from the Pediatric Rheumatology Clinic in Cairo University Specialized Children’s Hospital and 43 matched healthy children were enrolled in the study. SLE disease activity score-2000 (SLEDAI-2K) and renal activity score were assessed. Serum levels of ferritin, was quantified by enzyme-linked immunosorbent assay.Results
The mean age of the patients was 12.6?±?3.02?years and disease duration 3.4?±?2.5?years. Serum ferritin significantly higher in patients (416.1?±?1022.9?ng/ml) compared with control (36.1?±?18.2?ng/ml) (p?<?0.001). Serum ferritin was significantly higher in active (n?=?20) (890.4?±?1474.8?ng/ml) compared to inactive (n?=?28) (77.4?±?74.1?ng/ml) patients (p?<?0.001). A significant correlation was found between serum ferritin with SLEDAI-2K (r?=?0.35, p?=?0.014), renal-SLEDAI-2K (r?=?0.49, p?<?0.001) and with renal activity score (r?=?0.38, p?=?0.008). A significant correlation was found between serum ferritin and anti-double stranded-DNA (r?=?0.44, p?=?0.002) and complement 3 (r?=??0.42, p?=?0.003).Conclusion
Serum ferritin level can be considered a reliable biomarker for monitoring disease and renal activity in children with JSLE and LN. This may lead to improvement of management and consequently prognosis of JSLE patients as serum ferritin is an available and relatively cheap marker. 相似文献9.
Cem Ozisler Askin Ates Yasar Karaaslan Ozgul Ucar Elalmis Izzet Selcuk Parlak Fulya Dortbas Kubilay Sahin Huseyin Tutkak 《The Egyptian Rheumatologist》2019,41(2)
Aim of the work
Cardiovascular diseases represent a major source of morbidity and mortality for patients with rheumatoid arthritis (RA). The increase in aortic stiffness, carotid intima-media thickness (CIMT) and serum osteoprotegerin (OPG) have been shown to be independent risk factors for cardiovascular events. This work aimed to investigate the clinical significance of these parameters in RA patients.Patients and methods
60 RA patients and 30 control with no primary cardiovascular risk factors were included. Disease activity score (DAS28) was assessed in patients. Aortic stiffness was evaluated by transthoracic echocardiography and CIMT evaluated by Doppler ultrasonography. OPG was determined by ELISA.Results
The 60 RA patients had a mean age of 40.8?±?8.3?years, disease duration of 6.9?±?4.9?years and were 46 females and 14 males. In RA patients, serum OPG and CIMT (thickest and mean) were significantly higher than the control (60.5?±?32.4?pg/ml vs 29.4?±?16.7?pg/ml, p?<?0.001; 0.73?±?0.18?mm vs 0.63?±?0.13?mm, p?<?0.001; 0.61?±?0.1?mm vs 0, 56?±?0.1?mm, p?=?0.007, respectively). The aortic stiffness tended to be higher in patients (6.9?±?4.8 vs 5.2?±?2.5, p?=?0.114) and in males (9.7?±?7.4) vs females (5.7?±?3.4, p?=?0.013). OPG levels were significantly higher in those with erosions (n?=?41) (68.6?±?34.5?pg/ml vs 49.1?±?22?pg/ml p?=?0.038) and in those seropositive (n?=?54) (65.4?±?32.2?pg/ml vs 36?±?18.3?pg/ml p?=?0.012). In patients, CIMT (thickest and mean) correlated significantly with the aortic stiffness (p?=?0.02 and p?=?0.04 respectively).Conclusion
RA is an independent risk factor associated with cardiovascular events. For determining this risk, measuring the serum OPG, CIMT and aortic stiffness may be a useful guide. 相似文献10.
