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Biomedical subjects

Ali Metin Esen

Publications and source records attributed to Ali Metin Esen.

At least 19 recordsLinked to original sources

Effects of isolated coronary artery ectasia on electrocardiographic parameters reflecting ventricular heterogeneity.

Isolated coronary ectatic but otherwise normal epicardial coronary arteries are an infrequent angiographic finding. We sought to determine whether coronary artery ectasia (CAE) may alter QT-interval duration and dispersion. The study population consisted of 24 patients with isolated CAE and otherwise normal epicardial coronary arteries (group 1) and sex- and age-matched subjects with atypical chest pain and otherwise normal coronary flow (group 2). Both groups underwent a routine standard 12-lead surface electrocardiogram recorded at 50 mm/s during rest. QT dispersion (QTd), corrected QT (QTc), and corrected QT dispersion (QTcd) were calculated. Distribution of sex, age, body mass index, and cardiac risk factors were similar in the 2 groups. Mean heart rate was similar in the 2 groups (74 +/- 10 vs 70 +/- 7, P > .05). In group 1, QTd, QTcd, and QTc were significantly higher than those of group 2 (QTd, 40 +/- 17 vs 29 +/- 10 milliseconds [P < .05]; QTcd, 43 +/- 19 vs 30 +/- 10 milliseconds [P < .05]; QTc, 410 +/- 21 vs 397 +/- 19 milliseconds [P < .05]). In conclusion, CAE was found to be associated with prolonged QT interval and increased QTd. Microvascular dysfunction and/or ischemia may be responsible mechanisms.

Coronary Aneurysm↗

Relationship between circulating plasma matrix metalloproteinase-9 (gelatinase-B) concentration and aortic root dilatation.

BACKGROUND: Expression of matrix metalloproteinase (MMP) has been shown in aortic dissection and aneurysms indicating increased proteolysis compared with the normal aorta. However, its role in the development of aortic root dilatation has not been studied. We therefore attempted to determine the relationship between aortic root diameter and MMP-9 concentration in a hypertensive population. METHODS: The 53 hypertensive patients with (n = 27) and without aortic dilatation (n = 26) were included in the study. All participants underwent a complete transthoracic echocardiographic examination including aortic root measurement. Plasma concentration of MMP-9 were determined by the one-step sandwich enzyme immunoassay method and compared in both groups. RESULTS: Baseline demographic properties were similar in both groups. No subject had significant valvular disorder and wall motion abnormality on echocardiographic evaluation. On echocardiographic examination only five patients had bicuspid aortic valve. In patients with aortic root dilatation, 21 patients were using an antihypertensive agent, whereas in patients without aortic root dilatation, 19 patients were using an antihypertensive agent. Plasma MMP-9 level was significantly higher in patients with aortic root dilatation than in those without dilatation (2.5 +/- 1.0 v 1.6 +/- 0.9 ng/mL; P = .003). On correlation analysis, we found a positive correlation between aortic diameter and plasma MMM-9 levels (r = 0.43, P = .001). CONCLUSIONS: Aortic root dilatation is associated with higher MMP release, which may indicate the role of increased collagenolytic and elastolytic activities in hypertension-induced aortic root dilatation.

Aged↗

Effect of percutaneous mitral balloon valvuloplasty on left atrial appendage function: a Doppler tissue study.

