A 23-year-old female patient was admitted with progressive dyspnea of two-month history. On physi... more A 23-year-old female patient was admitted with progressive dyspnea of two-month history. On physical examination, her blood pressure, heart rate, and axillary temperature were 95/60 mmHg, 96 beats/min, and 37.4 °C, respectively. Cardiac auscultation showed reduced heart sounds without any murmur. A 12-lead electrocardiogram revealed reduced QRS amplitude (<10 mm) in both extremity and precordial leads. Transthoracic echocardiography revealed a large pericardial effusion rich in fibrin fibers. Late systolic compression of both atria was noted in the two-dimensional apical four-chamber view (Fig. A) and M-mode recording of the parasternal long-axis view revealed left atrial compression at early diastole, a rare finding of pericardial effusion (Fig. B). A two-dimensional modified parasternal short-axis view revealed double "Mercedes-Benz" sign, one was on the left and anteriorly located, and the other was on the right and posteriorly located,
Scandinavian Journal of Clinical and Laboratory Investigation, Aug 7, 2015
The balance of oxidant and antioxidant status plays an important role in the left ventricular dia... more The balance of oxidant and antioxidant status plays an important role in the left ventricular diastolic dysfunction (LVDD) in patients with hypertension (HT). Thiol is an important part of antioxidant system in the body. The aim of this study was to investigate the relationship between plasma thiol levels and LVDD in patients with HT. A total of 138 patients with newly diagnosed essential hypertensive and 20 age-gender matched subjects as control group enrolled in the study. After echocardiographic assessment, the hypertensive patients were divided into three groups: Group 1: without LVDD (n = 41); group 2: with LVDD grade 1 (n = 57); and group 3: with LVDD grade 2 (n = 40). Plasma thiol, lipid and glucose levels were measured in all subjects. Plasma thiol levels were significantly different between the groups (all of p < 0.05). While the lowest thiol level was in the group 3, the highest level was in the control group. The presence of LVDD was correlated with age, systolic and d...
The balance of oxidant and antioxidant status plays an important role in the left ventricular dia... more The balance of oxidant and antioxidant status plays an important role in the left ventricular diastolic dysfunction (LVDD) in patients with hypertension (HT). Thiol is an important part of antioxidant system in the body. The aim of this study was to investigate the relationship between plasma thiol levels and LVDD in patients with HT. A total of 138 patients with newly diagnosed essential hypertensive and 20 age-gender matched subjects as control group enrolled in the study. After echocardiographic assessment, the hypertensive patients were divided into three groups: Group 1: without LVDD (n = 41); group 2: with LVDD grade 1 (n = 57); and group 3: with LVDD grade 2 (n = 40). Plasma thiol, lipid and glucose levels were measured in all subjects. Plasma thiol levels were significantly different between the groups (all of p < 0.05). While the lowest thiol level was in the group 3, the highest level was in the control group. The presence of LVDD was correlated with age, systolic and d...
Ceruloplasmin (CP) is a blue serum protein found in human serum; it carries approximately 95% of ... more Ceruloplasmin (CP) is a blue serum protein found in human serum; it carries approximately 95% of the total circulating copper (Cu) in healthy individuals. The relationship of CP with OS, inflammation, and DNA damage is known. Oxidative stress (OS), inflammation, and DNA damage are the main causes underlying atherosclerotic heart disease. Several studies have indicated a close association between high serum CP and several types of heart disease. However, the CP levels are still unknown in many heart diseases. To gather the studies of CP in heart disease and to prepare the ground for new studies for researchers, we designed this review.
The role of oxidative stress in the pathogenesis of many heart diseases has been well established... more The role of oxidative stress in the pathogenesis of many heart diseases has been well established (5-8). Many studies have shown an imbalance between oxidant production and antioxidant response in HF (9-11). It is known that chronic systolic HF is associated with increased ROS and decreased antioxidant level. Furthermore, the imbalance between oxidants and antioxidants is clearly associated with poor prognosis in patient with chronic systolic heart failure (10). Although oxidative stress status in subgroup of HF syndrome still remains unknown. We aimed to study Total Antioxidant Status (TAS), Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) in both systolic and diastolic HF, and also in ischemic and non-ischemic HF.
