Anadolu Kardiyoloji Dergisi, Anadolu Kardiyol Derg, The Anatolian Journal of Cardiology, Anatol J Cardiol, Cardiology, Cardiovascular Medicine, Surgery, Pediatric Cardiology, Angiology

Objective: To investigate whether or not patients with subclinical hypothyroidism (SH) have increased epicardial adipose tissue (EAT). Subjects and Methods: Sixty-one patients with newly diagnosed SH and without any known cardiovascular disease were enrolled. Twenty-four subjects matched for age, gender and body mass index without any thyroid dysfunctions were included as a control group. The EAT was measured by echocardiography and thyroid functions were assessed by routine blood examination. Results: Patients with SH had higher EAT values than control subjects (3.6 ± 0.9 vs. 2.8 ± 1.4, p = 0.005). Also, SH patients with thyroid-stimulating hormone (TSH) ≥10 mU/l had higher EAT than those with SH with TSH <10 mU/l and control subjects (p = 0.013). In addition, while there was significant correlation between EAT and TSH (r = 0.31, p = 0.014) in patients with SH, there was no significant relation between EAT and TSH in normal subjects (r = 0.09, p = 0.64). Conclusions: There was a higher level of EAT in patients with SH compared with normal subjects and a significant correlation between EAT and TSH was found.

Stiffness of large arteries has been related to cardiovascular mortality. The cardioankle vascular index (CAVI) is a novel parameter of arterial stiffness. The main aim of the present study was to investigate the association between presystolic wave (PSW) on left ventricular outflow tract (LVOT) and CAVI. Patients admitted to the cardiology outpatient clinic were consecutively enrolled. Arterial stiffness was assessed by the CAVI. It was measured using a VaSera VS-1000 CAVI instrument. Pulse Doppler flow evaluation in LVOT was performed just proximal to the aortic valve in an apical five-chamber view. The presence of a PSW preceding the LVOT flow was assessed in all patients. A total of 200 patients were enrolled consecutively. Patients with PSW had higher CAVI values compared with those without PSW (8.6±1.6 vs. 7.3±1.5). There was a significant correlation between PSW velocity and CAVI (r=0.34, P<0.001). Analysis using the receiver operating characteristics curve showed that PSW velocity of 61 cm/s constitutes the cutoff value for abnormal CAVI (CAVI≥9) with 75% sensitivity and 74% specificity (area under the curve: 0.883, 95% confidence interval: 0.694-0.972). Assessment of presystolic A wave on echocardiography examination may provide important information on the vascular function, which has a prognostic impact.

Syntax score (SS) is a prognostic marker in patients with acute coronary sydromes (ACS). Carotid intima media thickness (CIMT) and cardio ankle vascular index (CAVI) are well known surrogate marker of atherosclerosis burden. But association between atherosclerosis burden and coronary artery disease (CAD) complexity in ACS patients has not been investigated yet. Consecutive patients with first time diagnosis of ACS (n = 172) were enrolled. SS, a marker of CAD complexity, was assessed by dedicated computer software. CIMT was examined by B-mode ultrasound. CAVI was assessed by VaSera VS-1000 cavi instrument. SS for low, intermediate and high tertiles of CIMT value were 10.1 ± 8.2 vs 11.4 ± ± 7.9 and 15.2 ± 8.8; p = 0.02). SS for normal, borderline and abnormal CAVI values were 4 ± 3.7 vs 11.1 ± 7.2 and 14.1 ± 9.1, respectively p = 0.009). Also, there was independent association between SS and CIMT (95% coinfidence interval [CI] 2.1-19, p = 0.014) and CAVI (95% CI 15-29, p = 0.021]. Neither traditional cardiovascular risk factor nor thrombolysis in myocardial infarction (TIMI) risk score was independent determinant of SS. We have shown that patients with higher atherosclerosis burden have more complex coronary artery lesions. Also these patients may be identified early by using surrogate markers of atherosclerosis. Its clinical significance requires further research.

Endocan is a soluble proteoglycan, secreted by human vascular endothelial cells. Endocan is a marker for vascular pathologies and an important mediator of angiogenesis, strongly associated with inflammation, vascular endothelial dysfunction, and atherosclerosis. The relationship between coronary artery ectasia (CAE) and endocan has not been evaluated. We aimed to investigate this association. Fifty-four patients with isolated CAE without coronary stenosis and 30 controls with normal coronary angiogram were included in this study. Endocan plasma concentrations were measured using an enzyme-linked immunosorbent assay. Patients with isolated CAE had significantly higher levels of endocan compared to the controls (18.9 ± 7.3 vs 15.6 ± 3.6 ng/mL; P = .007). There was a significant correlation between endocan levels and severity of isolated CAE according to the Markis classification (r = −.593, P < .001). Plasma endocan levels may reflect the presence and severity of isolated CAE, suggesting that endocan may be involved in pathogenesis of isolated CAE.