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Behçet's disease (BD) is a chronic, multisystem disorder characterized by genital and oral aphthae, skin lesions, uveitis, and tendency to thrombosis. Pulse wave velocity (PWV) is an important factor in determining cardiovascular mortality and morbidity. It is an index of arterial wall stiffness and inversely related to the arterial distensibility. In this study we investigated the arterial distensibility in BD by PWV. We studied 14 patients with BD (18-44 years old, 10 men) and 28 healthy subjects (18-39 years old, 21 men) without known cardiovascular disease. Arterial distensibility was assessed by automatic carotid-femoral PWV measurement using the Complior Colson device. PWV is calculated from measurements of pulse transit time and the distance traveled by the pulse between two recording sites, according to the following formula: pulse wave velocity (m/s)=distance (m)/transit time(s). The mean ages, systolic blood pressure, diastolic blood pressure, pulse pressure, heart rate, and PWV of Behçet's disease and control subjects were 32.1+/-7.4 vs 27.9+/-6.1 years, 112.9+/-12.0 vs 108.7+/-10.0 mmHg, 72.1+/-10.7 vs 67.7+/-7.5 mmHg, 40.7+/-12.2 vs 41.0+/-10.7 mmHg, 74.1+/-10.2 vs 77.2+/-10.1 bpm, and 8.4+/-1.4 vs 8.5+/-1.1 m/s, respectively. Differences between all parameters studied were not found to be statistically significant (p>0.05). The carotid-femoral PWV, an index of arterial stiffness and a marker of atherosclerosis, is not increased in patients with BD compared with control subjects.

T he vascular endothelium is a metabolically active paracrine organ. It regulates thrombogenicity, vascular tone, leukocyte adhesion, and platelet and smooth muscle function (1). While normal endothelium is in a nonthrombotic state, deterioration of the vascular endothelium results in the synthesis and release of procoagulant and anticoagulant substances from the disrupted vascular endothelium (2,3).One of the major risk factors for atherosclerosis is hypertension. Most of the studies on hypertensive subjects have shown that hypertension is associated with cardiovascular abnormalities marked by oxidative stress induction, endothelial dysfunction and derangement of the normal hemostatic and fibrinolytic balance (4-6). Optimal blood pressure (BP) control in hypertensive patients does not always lead to restoration of normal endothelial function, and drugs with comparable BPlowering effects do not counteract hypertension-induced endothelial dysfunction to a similar degree (7).Nebivolol is a selective beta 1 -adrenergic receptor antagonist that relaxes vascular smooth muscle by nitric oxide-and cyclic GMP-dependent mechanisms (8). Nebivolol reverses endothelial dysfunction in essential hypertension (9). The direct effect of nebivolol on endothelial function as assessed by the measurement of plasminogen activator inhibitor type 1 antigen (PAI-1-Ag), PAI-1 activity, tissue plasminogen activator antigen (tPA-Ag), tPA-Ag/PAI-1-Ag index, fibrinogen and euglobulin lysis time (ELT) has not been reported. The BACKGROUND: The aim of the present study was to investigate the effects of nebivolol (5 mg daily) on plasma levels of hemostatic and fibrinolytic endothelial function markers in mild or moderate hypertensive patients. METHODS AND RESULTS: Thirty-five (22 female, 13 male; mean ± SD 54.7±11.3 years of age) mild and moderate hypertensive patients were included the study. The mean systolic blood pressure [BP] was 160 mmHg (range 150 mmHg to 165 mmHg) and the mean diastolic BP was 100 mmHg (range 90 mmHg to 100 mmHg). Plasma tissue plasminogen activator antigen (tPA-Ag), plasminogen activator inhibitor type 1 antigen (PAI-1-Ag), PAI-1 activity, tPA-Ag/PAI-1-Ag index, fibrinogen and euglobulin lysis time were determined before and after two months of therapy. tPA-Ag and PAI-Ag levels were measured by ELISA. After this period, treatment with nebivolol (5 mg/day) in all patients was associated with a significant decrease in systolic BP and diastolic BP (P<0.001 for each), heart rate (P<0.01), fibrinogen (P<0.005) and euglobulin lysis time (P<0.01). The tPA-Ag and tPA-Ag/PAI-1-Ag index levels were increased significantly (P<0.001 for each) in all patients, but the PAI-1-Ag (P>0.05) and PAI-1 activity (P>0.05) did not show significant change. In the present study, there was no correlation between decreases in arterial BP and decreases in fibrinolytic parameters (P>0.05), but there was a positive, statistically significant correlation between fibrinogen and body mass index (P<0.001). CONCLUSIONS: The results indicated that, comp...

Spontaneous coronary artery dissection (SCAD) is a clinical condition rarely leading to acute myocardial infarction (AMI). We report the case of SCAD presenting AMI in a 25-year-old man with coronary risk factors after strenuous exercise, who was successfully treated with systemic thrombolysis. Coronary angiography revealed spiral dissection of the proximal part of the left anterior descending artery. The present case supports the occurrence of SCAD as a cause of AMI in young male patients who have coronary risk factors, after heavy lifting.