Background and Objectives. Chronic venous insufficiency (CVI) is a common pathology of the circulatory system and is associated with a high morbidity for the patients and causes high costs for the healthcare systems. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality. The relationship between CVI and arterial stiffness using pulse wave velocity (PWV) and augmentation index (Aix) was evaluated in this study. Methods. Sixty-two patients with the stage of C3-C5 chronic venous disease (CVD) and 48 healthy subjects were enrolled in the study. To assess arterial stiffness, all cases were evaluated with I.E.M. Mobil-O-Graph brand ambulatory blood pressure monitor device. PWV and Aix were used to assess arterial stiffness in this study. Results. The mean age was 61.9±11.05 years and 54 % of the patient population was females. PWV and Aix were significantly higher in CVI patients than controls (8.92±1.65 vs. 8.03±1.43, p=0.001; 25.51±8.14 vs. 20.15±9.49, p=0.003, respectively) and also positive linear correlation was observed between CVI and all measured arterial stiffness parameters (r=0.675 for CVI and PWV, r=0.659 for CVI and Aix, respectively). A PWV value of > 9.2 has 88.9 % sensitivity and 71.4 % specificity to predict the presence of CVI. Conclusions. PWV and Aix are the most commonly used, easy, reproducible, reliable methods in the clinic to assess arterial stiffness. Logistic regression analysis showed that PWV and Aix were the independent predictors of CVI. PWV has the sensitivity of 88.9 % and specificity of 71.4 % to detect the presence of CVI.

Coronary slow flow phenomenon (CSFP) is characterized by delayed coronary artery filling in the absence of significant obstructive coronary artery disease. It typically presents with angina-like chest pain and is defined by delayed opacification of the coronary arteries despite the absence of obstructive lesions. Although the pathophysiology of CSFP remains poorly understood, microvascular dysfunction, endothelial impairment, and systemic inflammation have been proposed as contributing factors. Hematological parameters, such as eosinophil and basophil counts, along with the eosinophil-to-basophil ratio (EBR) and monocyte-to-basophil ratio (MBR), have emerged as potential indicators of inflammation and cardiovascular pathology. This study aimed to investigate the association between these hematological markers and CSFP to enhance understanding and guide the development of diagnostic and therapeutic strategies. In this retrospective study, eosinophil, basophil, and monocyte counts, as well as derived ratios (EBR and MBR), were analyzed in 233 patients with CSFP and 229 controls who underwent coronary angiography but had normal coronary arteries. Blood samples were processed using an automated hematology analyzer. Group comparisons were performed using the independent samples t-test and Mann–Whitney U test (P < .05). Spearman correlation and logistic regression analyses were conducted to assess associations among variables. There was no statistically significant difference in the median age between the CSFP group (56.0 [IQR: 15.0]) and the control group (57.0 [IQR: 15.0]; P = .905). The CSFP group consisted predominantly of males (161 males, 72 females), whereas the control group had a higher proportion of females (152 females, 77 males), with a statistically significant difference in sex distribution (P < .001). Patients with CSFP exhibited significantly higher monocyte counts (P < .001), eosinophil counts (P = .012), EBR (P = .010), and MBR (P = .008) than controls. This study demonstrated significant differences in hematological parameters between patients with CSFP and controls. These findings suggest that specific hematological indices, particularly immune cell ratios, could serve as accessible, cost-effective biomarkers for CSFP. Further studies are needed to clarify their mechanistic roles and therapeutic relevance.

Circadian hypertension patterns, classified as dipper and non-dipper, influence cardiovascular risk and are linked to systemic inflammation. This study aimed to examine the relationship between hypertension phenotypes and inflammatory biomarkers. This retrospective cross-sectional study included 160 hypertensive patients with elevated office blood pressure (BP) who underwent 24-hour ambulatory BP monitoring and were categorized into dipper and non-dipper groups. Inclusion criteria comprised newly diagnosed, untreated individuals without hematological disorders, chronic inflammatory conditions, active infections, or moderate to severe chronic kidney disease. Inflammatory indices derived from complete blood counts were analyzed alongside demographic and clinical data. The cohort consisted of 79 dippers and 81 non-dippers, with a mean age of 46 ± 5 ± 11 ± 1 years. Non-dippers were more likely to be smokers ( P = .006) and exhibited significantly higher 24-hour, awake, and sleep systolic BPs and sleep diastolic BPs than dippers ( P = .001, P = .003, P < .001, and P < .001, respectively). Non-dippers also had elevated white blood cell counts, neutrophil (NEU) levels, neutrophil-to-lymphocyte ratio (NLR), derived NLR (dNLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and systemic inflammation response index (SIRI) scores ( P < .001, P < .001, P < .001, P < .001, P < .001, P = .002, P < .001, and P < .001, respectively), while dippers exhibited higher lymphocyte counts ( P < .001). Logistic regression analyses indicated that NLR, dNLR, MLR, PLR, SII, and SIRI scores significantly predicted the inflammatory status of non-dipper hypertensive patients. Notably, dNLR demonstrated the highest specificity, sensitivity, and area under the curve values in the receiver operating characteristic analysis. This study identified significant differences in inflammatory status between dipper and non-dipper hypertensive groups, with inflammatory biomarkers strongly correlating with non-dipper hypertension. The dNLR score exhibited the strongest predictive value for non-dipper hypertension. Routine screening of inflammatory markers in clinical practice could facilitate early identification of at-risk patients and potentially improve treatment outcomes. However, further research is needed to validate these findings.

