fQRS and QRS distortion may be useful for identifying patients at higher cardiac risk. fQRS can foresee thrombolytic therapy failure and three vessels disease whereas QRS distortion does not possess such quality. These findings may guide the physician deciding initial treatment modality in STEMI.

f(QRS-T) angle may be used as a beneficial tool for determining high risk patients in acute STEMI. Unlike previous studies, we showed for the first time that that post-procedural f(QRS-T) can predict in-hospital mortality and TT failure.

Hypothyroidism may cause cardiac autonomic dysfunction. Treating hypothyroidism with L-thyroxine therapy does not effectively restore cardiac autonomic function. HRV and HRT can be used as to help monitor cardiovascular-related risk in this population.

In the present study, we found that NLR levels were significantly correlated with BP variability. The measurement of NLR may be used to indicate increased risk of HT-related adverse cardiovascular events.

The circulating caspase 9 and oxidant status might contribute to apoptotic dysregulation in PCOS.

Abnormal left ventricle (LV) geometric patterns are associated with an increased risk of vascular complications of hypertension (HT). The association between red-cell distribution width (RDW) and HT has been recently investigated; however, the relationship between abnormal LV geometric patterns and RDW has not been studied before. The aim of this study was to investigate the relationship between RDW and abnormal LV geometric patterns in patients with untreated essential HT. Measurements were obtained from 139 patients with untreated essential HT (mean age=51.3±16.3 years). Four different geometric patterns (NG, normal geometry; CR, concentric remodeling; EH, eccentric hypertrophy; CH, concentric hypertrophy) were determined according to the LV mass index (LVMI) and relative wall thickness (RWT). RDW, lipid parameters and other biochemical markers were measured in all patients. While the highest RDW values were detected in the CH group (P<0.05, for all), it was similar among the NG, CR and EH groups (P>0.05, for all). RDW was associated with age, LVMI and LV geometry in bivariate analysis (P<0.05, for all). In a receiver operating characteristic (ROC) curve analysis, a level of RDW>14.5 predicted CH with 81% sensitivity and 59% specificity. Age (beta=0.309, P=0.001), LV geometry type (beta=0.228, P=0.01) and RWT (beta=-0.278; P=0.25) were independent predictors of high RDW in multiple linear regression analysis. In conclusion, the highest RDW values were observed in the CH group in the untreated essential HT patients. RDW seems to be a useful tool for the prediction of end-organ damage in patients with untreated essential HT.

Epicardial fat tissue is a visceral fat depot with anatomical and functional contiguity to the myocardium and coronary arteries. The objective of this study was to evaluate the association between epicardial fat thickness (EFT) and cardiac changes in healthy female subjects. The study population consisted of ninety-six consecutive healthy female (mean age 31.1 ± 6.7 years) who underwent transthoracic echocardiography. EFT was measured by echocardiography. Subjects were divided into two groups according to the EFT; EFT < 6 mm and EFT ≥ 6 mm. The cardiac structural changes, increased left atrial volume indices (LAVI) (41.2 ± 9.9 vs. 52.6 ± 12.5, p = 0.001) and left ventricular mass indices (LVMI) (129.6 ± 32.1 vs. 155.6 ± 31.6 p < 0.05), were observed in patients with increased EFT. Myocardial tei index (MTI), which was used to evaluate both systolic and diastolic functions, was higher with increased EFT (0.44 ± 0.07 vs. 0.48 ± 0.08, p = 0.02). The correlation analysis revealed significant correlation between EFT and each of LAVI (r = 0.312, p = 0.002), LVMI (r = 0.301, p = 0.003), body mass index (BMI) (r = 0.8, p < 0.001), and MTI (r = 0.27, p = 0.005). Multivariate regression analysis demonstrated that EFT was associated with BMI (t = 5.28, p = 0.001), MTI (r = 2.39, p = 0.019), LVMI (r = 2.16, p = 0.01), and LAVI (r = 3.21, p = 0.002).In conclusion, EFT is an important predictor of cardiac alterations in women who are prone to obesity.Keywords: epicardial fat tissue; left atrial volume index; left ventricular mass index; metabolic syndrome; myocardial Tei index Tohoku

Objective:Cardiac autonomic dysfunction may develop in patients with polycystic ovary syndrome (PCOS). Heart rate variability (HRV) and heart rate turbulence (HRT) are used in assessing cardiac autonomic functions. The goal of this study was to compare the cardiac autonomic functions in patients with PCOS and healthy controls. To our knowledge, this is the first study evaluating cardiac autonomic functions in patients with PCOS with respect to both HRV and HRT.Methods:Twenty-three patients with PCOS (mean age 22.8±3.9 years) and 25 healthy female volunteers who were matched for age and body mass index (BMI) (mean age 23.5±6.2 years) were enrolled in this as case-control study. Twenty-four hour ambulatory electrocardiogram recordings of all participants were taken using Pathfinder software. The time domain parameters of HRV and HRT, including turbulence onset (TO) and turbulence slope, were calculated. Diagnosis of PCOS was made with physical and laboratory findings of hirsutism or biochemical hyperandrogenism and chronic anovulation. Diabetes mellitus, other hormon disorders or hormon therapy, pregnancy, atrial fibrilation, obesite, chronic diseases, disorders of the autonomic nervous system, a history of drug use affecting the autonomic nervous system were excluded.Results:There were no significant differences in HRV and HRT parameters between the two groups. Cardiovascular risk factors, such as BMI, blood pressure, fasting blood glucose, and lipid parameters, were also similar. Triangular index measure of HRV was negatively correlated with high density lipoprotein cholesterol levels (r=-0.47, p<0.05), while age and BMI were significantly correlated with TO (r=0.31 and 0.47, respectively; p<0.05 for all).Conclusion:Cardiac autonomic functions were not found to be altered in patients with PCOS in comparison with healthy controls. These results may be explained with the absence of concomitant cardiovascular risk factors with the patients being in the early stage of the disease.