OBJECTIVE We aimed in this study to investigate the differences in left ventricular (LV) structure, function and elastance parameters in the patients with normotensive blood pressure (BP) levels. METHODS A total of 294 normotensive patients (<140/90 mmHg) (135 males, mean age: 45+/-11 years; 159 females, mean age 38+/-10 years) were enrolled into the present cross-sectional study. Patients were categorized into three groups according to their BP levels as optimal BP (<120/80 mmHg), normal BP (120-129 / 80-84 mmHg) and high normal BP (129-139 / 84-89 mmHg) groups. We evaluated LV structure and functions by using Doppler echocardiography in all participants. Afterwards we compared the measurements for revealing the echocardiographic differences among the BP groups. In this study, one-way ANOVA Kruskal-Wallis, one-way ANCOVA and partial correlation analysis tests were used for the statistically evaluation of the data. In addition, relative risk ratios (RR) were also calculated for determination of the effects of BP levels to echocardiographic parameters. RESULTS There were significant statistical differences in left atrial diameter (LA) (p=0.002), transmitral A wave velocity (A) (p=0.002), meridional wall stress (MWS) (p<0.001), pulmonary capillary wedge pressure (PCW) (p=0.029) among BP groups. After the correction of the data for anthropometric measurements, multiple comparisons have shown that only end-systolic (Es) and end-diastolic elastance (Ed) were different between the normal and high-normal BP groups (for Es, p=0.013; for Ed, p=0.007). But it was found that optimal BP group had significant differences in LV structure and function parameters when compared to high normal BP group (for LA, p=0.028; for A, p=0.035; for MWS, p=0.002; for Es, p<0.001; for Ed, p<0.001). Besides, increased RR were detected for increased left atrial diameter index and pulmonary capillary wedge pressure values in high-normal BP group (RR: 1.537, 95% CI (1.197-1.974), p=0.005 and RR: 1.272, 95% CI (1.089-1.485), p=0.032, respectively). CONCLUSION Pathologic changes in LV due to increasing BP begin at below-hypertensive BP levels. It could be possible that normal BP stage is the beginning level of these changes.
Recently, agents with natural antioxidant and antimicrobial properties have been popularly studied. For this purpose, phenolic compounds, terpenes, and organic acids are examined in their antioxidant and antimicrobial properties. Of these, organic acids are increasingly being used in pharmacology, medicine, food, and industry. Quinic acid is a natural organic compound found in many edible fruits and plants. In this study, the antioxidant effect of quinic acid, which has the structure of cyclohexane carboxylic acid, was determined in vitro using seven different methods (DPPH, ABTS, CUPRAC, DMPD, FRAP, Fe3+ reduction, and Total antioxidant method). In addition, its antimicrobial effect on fungi (C. albicans), gram-positive bacteria (S. aureus, S. pyogenes), and gram-negative bacteria (E. coli, K. pneumoniae, and P. aeruginosa) were determined by the disk diffusion method. As a result, it was found that quinic acid has broad-spectrum antimicrobial properties, but its antioxidant properties are too low to be highlighted. While its antimicrobial activity was quite good, especially on K. pneumoniae E. coli, S. aureus, S. Pyogenes, and P. aeruginosa, it did not show any effect on C. albicans. Although the antioxidant property of quinic acid is low, it showed more antioxidant properties in the DMPD method, which is one of these methods, because it dissolves very well in water.
Hypertension (HT) is known to be of the main risk factors for erectile dysfunction (ED). But non-dipping (<%10 drop in the night) of HT is not investigated truly. The aim of this study was to test the hypothesis that the non-dipper hypertensive patients are more prone to develop erectile dysfunction.This was a cross-sectional clinical study. 70 HT patients diagnosed by Ambulatory blood pressure monitoring (ABPM) were classified into 3 groups (No ED, mild to moderate and severe) according to their International Index of Erectile Function (IIEF) scores. All three groups were compared for their dipping status by ABPM, heart rate variability (HRV) by holter monitoring.In our study non-dipper hypertensives had statistically more erectile dysfunction (P=0.004). Also severe ED patients with non-dipping pattern had decreased dipping blood pressure levels then those of ED(-) patients with non-dipping HT (P= .003)(Daytime Systolic/Nighttime Diastolic Blood Pressure= 0.8 ± 0.07 / 3.90 ± 1.5, respectively). LF/HF daytime/ nighttime in holter reflecting sympathetic overactivity (P< .001).Autonomic dysfunction especially sympathetic overactivity is associated with both non dipping pattern of HT and erectile dysfunction as a common pathologic pathway, besides there might be an association between ED and non dipping HT.
These original images were encountered during interventional procedures. Awareness about the abnormalities that they depict is important to identify them. We present an original image of the coronary sinus lead. The lead was placed in the posterolateral branch of the coronary sinus during cardiac resynchronization therapy combined with implantation of an implantable cardioverter-defibrillator. We observed that the lead achieved a heart shape in the left anterior oblique position (Fig. 1). We would like to dedicate this image to all physicians who are devoted to their work. The fluoroscopic image showing the heart-shaped coronary sinus lead in the left anterior oblique position. We confirm that there are no known conflicts of interest associated with this publication.
The activity of proteolytic enzymes is commonly measured using casein as a substrate. A modified caseinolysis assay was developed with natural dyes such as juglone, lawsone, berberine, and quercetin for Subtilisin carlsberg, protease type XVI, and trypsin, respectively. The pH dependence and incubation time were determined. K(m), V(max), and k(cat)/K(m) values were also determined for these enzymes. Lawsone was found to be a better substrate than the others.