No abstract

Background and aims: It has been proven that a disturbance in angiogenesis contributes to the progression of myocardial interstitial fibrosis in idiopathic dilated cardiomyopathy (DCM). This study was designed to evaluate the relationship between serum activity of angiogenic factors and myocardial ultrasonic tissue characterization in patients with DCM. Methods and results:We studied 30 patients with DCM and 15 healthy control subjects. Serum levels of vascular endothelial growth factor (VEGF), interleukin (IL)-4 and IL-13 were measured using enzyme-linked immunosorbent assay. We determined calibrated myocardial integrated backscatter (IB) as the value of myocardial interstitial fibrosis using ultrasonic tissue characterization and also quantified the magnitude of cyclic variations in IB (CV-IB). Serum levels of VEGF and IL-13 were significantly higher in patients with DCM than in control subjects (both Pb0.05). Calibrated IB was significantly higher and CV-IB was markedly lower in patients with DCM than in control subjects (both Pb0.01). In patients with DCM, the levels of IL-13 significantly correlated with calibrated IB (r=0.520, P=0.018). In addition, there was a significant negative correlation between levels of VEGF and CV-IB (r=À0.611, P=0.007). Conclusion: The increase in serum VEGF and IL-13 may be closely related to alterations in myocardial texture in DCM.

Augmentation index (AI), brachial-ankle pulse wave velocity (baPWV) and cardio-ankle vascular index (CAVI) are available for the assessment of arterial stiffness in clinical practices. However, influences of meal intake on these indices are still poorly understood. The aim of this study is to elucidate the effects of daily meal intake on pulse wave indices in patients with type 2 diabetes. We studied 17 patients with type 2 diabetes. AI was measured at fasting, 60 and 120 min after a commercial mixed meal (500 kcal) intake. The baPWV and CAVI were measured at fasting and 80-100 min after meal intake. All pulse indices decreased significantly after meal intake (AI, 89.3 ± 9.7% to 77.9 ± 9.4%, 82.0 ± 8.4%, Po0.001; baPWV, 1652 ± 286-1586±240 cm s -1 , P¼0.002; CAVI, 9.52±0.92-9.20±0.89, P¼0.037). D 120 (value 120 min after meal intakeÀfasting value) AI correlated significantly with age, body weight, D 120 systolic blood pressure (SBP), D 120 diastolic blood pressure, D 120 pulse pressure, D 120 heart rate and fasting AI. D (postprandial valueÀfasting value) baPWV correlated significantly with fasting baPWV, D SBP, D pulse pressure and HbA1c. In contrast, D CAVI did not correlate with any clinical variables. In conclusion, postprandial decreases in AI, baPWV and CAVI can lead to underestimate arterial stiffness in patients with type 2 diabetes. Postprandial changes in AI and baPWV, but not CAVI, are associated with changes in hemodynamic variables after daily meal intake.

In the evaluation of intermediate lesions in the LAD, CFVR as assessed by CE-TTDE could accurately predict the presence of ischemia on stress thallium imaging, whereas angiographic stenosis did not yield reliable results.