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Adiponectin has multiple protective effects on vascular endothelium through anti-inflammatory and anti-atherogenic properties. Recent data suggested that endothelial activation and inflammation may contribute to the pathogenesis of slow coronary flow (SCF). Therefore, we investigated whether adiponectin plasma concentrations were decreased in patients with SCF compared to subjects with normal coronary flow. The study population consisted of 35 patients with angiographically documented SCF in all three coronary arteries and 35 sex- and age-matched cases with normal coronary flow. Coronary flow rates of all participants were determined by Thrombolysis in Myocardial Infarction (TIMI) frame count. Plasma adiponectin concentrations were measured by an enzyme-linked immunosorbent assay method using commercially available adiponectin kits. There were no statistically significant differences between the patients with SCF and the subjects with normal coronary flow in terms of demographic characteristics and cardiovascular risk factors (P>0.05). Plasma adiponectin concentrations of patients with SCF were found to be significantly lower than those with normal coronary flow (4.77+/-3.86 mg/ml vs 10.8+/-6.60 mg/ml, P=0.001, respectively). Plasma adiponectin levels were correlated significantly and inversely with mean TIMI frame count in patients with SCF (r= -0.441, P=0.008). Furthermore, the Receiver Operator Characteristics curve of adiponectin concentrations showed that an adiponectin <4.6 mg/ml is associated with SCF with a sensitivity of 68.6%, specificity of 82.9%, positive predictive value of 80.0%, and negative predictive value of 72.5%. Our findings suggest that endothelial inflammation may play a role in the pathogenesis of SCF phenomenon.

In the present study, we assessed oxidative stress in patients with dilated cardiomyopathy of ischemic or idiopathic etiology. For this reason we measured whole blood reduced glutathione, erythrocyte superoxide dismutase, susceptibility of erythrocyte membranes and erythrocytes to peroxidation, and SH content of erythrocyte membranes in 12 patients (8 men and 4 women, ages 31 to 66 years) with idiopathic dilated cardiomyopathy, in 11 patients (8 men and 3 women, ages 32 to 65 years) with ischemic dilated cardiomyopathy, and in 21 healthy volunteers (12 men and 9 women, ages 25 to 67 years). There was no statistically significant difference between the two patient groups for the indicators studied (P &gt;0.05). Blood glutathione, erythrocyte superoxide dismutase, and membrane SH content of both groups of patients was decreased compared with controls (P &lt;0.05), whereas erythrocyte and membrane susceptibility to peroxidation were increased (P &lt;0.05). We conclude that patients with idiopathic or ischemic dilated cardiomyopathy exhibit abnormalities of a range of markers of increased oxidative stress. These abnormalities may contribute to contractile dysfunction, increased incidence of fatal arrhythmias, and sudden death.

SUMMARYThe objectives of this study were to assess the effect of percutaneous mitral balloon valvuloplasty (PBMV) on the plasma levels of N-terminal-pro B-type natriuretic peptide (NT-proBNP) in patients with mitral stenosis (MS) and to investigate the relationship between the changes in hemodynamic variables and NT-proBNP levels after PBMV. Plasma NT-proBNP concentrations were obtained from 60 symptomatic patients with rheumatic MS who underwent PBMV, and in 35 age-and gender-matched healthy volunteers. Patients with MS were found to have significantly higher levels of plasma NTproBNP compared to the control group (293 [77-1093] pg/mL versus 24 [12-67] pg/mL, respectively; [P < 0.001]). The mean preprocedural NT-proBNP level fell significantly from 293 (77-1093) pg/mL to 214 (69-1028) pg/mL (P < 0.001) following PBMV. The percentage decrease in plasma NT-proBNP levels was correlated only with the percentage decrease in systolic pulmonary artery pressure (r = 0.687, P < 0.001) and this correlation persisted in linear regression analysis (β = -0.013; 95% CI [-0.018--0.008] and P < 0.001). However, NT-proBNP levels did not correlate with the percentage of improvement in NYHA functional class, mitral valve gradients, or left atrial pressure (all P > 0.05). These findings indicate that NT-proBNP measurement following PBMV may be valuable for evaluating changes in pulmonary artery pressure and that elevated NTproBNP levels in patients with MS may reflect the increased wall stress in the left atrium and right side of the heart. (Int Heart J 2007; 48: 579-590) Key words: Mitral balloon, NT-proBNP, Pulmonary hypertension BRAIN natriuretic peptide (BNP) is a member of the natriuretic peptide family that has regulatory and modulatory roles in the cardiovascular system 1) including natriuresis, diuresis, and vasodilatation.

: Reactive oxygen metabolites (ROMs) contribute to tissue injury in inflammatory bowel disease. The aim of this study is to examine the role of ROMs in the tissue injury in ulcerative colitis (UC). The study group consisted of 27 patients with UC (14 active, 13 quiescent) and a control group of 10 patients with various anal diseases. We measured the content of malondialdehyde (MDA), superoxide dismutase (SOD), and myeloperoxidase (MPO) in colorectal biopsies. MDA was measured by the thiobarbituric acid assay. SOD and MPO were measured using the nitro blue tetrazolium and odianisidine methods, respectively. The MDA, SOD, and MPO tissue levels were significantly different between the patients with active UC, the patients with quiescent UC, and the control subjects (p < 0.001). A positive correlation was found between the tissue concentrations of MDA and MPO and the activity of the disease (p < 0.001). The SOD tissue concentrations were negatively correlated with the disease activity (r = -0.507, p < 0.05).

: Reactive oxygen metabolites (ROMs) contribute to tissue injury in inflammatory bowel disease. The aim of this study is to examine the role of ROMs in the tissue injury in ulcerative colitis (UC). The study group consisted of 27 patients with UC (14 active, 13 quiescent) and a control group of 10 patients with various anal diseases. We measured the content of malondialdehyde (MDA), superoxide dismutase (SOD), and myeloperoxidase (MPO) in colorectal biopsies. MDA was measured by the thiobarbituric acid assay. SOD and MPO were measured using the nitro blue tetrazolium and odianisidine methods, respectively. The MDA, SOD, and MPO tissue levels were significantly different between the patients with active UC, the patients with quiescent UC, and the control subjects (p < 0.001). A positive correlation was found between the tissue concentrations of MDA and MPO and the activity of the disease (p < 0.001). The SOD tissue concentrations were negatively correlated with the disease activity (r = -0.507, p < 0.05).

These findings suggest that hypoadiponectinemia may play a role in the development of coronary atherosclerosis and the observation of adiponectin levels may be indicative of the presence of significant CAD in patients with MetS.

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