The aim of this study was to compare left atrial appendage (LAA) functions by Doppler tissue imaging (DTI) before and after percutaneous balloon mitral valvuloplasty (PBMV). Twenty patients with symptomatic rheumatic mitral stenosis who underwent PBMV were included in this study. LAA functions were measured before and after PBMV. To determine LAA functions, LAA late filling (LAALF) velocity, LAA late emptying (LAALE) velocity, and area change of LAA percent were measured. In the DTI records, the first positive wave identical to the LAALE wave after the P wave was accepted as LAA late systolic wave, and the second negative wave identical to the LAALF flow was accepted as late diastolic wave. There was no difference in LAALF velocity and area change of LAA percent after PBMV. LAALE velocity increased after PBMV compared with baseline (P = .005). Late emptying, systolic, and diastolic wave values measured by DTI were found to be increased after PBMV compared with baseline (P = .023, P = .002, and P = .002, respectively). LAALE velocity measured by standard Doppler was increased after PBMV compared with baseline (P = .005), but there was no change in area change of LAA percent or LAALF. Spontaneous echocontrast was present in 7 of the 20 patients before procedure. It completely disappeared (4 patients) or decreased (3 patients) after procedure. In patients with spontaneous echocontrast, LAALE and late emptying, systolic, and diastolic wave values measured by DTI were found to be increased after PBMV compared with baseline. Our results suggest that PBMV improves LAA functions and, thereby, may have a favorable influence on future thromboembolic complications.

Adult↗

Treatment of aortocoronary graft lesions with graft-stents.

OBJECTIVE: Previous controlled trials do not indicate a superiority of the polytetrafluoroethylene membrane-covered stent graft compared with a conventional stent with respect to acute results, restenosis, or clinical event rates. We evaluated the outcome of stenting aortocoronary bypass grafts with polytetrafluoroethylene-covered stent. METHODS: The study included 64 patients who had 73 saphenous graft-stent implants. Clinical follow-up was obtained for a median of 6.2 months (1-9 months) for 54 patients. RESULTS: The mean age of the grafts was 9.2+/-6 years (2-14 years). Procedural success was achieved in 72 of 73 lesions (98.6%). One patient having an anterior Q-wave myocardial infarction died on the second day of procedure. Four patients (6.2%) sustained distal embolization and no reflow. No reflow was overcome after intracoronary administration of nitroglycerine and verapamil in two cases. At follow-up, stable angina pectoris had developed in 10 patients (18%), unstable angina pectoris in two patients (3.7%), acute myocardial infarction in two patients (3.7%), and cardiac death in one patient (1.8%). A total of 45 patients had a coronary angiogram at 6 months of follow-up or earlier, and restenosis at the target site was detected in eight of 53 lesions (15%). CONCLUSIONS: Saphenous graft lesions can be managed successfully with polytetrafluoroethylene-covered stents with acceptable long-term clinical outcome. Further and larger studies are needed to compare conventional stents, polytetrafluoroethylene-covered stents, drug eluting stents, and additional benefit of distal protection devices in these subgroups.

Aged↗

Tissue Doppler evaluation of intraventricular asynchrony in isolated left bundle branch block.

BACKGROUND: The aim of this study was to evaluate normal subjects with isolated left bundle branch block (LBBB) using tissue Doppler imaging (TDI) for the presence of intraventricular asynchrony. METHODS AND RESULTS: For this purpose, 23 subjects with isolated LBBB were compared with age-matched asymptomatic healthy subjects without LBBB with respect to global ejection fraction (EF) and isovolumic contraction time (ICTm) in separate left ventricular segments. TDI evaluation revealed prolongation of the ICTm in all of the segments in the LBBB group. Moreover, the ICTm differed significantly in each segment in the LBBB group. The ICTm in the lateral segments were shown to be longer compared to the anteroseptal segments. CONCLUSION: Our results indicate the presence of intraventricular asynchrony in isolated LBBB. This fact may play a role in the decreased global EF and increased cardiac mortality in patients with isolated LBBB.

Bundle-Branch Block↗

Contribution of plasma matrix metalloproteinases to development of left ventricular hypertrophy and diastolic dysfunction in hypertensive subjects.

