Background and objectives: Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Materials and Methods: This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2-dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results: Patients had lower waist/hip ratio (p< 0.001), higher urea level (p = 0.002), and lower white blood cells (p = 0.011), compared with controls. All other clinical, biochemical, and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p< 0.001], higher A wave [p = 0.028], lower E/A ratio [p< 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p< 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion—MAPSE [p = 0.005], as were lateral and septal s’ [p< 0.001 for both]). Conclusions: In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease that requires optimum management.
Background and AimType 2 diabetes mellitus (T2DM) is a known risk factor in patients with heart failure (HF), but its impact on phenotypic presentations remains unclear. This study aimed to prospectively examine the relationship between T2DM and functional exercise capacity, assessed by the 6-min walk test (6-MWT) in chronic HF.MethodsWe studied 344 chronic patients with HF (mean age 61 ± 10 years, 54% female) in whom clinical, biochemical, and anthropometric data were available and all patients underwent an echo-Doppler study and a 6-MWT on the same day. The 6-MWT distance divided the cohort into; Group I: those who managed ≤ 300 m and Group II: those who managed >300 m. Additionally, left ventricular (LV) ejection fraction (EF), estimated using the modified Simpson's method, classified patients into HF with preserved EF (HFpEF) and HF with reduced EF (HFrEF).ResultsThe results showed that 111/344 (32%) patients had T2DM, who had a higher prevalence of arterial hypertension (p = 0.004), higher waist/hips ratio (p = 0.041), higher creatinine (p = 0.008) and urea (p = 0.003), lower hemoglobin (p = 0.001), and they achieved shorter 6-MWT distance (p < 0.001) compared with those with no T2DM. Patients with limited exercise (<300 m) had higher prevalence of T2DM (p < 0.001), arterial hypertension (p = 0.004), and atrial fibrillation (p = 0.001), higher waist/hips ratio (p = 0.041), higher glucose level (p < 0.001), lower hemoglobin (p < 0.001), larger left atrium (LA) (p = 0.002), lower lateral mitral annular plane systolic excursion (MAPSE) (p = 0.032), septal MAPSE (p < 0.001), and tricuspid annular plane systolic excursion (TAPSE) (p < 0.001), compared with those performing >300 m. In the cohort as a whole, multivariate analysis, T2DM (p < 0.001), low hemoglobin (p = 0.008), atrial fibrillation (p = 0.014), and reduced septal MAPSE (p = 0.021) independently predicted the limited 6-MWT distance.In patients with HFpEF, diabetes [6.083 (2.613–14.160), p < 0.001], atrial fibrillation [6.092 (1.769–20.979), p = 0.002], and septal MAPSE [0.063 (0.027–0.184), p = 0.002], independently predicted the reduced 6-MWT, whereas hemoglobin [0.786 (0.624–0.998), p = 0.049] and TAPSE [0.462 (0.214–0.988), p = 0.041] predicted it in patients with HFrEF.ConclusionPredictors of exercise intolerance in patients with chronic HF differ according to LV systolic function, demonstrated as EF. T2DM seems the most powerful predictor of limited exercise capacity in patients with HFpEF.
Background and Aim Long standing hypothyroidism may impair myocardial relaxation, but its effect on systolic myocardial function is still controversial. The aim of this study was to investigate left ventricular (LV) systolic and diastolic function in patients with hypothyroidism. Methods This study included 81 (age 42 ± 13 years, 92% female) patients with hypothyroidism, and 22 age and gender matched controls. All subjects underwent a detailed clinical examination followed by a complete biochemical blood analysis including thyroid function assessment and anthropometric parameters measurements. LV function was assessed by 2 dimensional, M-mode and Tissue-Doppler Doppler echocardiographic examination performed in the same day. Results Patients had lower waist/hip ratio (p < 0.001), higher urea level (p = 0.002) and lower white blood cells (p = 0.011), compared to controls. All other clinical, biochemical and anthropometric data did not differ between the two groups. Patients had impaired LV diastolic function (lower E wave [p < 0.001], higher A wave [p = 0.028], lower E/A ratio [p < 0.001], longer E wave deceleration time [p = 0.01], and higher E/e’ ratio [p < 0.001]), compared with controls. Although LV global systolic function did not differ between groups, LV longitudinal systolic function was compromised in patients (lateral mitral annular plane systolic excursion - MAPSE [p = 0.005], as were lateral and septal TDI s’ [p < 0.001 for both]). Conclusion In patients with hypothyroidism, in addition to compromised LV diastolic function, LV longitudinal systolic function is also impaired compared to healthy subjects of the same age and gender. These findings suggest significant subendocardial function impairment, reflecting potentially micro-circulation disease, that requires optimum management.
