Chemerin is a novel adipokine that plays a role in inflammation and atherosclerosis. Although there are several correlations between hypertension and the inflammatory system, there is still insufficient information about the relationship between blood pressure variability and inflammatory markers. In this study, we aimed to determine whether chemerin levels are elevated in non-dipper patients compared with dippers and healthy controls. This study was composed of a group of 90 patients: 60 hypertensive patients and 30 healthy control subjects (12 males, mean age 53.2±15.4 years). Ambulatory blood pressure monitoring devices (ABPM) were connected to all patients. Using data from the ABPM, hypertensive patients were divided into 2 groups: 30 dipper patients (12 males, mean age 52.5±15.1 years) and 30 non-dipper patients (11 males, mean age 54.6±13.0 years). Complete blood count and biochemistry were measured by standard methods and plasma chemerin concentrations were quantified by ELISA. Non-dipper patients demonstrated higher chemerin levels compared to dippers and normotensives (219.7±16.3 vs. 182.4±21.4 ng/ml; 219.7±16.3 vs. 85.4±38.1 ng/ml, respectively, p<0.001 for both comparisons). A receiver operating characteristic curve analysis revealed that the optimal cut-off value for chemerin to predict a non-dipping pattern was 201.4, with 90% sensitivity and 90% specificity. There was a positive correlation between chemerin levels and all ambulatory blood pressure values in all hypertensive patients. Chemerin, which plays a role in inflammation and atherosclerosis, was higher in non-dippers compared to dippers and normotensives. Additionally, chemerin shows positive correlations with blood pressure.

Background and Objectives: The mean platelet volume (MPV) represents a possible marker of platelet activation. There is an association between the platelet count (PC) and inflammation and platelet reactivity. We assessed the association between the MPV/PC ratio and circadian alterations in blood pressure (BP). Material and Methods: One hundred and twenty subjects in total, 80 hypertensive subjects and 40 healthy subjects (controls), were enrolled in the study group. Twenty four hour ambulatory BP monitoring (ABPM) was applied to all subjects. According to ABPM results, the hypertensive subjects were separated into two groups, such as dippers (n = 40) and non-dippers (n = 40). In all subjects, the collection of venous peripheral blood samples was performed on admission for PC and MPV measurements. Results: The two groups exhibited similar clinical baseline characteristics. A significantly higher MPV/PC ratio was determined in non-dippers compared to that in dippers and normotensives. The higher MPV/PC ratio was observed in non-dippers in comparison with that in dippers and normotensives (0.046 ± 0.007 to 0.032 ± 0.004 fL/[10⁹/L]; 0.046 ± 0.007 to 0.026 ± 0.004 fL/[10⁹/L], p < 0.001, respectively). A receiver operating characteristic (ROC) curve analysis showed that the optimum cut-off value of the MPV/PC ratio for predicting non-dipping patterns in hypertensive patients was 0.036 (area under the curve [AUC]: 0.98, p < 0.001). According to the cut-off value, sensitivity and specificity were found to be 95% and 95%, respectively. Conclusions: The higher MPV/PC ratio was determined in non-dipper hypertensive subjects in comparison with that in dipper hypertensive subjects. An elevation of platelet activity and an increase in thrombus burden are reflected by an increase in the MPV/PC ratio. The MPV/PC ratio may underlie the increase in cardiovascular risk in non-dippers compared to that in dippers.

Woven coronary artery is characterized by the twisting course of multiple thin channels along the vessel in any coronary artery with a TIMI‐III blood flow. It is an extremely rare coronary anomaly, which is generally considered to be benign. We present a 48‐year‐old male patient with a woven coronary artery anomaly with a right woven who presented with a myocardial infarction and review the literature on this coronary anomaly. (J Card Surg 2012;27:345‐346)

Background and Objectives: Comorbidities, the coexistence of additional conditions with a primary disease, are increasingly prevalent, complicating disease management and clinical outcomes. While CTEPH is a well-studied condition in terms of risk factors and outcomes, the specific impact of comorbidity burden on clinical presentation, treatment decisions, and survival remains insufficiently explored. This study aims to assess the prevalence and burden of comorbidities in CTEPH and to examine their associations with initial clinical characteristics, treatment allocation, and survival, stratified by pulmonary endarterectomy (PEA) status. Materials and Methods: We included 187 CTEPH patients from eight tertiary PH centers (2009–2020). Cardiovascular and non-cardiovascular comorbidities were identified and categorized as 0, 1–2, or ≥3. Their impact on baseline six-minute walk distance (6MWD), hemodynamic parameters, operability decision, and survival was assessed. Results: Comorbidities were prevalent (90%), with 49% of patients having three or more. Hypertension, diabetes, coronary artery disease, and chronic kidney disease (CKD) were associated with lower 6MWD. Hypertension, atrial fibrillation, left heart failure, and CKD were linked to elevated right atrial and pulmonary arterial wedge pressures. Comorbidities rendered 39% of anatomically operable patients ineligible for surgery. No single comorbidity predicted survival. Among PEA patients, those with ≥3 cardiovascular comorbidities had worse survival (p = 0.010). In contrast, the comorbidity burden did not impact survival in non-PEA patients. PEA surgery (HR 0.342, 95% CI 0.130–0.899, p = 0.030) and baseline 6MWD (HR 0.997, 95% CI 0.994–1.000, p = 0.036) were identified as independent predictors of mortality. Conclusions: A high comorbidity burden is common in CTEPH and influences functional status, hemodynamics, and operability decisions. It may worsen long-term outcomes after PEA but appears to be less prognostic in non-operated patients, where disease severity seems to be the primary determinant of outcomes. These findings underscore the importance of careful operability assessment and proactive comorbidity management.