Matrix metalloproteinases (MMPs) are involved in the regulation of the extracellular matrix (ECM) of the myocardium and thus the pathogenesis of vascular and cardiac hypertrophy. In this study, we investigated contribution of plasma matrix metalloproteinases to development of left ventricular hypertrophy (LVH) and diastolic dysfunction in hypertensive subjects. Hypertensive patients with (n = 27) and without LVH (n = 23) were included. All participants underwent a complete transthoracic echocardiographic examination, including recordings of the mitral annular early, late, systolic and diastolic velocities by Doppler imaging. Plasma concentrations of MMP-3 and MMP-9 were determined by the one-step sandwich enzyme immunoassay method. Plasma MMP-3 and MMP-9 concentrations were significantly higher in patients with LVH than those without LVH (2.4 +/- 1.2 vs 1.5 +/- 0.7 ng/ml, p = 0.006 and 5.2 +/- 2.8 vs 3.3 +/- 1.7 ng/ml, p = 0.003, respectively). MMP-3 and MMP-9 levels were also correlated with left ventricular posterior wall thickness and Doppler indices of diastolic dysfunction. Our findings have suggested that increased MMP levels may contribute to LVH and left ventricular diastolic dysfunction. Therefore, treatment of hypertension with MMP lowering drugs, such as angiotensin converting enzyme inhibitors and angiotensin receptor blockers, may have favorable effects on LVH and left ventricular diastolic dysfunction.

Aged↗

Impaired left ventricular filling in patients with essential hyperhidrosis: an echo-Doppler study.

Essential hyperhidrosis is a well recognized dermatologic and neurologic disorder, characterized by excessive sweating of the eccrine sweat glands. It is also associated with cardiac autonomic dysfunction because sympathetic fibers to eccrine glands of palms of the hand arise from stellate and upper thoracic ganglia, which also innervate the heart. In this study, we investigated cardiac function in patients with essential hyperhidrosis by conventional and tissue Doppler imaging methods. Eighteen subjects with essential hyperhidrosis and eighteen control subjects were included in this study. Pulsed-wave Doppler parameters of the left and right ventricles, which represent diastolic filling abnormalities, were obtained by conventional Doppler and tissue Doppler imaging. Isovolumetric relaxation time, isovolumetric contraction time, ejection time and myocardial performance index were also calculated. Mitral inflow peak early (E(M)) and late (A(M)) velocities and E(M)/A(M) ratio, which represent diastolic filling of left ventricle, were significantly lower in hyperhidrotic subjects than in controls. Also, mitral lateral annulus early and late velocities and early/late velocity ratio, reflecting diastolic filling of left ventricle, were significantly lower in hyperhidrotic subjects than those of controls. However, there were no differences between hyperhidrotic subjects and control subjects with regard to the other echocardiographic indices of left and right ventricle diastolic functions. In conclusion, decreased mitral inflow suggests left ventricle diastolic dysfunction in patients with essential hyperhidrosis. This indicates that hyperactivity of sympathetic nervous system in patient with hyperhidrosis may alter cardiac function in long term.

Adult↗

Early effects of percutaneous mitral valvuloplasty on left atrial mechanical functions.

It has been suggested that successful percutaneous balloon mitral valvuloplasty (PMV) decreases the intensity of spontaneous left atrial contrast, reduces the size of the left atrium, and improves left atrial function in patient with mitral stenosis. However, left atrial mechanical functions immediately after PMV have not been extensively evaluated yet. The aim of this study was to evaluate the effects of PMV on left atrial mechanical functions. Twenty patients with critical mitral stenosis who have normal sinus rhythm (male/female: 4 to 16; mean age: 33 +/- 8 years) were included in the study. Left atrial mechanical functions were evaluated before and after PMV, including left atrial passive emptying volume, LA passive emptying fraction, conduit volume, left ventricular stroke volume, LA active emptying volume, LA active emptying fraction, LA total emptying volume and LA total emptying fraction. PMV resulted in a significant increase in the mitral valve area (p < 0.001) and a substantial reduction in the mean transmitral pressure gradient (p < 0.001) as well as LA diameter (p < 0.002). LA maximal volume, minimal volume and atrial presystolic volumes were significantly decreased after PMV (p: 0.001; p: 0.002; p: 0.001, respectively). The conduit volume was increased and LA total emptying volume was decreased after PMV (p: 0.014; p: 0.035). The other left atrial volumes were not altered after PMV. The early increase in conduit volume and the decrease in left atrial presystolic volume indicate that PMV has favorable effects on atrial reservoir and conduit functions. PMV therefore improves atrial mechanic functions.

