Fundamento: Não há estudos avaliando o intervalo T pico-T fim (Tpe), a relação Tpe/QT e a relação Tpe/QTc para avaliar arritmias cardíacas em pacientes com COVID-19. Objetivo: Visamos investigar se há alterações nos intervalos QT, QTc e Tpe e nas relações Tpe/QT e Tpe/QTc em pacientes com COVID-19. Métodos: O estudo incluiu 90 pacientes com infecção por COVID-19 e 30 controles saudáveis pareados por sexo e idade. Foram aferidos os intervalos QT, QTc e Tpe e as relações Tpe/QT e Tpe/QTc. Os participantes incluídos no estudo foram divididos nos seguintes 4 grupos: controles saudáveis (grupo I), pacientes com COVID-19 sem pneumonia (grupo II), pacientes com COVID-19 e pneumonia leve (grupo III) e pacientes com COVID-19 e pneumonia grave (grupo IV). Significância estatística foi definida por valor p < 0,05. Resultados: Verificou-se que a frequência cardíaca basal, a presença de hipertensão e diabetes, a contagem de leucócitos, o nitrogênio ureico no sangue, a creatinina, o potássio, o aspartato aminotransferase, a alanina aminotransferase, o NT-proBNP, a proteína C reativa de alta sensibilidade, o dímero-D, a TncI-as, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc aumentaram do grupo I para o grupo IV e foram significativamente mais altos em todos os pacientes do grupo IV (p < 0,05). A pressão arterial sistólica, a hemoglobina e os níveis de cálcio eram menores no grupo IV e significativamente menores em comparação com os demais grupos (< 0,05). Os intervalos QT e QTc eram semelhantes entre grupos. Determinou-se que os níveis elevados de frequência cardíaca, cálcio, dímero-D, NT-proBNP e PCR-as eram significativamente relacionados a Tpe, Tpe/QT e Tpe/QTc. Conclusões: Em pacientes com COVID-19 e pneumonia grave, o intervalo Tpe, a relação Tpe/QT e a relação Tpe/QTc, que estão entre os parâmetros de repolarização ventricular, foram aumentados, sem prolongação dos intervalos QT e QTc. A partir deste estudo, não podemos definitivamente concluir que as alterações eletrocardiográficas observadas estão diretamente relacionadas à infecção por COVID-19 ou à inflamação, mas sim associadas a cenários graves de COVID-19, que podem envolver outras causas de inflamação e comorbidades.
Nonalcoholic fatty liver disease is very common in patients with polycystic ovary syndrome (PCOS). In patients with PCOS, the clinical use of liver stiffness (LS) and whether LS increases or decreases are still unclear. The purpose of this study was to determine the parameters related to LS and whether there is an increase in LS in patients with PCOS compared with healthy controls. Thirty-eight women diagnosed with PCOS according to Rotterdam criteria and 28 healthy ageand sex-matched controls were included in this study. In addition to routine follow-up parameters for all patients, serum homeostatic model assessment of insulin resistance (HOMA-IR) and complement C1q/ tumor necrosis factor-related protein 3 (CTRP3) levels were measured, and point shear wave elastography was performed. Body mass index; waist circumference; systolic blood pressure; serum glucose, alanine aminotransferase, highly sensitive C-reactive protein, and dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels; and luteinizing hormone/follicle-stimulating hormone ratio were higher in PCOS group compared with healthy controls (P < 0.05). Serum CTRP3 levels were lower in patients with PCOS (P < 0.05). Liver stiffness value was significantly higher in PCOS group than healthy controls (P < 0.001). Positive correlation was found between LS and waist circumference as well as calcium, dehydroepiandrosterone sulfate, testosterone, and HOMA-IR levels (P < 0.05 for each one). Negative correlation was found between LS and CTRP (P < 0.01 for each one). In linear regression analysis, only CTRP3 level was found to be related to LS (P < 0.001 and β = 0.734). Liver stiffness value obtained by point shear wave elastography increases in patients with PCOS compared with healthy controls and is closely and negatively related to serum CTRP3 levels.
