To evaluate the utility of elasticity imaging techniques, such as transient elastography (FibroScan), in assessing the liver and transplanted kidney in patients with AA amyloidosis (AA-A). This study was conducted in patients with AA-A, while patients with immunoglobulin light chain amyloidosis (AL-A), Familial Mediterranean Fever (FMF) without amyloidosis, and healthy controls (HC) were included as comparison groups for liver stiffness (LS) measurements. Additionally, kidney stiffness (KS) was measured in renal transplant recipients (RTRs) with transplants due to AA-A or other causes of chronic renal failure. LS evaluations were performed in 65 patients with AA-A, 14 with AL-A, 20 with FMF, and 27 with HC. LS (kPa) was significantly higher [median (IQR)] in patients with AA-A [6.4 (5.4)] and AL-A [9.8 (11)] compared to HC [4.7 (1.7)] (p < 0.001). However, the difference between AL-A and AA-A was not statistically significant. LS values were comparable in FMF-AA patients with [6.8 (6.6)] and without [5.7 (3.6)] liver involvement, and FMF patients without amyloidosis [7.15 (4.6)]. The median KS values were comparable in 19 AA-A and 16 disease controls. However, KS values were significantly higher in patients with recurrent amyloidosis in the transplanted kidney [29.3 (18.9)] compared to those without recurrence [10.9 (7.7)] (p = 0.003). In our study, increased liver stiffness measurements were observed in patients with AA-A, AL-A, and FMF compared to HC. Transient elastography using FibroScan appears to be a promising non-invasive tool for assessing liver involvement in AA-A and may aid in detecting recurrence of amyloidosis in transplanted kidneys. Further studies are needed to validate the utility of FibroScan in evaluating the involvement of the liver and kidneys in patients with AA-A.

Objectives: Peroxisome proliferator-activated receptor gamma (PPAR-γ) modifies many cellular processes that contribute to atherosclerosis. The increased concentrations of osteoprotegerin (OPG) are related with coronary artery disease, calcification in vascular tissue, advanced atherosclerosis, and diabetic complications has been informed. The aim of our study was to define the relation among PPAR-γ Pro12Ala and, OPG and PPAR-γ in Peripheral Vascular Disease (PVD) and hypertension (HT). Also, it was aim to investigate the relationship between flow-mediated dilatation (FMD) in HT and ankle brachial index (ABI) in PVD in terms of endothelial dysfunction (ED). Methods: Fifty-four patients with HT, 47 with PVD, and 52 healthy for the controls were included. Blood samples were used for analyzing PPAR-γ and OPG by Enzyme-Linked Immunosorbent Assay (ELISA), and biochemical assays. The PPAR-γ Pro12Ala was examined using TaqMan with PrimerProbMix. p value less than 0.05 was accepted as the limit of significance. Results: The PPAR-γ was significantly decreased in both HT and PVD (p<0.001). The serum concentrations of OPG were higher in HT (p<0.001) and increased in diabetic ones (p<0.05). CG genotype of PPAR-γ Pro12Ala was more frequent in HT patients (p<0.001). In the HT patients, increased OPG and decreased PPAR-γ were found in CC (p<0.001). In the PVD patients, PPAR-γ levels decreased in carrying with CC (p<0.05). Conclusions: It may be significant that increased OPG, as a marker of endothelial dysfunction, is found in HT. Moreover, decreased PPAR-γ in those who have to carry CC may be protective in both HT and PVD.

Background/Objectives: Patients with type 2 diabetes mellitus (T2DM) frequently develop diffuse and anatomically complex coronary artery disease (CAD), resulting in a substantially increased cardiovascular risk. Although both HDL-C and the triglyceride-to-high-density lipoprotein cholesterol (TG/HDL-C) ratio have been associated with cardiovascular risk, their relative associations with and discriminatory performance for angiographic CAD complexity remain uncertain. This study aimed to evaluate and compare these two lipid parameters in relation to CAD complexity as assessed by the SYNTAX score. Methods: A retrospective, observational, single-center study was conducted involving 167 consecutive T2DM patients who underwent diagnostic coronary angiography. CAD complexity was quantified using the SYNTAX score, with patients categorized into low (≤22) and higher (>22) complexity groups. Statistical evaluation included correlation analyses, univariable and multivariable logistic regression, and receiver operating characteristic (ROC) curve analysis. Results: Of the 167 patients, 48 (28.7%) were classified with higher SYNTAX scores. HDL-C showed a significant inverse correlation with the SYNTAX score (r = −0.339, p < 0.001), whereas the TG/HDL-C ratio showed a weak positive correlation (r = 0.159, p = 0.040). In separate multivariable models adjusted for sex, both HDL-C (OR 0.944, 95% CI 0.908–0.980; p = 0.003) and the TG/HDL-C ratio (OR 1.085, 95% CI 1.003–1.175; p = 0.041) remained associated with a higher SYNTAX score. HDL-C showed a numerically higher AUC than the TG/HDL-C ratio (0.659 vs. 0.621); however, the difference between the AUCs was not statistically significant (DeLong p = 0.268). Conclusions: Lower HDL-C and a higher TG/HDL-C ratio remained associated with a higher SYNTAX score after adjustment for sex. Although HDL-C showed numerically better discrimination, no statistically significant difference in discriminatory performance was demonstrated between the two markers.