Ozgur Kaplan Ertugrul Kurtoglu Gokay Nar Erdogan Yasar Gokhan Gozubuyuk Cem Dogan Ahmet Ugur Boz S?ho Hidayet Hasan Pekdemir 《Arquivos brasileiros de cardiologia》2015,105(6):566-572
Background
The association between periatrial adiposity and atrial arrhythmias has been shown in previous studies. However, there are not enough available data on the association between epicardial fat tissue (EFT) thickness and parameters of ventricular repolarization. Thus, we aimed to evaluate the association of EFT thickness with indices of ventricular repolarization by using T-peak to T-end (Tp-e) interval and Tp-e/QT ratio.Methods
The present study included 50 patients whose EFT thickness ≥ 9 mm (group 1) and 40 control subjects with EFT thickness < 9 mm (group 2). Transthoracic echocardiographic examination was performed in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead electrocardiogram.Results
QTd (41.1 ± 2.5 vs 38.6 ± 3.2, p < 0.001) and corrected QTd (46.7 ± 4.7 vs 43.7 ± 4, p = 0.002) were significantly higher in group 1 when compared to group 2. The Tp-e interval (76.5 ± 6.3, 70.3 ± 6.8, p < 0.001), cTp-e interval (83.1 ± 4.3 vs. 76±4.9, p < 0.001), Tp-e/QT (0.20 ± 0.02 vs. 0.2 ± 0.02, p < 0.001) and Tp-e/QTc ratios (0.2 ± 0.01 vs. 0.18 ± 0.01, p < 0.001) were increased in group 1 in comparison to group 2. Significant positive correlations were found between EFT thickness and Tp-e interval (r = 0.548, p < 0.001), cTp-e interval (r = 0.259, p = 0.01), and Tp-e/QT (r = 0.662, p < 0.001) and Tp-e/QTc ratios (r = 0.560, p < 0.001).Conclusion
The present study shows that Tp-e and cTp-e interval, Tp-e/QT and Tp-e/QTc ratios were increased in subjects with increased EFT, which may suggest an increased risk of ventricular arrhythmia. 相似文献11.
Maya Fayfman Georgia Davis Elizabeth W. Duggan Maria Urrutia David Chachkhiani Joanna Schindler Francisco J. Pasquel Rodolfo J. Galindo Priyathama Vellanki David Reyes-Umpierrez Heqiong Wang Guillermo E. Umpierrez 《Journal of diabetes and its complications》2018,32(12):1091-1096
Aim
We investigated if a dipeptidyl peptidase-4 inhibitor, sitagliptin, can prevent perioperative stress hyperglycemia in patients without prior history of diabetes mellitus undergoing general surgery.Methods
This double-blind pilot trial randomized general surgery patients to receive sitagliptin (n?=?44) or placebo (n?=?36) once daily, starting one day prior to surgery and continued during the hospital stay. The primary outcome was occurrence of stress hyperglycemia, defined by blood glucose (BG) >140?mg/dL and >180?mg/dL after surgery. Secondary outcomes included: length-of-stay, ICU transfers, hypoglycemia, and hospital complications.Results
BG >140?mg/dL was present in 44 (55%) of subjects following surgery. There were no differences in hyperglycemia between placebo and sitagliptin (56% vs. 55%, p?=?0.93). BG >180?mg/dL was observed in 19% and 11% of patients treated with placebo and sitagliptin, respectively, p?=?0.36. Both treatment groups had resulted in similar postoperative BG (148.9?±?29.4?mg/dL vs. 146.9?±?35.2?mg/dL, p?=?0.73). There were no differences in length-of-stay (4 vs. 3?days, p?=?0.84), ICU transfer (3% vs. 5%, p?=?1.00), hypoglycemia <70?mg/dL (6% vs. 11%, p?=?0.45), and complications (14% vs. 18%, p?=?0.76).Conclusion
Preoperative treatment with sitagliptin did not prevent stress hyperglycemia or complications in individuals without diabetes undergoing surgery. 相似文献12.
