Objective:Systemic lupus erythematosus (SLE) is a chronic, inflammatory, and autoimmune connective tissue disease. One of the leading causes of mortality among SLE patients is pulmonary hypertension. The aim of this study was to evaluate the association between echocardiographic findings, including the pulmonary pulse transit time and pulmonary hypertension parameters, in SLE patients.Methods:Thirty SLE patients (aged 39.9±11 years, 28 females) as the study group and 34 age-and sex-matched healthy volunteers (aged 37.9±11.5 years, 31 females) as the control group were included in the study. After detailed medical histories were recorded, 12-lead electrocardiography, blood tests, and echocardiography were performed in the groups. In addition to basic echocardiographic measurements, other specialized right ventricular indicators [i.e, Tricuspid Annular Plane Systolic Excursion (TAPSE), estimated pulmonary artery systolic pressure (ePASP), right ventricular dimensions, and myocardial performance index (MPI)] were measured. The pulmonary pulse transit time was defined as the time interval between the R-wave peak in ECG and the corresponding peak late-systolic pulmonary vein flow velocity.Results:The mean disease duration was 121.1±49.9 months. The mean age at diagnosis was 35.0±15.4 years. The mean RV MPI was higher (p=0.026), mean TAPSE measurements were shorter (p=0.021), and mean ePASP was higher (p=0.036) in the SLE group than in the control group. In addition, pPTT was significantly shorter in the SLE group (p=0.003). pPTT was inversely correlated with disease duration (p<0.001), MPI (p=0.037), and ePASP (p=0.02) and positively correlated with TAPSE (p<0.001).Conclusion:SLE patients have higher pPTT values than controls. Further, pPTT shows an inverse correlation with disease duration, MPI, and ePASP and a positive correlation with TAPSE.
Pulmoner emboli yüksek mortalite ve morbidite oranları ile giden akut acil bir durumdur. Monosit/ yüksek yoğunluklu lipoprotein (HDL) oranının, inflamasyon ve oksidatif stresin yeni bir belirteci olabileceği, ayrıca bazı kardiyovasküler hastalıkların varlığı ve prognozu ile de yakından ilişkili olduğu gösterilmiştir. Pulmoner emboli fizyopatolojisinde inflamasyon ve oksitadif stres önemli bir rol oynamaktadır. Çalışmanın amacı akut pulmoner emboliden monosit/HDL oranının kısa dönemde prognostik değerini belirlemektir. Hastalar ve Yöntem: Acil servise başvuran ve akut pulmoner emboli tanısı çok kesitli bilgisayarlı tomografi ile teyit edilen 99 hasta çalışmaya retrospektif olarak dahil edildi. Bulgular: Pulmoner emboli tanısı alan 99 hastanın, tanı aldıktan sonra 26 (%25.2)'sı bir ay içinde eksitus oldu. Hastalar, tanı sonrası bir ay içinde ölenler (1. grup) ve hayatta kalanlar (2. grup) olmak üzere iki gruba ayrıldı. Yaş, malignite, koroner arter hastalığı, sağ ventrikül fonksiyon bozukluğu, beyaz kan hücresi, nötrofil, lenfosit, trombosit ve monosit sayımları, sistolik pulmoner arter basıncı, diyastolik kan basıncı, nötrofil/ lenfosit oranı, monosit/HDL oranı, basitleştirilmiş pulmoner emboli ciddiyet indeksi 1. grupta 2. gruba göre anlamlı derecede yüksek bulundu. Monosit/HDL oranı, nötrofil/lenfosit oranı ve basitleştirilmiş pulmoner emboli ciddiyet indeksi akut pulmoner emboli tanısı almış hastalarda mortalitenin bağımsız bir belirleyicisi olduğu görüldü. Sonuç: Monosit /HDL oranı, pulmoner emboli sonrası erken dönemde mortalite gelişen hastalarda, mortalite gelişmeyenlere göre daha yüksekti. Bu nedenle, monosit/HDL oranı gibi ucuz ve pratik bir parametre akut pulmoner embolide mortalite risk tahmininde kullanılabilir.
Background and ObjectivesNon-dipper hypertension is frequently accompanied by endothelial dysfunction and activation. Previous studies suggested that endocan may be a novel endothelial dysfunction marker. This study aims to investigate the association between circadian blood pressure (BP) pattern and plasma endocan levels together with high-sensitivity C-reactive protein (hsCRP) in patients with newly diagnosed untreated hypertension.Subjects and MethodsTwenty-four hour ambulatory blood pressure monitoring was recorded in 35 dipper, 35 non-dipper hypertensives and 35 healthy controls. Endocan levels were measured by enzyme-linked immunosorbent assay. Serum levels of hsCRP were also recorded.ResultsDespite similar daytime and 24-hour average BP values between dippers and non-dippers, statistically significant high nocturnal BP was accompanied by a non-dipping pattern (Systolic BP: 132±9 vs. 147±11 mmHg; Distolic BP: 80±7 vs. 91±9 mmHg, respectively, p<0.001 for both). Non-dipper patients demonstrated higher endocan levels compared to dippers and normotensives (367 (193-844) pg/mL, 254 (182-512) pg/mL and 237 (141-314) pg/ml, respectively, p<0.001). HsCRP levels were significantly higher in non-dippers than the other groups (p=0.013). In a multivariate logistic regression analysis, endocan (p=0.021) and hsCRP (p=0.044) were independently associated with a non-dipping pattern.ConclusionElevated endocan levels were found in non-dipper groups. Endocan and hsCRP were found to be independently associated with a non-dipping pattern. We suggest that elevated levels of endocan in non-dipper hypertensive patients might be associated with a longer duration of exposure to high BP. These results point to the possible future role of endocan in selection of hypertensive patients at higher risk or target organ damage.
pPTT was found to be shorter in SSc patients. pPTT might serve as a surrogate marker of pulmonary hemodynamics in patients with SSc, even prior to the development of pulmonary hypertension.
Marijuana and its synthetic forms, called synthetic cannabinoids (SCs), are used as recreational drugs. Bonzai is a kind of SC. Adverse cardiovascular events have been reported with abuse of marijuana and SCs, including arrhythmia, myocardial infarction, and sudden cardiac death. Presently described is a case of a 23-year-old, previously healthy man, who was admitted to the emergency department with atrial fibrillation after Bonzai abuse. Sinus rhythm was restored during observation.
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