Objective: Although obesity is a well-established risk factor for coronary artery disease (CAD), several recent studies have paradoxically demonstrated lower cardiovascular mortality rates among obese individuals. This study aimed to compare the extent of CAD between obese and non-obese diabetic patients and evaluate the presence of the obesity paradox in this population.Materials and Methods: A total of 1,557 patients who underwent coronary angiography were retrospectively screened. Fifty-three diabetic patients were included and divided into two groups according to body mass index (BMI): ≥30 and <30. The groups were matched for age, gender, and other cardiovascular risk factors. The extent of CAD was assessed using the SYNTAX score. Statistical analyses were performed using IBM SPSS Statistics version 27, and a p-value of <0.05 was considered statistically significant.Results: There were no statistically significant differences between the groups (BMI ≥30 vs. <30) regarding age, gender, HbA1c, LDL, total cholesterol, creatinine levels, hypertension, family history, atrial fibrillation, cerebrovascular disease, and smoking status. The SYNTAX score was significantly lower in the obese group (12.67±9.68) compared to the non-obese group (19±12.68) (p=0.046).Conclusion: Among diabetic patients, those who were obese had significantly less extensive and severe CAD compared to their non-obese counterparts, supporting the concept of the obesity paradox.

The growing incidence of diabetes and the increasing life expectancy of the diabetic population worldwide has increased the number of diabetic vascular complications occurring in cardiology practice. As current treatment and prevention methods are less effective in this patient group, there is a need for new treatment methods in this area.

Background/Objectives: Myocardial infarction with non-obstructive coronary arteries (MINOCA) represents a heterogeneous clinical entity in which patients exhibit symptoms and biomarker evidence of myocardial infarction despite the absence of significant coronary stenosis. This study aimed to evaluate the diagnostic and follow-up value of left ventricular global longitudinal strain (LV-GLS) in patients with MINOCA and to investigate its association with inflammatory and glycemic biomarkers. Methods: A total of 287 patients presenting with acute coronary syndrome were prospectively enrolled. Based on coronary angiographic findings, patients were classified into two groups: myocardial infarction with obstructive coronary arteries (MIOCA; ≥50% stenosis, n = 237) and MINOCA (<50% stenosis, n = 50). In addition, an ischemic control group without obstructive disease (INOCA, n = 50) was included for comparative analysis. Laboratory tests, echocardiography, and LV-GLS were assessed at baseline and at 3 months. Results: Baseline left ventricular ejection fraction (LVEF) and LV-GLS were significantly lower in MIOCA compared with MINOCA (LVEF: 52.9 ± 10.3% vs. 59.7 ± 8.7%, p < 0.001; LV-GLS: −11.46 ± 4.84% vs. −12.63 ± 6.33%, p = 0.007, respectively). At 3 months, LVEF remained lower in the MIOCA group (57.5 ± 6.6% vs. 62.0 ± 7.9%; p < 0.001, respectively), whereas LV-GLS improved similarly in both groups with no significant difference (−15.27 ± 2.60% vs. −14.87 ± 5.21%; p = 0.29, respectively). Among MINOCA patients, the neutrophil-to-platelet ratio (NPR) (p = 0.017) and admission glucose (p = 0.047) were independently associated with impaired LV-GLS (defined as values greater than −16%). Conclusions: Although LVEF remained higher in MINOCA patients during follow-up, LV-GLS impairment persisted at levels comparable to those observed in MIOCA, suggesting ongoing subclinical myocardial dysfunction. LV-GLS offers superior diagnostic sensitivity to LVEF. Inflammatory and glycemic markers may aid in early risk stratification and guide management in patients with MINOCA.