Abdulameer A. Al-Mosawi Hussein Nafakhi Mohammed Bader Hassan Mohammed Alareedh Hasan A. Al-Nafakh 《Journal of electrocardiology》2018,51(4):569-572
Background
Several novel ECG markers are proposed to predict the risk of sudden cardiac death in several clinical conditions in the recent years. However, little is known about the association of pericardial fat or obesity with these markers.Objectives
To assess the possible relationship between pericardial fat volume (PFV) and body mass index (BMI) with novel ECG markers (Tp-e, Tp-e/QT, Tp-e/QTc*QRS and QTc/QRS) in patients with coronary atherosclerosis.Patients and methods
We enrolled 100 patients with suspected coronary artery disease who underwent 64-slice multi-detector CT angiography.Results
Higher values of Tp-e/QTc*QRS and QTc/QRS were observed among high PFV group in comparison to low PFV group particularly in patient with coronary atherosclerosis and these relationships persisted after adjustment for cardiac risk factors and coronary calcium score (CAC) while no significant differences in QTc, Tp-e, Tp-e/QTc and Tp-e/QRS values were observed between the PFV groups in patients without coronary atherosclerosis. There was no significant difference in QTc, Tp-e/QTc, Tp-e/QRS, Tp-e/QTc*QRS and QTc/QRS observed between the BMI groups either in patients with and without coronary atherosclerosis.Conclusion
PFV and not obesity measured by BMI is significantly associated with novel ECG markers of arrhythmia risk in patients with coronary atherosclerosis. These results could suggest the potential role of PFV in cardiac arrhythmogenesis through depolarization–repolarization conduction abnormalities. 相似文献13.
Background
Left ventricular (LV) global longitudinal strain (GLS) reliably assesses LV systolic function. The precise relation between LV wall stress and serum Brain natriuretic peptide (BNP) concentrations in hemodialysis (HD) patients needs to be clarified. BNP levels are raised in patients with end-stage renal disease (ESRD) and could reflect LV impairment among HD patients.Aim of this work
This study sought to evaluate the clinical utility of LV-GLS, wall stress and serum BNP levels in chronic HD patients. The correlations between BNP levels with both LV wall stress and LV-GLS were assessed.Patients and methods
30 ESRD patients on regular HD {categorized into 15 patients with LV ejection fraction (EF)?≤?50% and 15 patients with LV EF?>?50%} and 15-age matched healthy subjects were included. LV function and structure were assessed by conventional echocardiography including LV meridional wall stress (LVMWS), LV mass index (LVMI) and 2-dimensional speckle tracking echocardiography for determination of LV-GLS. Serum BNP levels were evaluated after HD session.Results
There were significant increase of LVMSW (189.2?±?81 vs. 72.2?±?20.6?dynes/cm2?×?1000, P?<?0.0001), higher levels of BNP (1238?±?1085.5 vs. 71?±?23.4?pg/ml, P?<?0.0001) while LV-GLS was significantly reduced (15.1?±?3.1 vs. 20.8?±?1.7%, P?<?0.0001) in HD patients compared to controls. Higher values of LVMWS (246.9?±?67.5 vs. 131.5?±?43.6?dynes/cm2?×?1000, P?<?0.0001) and BNP (1925.4?±?1087 vs. 550.5?±?496.5?pg/ml, P?<?0.0005) with further impairment of LV-GLS (13.8?±?2.5 vs. 16.4?±?5.4%, P?<?0.05) were found in patients with LV EF?≤?50% than those with LV EF?>?50%. Serum levels of BNP were positively correlated with LVMI (r?=?0.896, P?<?0.0001) and LVMWS (r?=?0.697, P?<?0.0001) but negatively correlated with LV-GLS (r?=??0.587, P?<?0.0001).Conclusion
LV-GLS and LVMWS are useful imaging markers for detection of LV dysfunction in HD patients. Serum BNP level is influenced by LV structural abnormalities and suggested to be a crucial hemodynamic biomarker in those patients. 相似文献14.
