SUMMARYThe pathophysiology of cardiac syndrome X (CSX) is still unclear, but most patients with CSX have endothelial dysfunction. It has been shown that adropin uniquely effects the regulation of endothelial function. The purpose of the study was to evaluate the role of adropin in CSX. Eighty-six consecutive cardiac syndrome X-diagnosed patients and 86 age-sex matched healthy subjects were enrolled into the study. Serum adropin levels, nitrite/nitrate levels were measured in each subject. The adropin levels were significantly lower in patients with CSX than healthy subjects (1.7 AE 0.8 ng/mL and 3.4 AE 1.8 ng/mL, respectively; P < 0.001). The BMI values of patients with CSX were significantly higher than control subjects (28.1 AE 2.4 kg/m 2 and 26.0 AE 3.7 kg/m 2 , respectively; P < 0.001). Plasma nitrite/ nitrate levels were lower in patients with CSX than control subjects (15.9 AE 1.6 lmol/L vs. 25.4 AE 2.8 lmol/L, respectively; P < 0.001), and they have a significantly positive correlation with plasma adropin levels (r = 0.463, P < 0.001). In the multiple linear regression analysis, nitrite/nitrate levels, BMI, and adropin were found to be independent risk factors for CSX. A ROC curve is used to identify the ability of adropin levels to predict the cardiac syndrome X. The area under the ROC curve was 0.854 for adropin levels (P = 0.0001). The sensitivity and specificity values of adropin levels were 90.7 and 70.9%, respectively (cutoff value 2.73). In conclusion, lower serum adropin levels were associated with CSX. Adropin is an independent risk factor for CSX.Patients with a normal coronary angiogram, effort-induced angina pectoris, positive exercise stress test, and/or positive single-photon emission computed tomography study are considered to have cardiac syndrome X (CSX) [1]. The long-term prognosis of patients with CSX appears to be good, but these patients have recurrent chest pain attacks, a situation that does increase the rate of morbidity. The pathogenesis of CSX is still unclear. Although endothelial dysfunction is regarded as one of the main underlying reasons for CSX, the pathophysiology seems to be more complex. Motz et al. [2] first showed the impaired coronary endothelial function in patients with CSX. Patients with CSX have increased resistance in coronary flow which is attributed to endothelial dysfunction in microcirculation [3]. The endothelium has very important roles in the control of vascular tone, including regulation of both vasodilatory substances such as nitric oxide and prostacycline, and vasoconstrictive substances such as endothelin-1 and angiotensin II [4]. An adequate balance between these vasoconstrictors and vasodilators is essential for maintaining vascular homeostasis. Nitric oxide synthesized from the amino acid L-Arginine by the endothelial nitric oxide-synthetase (eNOS) enzyme plays a key role in the regulation of vascular tone and also inhibits the activation of plaque and leukocytes and has an antiproliferative effect on smooth vascular muscle [4]. L-arginine and tetra...

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High blood pressure, LVH, diastolic dysfunction and increased left atrium diameter and volume shows parallelism in hypertensive cases. These physiopathological changes may cause different and heterogeneous atrial electrical conduction. This led to a marked increase in P(max) and PD in our cases. Thus, the results support the hypothesis that PD can be used as a non-invasive marker of target organ damage (LVH and LV diastolic dysfunction) in the hypertension population.

BackgroundIt was speculated that fatty tissue originated adipocytokines may play role in pathogenesis of atherosclerosis. These adipocytokines may alter vascular homeostasis by effecting endothelial cells, arterial smooth muscle cells and macrophages. Vaspin is a newly described member of adipocytokines family. We aimed to investigate whether plasma vaspin level has any predictive value in coronary artery disease (CAD).MethodsForty patients who have at least single vessel ≥ 70 % stenosis demostrated angiographically and 40 subjects with normal coronary anatomy were included to the study. The vaspin levels were measured from serum that is obtained by centrifigation of blood and stored at -20 oC by ELISA method. The length, weight and body mass index of patients were measured. Biochemical parameters including total cholesterol, low density lipoprotein, high density lipoprotein, creatinine, sodium, potassium, hemoglobine, uric acid and fasting glucose were also measured.ResultsBiochemical markers levels were similar in both groups. Serum vaspin levels were significantly lower in CAD patients than control group (respectively; 256 ± 219 pg/ml vs. 472 ( 564 pg/ml, P < 0.02). Beside this serum vaspin level was lower in control group with high systolic blood pressure.ConclusionSerum vaspin levels were found significantly lower in patients with CAD than age-matched subjects with normal coronary anatomy. Vaspin may be used as a predictor of CAD.KeywordsCoronary artery disease; Vaspin; Adipokine

The findings of the present study suggest that the disorder may be associated with an increase in PWD. This association may result from prolonged anxiety and increase in sympathetic modulation, which are main characteristics of panic disorder.