Purpose: Oxidative damage plays an important role in atherosclerosis development. Statin drugs ha... more Purpose: Oxidative damage plays an important role in atherosclerosis development. Statin drugs have anti-oxidant properties, but the clinical value of their antioxidant properties remains unclear. In this study, our aims were: (1) to assess the anti-oxidant effects of statins in patients with coronary artery disease (CAD) using a newly developed valid measure of total oxidant and anti-oxidant capacity; and (2) to identify whether statins influence ceruloplamin levels. Methods: Within a cross-sectional study, 67 dyslipidemic CAD patients on atorvastatin for at least three months were compared with 69 age- and gender-matched CAD patients not using atorvastatin. All patients were either newly-diagnosed with or already had established CAD. Patients and controls were selected from among patients who had undergone coronary angiography for a variety of reasons. Immediately prior to angiography, plasma total oxidant and antioxidant capacity and ceruloplasmin (Cp) levels were measured by mea...
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2016
In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, le... more In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, left ventricular diastolic parameters, and left ventricular mass (LVM) index in moderate to severe obstructive sleep apnea syndrome (OSAS) patients without coexisting disorders were investigated. Methods: A total of 66 non-diabetic, non-hypertensive, and non-smoking volunteers were enrolled. Participants were categorized by apnea-hypopnea index (AHI; event/hour). The control group was defined as no OSAS: AHI<5 (n=35), and OSAS group had moderate to severe OSAS: AHI>15 (n=31). Echocardiographic and biochemical tests, including measurement of C-reactive protein (CRP), were performed. PAS (kHz/s) was calculated by dividing the maximal frequency shift of the pulmonary flow by the acceleration time. Results: PAS (kHz/s), obtained by echocardiography, was statistically significantly higher in the OSAS group than the control group (28±5 vs 18±4, p<0.001), and was positively correlated with AHI, CRP, aortic stiffness index, E/E', and LVM index (p=0.034, p=0.039, p<0.001, p=0.040, and p<0.001, respectively), and negatively correlated with aortic strain (AS), aortic distensibility (AD), E/A, E'/A', and E' (p<0.001). Regression analyses indicated that CRP and PAS are independent predictors of aortic stiffness (p<0.05). E/A and LVM index were independent predictors of PAS (p=0.002 and p=0.001, respectively). Conclusion: Increased PAS is associated with aortic stiffness, left ventricular diastolic function, and increased LVM index. PAS may be a more effective indicator of aortic stiffness in OSAS patients than CRP. Amaç: Bu çalışmada, eşlik eden hastalıkları bulunmayan orta ve ciddi derece obstrüktif uyku apne sendromuna (OUAS) sahip hastalarda pulmoner arter sertliğinin (PAS) aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu parametreleri ve sol ventrikül kitle indeksi ile ilişkisi araştırıldı. Yöntemler: Hipertansiyon ve diyabeti bulunmayan ve sigara kullanmayan 66 gönüllü çalışmaya alındı. Katılımcılar apne hipopne indeksine göre sınıflandırıldılar (AHI, olay/saat). Kontrol grubu sağlıklı bireylerden oluştu AHI <5 normal (n=35), OUAS grubu orta veya ciddi OUAS'lı hastaları kapsadı AHI >15 orta/ciddi (n=31). Ekokardiyografi ve C-reaktif proteinin (CRP) dahil olduğu biyokimyasal testler değerlendirildi. PAS (kHz/s) = pulmoner akım maksimal sapma sıklığı/akselerasyon zamanı, formülüyle hesaplandı. Bulgular: Ekokardiyografiyle elde edilen PAS (kHz/s) OUAS grubunda istatistiksel olarak anlamlı derecede daha yüksekti (18±4 ve 28±5, p<0.001) ve AHI, CRP, aort sertlik indeksi, E/E' oranı ve sol ventrikül kitle indeksi ile pozitif (sırasıyla, p=0.034, p=0.039, p<0.001, p=0.040 ve p<0.001) ve aort straini, aortgerilebilirliği, E/A oranı, E'/A' oranı ve E' ile negatif korelasyona sahipti (p<0.001). Regresyon analizi CRP ve PAS'nin aort sertliği için bağımsız öngördürücüler olduğunu gösterdi (p<0.05). E/A oranı ve sol ventrikül kitle indeksi PAS için bağımsız öngördürücülerdi (sırasıyla; p=0.002 ve p=0.001). Sonuç: Artmış PAS aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu ve artmış sol ventrikül kitle indeksiyle ilişkiliydi. OUAS'li hastalarda PAS aort sertliği için CRP'den daha iyi bir belirteç olabilir.
