Abstract:Background: The role of adiponectin in the development of cardiac disease remains less clear than in metabolic disorders. While some studies indicated that low adiponectin levels were associated with cardiovascular disease, not all studies have been able to show such association. Adiponectin levels may infl uence the development of chronic heart failure, but the epidemiological data are somewhat complex. Thus, the aim of this study was a survey of relationship between serum Adiponectin and prognosis of patients with heart failure in Iran. Methods and materials:In this cohort study, we evaluated 96 chronic heart failure patients. Patients with systolic dysfunction that was defi ned as left ventricular Ejection Fraction (EF) ≤40 % or had a history of heart failure were included in the study. At the baseline visit, all patients were examined by a physician and the following information was obtained: medical history, physical examination, New York Heart Association (NYHA) classifi cation. After the fi rst evaluation, analyses of adiponectin, Pro BNP, creatinine and uric acid were performed. Then the patients were followed up for a median of 12 months. Results: There was a signifi cant relationship between the mean adiponectin and Pro BNP levels and the ejection fraction (p=0.003 and p=0.003 respectively). Higher levels of adiponectin and Pro BNP were associated with a lower ejection fraction and there were no such associations between creatinine and uric acid levels. There was a signifi cant association between the functional capacity as assessed by NYHA class and the mean of adiponectin and uric acid, these means that higher levels of adiponectin and uric acid were associated with a higher functional class in patients with CHF (p=0.03 and p=0.04 respectively). During a 12 month follow-up, 22 (22.9 %) patients died. In subjects who died, the baseline mean plasma adiponectin and Pro BNP levels were higher compared to those who were alive at the follow-up and these difference were statistically signifi cant (19±7.4 vs.15.8±8 ng/ml and 9520±10249 vs. 3172±4628 ng/L p=0.000). Conclusion:The present study demonstrated that the plasma adiponectin level increased according to the severity of heart failure and also there was such relationship between Pro BNP and heart failure (Tab. 3, Ref. 35). Full Text in PDF www.elis.sk.
IntroductionBehçet's disease is an inflammatory disorder of unknown origin, with mucocutaneous, ocular, articular, vascular, gastrointestinal and central nervous system manifestations. Although cardiac involvement is not an uncommon manifestation of Behçet's disease, coronary aneurysm has rarely been reported.Case presentationA 36-year-old Iranian man was admitted to our emergency department for retrosternal pain of two and a half hours duration. His detailed medical history revealed that he had no risk factors for coronary artery disease, however, Behçet's disease had been diagnosed about 10 years earlier. His electrocardiogram showed inferior myocardial infarction. He underwent coronary angiography that showed multiple giant aneurysms in his coronary arteries. Two months later, he experienced another episode of unstable angina. This was followed by two episodes of anterior myocardial infarction 2 and 5 months afterwards.ConclusionThis case highlights the importance of careful diagnostic work-up in the evaluation of myocardial infarction in patients. In our patient, Behçet's disease proved to be the cause of recurrent myocardial infarction.
Abstract:Background: Early diagnosis of acute coronary syndrome (ACS) is an important factor in reducing mortality of this disease. Cardiac troponins are not elevated within fi rst hours. So there is a need to optimize the clinical applicability and accuracy of novel ACS markers, particularly with regard to utilizing this technique in combination with other diagnostic methods. Methods: In this prospective study, we examined 226 patients between July 2009 and March 2010, admitted with chest pain to emergency room (ER). The study groups constisted of 120 subjects presenting with chest pain whose initial and subsequent diagnosis was unstable angina (UA), and 106 subjects whose initial diagnosis was unstable angina but subsequent diagnosis was non ischemic chest pain(NICP). For each patient electrocardiogram (ECG), cardiac troponins (cTnT), creatinine phosphokinase (CPK), IMA levels were measured. We used McNemar's test for correlated proportions and logistic regression and ROC curve for achieving better result. Results: In this study median IMA values were defi nitely higher in patients with ACS compared with non ischemic chest pain (NICP) (p < 0.0001) (83.5 to 49.6). An IMA cut-off threshold derived from the receiver operating characteristics curve (ROC) was 85U/ml and gives 54 % (95%CI 51 to 56) sensitivity and 87 % (95%CI 83 to 92) specifi city in our population. Negative predictive value was 62 % (95%CI 59 to 66). When IMA and ECG and cTnT were considered together sensitivity was 97.5 % and specifi city was 63 %, respectively. Conclusion: Ischemia-modifi ed albumin did not provide superior sensitivity or specifi city compared with other diagnostic tests (Tab. 1, Fig. 2, Ref. 25). Full Text in PDF www.elis.sk.
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