Introduction. Recent in vitro and in vivo studies have suggested a role of undercarboxylated osteocalcin (ucOC), not total (TOC) osteocalcin in glucose and energy metabolism.Aims: to investigate the relationship of ucOC level and blood glucose (BG) control in newly diagnosed type 2 diabetes and its change with BG control improvement.Subjects and methods. Fifty seven newly diagnosed type 2 diabetic patients with no history of bone metabolism disturbances had two visits3 months apart, with physical examination and blood sampling. The patients had consultation about life style changes, no medication was prescribed on visit 1. Weekly (first month) and biweekly telephone contacts were performed to enhance compliance. Samples for parameters of BG metabolism and bone turnover were collected on visit 1 and 2. Standard automated or semi-automated methods were used for measurements, for ucOC the only available commercial kit.Results. Forty seven patients completed the study. Thirty two (56%) patients reached the target HbA1c (≤7%). No correlation of ucOC and HbA1c and FBG was observed. Median HbA1c and FBG changed significantly (8.0 to 6.5%; 9.0 to 7.0 mmol/L resp.; Wilcoxon signed rank test p<0.001), ucOC was slightly but not significantly lower (2.0 to 1.4 mcg/L; p=0.465). No correlation between differences in HbA1c and ucOC between Visits 1 and 2 was revealed. There was a significant change in HOMA%B but not HOMA IR, not correlated to ucOC.Conclusion. This study failed to prove the relationship between blood glucose regulation and ucOC level. However, it does not exclude it, so further research is needed. A lack of robust essay for human ucOC might explain inconclusive results of clinical studies. The fact that as much as 56% patients achieved the target HbA1c with no medication, challenges most BG control guidelines.
Tobacco, cannabis, and alcohol consumption, found to be most common among college students, is known to cause life-threatening diseases, and is correlated with social, financial and health problems. For the present study, we aimed to assess the sociodemographic factors affecting tobacco, alcohol, and cannabis consumption among university students. A cross-sectional study was conducted from January to March 2020, on a random sample of 507 undergraduates, between the ages of 18 and 24. The research instrument was a self- administered questionnaire with questions on the sociodemographic characteristics, and questions regarding the consumption of tobacco, alcohol, and cannabis.The mean ± standard deviation age of study sample was 21.56 ± 1.81 years, and 56.4% participants were females. The lifetime prevalence of tobacco usage among the study sample was 66.7%, alcohol 54.2%, and the cannabis had a prevalence of 13.8%. About 46.2% (n = 234) were co-users of tobacco smoking and alcohol, and 12.6% (n = 64) were co-user of tobacco smoking, alcohol consumption, and drug use. Analyzed with Pearson's chi-squared test, there was no statistically significant difference between students from private and public institutions on lifetime, in the past 1 year/1 month of tobacco smoking, alcohol consumption, and cannabis use (p > 0.05). The logistic regression model for dependent variable cannabis abuse in the past 1 year is associated with lower odds among female students (odds ratio: 0.337, 95% confidence interval: 0.167–0.682; p = 0.002). Smoking, drinking, and cannabis were found to be highly prevalent among university students. These findings can help program managers and policy makers devise effective and appropriate control programs and policies for substance-using university students.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.