The balance of oxidant and antioxidant status plays a key role in the coronary artery diseases (C... more The balance of oxidant and antioxidant status plays a key role in the coronary artery diseases (CAD). Thiol is one of the most important antioxidant barriers in humans, and thiol/disulfide homeostasis is a novel oxidative stress marker. We aimed to investigate the relation of serum thiol levels and thiol/disulfide homeostasis with the presence and severity of coronary artery disease. A total of 161 patients who underwent coronary angiography owing to stable angina pectoris were consecutively enrolled. They were divided into three groups. Group I:47 age-gender matched subjects with normal coronary angiography (control), group II:71 newly diagnosed CAD patients with noncritical stenosis, and group III:43 newly diagnosed CAD patients with critical stenosis. Serum native thiol, total thiol, and disulfide levels were measured, and disulfide/thiol ratios were calculated. Gensini scores were calculated in CAD patients. While the highest thiol levels were found in group I, the lowest one was observed in group III (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Total and native thiol levels were significantly lower in group II than group I (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 for each), but they considerably increased in group II compared with group III (p=0.031 and p=0.028, respectively). Disulfide levels decreased in group II and III compared with group I (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 for each). No statistically significant changes were observed in disulfide/thiol ratios (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Gensini scores were negatively correlated with total and native thiols, and positively with age and dyslipidemia. Stepwise linear regression analyses showed that native thiol was an independent predictor in the final model for Gensini score. ROC curve analysis demonstrated that thiol values of 310.7 or below could predict CAD with 89% sensitivity and 85% specificity (AUC=0.918; 95%CI:0.870-0.965). While disulfide/thiol ratio did not change significantly, decreased native thiol levels were associated with the presence and severity of CAD. This result indicates that the reduction of thiols may be important factor in development of CAD.
Cardiac syndrome X (CSX) is characterized by the presence of myocardial ischemia in the absence o... more Cardiac syndrome X (CSX) is characterized by the presence of myocardial ischemia in the absence of coronary artery stenosis on angiograms. Its relation to oxidative stress and inflammation is well known. There are no data on thiols and their relation with inflammation in CSX. The aim of this study was to investigate thiol levels and thiol/disulfide homeostasis in CSX patients. Fifty consecutive patients who had documented myocardial ischemia and normal coronary angiogram (CSX group), and 45 age-matched and sex-matched consecutive patients who had normal coronary angiogram without myocardial ischemia (control group) were enrolled in this study. C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), native thiol, total thiol, and disulfide levels were measured and disulfide/thiol ratios were calculated in all patients. Demographic, clinical, basic laboratory, and echocardiographic characteristics were similar in the two groups (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Serum total thiol, native thiol, and disulfide levels decreased significantly in the CSX group compared with the control group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). CRP and NLR increased significantly in the CSX group compared with the control group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Although disulfide/native thiol levels increased in the CSX group, this reduction did not reach statistical significance (5.8 vs. 5.5, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The reduction of thiols was correlated negatively with CRP and NLR (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Although univariate logistic regression analyses showed that serum total and native thiol levels, CRP and NLR were independent predictors for CSX estimation, stepwise multivariate logistic regression analysis showed only total thiol levels as an independent predictor for CSX (odds ratio=0.966, 95% confidence interval: 0.950-0.982, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Also, receiver operating characteristic curve analysis showed that serum total thiol values of 338.4 or below could predict the CSX with 86% sensitivity and 84% specificity (area under curve=0.903; 95% confidence interval: 0.842-0.965). Serum total thiol levels decreased significantly in CSX and this reduction independently predicted CSX with strong sensitivity and specificity. This suggests that the reduction in thiols along with increased inflammation may play a pathophysiological role in the development of CSX.
Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (R... more Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (RDW) is associated with subclinical cardiac diseases. The aim of this study was to investigate the association between RDW and aortic stiffness in overweight or obese subjects. A total of 101 overweight or obese subjects without overt cardiovascular disorders, and 48 healthy controls were enrolled. RDW, aortic pulse-wave velocity (PWV) and augmentation index 75 (Aix75) were evaluated. The case subjects were divided into two sub-groups according to PWV values; ≥ 10 m/s in group I, and < 10 m/s in group II. Bivariate correlation and multiple regression analyses (stepwise) were performed. RDW and PWV were considerably increased in the case groups compared with the controls. RDW was significantly increased in group I compared with group II and the controls [median 12.0 m/s, interquartile range (IQR): 10.5-17.5; median 11.7 m/s, IQR: 10.2-14.2, and median 11.4 m/s, IQR: 9.6-15.5, p < 0.0...
To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery... more To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery stiffness (PAS) derived from echocardiographic calculation. Fifty-two patients with newly diagnosed OSAS and forty-two subjects without OSAS matched by age and sex were enrolled in the study. OSAS was categorized according to apnea hypopnea index (AHI, event/h) as follows: normal (AHI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5), mild OSAS (AHI 5-15), moderate and severe OSAS (AHI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15). All participants were evaluated by echocardiography to determine PAS and right ventricle functions. PAS was calculated throughout pulmonary artery flow by the formula; PAS (kHz/sec) = maximal frequency shift/acceleration time. Demographic and clinical parameters were similar in both groups. PAS significantly increased in OSAS compared with the control group (26.9 ± 6.1 vs. 18.0 ± 3.5, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Additionally, PAS in severe and moderate OSAS was considerably high compared with that in mild OSAS and control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Right ventricular myocardial performance index (MPI) and mean pulmonary artery pressures (mPAP) were considerably higher in OSAS group than control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Tricuspid E/A, right ventricle tissue Doppler E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, and right ventricular ejection time (RVET) decreased in OSAS group compared with control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There was a significantly positive correlation between PAS and AHI, mPAP, and MPI (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and a significantly negative correlation between PAS and tricuspid E/A, E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, and RVET (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Linear regression analyses showed that PAS was an independent factor for mPAP (ß = 0.595, P =…
Background: Fetuin-A is an acute phase protein that exists in circulation and prevents the format... more Background: Fetuin-A is an acute phase protein that exists in circulation and prevents the formation of dystrophic vascular and valvular calcification. The aim of this study was to determine how serum fetuin-A levels changed in Rheumatic Mitral Stenosis patients when compared to healthy control subjects and whether it was associated with echocardiographical data. Methods: Fifty Rheumatic Mitral Stenosis patients diagnosed by echocardiography and age-sex matched fifty-two control subjects were included into the study. Serum fetuin-A level of each subject was measured by ELISA method. Results: There was no significant difference between patients and controls in serum fetuin-A levels (respectively 27,64±6,35 ng/mL and 29,35±6,41 ng/mL; p=0,262). In additon, no significant correlation was found between Wilkins calcification score determined by echocardiography and serum fetuin-A levels in patients.
Renal artery aneurysms and pseudoaneurysms are rare vascular abnormalities. These anomalies, whic... more Renal artery aneurysms and pseudoaneurysms are rare vascular abnormalities. These anomalies, which are usually asymptomatic, may be associated with hypertension. Here, we present the successful treatment of a renal artery pseudoaneurysm in a patient with hypertension, with an overview of the literature.
Aim: It is known that renin-angiotensin system, inflammation, signaling pathways, and genetic pre... more Aim: It is known that renin-angiotensin system, inflammation, signaling pathways, and genetic predisposition play a major role in the pathogenesis of heart valve disease. Scarring and collagen deposition in the valves and destruction of myocytes may result from the combined effects of rheumatic and degenerative process in heart valve diseases. Prolidase plays an important role in collagen metabolism, matrix remodeling and cell growth. The aim of the study was to comparatively assess the serum prolidase activity in rheumatic and degenerative heart valve diseases. Materials and methods: The study included 26 patients who had undergone valve replacement due to rheumatic etiology (Group I), 24 patients who had undergone valve replacement due to degenerative etiology (Group II) and 20 healthy volunteers (Group III). Prolidase activity was determined in all subjects. High sensitive C-reactive protein and white blood cell count were studied in only valve patients. Results: Prolidase activi...