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experience syncope and present with signs of cardiomyopathy and heart failure as a result of nonsustained ventricular tachycardia (VT), sustained VT, or ventricular fibrillation, caused by PVCs. Triggering factors of PVCs include stress, dehydration, caffeine and alcohol consumption, medical treatment, hormonal cycles in women, and poor sleep quality (PSQ). 3 In daily practice, PSQ is frequently associated with PVCs and it is often overlooked that PSQ may occur due to PVCs. In the routine evaluation of patients with PVCs, lifestyle changes INTRODUCTION Premature ventricular contractions (PVCs) are a very common arrhythmia in clinical practice. In the general population, it has been seen in 1% to 4% of patients on electrocardiography (ECG) and in 40% to 75% on 24-hour Holter ECG. 1,2 This condition, which is generally benign, may cause sudden cardiac death in patients with structural heart disease. Numerous patients with PVCs are asymptomatic. Those symptomatic complain of palpitations, dizziness, near-syncope, dyspnea, chest pain, and fatigue. Apart from that, patients may
Background In our study, we aimed to evaluate left ventricular global longitudinal strain (LV‐GLS) value in patients with premature ventricular contractions (PVCs) and reduced LV ejection fraction (LVEF) and to determine the effect of radiofrequency catheter ablation (RFA) procedure on LV‐GLS. Methods In this cross‐sectional study, 150 patients who underwent three‐dimensional RFA with the diagnosis of PVCs were included. LV‐GLS was measured with strain echocardiography in all patients before RFA and in the sixth‐month control. Patients included in the study were grouped as LVEF <50% (Group I) and LVEF ≥50% (Group II) according to baseline LVEF, and patients within Group I were grouped as LVEF <50% (Group A) and LVEF ≥50% (Group B) according to the sixth‐month LVEF. Results There were 39 patients (26%) with baseline LVEF <50%. In 14 (36%) of these patients, LVEF <50% was observed to continue during the sixth‐month controls. Both the baseline and sixth‐month LV‐GLS values were significantly lower in Group I patients (<0.01). RFA treatment significantly increased both LVEF and LV‐GLS (<0.01). It was found that age, N‐terminal pro‐brain natriuretic peptide, LV diameters, and baseline LVEF were higher, and baseline LV‐GLS level was lower in Group A patients (P < .01). Baseline LVEF and LV‐GLS values were found to independently determine the patients in Group A (P < .01). In receiver operator characteristic analysis, when the limit value is accepted as 40% for baseline LVEF and 18% for baseline LV‐GLS, it can determine Group A with acceptable sensitivity and specificity. Conclusions LV‐GLS decreases significantly in patients with reduced LVEF and PVCs. In these patients, RFA treatment significantly increases both LVEF and LV‐GLS.
Fundamento: A espessura médio-intimal (EMI) da artéria aorta abdominal (EMI-A) pode ser um marcador precoce de aterosclerose subclínica e um indicador objetivo de estresse oxidativo em pacientes com talassemia menor. Objetivo: Avaliar se as EMIs da artéria aorta e da artéria carótida (EMI-C) se alteram com estresse oxidativo, e examinar a relação entre esses parâmetros em pacientes com talassemia menor. Métodos: O estudo incluiu 80 pacientes diagnosticados com talassemia menor, e 50 indivíduos sadios com idade e sexo similares. Após procedimentos de rotina, as amostras de sangue foram coletadas dos grupos de estudo para a medida da homeostase tiol/dissulfeto e da albumina modificada pela isquemia (AMI). As medidas da EMI-C foram realizadas a partir de quatro regiões diferentes (artéria carótida externa direita e esquerda e artéria carótida interna direita e esquerda) por ultrassonografia, e a medida da EMI-A foi realizada por ultrassonografia abdominal. Um valor de p<0,05 foi definido como estatisticamente significativo. Resultados: Nos pacientes com talassemia menor, os níveis de tiol nativo e tiol total, e a razão tiol nativo/tiol total foram mais baixos, e os valores de AMI, razão dissulfeto/tiol nativo, e razão dissulfeto/tiol total foram mais altos que no grupo controle. A EMI-A foi significativamente maior no grupo de pacientes com talassemia menor que nos controles (1,46±0,37 vs 1,23±0,22 e p<0,001). Quando os parâmetros associados com EMI-A na análise univariada foram avaliados por regressão linear multivariada, EMI-A apresentou uma relação positiva, e os níveis de tiol nativo e tiol total apresentaram uma forte relação negativa com AMI (p<0,01). Conclusão: Nós demonstramos, pela primeira vez, um aumento no estresse oxidativo com a elevação da EMI-A, e valores inalterados da EMI-C em pacientes com talassemia menor.
Objective: Insulin-like growth factor-1 (IGF-1) level was used in the follow-up of acromegaly patients. The aim of this study is to investigate the relationship between pre-and postoperative IGF-1 levels and monocyte/high-density lipoprotein (HDL) ratio, which is a novel inflammatory marker, in patients diagnosed with acromegaly.Material and Methods: Thirty-two acromegaly patients (17 males and 15 females) were included in this retrospective study. Demographic characteristics of the patients and their laboratory data before and six months after the operation were scanned from their files.Results: While preoperative IGF-1 level was 515.8 ± 197.0 ng/ml, postoperative IGF-1 level was 121.1 ± 89.4 ng/ml. While preoperative MHR was 13.9 ± 4.33 µl/mg/dl, it was calculated as 9.52 ± 4.43 µl/ mg/dl postoperatively. There was a significant difference in pre-and postoperative IGF-1 levels and monocyte/HDL ratio (p= 0.006 and p< 0.001, respectively). A positive relationship was found between the pre-and post-operative monocyte/HDL ratio and IGF-1 levels. (p< 0.001 vs β= 0.727 and p= 0.001 vs β= 0.540, respectively). Conclusion:IGF-1 level is correlated with the monocyte/HDL ratio. In addition to IGF-1 level, monocyte/HDL ratio may also be directive during the follow-up of patients with acromegaly and especially for complications that may develop. Prospective and randomized studies with large patient groups are needed to give more detailed results.
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