Dalia H. El-Lebedy Alshaymaa A. Ibrahim Ingy O. Ashmawy 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(5):643-648
Aims
Vaspin and irisin are novel cytokines proposed as potential new biomarkers of insulin resistance and endothelial dysfunction. This work is to investigate circulating levels of vaspin and irisin in patients with type 2 diabetes mellitus (T2DM) with and without cardiovascular disease (CVD) to study potential association with disease risk.Materials and Methods
Circulating levels of vaspin and irisin were assayed in serum from 135 T2DM patients (with and without CVD) and 70 control subjects by ELISA.Results
Vaspin levels were significantly higher in T2DM patients than in control subjects (6798?±?3540?pg/ml vs. 3215?±?3209?pg/ml, p?=?0.001) and in CVD patients than in non-CVD patients (7417.3?±?3507.6?pg/ml vs. 6017.3?±?3606.4?pg/ml, p?=?0.001), with significant positive correlations with BMI, FPG, serum insulin and HOMA-IR. Irisin levels were significantly lower in T2DM patients than in controls (71.15?±?67.57?ng/ml vs.127?±?71.57?ng/ml, p?=?0.004), and in CVD patients than in non-CVD patients (55.77?±?54.82?ng/ml vs. 115.5?±?67?ng/ml, p?=?0.003), with significant correlations with HbA1c, HOMA-IR and BMI in diabetic patients, and with HbA1c and TG in CVD patients. Elevated levels of vaspin was associated with 1.7 times increased CVD risk (p?=?0.001, OR?=?1.7, 95%CI?=?1.21–2.39), while lower levels of irisin associated with 1.6 times increased CVD risk (p?=?0.007, OR?=?1.6, 95%CI?=?1.45–2.28). ROC analysis indicated serum vaspin and irisin as independent CVD risk biomarkers with sensitivity, 94% and 73.7%, and specificity, 74% and 74.1%; respectively.Conclusion
Our results indicate that circulating vaspin and irisin are potential new independent CVD risk biomarkers in T2DM. 相似文献15.
Marcelo Alves Alvarenga William Ricardo Komatsu Joao Roberto de Sa Antonio Roberto Chacra Sergio Atala Dib 《Diabetology & metabolic syndrome》2018,10(1):77
Background
Clinical inertia is related to the difficulty of achieving and maintaining optimal glycemic control. It has been extensively studied the delay of the period to insulin introduction in type 2 diabetes mellitus (T2DM) patients. This study aims to evaluate clinical inertia of insulin treatment intensification in a group of T2DM patients followed at a tertiary public Diabetes Center with limited pharmacologic armamentarium (Metformin, Sulphonylurea and Human Insulin).Methods
This is a real life retrospective record based study with T2DM patients. Demographic, clinical and laboratory characteristics were reviewed. Clinical inertia was considered when the patients did not achieve the individualized glycemic goals and there were no changes on insulin daily dose in the period.Results
We studied 323 T2DM patients on insulin therapy (plus Metformin and or Sulphonylurea) for a period of 2 years. The insulin daily dose did not change in the period and the glycated hemoglobin (A1c) ranged from 8.8?+?1.8% to 8.7?±?1.7% (basal vs 1st year; ns) and to 8.5?±?1.8% (basal vs 2nd year; p?=?0.035). The clinical inertia prevalence was 65.8% (basal), 61.9% (after 1 year) and 58.2% (after 2 years; basal vs 1st year vs 2nd year; ns). In a subgroup of 100 patients, we also studied the first 2 years after insulin introduction. The insulin daily dose ranged from 0.22?±?0.12 to 0.32?±?0.24 IU/kg of body weight/day (basal vs 1st year; p?<?0.001) and to 0.39?±?0.26 IU/kg of body weight/day (basal vs 2nd year; p?<?0.05). The A1c ranged from 9.6?+?2.1% to 8.6?+?2% (basal vs 1st year; p?<?0.001) and to 8.7?+?1.7% (1st year vs 2nd year; ns). The clinical inertia prevalence was 78.5% (at the moment of insulin therapy introduction), 56.2% (after 1 year; p?=?0.001) and 62.2% (after 2 years; ns).Conclusion
Clinical inertia prevalence ranged from 56.2 to 78.5% at different moments of the insulin therapy (first 2 years and long term) of T2DM patients followed at a tertiary public Diabetes Center from an upper-middle income country with limited pharmacologic armamentarium.16.
