Study on the Relationship Between Myocardial Microcirculation Perfusion and Electrocardiogram ST Segment Depression in Patients With Hypertrophic Cardiomyopathy

Author(s):  
Lina Guan ◽  
Chao Yuan ◽  
Yuming Mu ◽  
Guri Qiman Hoga Abdullah

Abstract Objective: To investigate the correlation between myocardial microcirculation perfusion status and the ST-segment depression(STD) in patients with hypertrophic cardiomyopathy (HCM)Method: Myocardial microcirculation perfusion of 32 patients with HCM (HCM group) and 28 healthy volunteers (control group) were examined using MCE, and the parameters including peak intensity (PI), area under the curve (AUC), rising slope (RS), and the time to peak (TTP) were analyzed. All subjects were examined by electrocardiogram, and the amplitude of downward movement of ST segment was measured. Then patients were divided into 3 groups according to the degree of downward movement of ST segment: ST1 group (0<ST≤0.1 MV); ST2 group (0.1 MV<ST≤0.2MV); ST3 group (0.2< MV<ST≤0.3 MV). At last, the relationship between myocardial microcirculation disorder and the degree of ST segment depression was explored.Results: Patents with HCM exhibit lower PI and AUC than their healthy counterparts (P < 0.001). No significant difference was found in RS and TTP between two groups (P > 0.05). ST depression was found in all the patients in the HCM group (P < 0.001). There was no significant linear correlation between PI and the degree of ST segment depression (r = -0.348). Then PI value was compared among ST1, ST2, ST3 and control group. The results showed that the PI value in both ST1 group and ST2 group differs from ST3 group (P < 0.01), while there was no significant difference between ST1 and ST2 group (P < 0.05). Conclusion: When ST depressed more than 0.20 mV, the STD is related to the decrease of microcirculation perfusion in hypertrophic myocardium.

Sensors ◽  
2020 ◽  
Vol 20 (18) ◽  
pp. 5041
Author(s):  
Shuji Shinohara ◽  
Hiroyuki Toda ◽  
Mitsuteru Nakamura ◽  
Yasuhiro Omiya ◽  
Masakazu Higuchi ◽  
...  

Recently, the relationship between emotional arousal and depression has been studied. Focusing on this relationship, we first developed an arousal level voice index (ALVI) to measure arousal levels using the Interactive Emotional Dyadic Motion Capture database. Then, we calculated ALVI from the voices of depressed patients from two hospitals (Ginza Taimei Clinic (H1) and National Defense Medical College hospital (H2)) and compared them with the severity of depression as measured by the Hamilton Rating Scale for Depression (HAM-D). Depending on the HAM-D score, the datasets were classified into a no depression (HAM-D < 8) and a depression group (HAM-D ≥ 8) for each hospital. A comparison of the mean ALVI between the groups was performed using the Wilcoxon rank-sum test and a significant difference at the level of 10% (p = 0.094) at H1 and 1% (p = 0.0038) at H2 was determined. The area under the curve (AUC) of the receiver operating characteristic was 0.66 when categorizing between the two groups for H1, and the AUC for H2 was 0.70. The relationship between arousal level and depression severity was indirectly suggested via the ALVI.


Author(s):  
Owen Stafford ◽  
Anna Berry ◽  
Laura K. Taylor ◽  
Sinead Wearen ◽  
Cian Prendergast ◽  
...  

Abstract Objective: The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors. Methods: This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n128) were compared to a control group without a medical condition (n128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27.03.202008.06.2020). Results: Individuals with existing medical conditions reported significantly higher levels of anxiety (p<.01) and felt less gratitude (p.001). Exploratory analysis indicates that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post-hoc analysis reveal no significant difference between the number of comorbidities and condition type (e.g. respiratory disorders). Conclusion: This research supports individualised supports for people with ongoing medical conditions through the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.


2018 ◽  
Vol 48 (1) ◽  
pp. 385-396 ◽  
Author(s):  
Chang-Zheng Gao ◽  
Qian-Qian Ma ◽  
Jing Wu ◽  
Rui Liu ◽  
Fen Wang ◽  
...  

