In chronic obstructive pulmonary disease (COPD) patients, functional and structural changes of the respiratory system greatly influence cardiovascular autonomic functions. Determining autonomic balance may be important in understanding the pathophysiology of COPD and useful clinically in the treatment of COPD patients. Heart rate variability (HRV) and heart rate turbulence (HRT) are useful tools in assessing the autonomic neurovegetative function. Our aim in this study was to evaluate the HRV and HRT variables in COPD patients. Twenty five moderate to severe COPD patients and 25 healthy subjects were included in this study.Pulmonary function tests and echocardiographic examination, arterial blood gases analysis were performed, HRV and HRT analysis were assessed from a 24-hour Holter recording.When HRV and HRT parameters were compared, COPD patients had significantly decreased sNN50 total, pNN50, SDANN, SDNN, SDNNI, rMSDD in time domain HRV parameters, and the values of the HRT onset was significantly less negative in COPD patients. Although the values of the HRT slope were lower in COPD patients, there was no significant difference between the two groups. We also found a correlation between HRT and HRV parameters.In addition to HRV parameters, HRT onset was significantly different in COPD patients. In our opinion, the combination of HRV variables and HRT onset may be simple and elegant ways of evaluating cardiac autonomic functions. New investigations of HRT and HRV in COPD patients have a potential importance for improving risk stratification and therapeutic approaches, and understanding the autonomic outcomes of the disease process.
While large left atrial mural thrombi are frequently occurred in moderate and severe mitral stenosis, left atrial thrombi are rarely seen in mild mitral stenosis.In this report we presented a case of 71-year-old woman with rheumatic mild mitral valve stenosis but had a giant left atrial thrombus derected by echocardiography.
Objective: Epicardial adipose tissue (EAT) has been found to be associated with the diastolic dysfunction in recent years, but this relationship has not been fully elucidated. Echocardiography is a non-invasive, simple, cost effective and accessible approach to assess EAT thickness, which can be performed easily. The aim of this study was to evaluate the effectiveness of EAT on prediction of diastolic dysfunction . Materials and Methods: A total of 138 patients without any cardiovascular, inflammatory, autoimmune and cancer disease, were enrolled. Our study was performed in the Cardiology clinic of Sakarya University Training and Research Hospital between May 2019 and December 2019. Subjects were divided into two groups, those with and without diastolic dysfunctions . Conventional echocardiography parameters and tissue Doppler imaging (TDI) were performed to evaluate left ventricular functions. EAT thickness on the free wall of the right ventricle in parasternal long-axis view were measured using transthoracic echocardiography. Results: In comparison with the non- diastolic dysfunction group, patients with diastolic dysfunction had significantly higher epicardial fat thickness (5.98±1.52 mm vs 4.32±1.03 mm; p<0.001). The multivariate regression analysis indicated that EAT independently predicts diastolic dysfunction (OR, 0.278, 95%CI 0.396 to 1.400) Conclusions: According to the findings of this study, EAT thickness is an independent predictor for the development of diastolic dysfunction in patients without cardiovascular disease.
Polycystic ovary syndrome (PCOS) is related to metabolic syndrome, insulin resistance, and cardiovascular metabolic syndromes. This is particularly true for individuals with central and abdominal obesity because visceral abdominal adipose tissue (VAAT) and epicardial adipose tissue (EAT) produce a large number of proinflammatory and proatherogenic cytokines. The present study aimed to determine whether there are changes in VAAT and EAT levels which were considered as indirect predictors for subclinical atherosclerosis in lean patients with PCOS. The clinical and demographic characteristics of 35 patients with PCOS and 38 healthy control subjects were recorded for the present study. Additionally, the serum levels of various biochemical parameters were measured and EAT levels were assessed using 2D-transthoracic echocardiography. There were no significant differences in mean age (p = 0.056) or mean body mass index (BMI) (p = 0.446) between the patient and control groups. However, the body fat percentage, waist-to-hip ratio, amount of abdominal subcutaneous adipose tissue, and VAAT thickness were higher in the PCOS patient group than in the control group. The amounts of EAT in the patient and control groups were similar (p = 0.384). EAT was correlated with BMI, fat mass, waist circumference, and hip circumference but not with any biochemical metabolic parameters including the homeostasis model assessment of insulin resistance index or the levels of triglycerides, low-density lipoprotein cholesterol, and high-density lipoprotein (HDL) cholesterol. However, there was a small positive correlation between the amounts of VAAT and EAT. VAAT was directly correlated with body fat parameters such as BMI, fat mass, and abdominal subcutaneous adipose thickness and inversely correlated with the HDL cholesterol level. The present study found that increased abdominal adipose tissue in patients with PCOS was associated with atherosclerosis. Additionally, EAT may aid in the determination of the risk of atherosclerosis in patients with PCOS because it is easily measured.
The aim of this study was to evaluate the effect of mobile phone (MP) on cardiac electrical activity by examining the heart rate variability (HRV), QT, P dispersions and blood pressure (BP) while the MP is located on the precordium.A total of 24 healthy volunteers were included in this prospective study. In the first step; 12-lead electrocardiogram (ECG) and BP recordings of the subjects without MP, while the MP is off, on, and ringing were recorded. In the second step; rhythm and BP were recorded for 30 minutes with the Holter without MP, and when the MP was "on" at the precordial location. P-wave and QT interval dispersions were measured from 12-lead ECG, while Holter 24-hour recordings were used for HRV analysis. Statistical analysis was performed using paired t test for comparison of hemodynamic and HRV variables without MP and during MP on. ANOVA for repeated measures was used to compare hemodynamic and ECG variables through baseline and 3 experimental settings: MP on, off and ringing.There were no statistically significant differences between the groups in the BP, heart rate, P-wave dispersion, QT dispersion and QT corrected dispersion parameters (p>0.05) in the first step of the study. In the second step, there were no significant differences between two groups in the BP, heart rate and HRV parameters (p>0.05).We conclude that MP has no effect on hemodynamic (heart rate, blood pressure) and cardiac electrical activity (P-wave and QT dispersions) parameters when it is positioned on the chest in immediate proximity to the heart, and it does not cause cardiac autonomic dysfunction examined by HRV analysis in healthy adult subjects.
Liver disease may lead to both reduced and increased risk of venous thromboembolism (VTE) caused by the changes in the coagulation cascade. We present a case of pulmonary embolism after the use of pegylated interferon (peg-IFN) plus ribavirin for treatment of chronic hepatitis C (CHC). Echocardiography revealed thrombus imaging in the pulmonary bifurcation zone and the patient treated successfully with thrombolytic therapy. Hemostatic work up showed no significant abnormalities. In the absence of underlying diseases and predisposing factors, drug interactions and incidental co-existence of pulmonary embolism should be kept in mind.