Hania S. Zayed Amr Amin Samy Alsirafy Nahla D. Elsayed Soheir Abo Elfadl Mohamed Nasreldin Dalia Enaba Zeinab Nawito 《Arab Journal Of Gastroenterology》2018,19(2):71-75
Background and study aims
Central nervous system (CNS) involvement in hepatitis C virus (HCV) infection has different facets such as anxiety, depression, cognitive impairment and vasculitis. We were interested in detecting subclinical CNS involvement in chronic HCV infected subjects with and without systemic vasculitis.Patients and methods
Nineteen patients (15 females and 4 males) with chronic HCV infection (mean age 46.5?±?7 and mean duration since diagnosis of HCV infection 4.7?±?4?years, including 6 (32%) Child-Pugh class A cirrhotic patients) and 30 age, sex and education matched healthy control subjects were studied. Thirteen patients had associated vasculitis. Patients and control subjects were assessed using the block design and comprehension subtests of Wechsler Bellevue Adult Intelligence Scale, Wechsler Memory scale (WMS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). Brain HMPAO Single Photon Emission Computed Tomography (SPECT) was performed for HCV patients.Results
Patients with HCV had lower scores on the block design test compared to control subjects (8.37?±?1.89 versus 10.37?±?1.47, p?<?0.001), lower total WMS scores (43.15?±?10.49 versus 60.27?±?8.08, p?<?0.001) and higher anxiety and depression scores (16.94?±?10.46 and 37.17?±?10.38 versus 10.3?±?4.67 and 28.9?±?5.99, p?=?0.004 and 0.001, respectively). Total WMS were lower in HCV patients with vasculitis compared to those without vasculitis (39.14?±?9.3 versus 51.17?±?8.3, p?=?0.019) while the block design and comprehension tests, BAI and BDI were not significantly different between both groups. The block design and comprehension tests, WMS, BAI and BDI were not significantly different between cirrhotic and non-cirrhotic patients. Seven patients had different patterns of cerebral hypoperfusion on SPECT, and all of them had associated vasculitis. Abnormal SPECT was associated with lower total WMS scores (35.87?±?10.8 versus 46.79?±?8.6 in those with normal SPECT, p?=?0.049).Conclusions
Vasculitis may contribute to the development of neuropsychiatric involvement in HCV patients. 相似文献17.
Background
The beneficial effects of atrial septal defect (ASD) device closure on electrical cardiac remodeling are well established. The timing at which these effects starts to take place has yet to be determined.Objectives
To determine the immediate and short term effects of ASD device closure on cardiac electric remodeling in children.Methods
30 pediatric patients were subjected to 12 lead Electrocardiogram immediately before ASD device closure, 24 h post procedure, 1 and 6?months after. The maximum and minimum P wave and QT durations in any of the 12 leads were recorded and P wave and QT dispersions were calculated and compared using paired T test.Results
The immediate 24?h follow up electrocardiogram showed significant decrease in P maximum (140.2?±?6 versus 130.67?±?5.4?ms), P dispersion (49.73?±?9.01 versus 41.43?±?7.65?ms), PR interval (188.7?±?6.06?ms versus 182.73?±?5.8?ms), QRS duration (134.4?±?4.97?ms versus 127.87?±?4.44), QT maximum (619.07?±?15.73?ms versus 613.43?±?11.87), and QT dispersion (67.6?±?5.31 versus 62.6?±?4.68?ms) (P?=?0.001). After 1?month all the parameters measured showed further significant decrease with P dispersion reaching 32.13?±?6 (P?=?0.001) and QT dispersion reaching 55.0?±?4.76 (P?=?0.001). These effects were maintained 6?months post device closure.Conclusion
Percutaneous ASD device closure can reverse electrical changes in atrial and ventricular myocardium as early as the first 24 h post device closure. 相似文献18.