A 23-year-old female patient was admitted with progressive dyspnea of two-month history. On physi... more A 23-year-old female patient was admitted with progressive dyspnea of two-month history. On physical examination, her blood pressure, heart rate, and axillary temperature were 95/60 mmHg, 96 beats/min, and 37.4 °C, respectively. Cardiac auscultation showed reduced heart sounds without any murmur. A 12-lead electrocardiogram revealed reduced QRS amplitude (<10 mm) in both extremity and precordial leads. Transthoracic echocardiography revealed a large pericardial effusion rich in fibrin fibers. Late systolic compression of both atria was noted in the two-dimensional apical four-chamber view (Fig. A) and M-mode recording of the parasternal long-axis view revealed left atrial compression at early diastole, a rare finding of pericardial effusion (Fig. B). A two-dimensional modified parasternal short-axis view revealed double "Mercedes-Benz" sign, one was on the left and anteriorly located, and the other was on the right and posteriorly located,
Scandinavian Journal of Clinical and Laboratory Investigation, Aug 7, 2015
The balance of oxidant and antioxidant status plays an important role in the left ventricular dia... more The balance of oxidant and antioxidant status plays an important role in the left ventricular diastolic dysfunction (LVDD) in patients with hypertension (HT). Thiol is an important part of antioxidant system in the body. The aim of this study was to investigate the relationship between plasma thiol levels and LVDD in patients with HT. A total of 138 patients with newly diagnosed essential hypertensive and 20 age-gender matched subjects as control group enrolled in the study. After echocardiographic assessment, the hypertensive patients were divided into three groups: Group 1: without LVDD (n = 41); group 2: with LVDD grade 1 (n = 57); and group 3: with LVDD grade 2 (n = 40). Plasma thiol, lipid and glucose levels were measured in all subjects. Plasma thiol levels were significantly different between the groups (all of p < 0.05). While the lowest thiol level was in the group 3, the highest level was in the control group. The presence of LVDD was correlated with age, systolic and d...
The balance of oxidant and antioxidant status plays an important role in the left ventricular dia... more The balance of oxidant and antioxidant status plays an important role in the left ventricular diastolic dysfunction (LVDD) in patients with hypertension (HT). Thiol is an important part of antioxidant system in the body. The aim of this study was to investigate the relationship between plasma thiol levels and LVDD in patients with HT. A total of 138 patients with newly diagnosed essential hypertensive and 20 age-gender matched subjects as control group enrolled in the study. After echocardiographic assessment, the hypertensive patients were divided into three groups: Group 1: without LVDD (n = 41); group 2: with LVDD grade 1 (n = 57); and group 3: with LVDD grade 2 (n = 40). Plasma thiol, lipid and glucose levels were measured in all subjects. Plasma thiol levels were significantly different between the groups (all of p < 0.05). While the lowest thiol level was in the group 3, the highest level was in the control group. The presence of LVDD was correlated with age, systolic and d...
Ceruloplasmin (CP) is a blue serum protein found in human serum; it carries approximately 95% of ... more Ceruloplasmin (CP) is a blue serum protein found in human serum; it carries approximately 95% of the total circulating copper (Cu) in healthy individuals. The relationship of CP with OS, inflammation, and DNA damage is known. Oxidative stress (OS), inflammation, and DNA damage are the main causes underlying atherosclerotic heart disease. Several studies have indicated a close association between high serum CP and several types of heart disease. However, the CP levels are still unknown in many heart diseases. To gather the studies of CP in heart disease and to prepare the ground for new studies for researchers, we designed this review.
The role of oxidative stress in the pathogenesis of many heart diseases has been well established... more The role of oxidative stress in the pathogenesis of many heart diseases has been well established (5-8). Many studies have shown an imbalance between oxidant production and antioxidant response in HF (9-11). It is known that chronic systolic HF is associated with increased ROS and decreased antioxidant level. Furthermore, the imbalance between oxidants and antioxidants is clearly associated with poor prognosis in patient with chronic systolic heart failure (10). Although oxidative stress status in subgroup of HF syndrome still remains unknown. We aimed to study Total Antioxidant Status (TAS), Total Oxidant Status (TOS) and Oxidative Stress Index (OSI) in both systolic and diastolic HF, and also in ischemic and non-ischemic HF.