Background/Aims: Acute ST-segment elevation of myocardial infarction (STEMI) is the most severe type of acute coronary syndrome (ACS). Particular attention has been focused on studying the pathogenesis of STEMI, and how to prevent thrombosis, reduce inflammatory reaction, stabilize plaques and improve vascular endothelial functions to preserve the survived myocardium. This study aimed to compare the anti-inflammatory endothelium-protective effects, clinical prognosis, and relevant bleeding risks of ticagrelor versus clopidogrel in patients with STEMI who underwent urgent percutaneous coronary intervention (PCI) and provide certain experimental evidence and a theoretical basis for the selection of safe and effective drugs and their proper dosage, thereby further guiding clinical medication. Methods: We sequentially enrolled 193 patients (104 males and 89 females) admitted to hospital due to acute STEMI. These patients underwent urgent PCI between December 2013 and May 2015 and met the inclusion criteria. They were assigned (1: 1) into two groups according to different treatments, 97 patients in the ticagrelor group (treatment group), and 96 patients in the clopidogrel group (control group). Levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), and endothelial cell-specific molecule 1 (ESM-1) taken at admission and 24 h, 4 days, and 7 days after administration, as well as the correlation between the levels of IL-6, hs-CRP, and ESM-1, were determined in the two groups. At the same time, the effects of treatment with ticagrelor and clopidogrel on the efficacy endpoint events (ischemic and safety) were explored. Results: No statistically significant difference was found in the levels of hs-CRP, IL-6, or ESM-1 at admission between the two groups (P> 0.05); Their levels were significantly elevated 24 h after administration, with statistical differences between two groups (P< 0.05). Furthermore, a downward trend with statistically significant differences was found on Day 4 and Day 7 (P< 0.05); ESM-1 levels increased along with increases of hs-CRP and IL-6 levels, indicating ESM-1 was positively correlated with hs-CRP (r=0.523, P< 0.001) and IL-6 (r=0.431, P< 0.001); and the occurrence rates of ischemic endpoint events at 30 days were lower in the treatment group than in the control group. The occurrence of safety endpoint events was higher than in the control group; however, no statistically significant difference was found (P> 0.05). Conclusions: Compared with clopidogrel, ticagrelor appears to rapidly reduce the prevalence of inflammatory reactions and stabilize the functions of vascular endothelium to improve the stability of atherosclerotic plaque and decrease the occurrence rate of thrombosis as well as ischemic outcome events without any obvious increase in the risk of bleeding in patients with acute STEMI receiving urgent PCI. This renders it a potential drug for clinical practice. At the same time, measurement of ESM-1, a new biological marker for vascular endothelial function disorder, could possibly become a simple, effective, and practical new method for clinical evaluation of risk stratification of patients with acute STEMI at admission.


2020 ◽  
Vol 132 (3) ◽  
pp. 440-451 ◽  
Author(s):  
Panagiotis Flamée ◽  
Varnavas Varnavas ◽  
Wendy Dewals ◽  
Hugo Carvalho ◽  
Wilfried Cools ◽  
...  

Abstract Background Brugada Syndrome is an inherited arrhythmogenic disease, characterized by the typical coved type ST-segment elevation in the right precordial leads from V1 through V3. The BrugadaDrugs.org Advisory Board recommends avoiding administration of propofol in patients with Brugada Syndrome. Since prospective studies are lacking, it was the purpose of this study to assess the electrocardiographic effects of propofol and etomidate on the ST- and QRS-segments. In this trial, it was hypothesized that administration of propofol or etomidate in bolus for induction of anesthesia, in patients with Brugada Syndrome, do not clinically affect the ST- and QRS-segments and do not induce arrhythmias. Methods In this prospective, double-blinded trial, 98 patients with established Brugada syndrome were randomized to receive propofol (2 to 3 mg/kg-1) or etomidate (0.2 to 0.3 mg/kg-1) for induction of anesthesia. The primary endpoints were the changes of the ST- and QRS-segment, and the occurrence of new arrhythmias upon induction of anesthesia. Results The analysis included 80 patients: 43 were administered propofol and 37 etomidate. None of the patients had a ST elevation greater than or equal to 0.2 mV, one in each group had a ST elevation of 0.15 mV. An ST depression up to −0.15mV was observed eleven times with propofol and five with etomidate. A QRS-prolongation of 25% upon induction was seen in one patient with propofol and three with etomidate. This trial failed to establish any evidence to suggest that changes in either group differed, with most percentiles being zero (median [25th, 75th], 0 [0, 0] vs. 0 [0, 0]). Finally, no new arrhythmias occurred perioperatively in both groups. Conclusions In this trial, there does not appear to be a significant difference in electrocardiographic changes in patients with Brugada syndrome when propofol versus etomidate were administered for induction of anesthesia. This study did not investigate electrocardiographic changes related to propofol used as an infusion for maintenance of anesthesia, so future studies would be warranted before conclusions about safety of propofol infusions in patients with Brugada syndrome can be determined. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New


2019 ◽  
Vol 21 (4) ◽  
pp. 194-199
Author(s):  
Mahdi Ghafari ◽  
Ebrahim Banitalebi ◽  
Mohamad Faramarzi

