Epicardial fat tissue thickness may be a useful indicator of early atherosclerosis in SCH and OH patients with HT.

Objective: To investigate whether or not patients with subclinical hypothyroidism (SH) have increased epicardial adipose tissue (EAT). Subjects and Methods: Sixty-one patients with newly diagnosed SH and without any known cardiovascular disease were enrolled. Twenty-four subjects matched for age, gender and body mass index without any thyroid dysfunctions were included as a control group. The EAT was measured by echocardiography and thyroid functions were assessed by routine blood examination. Results: Patients with SH had higher EAT values than control subjects (3.6 ± 0.9 vs. 2.8 ± 1.4, p = 0.005). Also, SH patients with thyroid-stimulating hormone (TSH) ≥10 mU/l had higher EAT than those with SH with TSH <10 mU/l and control subjects (p = 0.013). In addition, while there was significant correlation between EAT and TSH (r = 0.31, p = 0.014) in patients with SH, there was no significant relation between EAT and TSH in normal subjects (r = 0.09, p = 0.64). Conclusions: There was a higher level of EAT in patients with SH compared with normal subjects and a significant correlation between EAT and TSH was found.

The cardiac sequelae of coronavirus disease 2019 , a worldwide global pandemic, are still uncertain, particularly in the asymptomatic, low cardiac risk outpatient population. This study aims to evaluate the asymptomatic, low cardiac risk out-patient population who recently recovered from COVID-19, using 2-D left ventricular-global longitudinal strain (LV-GLS) proven to be capable of detecting subclinical myocardial injury. Out of 305 COVID-19 positive patients, 70 asymptomatic out-patients were determined as the study group and 70 age and sex-matched healthy adults as the control group. The echocardiographic examination was performed with the Philips IE33 system, and LV-GLS was measured using commercially available software QLAB 9 (cardiac motion quantification; Philips Medical Systems). The absolute value of LV-GLS ≤ 18 did deem to be impaired LV-GLS. The absolute value of LV-GLS was statistically significantly lower in the COVID-19 group than in healthy controls (19.17 ± 2.65 vs. 20.07 ± 2.19, p = 0.03). The correlation between having recovered from COVID-19 and impaired LV-GLS (≤18) did detect with the Pearson correlation test (p = 0.02). Having recovered from COVID-19 was found as a predictor for detecting impaired LV-GLS (≤18) in the multivariable logistic regression analysis (odds ratio, 0.133 (0.038-0.461); 95% CI, p = 0.001). This study suggests that COVID-19 may cause subclinical LV dysfunction detected by LV-GLS during early recovery even in a population of patients at low cardiac risk, asymptomatic, and recovered with home quarantine. The study findings indicate that the long-term cardiovascular follow-up of these patients may be more important than thought.

We found that the presence of PSW was related with higher LVEF, lower SXscore and lower stage diastolic dysfunction in patients with AMI. PSW may be used in prediction of the coronary artery disease complexity and it could help risk stratification in patients with AMI.

Objectives: The diagnosis of pulmonary embolism (PE) in the emergency department still poses difficulties because symptoms and signs are nonspecific. There is a need for more reliable noninvasive diagnostic tests to support clinical suspicion before the costly invasive procedures with complication risks still used in the diagnosis of PE. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-EGF (epidermal growth factor) domain-containing protein 1 (SCUBE1) is a novel, secreted cell surface protein expressed during early embryogenesis. The goal of this study was to compare the SCUBE1 levels between PE patients and healthy subjects and also investigate the value of SCUBE1 in the diagnosis of PE.Methods: Eleven patients diagnosed with PE using spiral computerized tomographic pulmonary angiography were included in the study. A control group of 23 age-matched, healthy volunteers served as a reference for biochemical parameters.Results: Mean (AESD) SCUBE1 levels were 72.0 (AE32.6) ng/mL in the patients with PE and 31.4 (AE13.8) ng/ mL in the control group. SCUBE1 levels were significantly higher in the patients with PE (p = 0.001). Receiver operating characteristic (ROC) curve analysis was performed to determine cutoff thresholds in discriminating between PE and control group plasma SCUBE1 levels. Area under the ROC for that purpose was 0.862 (95% confidence interval [CI] = 0.70 to 1). A SCUBE1 cutoff point in patients with PE > 46 ng/mL had specificity and sensitivity of 91% (95% CI = 0.70% to 0.98%) and 82% (95% CI = 0.48% to 0.97%), respectively. Conclusions:This preliminary study suggests that plasma SCUBE1 values have a good level of specificity for PE and may be of use in the diagnosis of PE. Further studies involving larger case series and also clinical studies are needed to corroborate these findings.ACADEMIC EMERGENCY MEDICINE 2015;22:922-926 © 2015 by the Society for Academic Emergency Medicine P ulmonary embolism (PE) is a common and potentially life-threatening disorder. Diagnosis of PE in the emergency department (ED) still poses difficulties because symptoms and signs are nonspecific.