Purpose: Oxidative damage plays an important role in atherosclerosis development. Statin drugs ha... more Purpose: Oxidative damage plays an important role in atherosclerosis development. Statin drugs have anti-oxidant properties, but the clinical value of their antioxidant properties remains unclear. In this study, our aims were: (1) to assess the anti-oxidant effects of statins in patients with coronary artery disease (CAD) using a newly developed valid measure of total oxidant and anti-oxidant capacity; and (2) to identify whether statins influence ceruloplamin levels. Methods: Within a cross-sectional study, 67 dyslipidemic CAD patients on atorvastatin for at least three months were compared with 69 age- and gender-matched CAD patients not using atorvastatin. All patients were either newly-diagnosed with or already had established CAD. Patients and controls were selected from among patients who had undergone coronary angiography for a variety of reasons. Immediately prior to angiography, plasma total oxidant and antioxidant capacity and ceruloplasmin (Cp) levels were measured by mea...
Turk Kardiyoloji Dernegi Arsivi-Archives of the Turkish Society of Cardiology, 2016
In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, le... more In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, left ventricular diastolic parameters, and left ventricular mass (LVM) index in moderate to severe obstructive sleep apnea syndrome (OSAS) patients without coexisting disorders were investigated. Methods: A total of 66 non-diabetic, non-hypertensive, and non-smoking volunteers were enrolled. Participants were categorized by apnea-hypopnea index (AHI; event/hour). The control group was defined as no OSAS: AHI<5 (n=35), and OSAS group had moderate to severe OSAS: AHI>15 (n=31). Echocardiographic and biochemical tests, including measurement of C-reactive protein (CRP), were performed. PAS (kHz/s) was calculated by dividing the maximal frequency shift of the pulmonary flow by the acceleration time. Results: PAS (kHz/s), obtained by echocardiography, was statistically significantly higher in the OSAS group than the control group (28±5 vs 18±4, p<0.001), and was positively correlated with AHI, CRP, aortic stiffness index, E/E', and LVM index (p=0.034, p=0.039, p<0.001, p=0.040, and p<0.001, respectively), and negatively correlated with aortic strain (AS), aortic distensibility (AD), E/A, E'/A', and E' (p<0.001). Regression analyses indicated that CRP and PAS are independent predictors of aortic stiffness (p<0.05). E/A and LVM index were independent predictors of PAS (p=0.002 and p=0.001, respectively). Conclusion: Increased PAS is associated with aortic stiffness, left ventricular diastolic function, and increased LVM index. PAS may be a more effective indicator of aortic stiffness in OSAS patients than CRP. Amaç: Bu çalışmada, eşlik eden hastalıkları bulunmayan orta ve ciddi derece obstrüktif uyku apne sendromuna (OUAS) sahip hastalarda pulmoner arter sertliğinin (PAS) aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu parametreleri ve sol ventrikül kitle indeksi ile ilişkisi araştırıldı. Yöntemler: Hipertansiyon ve diyabeti bulunmayan ve sigara kullanmayan 66 gönüllü çalışmaya alındı. Katılımcılar apne hipopne indeksine göre sınıflandırıldılar (AHI, olay/saat). Kontrol grubu sağlıklı bireylerden oluştu AHI <5 normal (n=35), OUAS grubu orta veya ciddi OUAS'lı hastaları kapsadı AHI >15 orta/ciddi (n=31). Ekokardiyografi ve C-reaktif proteinin (CRP) dahil olduğu biyokimyasal testler değerlendirildi. PAS (kHz/s) = pulmoner akım maksimal sapma sıklığı/akselerasyon zamanı, formülüyle hesaplandı. Bulgular: Ekokardiyografiyle elde edilen PAS (kHz/s) OUAS grubunda istatistiksel olarak anlamlı derecede daha yüksekti (18±4 ve 28±5, p<0.001) ve AHI, CRP, aort sertlik indeksi, E/E' oranı ve sol ventrikül kitle indeksi ile pozitif (sırasıyla, p=0.034, p=0.039, p<0.001, p=0.040 ve p<0.001) ve aort straini, aortgerilebilirliği, E/A oranı, E'/A' oranı ve E' ile negatif korelasyona sahipti (p<0.001). Regresyon analizi CRP ve PAS'nin aort sertliği için bağımsız öngördürücüler olduğunu gösterdi (p<0.05). E/A oranı ve sol ventrikül kitle indeksi PAS için bağımsız öngördürücülerdi (sırasıyla; p=0.002 ve p=0.001). Sonuç: Artmış PAS aort sertliği, sol ventrikül diyastolik fonksiyon bozukluğu ve artmış sol ventrikül kitle indeksiyle ilişkiliydi. OUAS'li hastalarda PAS aort sertliği için CRP'den daha iyi bir belirteç olabilir.