Background and aims: Intermuscular lipolysis disorder plays an important role in insulin resistance and diabetes mellitus and perilipin PLIN5 and PLIN3 are the key proteins in regulating muscle cellular lipolysis. Therefore, the purpose of this study was to examine the relationship between the expression of PLIN3 and PLIN5 protein following endurance training in streptozotocin (STZ) rats. Methods: A number of 24 male Wistar rats were randomly divided into low endurance training group (n = 8), high-intensity training group (n = 8), and control group (n = 8). Diabetes was induced in every rat by STZ injection. Three days after injection, the blood samples were taken from the cut tip of the tails of the mice and animals with blood glucose greater than 300 mg/dL were considered diabetic. The training program included eight weeks of aerobic training at different intensities. Training in high- and low-intensity groups included 22-25 and 5-8 m/min of training. Finally, one-way analysis of variance (ANOVA) and correlation was used to determine the significance of the differences between variables, followed by utilizing Tukey’s post-hoc test for significance. Results: The comparison between the groups by ANOVA showed significant differences in PLIN3 (P=0.0006) and PLIN5 (P=0.012). The results of Tukey post hoc test also demonstrated a statistical difference between the mean values of diabetic control group and high-intensity endurance group regarding PLIN3 (P=0.01) and PLIN5 (P=0.009), but no significant increase was observed in the lowintensity exercise group as compared to the control group (PLIN3, P=0.067 & PLIN5, P=0.44). As regards insulin resistance, there was a significant difference among the three groups (P=0.0001). Eventually, the result of the correlation between PLIN3 and PLIN5 showed similar enhancement by increasing the intensity (P=0.0026). Conclusion: According to research results, high-intensity endurance training increased the expression of PLIN3 and PLIN5 in diabetic specimens and PLIN3 and PLIN5 followed a similar increase pattern in high-intensity training


Author(s):  
Mahmut Atum ◽  
Gürsoy Alagöz

Purpose: This study aimed to compare the neutrophil-to-lymphocyte (NLR) and plateletto- lymphocyte (PLR) ratios in patients with retinal artery occlusion (RAO) with those from a healthy control population and to identify the relationship between them. Methods: Forty-six patients with RAO and fifty-one healthy control subjects were included in this retrospective case-control study. RAO was diagnosed following an ophthalmic examination and fluorescein angiography (FA). Blood neutrophil, lymphocyte, and platelet counts were recorded for each of the 97 subjects, from which NLR and PLR values were calculated. Results: There were 46 patients (28 male [M], 18 female [F]) in the RAO group and 51 patients (27 M, 24 F) in the control group. No significant differences were found between patients with RAO and the control subjects in terms of gender and age (P > 0.05). Patients with RAO had significantly increased NLR values (2.85 ± 1.70) than the control subjects (1.63 ± 0.59, P < 0.001). The mean PLR in patients with RAO was 123.69 ± 64.98, while that in control subjects was 103.08 ± 36.95; there was no significant difference between the two groups (P = 0.055). A logistic regression analysis revealed that NLRs were 3.8 times higher in patients with RAO than in control subjects (odds ratio = 3.880; 95% confidence interval = 1.94 to 7.74; P < 0.001). Conclusion: NLRs were significantly increased in patients with RAO compared to the control subjects.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ibrar Ahmed ◽  
Khalid Abozguia ◽  
Ganesh Nallur-Shivu ◽  
Thanh T Phan ◽  
Abdul Maher ◽  
...  

Background. Previous studies have reported dyssynchrony using Tissue Doppler in patients with hypertrophic cardiomyopathy (HCM). In this study we assessed dyssynchrony using speckle tracking echocardiography (STE) in patients with non-obstructive hypertrophic cardiomyopathy vs a healthy control group and in a subgroup of highly symptomatic patients evaluated the acute effects of biventricular pacing on STE and Tissue Doppler (TDI) derived measures of dyssynchrony. Methods. We studied 48 healthy controls (age 48 ±18yrs, 22 males, LVEF 63 ±5%, QRS 86 ±7ms) and 57 patients with HCM (age 54 ±11yrs, 38 males, LVEF 61 ±7%, QRS 110 ±36ms). A subgroup of 15 symptomatic patients with HCM (Peak VO2<60% predicted) underwent biventricular pacing (age 53 ±12yrs, 12 males, LVEF 61 ±7%, QRS 110 ±32ms). Echocardiography was performed with the pacemaker off (VVi30) and on (DDDR, AV delay 90ms, LV-RV delay 0 – 4ms). Using STE, the standard deviation (SD) in time to peak longitudinal strain (Tϵ-SD), the time to peak longitudinal systolic velocity (Ts) for each of 18 left ventricular segments and the SD of this timing (Ts-SD) was derived. Using TDI dyssynchrony was assessed from the SD of Ts for the basal six segments and the maximum difference in Ts between any two basal segments (Ts-peak[basal]). Results. Using STE, Tϵ-SD (54.99 ±33.61ms vs 24.55 ±21.18ms p<0.001), Ts-SD (71.06 ±32.32ms vs 46.17 ±21.50ms p<0.001) and Ts (155.74 ±23.14ms vs 123.71 ±11.25ms p<0.001) were greater in HCM than in controls. Using STE we demonstrated that biventricular pacing significantly reduced Tϵ-SD and Ts-SD to values similar to those observed in controls (Ts-SD p=0.13). Using TDI we demonstrated that biventricular pacing significantly reduced Ts, Ts-SD, and Ts-peak[basal]. See Table . (All values expressed as mean ±SD) Conclusion. Cardiac resynchronisation therapy significantly reduced dyssynchrony in symptomatic patients with non-obstructive HCM as demonstrated using STE and TDI. Table