This study investigated the clinical significance of coronary artery tortuosity (CAT) in chronic coronary syndrome (CCS) using Gensini scores. This retrospective single-center study involved 388 patients undergoing coronary angiography for chest pain, excluding those with acute coronary syndromes or prior coronary interventions. Demographic, clinical, and angiographic data were collected and categorized based on the presence or absence of CAT. Analysis of 388 patients revealed that CAT was associated with older age (P < 0.001), female gender (P < 0.001), lower rates of smoking (19.3% vs. 29.6%, P = 0.025), and hypertension (53.5% vs. 38.7%, P = 0.05). There was a slightly higher, nearly significant, prevalence of diabetes in the CAT group (22.8% vs. 14.5%, P = 0.051). Furthermore, CAT correlated with diastolic dysfunction (P = 0.04) and was inversely related to the severity of coronary atherosclerosis, as indicated by lower Gensini scores correlating with higher CAT scores (P = 0.039 and P = 0.049, respectively). Univariate analysis confirmed CAT's association with older age (P < 0.001), female gender (P < 0.001), hypertension (P = 0.004), diabetes (P = 0.039), diastolic dysfunction (P = 0.003), and Gensini score (P = 0.012). Multivariate analysis further identified significant correlations with age (P = 0.001), female gender (P < 0.001), and Gensini score (P = 0.049). Our findings indicate that older age and female gender predict presence of CAT in CCS patients. The lower Gensini scores associated with CAT may possibly be due to a reduced atherosclerotic plaque burden in these patients. Further research into this relationship could inform the development of treatment and management strategies for coronary atherosclerosis.

Background: The sex-specific impact of micronutrient status on heart rate variability (HRV) in adults presenting with palpitations to cardiology outpatient clinics remains unclear. Thus, this study aimed to assess the demographic and biochemical determinants of HRV in a clinical cohort of patients presenting with complaints of palpitations. Methods: This retrospective study included 213 adults aged 18–65 years who presented with palpitations and underwent 24-hour Holter monitoring at our institution between 2023 and 2024. Patients with cardiovascular disease, known arrhythmias, chronic inflammatory conditions, renal dysfunction, or use of medications that affected autonomic function were excluded from the study. Demographic variables, laboratory parameters, and HRV indices were statistically analyzed. The standard deviation of all normal-to-normal intervals (SDNN) was the primary HRV parameter used in both univariate and multivariate linear regression analyses. Results: The SDNN was significantly lower in women and older adults. In the univariate analyses, age (β = –0.203; p = 0.003), male sex (β = 0.529; p < 0.001), ferritin, serum iron, folate, and Vitamin B12 were all associated with the SDNN. However, in the multivariable model, only male sex (β = 0.467; p < 0.001), iron-binding capacity (IBC) (β = –0.377; p < 0.001), and folate (β = 0.117; p = 0.037) remained independent predictors. Elevated IBC, reflecting functional iron deficiency, was strongly associated with a reduced SDNN, whereas higher folate levels were associated with better autonomic modulation. Conclusions: In patients presenting with palpitations, the SDNN is influenced by both demographic factors and biochemical markers of iron metabolism. Elevated IBC, reflecting alterations in iron metabolism and iron availability, was associated with impaired autonomic regulation, even in the absence of overt anemia. In contrast, adequate folate status appeared to support a more favorable autonomic function. These findings highlight the importance of integrating iron–vitamin assessment into the evaluation of autonomic function and underscore the need for prospective studies to determine whether correcting these abnormalities can improve HRV and clinical outcomes.