The balance of oxidant and antioxidant status plays a key role in the coronary artery diseases (C... more The balance of oxidant and antioxidant status plays a key role in the coronary artery diseases (CAD). Thiol is one of the most important antioxidant barriers in humans, and thiol/disulfide homeostasis is a novel oxidative stress marker. We aimed to investigate the relation of serum thiol levels and thiol/disulfide homeostasis with the presence and severity of coronary artery disease. A total of 161 patients who underwent coronary angiography owing to stable angina pectoris were consecutively enrolled. They were divided into three groups. Group I:47 age-gender matched subjects with normal coronary angiography (control), group II:71 newly diagnosed CAD patients with noncritical stenosis, and group III:43 newly diagnosed CAD patients with critical stenosis. Serum native thiol, total thiol, and disulfide levels were measured, and disulfide/thiol ratios were calculated. Gensini scores were calculated in CAD patients. While the highest thiol levels were found in group I, the lowest one was observed in group III (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Total and native thiol levels were significantly lower in group II than group I (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 for each), but they considerably increased in group II compared with group III (p=0.031 and p=0.028, respectively). Disulfide levels decreased in group II and III compared with group I (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001 for each). No statistically significant changes were observed in disulfide/thiol ratios (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Gensini scores were negatively correlated with total and native thiols, and positively with age and dyslipidemia. Stepwise linear regression analyses showed that native thiol was an independent predictor in the final model for Gensini score. ROC curve analysis demonstrated that thiol values of 310.7 or below could predict CAD with 89% sensitivity and 85% specificity (AUC=0.918; 95%CI:0.870-0.965). While disulfide/thiol ratio did not change significantly, decreased native thiol levels were associated with the presence and severity of CAD. This result indicates that the reduction of thiols may be important factor in development of CAD.
Cardiac syndrome X (CSX) is characterized by the presence of myocardial ischemia in the absence o... more Cardiac syndrome X (CSX) is characterized by the presence of myocardial ischemia in the absence of coronary artery stenosis on angiograms. Its relation to oxidative stress and inflammation is well known. There are no data on thiols and their relation with inflammation in CSX. The aim of this study was to investigate thiol levels and thiol/disulfide homeostasis in CSX patients. Fifty consecutive patients who had documented myocardial ischemia and normal coronary angiogram (CSX group), and 45 age-matched and sex-matched consecutive patients who had normal coronary angiogram without myocardial ischemia (control group) were enrolled in this study. C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), native thiol, total thiol, and disulfide levels were measured and disulfide/thiol ratios were calculated in all patients. Demographic, clinical, basic laboratory, and echocardiographic characteristics were similar in the two groups (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). Serum total thiol, native thiol, and disulfide levels decreased significantly in the CSX group compared with the control group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). CRP and NLR increased significantly in the CSX group compared with the control group (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Although disulfide/native thiol levels increased in the CSX group, this reduction did not reach statistical significance (5.8 vs. 5.5, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;0.05). The reduction of thiols was correlated negatively with CRP and NLR (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Although univariate logistic regression analyses showed that serum total and native thiol levels, CRP and NLR were independent predictors for CSX estimation, stepwise multivariate logistic regression analysis showed only total thiol levels as an independent predictor for CSX (odds ratio=0.966, 95% confidence interval: 0.950-0.982, P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Also, receiver operating characteristic curve analysis showed that serum total thiol values of 338.4 or below could predict the CSX with 86% sensitivity and 84% specificity (area under curve=0.903; 95% confidence interval: 0.842-0.965). Serum total thiol levels decreased significantly in CSX and this reduction independently predicted CSX with strong sensitivity and specificity. This suggests that the reduction in thiols along with increased inflammation may play a pathophysiological role in the development of CSX.
Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (R... more Obesity and overweight are risk factors for atherosclerosis. Red blood cell distribution width (RDW) is associated with subclinical cardiac diseases. The aim of this study was to investigate the association between RDW and aortic stiffness in overweight or obese subjects. A total of 101 overweight or obese subjects without overt cardiovascular disorders, and 48 healthy controls were enrolled. RDW, aortic pulse-wave velocity (PWV) and augmentation index 75 (Aix75) were evaluated. The case subjects were divided into two sub-groups according to PWV values; ≥ 10 m/s in group I, and < 10 m/s in group II. Bivariate correlation and multiple regression analyses (stepwise) were performed. RDW and PWV were considerably increased in the case groups compared with the controls. RDW was significantly increased in group I compared with group II and the controls [median 12.0 m/s, interquartile range (IQR): 10.5-17.5; median 11.7 m/s, IQR: 10.2-14.2, and median 11.4 m/s, IQR: 9.6-15.5, p < 0.0...
To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery... more To investigate whether obstructive sleep apnea syndrome (OSAS) has any effect on pulmonary artery stiffness (PAS) derived from echocardiographic calculation. Fifty-two patients with newly diagnosed OSAS and forty-two subjects without OSAS matched by age and sex were enrolled in the study. OSAS was categorized according to apnea hypopnea index (AHI, event/h) as follows: normal (AHI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;5), mild OSAS (AHI 5-15), moderate and severe OSAS (AHI&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;15). All participants were evaluated by echocardiography to determine PAS and right ventricle functions. PAS was calculated throughout pulmonary artery flow by the formula; PAS (kHz/sec) = maximal frequency shift/acceleration time. Demographic and clinical parameters were similar in both groups. PAS significantly increased in OSAS compared with the control group (26.9 ± 6.1 vs. 18.0 ± 3.5, P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Additionally, PAS in severe and moderate OSAS was considerably high compared with that in mild OSAS and control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Right ventricular myocardial performance index (MPI) and mean pulmonary artery pressures (mPAP) were considerably higher in OSAS group than control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Tricuspid E/A, right ventricle tissue Doppler E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, and right ventricular ejection time (RVET) decreased in OSAS group compared with control group (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). There was a significantly positive correlation between PAS and AHI, mPAP, and MPI (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and a significantly negative correlation between PAS and tricuspid E/A, E&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;/A&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;, and RVET (P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). Linear regression analyses showed that PAS was an independent factor for mPAP (ß = 0.595, P =…
Background: Fetuin-A is an acute phase protein that exists in circulation and prevents the format... more Background: Fetuin-A is an acute phase protein that exists in circulation and prevents the formation of dystrophic vascular and valvular calcification. The aim of this study was to determine how serum fetuin-A levels changed in Rheumatic Mitral Stenosis patients when compared to healthy control subjects and whether it was associated with echocardiographical data. Methods: Fifty Rheumatic Mitral Stenosis patients diagnosed by echocardiography and age-sex matched fifty-two control subjects were included into the study. Serum fetuin-A level of each subject was measured by ELISA method. Results: There was no significant difference between patients and controls in serum fetuin-A levels (respectively 27,64±6,35 ng/mL and 29,35±6,41 ng/mL; p=0,262). In additon, no significant correlation was found between Wilkins calcification score determined by echocardiography and serum fetuin-A levels in patients.
Renal artery aneurysms and pseudoaneurysms are rare vascular abnormalities. These anomalies, whic... more Renal artery aneurysms and pseudoaneurysms are rare vascular abnormalities. These anomalies, which are usually asymptomatic, may be associated with hypertension. Here, we present the successful treatment of a renal artery pseudoaneurysm in a patient with hypertension, with an overview of the literature.
Aim: It is known that renin-angiotensin system, inflammation, signaling pathways, and genetic pre... more Aim: It is known that renin-angiotensin system, inflammation, signaling pathways, and genetic predisposition play a major role in the pathogenesis of heart valve disease. Scarring and collagen deposition in the valves and destruction of myocytes may result from the combined effects of rheumatic and degenerative process in heart valve diseases. Prolidase plays an important role in collagen metabolism, matrix remodeling and cell growth. The aim of the study was to comparatively assess the serum prolidase activity in rheumatic and degenerative heart valve diseases. Materials and methods: The study included 26 patients who had undergone valve replacement due to rheumatic etiology (Group I), 24 patients who had undergone valve replacement due to degenerative etiology (Group II) and 20 healthy volunteers (Group III). Prolidase activity was determined in all subjects. High sensitive C-reactive protein and white blood cell count were studied in only valve patients. Results: Prolidase activi...
Uploads
Papers by Yusuf Sezen