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BackgroundThe aim of this study was to investigate the relationship between coronary artery disease and changing of high sensitivity troponin T (hs-TnT) values during the exercise stress test (EST) in patients with suspected coronary artery disease (CAD). Material and MethodsWe included 68 patients who underwent coronary angiography after positive EST. The hs-TnT values of all patients were measured before EST and at 4 hours after EST. Patients with coronary artery stenosis of 50% or more were divided into two groups (CAD [+]) and those without (CAD [-]). Hs-TnT values measured before and after EST were compared. Results Among the 68 patients evaluated, 26 patients (39.3%) were identified as CAD (-) and 42 patients (61.7) as CAD (+). There was no significant difference between the two groups in the hs-TnT values before and after EST. There was a significant correlation between hs-TnT before exercise and pre-EST systolic blood pressure (SBP) (r=0.313, p=0.009) and hs-TnT before exercise and peak SBP during EST (r=0.241, p=0.038) There was a significant correlation between hs-TnT after EST and peak SBP during EST (r=0.398, p=0.001). Also, a strong negative correlation was found between the Duke treadmill score (DTS) calculated by the exercise test parameters and the Syntax score, which indicates the extent and severity of coronary artery disease (r=-0.521, p=0.0001). Conclusions As a result of our study, it was observed that hs-TnT values did not contribute to the diagnosis of coronary artery disease. However, DTS evaluation performed before invasive coronary angiography can provide important information about coronary artery lesion complexity.

Objective: Systolic blood pressure variability (SBPV) is a measure of oscillations in SBP for 24 hours. There are conflicting data about the relationship between SBPV and cardiovascular (CV) diseases. In this study we aim to document relationship between SBPV and surrogate markers of CV damage in a hypertensive patient cohort. Methods: Previously documented hypertension patients were enrolled. Patients with previous documented CV disease, diabetes mellitus and secondary hypertension were excluded. 24-hour ambulatory blood pressure monitoring (ABPM), echocardiography, electrocardiography and cardioankle vascular index (CAVI) measurements were performed. SBPV is defined as standard deviation of mean systolic blood pressure readings from ABMP records. The relationship between SBPV and QTc distance, QT dispersion, presence of fragmented QRS, CAVI results were examined. Results: 64 patients were enrolled mean age 50 8, 24(37%) were male]. Mean SBPV was 15.12 4.6 mmHg and there was not a significant correlation between SBPV CAVI, QTc measurements of the study patients but there was a significant positive correlation with QT dispersion values (28.6 15.2 msec, p=0.004, p=0.354). When patients were divided into two categories as high SBPV and low SBPV, QT dispersion was consistently longer in high SBPV group (p=0.006). Conclusions: In hypertensive patients without documented CV disease and signs of hypertensive CV changes on clinical evaluation, SBPV is positively correlated with QT dispersion but high SBPV is not related with aortic stiffness according to CAVI results. These findings might be a sign of occult left ventricular fibrosis and high risk of arrhythmia in hypertensive patients with high SBPV.