2021 ◽  
pp. jim-2021-001785
Author(s):  
Rasha A Elkholy ◽  
Reham L Younis ◽  
Alzahraa A Allam ◽  
Rasha Youssef Hagag ◽  
Muhammad Tarek Abdel Ghafar

This study aimed to assess the diagnostic value of serum and urinary netrin-1 in patients with type 2 diabetes mellitus (T2DM) at different stages of diabetic nephropathy (DN) and to compare its efficacy of estimation in serum with that in the urine. This study was carried out on 135 patients with T2DM and 45 healthy subjects. The patients with diabetes were divided according to urinary albumin creatinine ratio (UACR) into: T2DM with normoalbuminuria, incipient DN with microalbuminuria, and overt DN with macroalbuminuria groups. Serum and urinary levels of netrin-1 were measured by ELISA. The mean levels of serum and urinary netrin-1 were significantly higher in the microalbuminuric and macroalbuminuric patients with DN than those in the normoalbuminuric patients with T2DM, with the highest values detected in macroalbuminuric patients with DN. Urinary netrin-1 level was significantly higher in the normoalbuminuric T2DM group than control group, whereas no significant difference existed regarding serum netrin-1 level. In T2DM groups, the urinary and serum netrin-1 correlated with each other and were independently related to fasting blood glucose, UACR, and estimated glomerular filtration rate. Receiver operating characteristic curve analysis showed that the area under the curve of urinary netrin-1 was 0.916 which is significantly higher than that of serum netrin-1 (0.812) for the detection of incipient DN and reached 0.938 on coestimation of both urinary and serum netrin-1. In conclusion, netrin-1 is a potential diagnostic marker for early detection of DN with its estimation in urine has higher accuracy than that of serum.


2019 ◽  
pp. 135910531987744
Author(s):  
Kevin S Spink ◽  
Colin W Federow ◽  
Joel L Lanovaz ◽  
Alison R Oates

This study examined the effect of descriptive norm messaging information on the relationship between haptic input and balance control. Participants were randomly assigned to either a message group where they balanced with haptic input after receiving a descriptive norm message about the positive effect of haptic input or a control group. Findings from an analysis of covariance revealed a significant difference between the two groups. Those in the descriptive norm message group had better balance control than those in the control group. These findings suggest that efforts designed to improve balance control through haptic input may be enhanced through normative messaging.


2016 ◽  
Vol 88 (1) ◽  
pp. 56 ◽  
Author(s):  
Mehmet Zeynel Keskin ◽  
Salih Budak ◽  
Saim Gubari ◽  
Kalender Durmaz ◽  
Mehmet Yoldas ◽  
...  

Objectives: There are a number of studies about the effect of cigarette and alcohol on semen parameters in the literature. There is not a consensus on the relationship between use of cigarette and alchol and semen parameters in those studies. The number of studies in which cigarette and alcohol use are evaluated together is limited. This study was aimed to analyze the effect of cigarette and/or alcohol use on semen parameters. Methods: In this prospective study, 762 patients who applied to an hospital urology polyclinic between January 2015 and March 2015 due to infertility, were questioned for alcohol and cigarette use in anamnesis. The remaining 356 patients were included in our study. Then, semen analysis of the patients was performed. The patients were divided into five groups according to cigarette use, into five groups according to alcohol use and into four groups according to cigarette and/or alcohol use. Significant differences were analyzed between the groups in terms of semen volume, semen concentration, total motility, forward motility and morphological (normality, head anomaly, neck anomaly, tail anomaly) values. Results: According to cigarette use, only in group 4 (who use more than 20 package-years cigarette) semen volume was significantly lower than the control group (Mann-Whitney U, p = 0.009). There was no significant difference in any of the other parameters and groups compared with the control group (Mann-Whitney U, p &gt; 0,05) Conclusion:According to our study, using more than 20 package- years cigarette decreases semen volume. The reason of this result might be the fact that the threshold value, from which the effect of cigarette and alcohol use on the semen parameters has to be determined.


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