We investigated the relationship between pancreatic fat accumulation and markers of atherosclerosis among patients with nonalcoholic fatty liver disease (NAFLD). Patients with NAFLD have been reported to be at an increased risk of vascular events. We grouped 183 patients in whom we detected and graded hepatosteatosis (HS) on transabdominal ultrasonography into 2 groups based on the presence/absence of pancreatic fat. There were 85 participants (50 female; mean age: 53.6 ± 9.7 years) who were nonalcoholic fatty pancreas disease (NAFPD) positive and 98 participants (56 female; mean age: 51.4 ± 9.3 years) who were NAFPD negative. Carotid intima media thickness (cIMT) was significantly greater in the group where HS was accompanied by NAFPD (0.51 [0.40–0.62] vs 0.45 [0.35–0.55] mm; P < .001). Multivariable analyses showed that the independent predictors of increased cIMT were age (odds ratio [OR]: 1.108; 95% CI: 1.059–1.158, P = .001), hypertension (OR: 2.244; 95% CI: 1.099–4.579, P = .026), and the presence of NAFPD (OR: 3.078; CI 95% CI: 1.531–6.190, P = .0002). In the present study we demonstrated that, in patients with NAFLD, pancreatic fat accumulation was significantly associated with cIMT, a marker of early atherosclerosis. NAFPD may increase the risk of vascular events associated with NAFLD.

Background: Elevated inflammatory markers have been found to correlate with higher risk for cardiac events in patients with acute myocardial infarction (AMI). It has been suggested that C-reactive protein (CRP) may be involved in the initiation process of atrial fibrillation (AF). However, the role of CRP levels in the occurence of AF in patients with AMI has not been studied. This study investigated whether CRP is a risk factor for AF in patients with acute anterior MI. Methods: We prospectively evaluated 92 consecutive patients (25 women and 67 men; aged 58±11 y) with a first acute anterior wall MI. Blood samples were obtained at the time of admission to the hospital, and serum CRP levels were measured by an ultrasensitive immunonephelometry method. All patients were evaluated by echocardiography to measure the left ventricular (LV) diameter and functions. All patients were monitored continuously for the detection of AF in the coronary care unit. Results: Atrial fibrillation occured in 19 (20%) of 92 patients. Univariate analysis showed that patients with AF had an advanced age (63±9.9 versus 56.7±11.7 y, p = 0.034), higher serum CRP level (2.95±2.5 versus 1.71±2.12 mg/dL, p = 0.034), larger LV end-systolic volume (74±15 versus 63±19, mL p = 0.02), higher LV ejection fraction (31.1±6.2 versus 38.4±10%, p = 0.001), and larger left atrial (LA) diameter (37.1±4.2 versus 34.7±3.3 mm, p = 0.01). In multivariate analysis, only age (odds ratio [OR]: 1.05, 95% confidence interval [CI]: 1-1.11, p = 0.036) and CRP levels (OR: 1.27, 95% CI: 1-1.59, p = 0.039) were independent predictors of AF. Conclusion: These results suggest that CRP may be a risk factor for AF in patients with acute anterior wall MI.

Introduction Carotid intima media thickness (CIMT), a direct marker of atherosclerosis, has emerged as a promising means for cardiovascular risk evaluation. Presystolic wave (PSW) is commonly detected by the Doppler interrogation of the left ventricular outflow tract (LVOT). It is thought to be a result of a stiff left ventricle and impaired LV compliance. Herein, we aimed to investigate a possible association between carotid intima media thickness, an atherosclerotic marker, and PSW. Method We prospectively enrolled 282 patients divided into two groups based on the presence of PSW: 221 (89F; mean age: 49.3 ± 11.5 years) had PSW on Doppler examination while 61 patients (32F; mean age: 46.4 ± 10.3 years) did not. Both groups were compared with respect to demographic, clinical properties, and CIMT. Results Both groups had comparable age, body mass index, and diabetes mellitus, hypertension, dyslipidemia, smoking, and family history for coronary heart disease. PSW‐positive group had significantly higher CIMT (PSW‐positive: 0.59 ± 0.22 mm vs PSW‐negative: 0.42 ± 0.11 mm; P < 0.001) than PSW‐negative group. Multivariate analysis showed that the independent predictors of increased CIMT were age (95% CI; 1.044–1.101, P < 0.001), dyslipidemia (95% CI; 0.147–0.664, P = 0.002), and the presence of PSW (95% CI; 2.168–7.836, P < 0.001).Correlation analysis showed that PSW velocity is correlated with increased CIMT in PSW‐positive group (r: 0.418, P < 0.001). Conclusion Assessment of PSW on TTE is easy and feasible method. Presence of PSW and increased PSW velocity on TTE might provide information that we should be careful in terms of subclinical atherosclerosis.