Background and aims: Visceral obesity is a marker of dysfunctional adipose tissue and ectopic fat infiltration. Many studies have shown that visceral fat dysfunction has a close relationship with cardiovascular disease. For a better identification of visceral adiposity dysfunction, the visceral adiposity index (VAI) is used. Coronary artery calcium score (CACS) is known to have a strong correlation with the total plaque burden therefore provides information about the severity of the coronary atherosclerosis. CACS is a strong predictor of cardiac events and it refines cardiovascular risk assessment beyond conventional risk factors. Our aim was to evaluate the association between VAI and CACS in an asymptomatic Caucasian population. Methods and results: Computed tomography scans of 460 participants were analyzed in a crosssectional, voluntary screening program. A health questionnaire, physical examination and laboratory tests were also performed. Participants with a history of cardiovascular disease were excluded from the analysis. Mean VAI was 1.41 AE 0.07 in men and 2.00 AE 0.15 in women. VAI showed a positive correlation with total coronary calcium score (r Z 0.242) in males but not in females. VAI was stratified into tertiles by gender. In males, third VAI tertile was independently associated with CACS>100 (OR: 3.21, p Z 0.02) but not with CACS>0 after the effects of conventional risk factors were eliminated. Conclusion: VAI tertiles were associated with calcium scores and the highest VAI tertile was an independent predictor for the presence of CACS>100 in males but not in females.

Detecting early-stage atherosclerosis is an important step towards cardiovascular disease prevention. Coronary artery calcium (CAC) score is a sensitive and non-invasive tool for detecting coronary atherosclerosis. Higher serum uric acid (SUA) levels are known to be associated with cardiovascular diseases. However, there is inconsistency regarding the independence of the association. The aim of our study was to assess the association of CAC and SUA in an asymptomatic population. CAC scans of 281 participants were analyzed in a voluntary screening program. A health questionnaire, physical examination, and laboratory tests were also performed. Participants with a history of cardiovascular disease were excluded from the analysis. 36.3% ( n = 102) of the participants had no detectable CAC and 13.9% ( n = 39) had a CAC score of > 300. SUA showed positive correlation with CAC score (0.175, p < 0.01). SUA was independently associated with Ca score > 300 (OR 5.17, p = 0.01) after the effects of conventional risk factors were eliminated.

Bevezetés: Az egyes európai országokban a prevenciós tevékenységnek köszönhető morbiditáscsökkenést Magyarországon még nem sikerült elérni. A hatékony prevenció alapfeltétele a lakosság egészségi állapotának, a kockázati tényezők jelenlétének pontos ismerete. Célkitűzés: A szerzők célja volt, hogy egy közép-magyarországi longitudinális lakossági vizsgálattal információt nyerjenek a magyar lakosság egészségi állapotáról, cardiovascularis kockázati státu-sáról, ami lehetővé teszi új rizikóbecslést befolyásoló tényezők azonosítását. Módszer: A Budakalász Vizsgálat a felnőtt lakosságot célzó (>20 év, ~8000 fő), átfogó, önkéntes alapú cardiovascularis szűrőprogram, amely egészségkérdőív-ből, noninvazív tesztekből (antropometriai mérések, szívultrahang, carotisultrahang, vérnyomásmérés, boka-kar index mérése), illetve vénás vérvételből és laborvizsgálatokból áll. Eredmények: 2014. januárig 2420 fő (a lakosság 30%-a, 41,2% férfi , átlagéletkor 54,8 év) kérdőíves, fi zikális vizsgálata és cardiovascularis kockázatbecslése történt meg. A résztvevők cardiovascularis morbiditása a korábbi országos felméréshez viszonyítva magasabb volt, illetve a cardiovascularis kockázati faktorok száma és a becsült 10 éves kockázat is emelkedettnek bizonyult a lakosok körében. Következtetések: Az eredmények felhívják a fi gyelmet a szűrések és a hatékony terápia fontosságára. Orv. Hetil., 2014, 155(34), 1344-1352. Kulcsszavak: cardiovascularis, morbiditás, kockázatbecslés, szűrővizsgálat Cardiovascular screening programme in the Central Hungarian region The Budakalász StudyIntroduction: The reduction in mortality due to prevention programmes observed in some European countries is not currently reached in Hungary. Effective prevention is based on the screening of risk factors and health state of the population. Aim: The goal of this study was to develop a longitudinal, population-based screening programme in the Central Hungarian region in order to collect information on the health state and cardiovascular risk profi le of the citizens and discover new potential cardiovascular risk factors. Method: The Budakalász Study is a self-voluntary programme involving the adult population (>20 yrs, approx. 8000 persons), and it consists of questionnaires, noninvasive tests (anthropometry, cardiac echo, carotid duplex scan, blood pressure measurement, ankle-brachial index), venous blood sample collection and laboratory tests. Results: Until January, 2014, 2420 persons (30% of the population, male: 41.2%, average age 54.8 years) participated in the programme. Cardiovascular morbidity was higher in contrast to a former national survey. The number of risk factors and, therefore, 10-year cardiovascular risk were also elevated in this population. Conclusions: These fi ndings underline the importance of screening programmes and effective therapies.

Introduction: Relaxin-1 (RLN1) has emerged as a possible therapeutic target in myocardial fibrosis due to its anti-fibrotic effects. Previous randomized clinical trials investigated therapeutic role of exogenous relaxin in patients with acute-on-chronic heart failure (HF) and failed to meet clinical endpoints. Here, we aimed to assess endogenous, circulating RLN1 levels in patients with heart failure with reduced ejection fraction (HFrEF) of ischemic origin. Furthermore, we analyzed relation of RLN1 and left ventricular diastolic function, left and right ventricular fibrosis, and invasive hemodynamic measurements. Unique feature of our study is the availability of ex vivo human myocardial tissue. Methods: Human myocardial samples were available from the Transplantation Biobank of the Heart and Vascular Center at Semmelweis University after local ethical approval and informed consent of all participants ( n = 47). Tissue was collected immediately after heart explantations; peripheral blood was collected before induction of anesthesia. Myocardial sections were stained for Masson’s trichrome and Picrosirius red staining to quantify fibrosis. Medical records were analyzed (ECG, anthropometry, blood tests, medication, echocardiography, and invasive hemodynamic measurements). Results: Average RLN1 levels in HFrEF population were significantly higher than measured in age and gender matched healthy control human subjects (702 ± 283 pg/ml in HFrEF vs. 44 ± 27 pg/ml in control n = 47). We found a moderate inverse correlation between RLN1 levels and degree of myocardial fibrosis in both ventricles ( r = −0.357, p = 0.014 in the right ventricle vs. r = −0.321, p = 0.028 in the left ventricle with Masson’s trichrome staining). Parallel, a moderate positive correlation was found in left ventricular diastolic function (echocardiography, E/A wave values) and RLN1 levels ( r = 0.456, p = 0.003); a negative correlation with RLN1 levels and left ventricular end-systolic diameter ( r = −0.373, p = 0.023), and diastolic pulmonary artery pressure ( r = −0.894, p < 0.001). RLN1 levels showed moderate correlation with RLN2 levels ( r = 0.453, p = 0.0003). Conclusion: Increased RLN1 levels were accompanied by lower myocardial fibrosis rate, which is a novel finding in our patient population with coronary artery disease and HFrEF. RLN1 can have a biomarker role in ventricular fibrosis; furthermore, it may influence hemodynamic and vasomotor activity via neurohormonal mechanisms of action. Given these valuable findings, RLN1 may be targeted in anti-fibrotic therapeutics and in perioperative care of heart transpl...

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