Endothelial cell-specific molecule-1 (endocan) is an immunoinflammatory marker linked to endothelial activation and dysfunction. We investigated the relationship between obstructive coronary artery disease (CAD), microvascular angina (MVA), and plasma levels of endocan. We included 53 healthy individuals as controls, 40 MVA patients, and 120 patients with obstructive CAD. The severity of CAD was assessed by the Gensini and SYNergy between percutaneous coronary intervention with TAXUS and Cardiac Surgery (SYNTAX) scores. Endocan levels were 382.7 (313.8-470.2) pg/mL in patients with obstructive CAD; 324.3 (277.1-460.7) pg/mL in MVA group, and 268.0 (226.4-336.5) pg/mL (P < .001) in controls. Endocan levels in obstructive CAD and MVA groups were similar but both were significantly higher than for the control group (P < .001 and P = .002, respectively). In subgroup analysis, similar to the hypertensive subgroup results, endocan was still an independent predictor of presence of obstructive CAD in normotensives (odds ratio = 1.005, 95% confidence interval = 1.001-1.010, P = .024). There was also an independent positive correlation between endocan levels and SYNTAX score both in the hypertensives (β = 0.414, t = 3.21, P = .002) and in the normotensives (β = .301, t = 2.23, P = .031). In conclusion, endocan could be a common predictor of the endothelium-dependent inflammatory processes, rather than related with specific risk factors.

Introduction: Left ventricular hypertrophy (LVH) is one of the most common cardiac abnormalities in patients with end stage renal disease (ESRD). Hypertension, diabetes, increased body mass index, gender, age, anemia, and hyperparathyroidism have been described as risk factors for LVH in patients on dialysis. However, there may be other risk factors which have not been described yet. Recent studies show that renalase is associated with cardiovascular events. The aim of this study was to reveal the relation between renalase, LVH in patients under hemodialysis (HD) treatment. Methods: The study included 50 HD patients and 35 healthy controls. Serum renalase levels and left ventricle mass index (LVMI) were measured in all participants and the relation between these variables was examined. Findings: LVMI was positively correlated with dialysis vintage and C-reactive protein (CRP) (r = 0.387, p = 0.005 and r = 0.597, p < 0.001, respectively) and was negatively correlated with residual diuresis and hemoglobin levels (r = −0.324, p = 0.022 and r = −0.499, p < 0.001, respectively). There was no significant association of renalase with LVMI in the HD patients (r = 0.263, p = 0.065). Serum renalase levels were significantly higher in HD patients (212 ± 127 ng/mL) compared to controls (116 ± 67 ng/mL) (p < 0.001). Renalase was positively correlated with serum creatinine and dialysis vintage (r = 0.677, p < 0.001 and r = 0.625, p < 0.001, respectively). Discussion: In our study, LVMI was correlated with dialysis vintage, residual diuresis, CRP, and hemoglobin. LVMI tends to correlate with renalase and this correlation may be significant in studies with more patient numbers. The main parameters affecting renalase levels are dialysis vintage and serum creatinine.

Çimen T, et al. Korean Circ J. 2016 Nov;46(6):827-833. https://doi.org/10.4070/kcj.2016.46.6.827

Flash pulmonary edema frequently develop in case of bilateral renal artery stenosis and unilateral renal artery stenosis with functional solitary kidney. In some rare cases, unilateral renal artery stenosis with bilaterally functional kidneys may also lead to flash pulmonary edema. Here, we present a case of flash pulmonary edema caused by accessory renal artery stenosis. To our knowledge, it is the first case reported in the literature.

Objectives: Elevated red blood cell distribution width (RDW) is an independent prognostic factor for cardiovascular events that are major causes of mortality in patients with carbon monoxide (CO) poisoning. Due to the limited number of studies, we aimed to investigate the relationship between RDW levels and long-term mortality for these patients. Method: This retrospective study included patients with CO poisoning, who presented to the emergency department. Baseline characteristics, laboratory results and survival status were retrieved from patients' hospital records. The severity of poisoning was determined according to COHb level and/or clinical signs and symptoms. Results: The study included 571 patients (median age was 37.0 years) and less than half of these patients were male (n = 206, 36.1%). There were mild-moderate CO poisoning in 389 (68.1%) patients and severe poisoning in 182 (31.9%). At a median follow-up of 6.2 years, there were 33 deaths (5.8%). Univariate coxregression analysis demonstrated that age, gender, presence of hypertension or diabetes mellitus, levels of hemoglobin, RDW, creatinine and alanine-aminotransferase, and white-blood-cell count were potential covariates of long-term all-cause mortality. In the multivariate analysis, the median age and RDW level remained independent predictors of mortality (age, Odds ratio [OR]: 1.070 95% confidence interval [CI]: 1.030-1.110, p = 0.001; RDW, OR: 1.221 95% CI: 1.042-1.431, p = 0.013). Patients with higher RDW levels had a significantly worse prognosis in terms of mortality than with lower RDW levels (log-rank test, p = 0.003). Conclusion: This study demonstrated that RDW level is an independent predictor of long-term mortality in patients with CO poisoning. Copyright (C) 2018 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.

Pulse pressure (PP) is the difference between systolic and diastolic blood pressure, and is an independent predictor of atrial fibrillation (AF). In this study we investigated the relationship between PP and atrial conduction times. The study included 157 patients with essential hypertension. PP of 60 mmHg or more was regarded as elevated (n=56). Atrial electromechanical delay (EMD) was assessed with tissue Doppler echocardiography and P-wave dispersion (Pd) was calculated from the electrocardiogram. Left atrial volume index (23.6±4.9 ml/m2 vs. 25.2±6.5 ml/m2, p=0.141), left ventricular mass index (77.3±13.5 g/m2 vs. 80.9±19.6 g/m2, p=0.180) and grade I diastolic dysfunction (42% vs. 53%, p=0.242) were similar between groups. Inter-atrial (33.6±9.2 ms vs. 41.5±11.3 ms, p<0.001), intra-left atrial (23.0±8.8 ms vs. 28.2±10.6 ms, p=0.001) and intra-right atrial (10.5±5.8 ms vs. 13.2±4.9 ms, p=0.004) EMD were found to be higher in patients with elevated PP. P-maximum (108±8 ms vs. 114±9 ms, p<0.001) and Pd (30±13 ms vs. 38±13 ms, p<0.001) were also prolonged in patients with elevated PP. Multivariate linear regression analysis revealed that PP was independently associated with inter-atrial EMD (β=0.379, t=4.088, p<0.001). This study showed that elevated PP is associated with prolonged atrial EMD and Pd. Atrial conduction is disturbed in hypertensive patients with elevated PP before the development of significant structural remodeling.