SummaryAn infl ammatory response is a key event for endothelial dysfunction. Pentraxin 3 (PTX3) is an infl ammatory protein produced at infl ammation sites such as leukocytes and vascular endothelial cells. Here, we compared the relationships between endothelial function assessed by fl ow-mediated dilation (FMD), and the levels of plasma PTX3 and highsensitive C-reactive protein (hsCRP), another infl ammatory protein of the pentraxin family.Levels of FMD, PTX3 and hsCRP were measured twice within 6 to 8 months and retrospectively analyzed in 36 patients with coronary artery disease. We examined the associations between the values of FMD and the levels of PTX3 and hsCRP at the fi rst measurement, and between the change ratios (second value/fi rst value) of these parameters.Univariate linear regression analysis showed signifi cantly negative correlations between FMD values and PTX3 and hsCRP levels at the fi rst measurement, and signifi cant associations with taking statins or calcium antagonists. Multivariate linear stepwise regression analysis identifi ed PTX3 levels and taking statins and calcium antagonists as independent factors for endothelial function. The change ratio of FMD correlated more closely with that of PTX3 than of hsCRP (r = -0.446, P = 0.006 versus r = -0.330, P = 0.050). Signifi cantly more patients with decreased FMD values had increased levels of PTX3 than those of hsCRP at the second measurement compared with the fi rst measurement. Furthermore, the ratio of patients with increased PTX3, but not increased hsCRP, was signifi cantly reduced among those with increased, rather than decreased, FMD values.Endothelial dysfunction might be more accurately predicted by plasma PTX3 levels than by serum hsCRP levels. (Int Heart J 2014; 55: 160-164)

Objective Previous studies have shown a possible role for obstructive sleep apnea syndrome (OSAS) in the development and/or progression of chronic kidney disease (CKD). However, the impact of treatment for OSAS on CKD has not been clarified. The aim of this study was to investigate the influence of OSAS and the short-term effects of nasal continuous positive airway pressure (CPAP) on the estimated glomerular filtration rate (eGFR). Methods We evaluated 38 men with OSAS diagnosed on polysomnography. The associations between the eGFR and patient characteristics, including polysomnographic parameters, were evaluated. A multivariate linear regression analysis was performed to determine the independent variables associated with eGFR. We reassessed the polysomnographic data and eGFR values after three months of CPAP treatment. Results The mean serum creatinine level was 0.83±0.10 mg/dL and the mean eGFR was 77.3±12.0 mL/ min/1.73 m 2 . A univariate analysis revealed that an older age (p<0.001), a longer mean apnea duration (p= 0.006) and BMI (p=0.022) were significantly associated with lower eGFRs. A multivariate linear regression analysis showed that the independent factors associated with lower eGFRs were older age (p<0.001) and a longer mean apnea duration (p=0.048). Three months after CPAP treatment, there were significant decreases in the serum creatinine levels (p=0.013) and increases in eGFR (p=0.014). Conclusion OSAS, especially that associated with an older age and a longer mean apnea duration, may contribute to lowering eGFR values, which can be reversed by CPAP treatment.

Higher levels of systemic PTX3 are associated with TCFA. Systemic PTX3 levels comprise a useful inflammatory marker that reflects coronary plaque vulnerability.

Aims: Echocardiography is widely used for screening of pulmonary hypertension (PH). More recently developed two-dimensional speckle-tracking echocardiography (2D-STE) can assess regional deformation of the myocardium and is useful for detecting left ventricular dysfunction. However, its usefulness to assess right ventricular (RV) dysfunction is not clear. Therefore, the aim of this study was to investigate the ability of peak systolic strain (PSS) and post-systolic strain index (PSI) at the RV free wall determined by 2D-STE to detect PH.Main methods: Thirty-six images (27 images from PH patients, nine from patients with connective tissue disease without PH) obtained by 2D-STE were analysed. We investigated the relationship between RV hemodynamics measured by right heart catheterization and PSS, PSI and other echocardiographic parameters reflecting RV overload including RV end-diastolic diameter (RVDd) and tricuspid valve regurgitant pressure gradient (TRPG).Key findings: PSS, PSI, RVDd and TRPG were all correlated with mean pulmonary arterial pressure (MPAP) and pulmonary vascular resistance (PVR). Furthermore, when PSS and MPAP were measured twice, the change in PSS was correlated with the change in MPAP (r=0.633, p=0.037). Multivariate logistic regression analysis identified PSS as the only independent factor associated with MPAP≥35 mmHg [odds ratio (OR), 1.616; 95% confidence interval (CI) 1.017-2.567; p=0.042] and PVR≥400 dyne·sec·cm -5 (OR, 1.804; 95% CI 1.131-2.877; p=0.013). Furthermore, the optimal PSS cut-off value to detect an elevated MPAP and PVR was -20.75%, based on receiver operating characteristic curve analysis.Significance: PSS of the RV free wall might serve as a useful non-invasive 2 indicator of PH.

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