Background: For cardiologists, management of acute chest pain continues to be a challenge. Physicians struggle to avoid unnecessary admissions and at the same time not to miss highrisk patients needing urgent intervention. Therefore, diagnostic strategies focus on identifying patients in whom an acute coronary syndrome can be safely ruled out based on findings from history, physical examination, and early cardiac marker measurement. The HEART score, a clinical prediction rule, was developed to provide the clinician with a simple and reliable predictor of cardiac risk. Aim: This study aimed to investigate the role of neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) as independent laboratory biomarkers when associated with the HEART risk score. Method: A cross-sectional study of 120 patients who attended the emergency department with acute chest pain. NLR and PLR were both measured. In addition, the HEART score was the valid instrument used in evaluating and risk stratifying patients into low-, intermediate-, and high-risk group. Results: There was a positive correlation between the HEART score and the mean PLR and NLR (p = 0.000*). PLR and NLR were found to be significantly higher in the high-risk HEART score group (p = 0.05 and 0.0001*, respectively). A PLR of 115.5 and above had a sensitivity of 73% and specificity of 78%, while an NLR of 3.95 and above had a sensitivity of 75% and specificity of 86% to detect high-risk HEART score patients. Conclusion: PLR and NLR proved to be a useful tool to identify highrisk patients when validated against the HEART score.

Hypertension is a serious medical condition that can increase the risk of developing heart, brain, kidney, and other diseases. Many asymptomatic hypertension patients experience asymptomatic organ damage (AOD). The purpose of this study was to determine the roles of LncRNA-GAS5 and β-catenin in predicting AOD in hypertensive nondiabetic patients. This study included 256 subjects, 128 hypertension patients (75 of whom had AOD, and 53 of whom did not) and 128 healthy controls. qRT-PCR was used to assess LncRNA-GAS5, and ELISA was used to assess β-catenin. The LncRNA-GAS5 expression level was decreased in hypertensive patients compared to controls (p-value < 0.001). On the other hand, β-catenin levels showed higher levels in the patients in comparison with controls (p-value < 0.001). A 0.38-fold change in LncRNA-GAS5 expression predicted AOD with 86.6% sensitivity and 88.7% specificity. β-Catenin > 80.5 pg/mL predicted AOD with a sensitivity of 82.6% and specificity of 69.8%. LncRNA-GAS5 expression was a better diagnostic predictor of AOD than β-catenin. According to multivariate logistic regression analysis, decreased LncRNA-GAS5 expression independently increased the risk of AOD (adjusted odds ratio = 0.03 (95% CI: 0.01–0.1) (p < 0.001). Furthermore, elevated β-catenin levels may be an independent risk factor for AOD (adjusted odds ratio = 14.3 (95% confidence interval, 3.3–61.9) (p < 0.001). Collectively, in hypertensive patients, LncRNA GAS5 and β-catenin can distinguish patients with AOD from those who do not have AOD. LncRNA GAS5 and β-catenin can be used as independent predictors of AOD in hypertensive patients.

No abstract

No abstract

Background : Left ventricular (LV) ejection fraction (LVEF) is mostly used as a parameter of systolic function which is often assessed without considering changes in ventricular structure, geometry and hypertrophy. LV global function index (LVGFI) is a novel parameter that integrates LV structure with global function in the assessment of LV cardiac performance. Our study aimed to throw light on LVGFI as a diagnostic marker of early subclinical contractile dysfunction in patients with concentric Left ventricular hypertrophy.Methods: A case-control study involving 123 participants; they were divided into three groups, control (Group 1) 41 volunteers, LVH without systolic dysfunction (Group 2) 41 cases, and LVH with systolic dysfunction (Group 3). Conventional systolic function assessment, LVGFI was expressed by the equation;(LV stroke volume / LV global volume) *100 and tissue doppler mitral annulus Sa wave, IVCT Isovolumetric contraction time.Results: (LVGFI), and Sa mitral annulus had the lowest mean value in G3. LVGFI had a positive correlation with average Sa (r=0.755, p <0.001), EF (mmode, r = 0.235, p=0.008) and EF (Simpson, r = 0.305, p=0.001).Multivariate analysis showed that LVGFI had the best relationship with Sa average (p=0.001), EF Simpson (p= 0.002) and then hypertension(p=0.02*). LVGFI had an area under the curve of 0.74, sensitivity of 85%, specificity of 80%, and cutoff of less than 22.4% for subclinical LV systolic dysfunction. Conclusion: LVGFI at a cut-off of less than 22.4% was useful in detecting subclinical LV systolic dysfunction in concentric LVH.