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BackgroundCentral augmentation index (cAIx) is an indicator for vascular stiffness. Obstructive and aneurysmatic vascular disease can affect pulse wave propagation and reflection, causing changes in central aortic pressures.AimTo assess and compare cAIx in patients with peripheral arterial disease (PAD) and / or abdominal aortic aneurysm (AAA).MethodscAIx was assessed by radial applanation tonometry (Sphygmocor) in a total of 184 patients at a tertiary referral centre. Patients were grouped as having PAD only, AAA only, or both AAA and PAD. Differences in cAIx measurements between the three patient groups were tested by non-parametric tests and stepwise multivariate linear regression analysis to investigate associations with obstructive or aneurysmatic patterns of vascular disease.ResultsIn the study sample of 184 patients, 130 had PAD only, 20 had AAA only, and 34 patients had both AAA and PAD. Mean cAIx (%) was 30.5 ± 8.2 across all patients. It was significantly higher in females (35.2 ± 6.1, n = 55) than males (28.4 ± 8.2, n = 129), and significantly higher in patients over 80 years of age (34.4 ± 6.9, n = 22) than in those under 80 years (30.0 ± 8.2, n = 162). Intergroup comparison revealed a significant difference in cAIx between the three patient groups (AAA: 27.3 ± 9.5; PAD: 31.4 ± 7.8; AAA & PAD: 28.8 ± 8.5). cAIx was significantly lower in patients with AAA, higher in patients with both AAA and PAD, and highest in patients with PAD only (beta = 0.21, p = 0.006).ConclusionNon-invasive assessment of arterial stiffness in high-risk patients indicates that cAIx differs according to the pattern of vascular disease. Measurements revealed significantly higher cAIx values for patients with obstructive peripheral arterial disease than for patients with aneurysmatic disease.

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Background: Insomnia has been closely associated with cardiovascular disease (CVD) including myocardial infarction (MI). Our study aims to assess the eligibility of insomnia as a potential risk factor for MI.Methods: PubMed, Scopus, and Web of Science were searched using terms; such as "Insomnia" and "MI." Only observational controlled studies with data on the incidence of MI among insomniacs were included. Revman software version 5.4 was used for the analysis.Results: Our pooled analysis showed a significant association between insomnia and the incidence of MI compared with noninsomniacs (relative risk [RR] = 1.69, 95% confidence interval [CI] = 1.41-2.02, p < .00001). Per sleep duration, we detected the highest association between ≤5 h of sleep, and MI incidence compared to 7−8 h

Was to study the results of open surgical reconstruction of huge abdominal aortic aneurysms (HAAAs) & their complications. Patients and methods: Twenty eight patients with huge abdominal aortic aneurysms were studied in the period from October 2012-March 2015. The diagnosis was done by: history, clinical examination, various imaging which included: Duplex Ultrasound, CTA, MRA, DSA & Mid-stream aortography. Open aortic reconstruction was done by using Bifurcated graft (Collagen coated or PTFE ) or aneurysmorrhaphy in two cases of mycotic saccular aneurysms. Results: The age incidence ranged from 45-78 years with a mean of 64 years. Male sex was predominant than female sex with M:F ratio 6:1. There was a history of Diabetes mellitus, smoking, hypertension, hypercholesterolaemia, obesity, myocardial infarction (seven cases) & renal impairment (two cases). The most common presentation of AAAs were abdominal pain, back pain, pulsating abdominal mass & acute abdomen (in two leaking AAAs). The size of the aneurysm (diameter) ranged between 12-22 cm with a mean of 16 cm, the size was measured by Duplex Ultrasound & CTA. Postoperative Morbidity: lower limb ischemia due to arterial thrombosis was present in two cases & distal embolization in two cases, thrombectomy & embolectomy were done respectively & successfully except one big toe amputated after embolectomy. Myocardial infarction occurred in four cases, two of them died. Another two cases developed uraemia, one of them died. Leaking abdominal aortic aneurysms occurred in two cases, one of them died. The overall all mortality rate within thirty postoperative days was four cases (14.3%), no intraoperative mortality. Conclusion: The morbidity & mortality rates were proportional with increase in size of the aneurysm & increase with the presence of preoperative cardiac, renal dysfunction & risk factors.