Letícia Dinis da C. Braga Amelio F. Godoy-Matos Priscila de Oliveira Siciliano José Otávio do Amaral Corrêa Denise Pires Carvalho 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(5):673-675
Aims
Dipeptidyl peptidase-4 (DPP4) is an adipokine with greater expression in visceral fat and related with insulin resistance (IR). Polycystic ovary syndrome (PCOS) is also associated with IR. Our study aims to evaluate DPP4 activity in PCOS.Materials and Methods
Thirty PCOS patients were compared to 28 healthy women. Body composition by dual X-ray absorptiometry (DXA), plasma activity of DPP4 and biochemical variables were performed. All participants underwent an oral glucose tolerance test for insulin and glucose analysis.Results
DPP4 activity was similar in both groups (PCOS 5823?±?926 vs Control 5501.8?±?975; p?=?0.20). PCOS patients were more IR with lower levels of SHBG (32 vs 47, p?=?0.02) and Matsuda index (15.6 vs 20.4, p?=?0.03) and higher HOMA-IR (2.8 vs 1.7, p?<?0.01), in addition to increased levels of testosterone (55 vs 25, p?<?0.01). DPP4 was correlated to HbA1c (r?=?0.279, p?=?0.03), HDL-c (r?=??0.28, p?=?0.03) and SHBG (r?=??0.256, p?=?0.05).Conclusions
Although PCOS was well characterized as IR and hyperandrogenic, DPP4 was not different in this group. However, a relationship between DPP4 and markers of IR were found. More studies are warranted. 相似文献19.
Tomoyuki Kabutoya Yasushi Imai Yasuhiro Yokoyama Ayako Yokota Tomonori Watanabe Takahiro Komori Kazuomi Kario 《Journal of electrocardiology》2018,51(6):1099-1102
Background
The association between the vectorcardiographic QRS area, bundle branch pattern and clinical long-term prognosis in patients who have undergone cardiac resynchronization therapy (CRT) has been unclear.Methods
We enrolled 50 consecutive patients who underwent CRT. Vectorcardiograms were constructed from preprocedural digital 12-lead electrocardiograms using the inverse Dower method. The vectorcardiographic QRS area was defined as the root of the sum of the square in the integral between the ventricular deflection curve and the baseline from QRS beginning to end in leads X, Y, and Z. The primary endpoints were total mortality and admission due to heart failure.Results
The vectorcardiographic QRS area in left bundle branch block (N?=?13), right bundle branch block (N?=?13), interventricular conduction delay (N?=?11) and pacemaker rhythm (N?=?13) were 218?±?99, 97?±?44, 90?±?40, and 131?±?58?μVs, respectively (ANOVA p?<?0.001). During the mean follow-up period of 28 (2–86) months, 13 primary endpoints occurred. We divided patients into two groups: a large QRS area group (QRS area ≥114?μVs, N?=?25) and a small QRS area group (QRS area <114?μVs, N?=?25) by the median. The large QRS area group had a significantly lower rate of the primary endpoint compared with that of the small QRS area group (log rank 4.35, p?=?0.037). The Cox regression analysis revealed that a QRS area <114?μVs was a significant predictor of the primary endpoint (HR 3.98, 95% CI 1.01–15.63, p?=?0.048).Conclusions
A larger preprocedural vectorcardiographic QRS area was associated with left bundle branch block and good prognosis in patients who underwent CRT. 相似文献20.
Pedro Brito Jorge Costa Nuno Gomes Sandra Costa Jorge Correia-Pinto Rufino Silva 《Journal of diabetes and its complications》2018,32(7):643-649