Adult↗

Acute smoking-induced alterations in Doppler echocardiographic measurements in chronic smokers.

Acute effects of smoking on left ventricular function have been studied previously. However, effects on right ventricular function have not yet been investigated. In this study, we attempted to investigate, through a combination of conventional and tissue Doppler imaging (TDI), the acute effects of smoking on both left and right ventricular function in chronic smokers. Thirty chronic smokers (with smoking habits of > or =1 pack/day for 74 +/- 1.3 years) underwent a complete transthoracic echocardiographic examination (2-dimensional, pulsed-wave Doppler transmitral and transtricuspid recordings, and TDI recordings of mitral and tricuspid annular velocities) by 3.5-MHz sector transducer. Pulsed-wave Doppler indices of left and right ventricular diastolic function-such as mitral and tricuspid inflows, peak early (E) and late (A) velocities, and E/A ratios-were obtained by conventional Doppler and TDI. Echocardiographic indices of the left and right ventricles--including isovolumetric relaxation time, isovolumetric contraction time, ejection time, and myocardial performance index of right ventricle-were also measured before and 30 minutes after each subject smoked a cigarette. Both mitral and tricuspid inflow measurements changed significantly after smoking a cigarette. Among the TDI measurements, mitral lateral annulus and tricuspid lateral annulus (diastolic, but not systolic) velocities changed after smoking a cigarette. Also, the right ventricular myocardial performance index increased immediately after smoking a cigarette. We found that acute cigarette smoking impaired both left and right ventricular diastolic function in chronic smokers.

Adult↗

Elevated plasma homocysteine level in slow coronary flow.

BACKGROUND: Slow flow velocity of dye in coronary arteries is not an infrequent finding during routine coronary angiography and its precise mechanism is unknown. In this study, we measured the plasma homocysteine level in patients with slow coronary flow (SCF) in comparison with subjects having normal coronary flow (NCF). METHOD: The study consisted 39 patients (mean age, 47+/-8 years) with angiographically diagnosed SCF. SCF was defined according to TIMI frame count (TFC) method. Thirty subjects (mean age 46+/-8 years) with NCF served as control group. Plasma homocysteine levels were measured after 12 h fasting period in each subject. RESULTS: Baseline demographic properties were similar in both groups. In patients with SCF, TFC was significantly higher than those with NCF. Similarly, in patients with SCF plasma homocysteine level was significantly higher than that of control group (14.1+/-2.2 vs. 5.5+/-1.3 micromol/l, respectively p < 0.001). CONCLUSION: Elevated plasma homocysteine level supports the hypothesis that endothelial function is impaired in slow coronary flow.

Case-Control Studies↗

Increased thrombolysis in myocardial infarction (TIMI) frame count in patients with aortic stenosis but normal coronary arteries.

Aortic stenosis (AS) with otherwise normal coronary arteries may be associated with angina pectoris and microvascular abnormalities. In this study, using the thrombolysis in myocardial infarction (TIMI) frame count (TFC) method, we tested whether the coronary blood flow velocity is decreased in patients with AS. Twenty-eight patients with severe AS and an otherwise normal coronary arteriogram (group I) and 25 subjects with atypical chest pain and a normal coronary arteriogram (group II) were included in this study. After transthoracic echocardiographic evaluation, all participants underwent coronary arteriography either to evaluate their coronary artery status before surgery or to exclude coronary artery disease. Later, TFC was calculated and compared for each artery, including the left anterior descending (LAD), circumflex (Cx), and right coronary arteries (RCA) in both groups. Baseline characteristics of the study groups were similar. In both groups, TIMI-3 flow was present in each artery at the time of arteriography and the coronary arteries were entirely normal. All subjects with AS had echocardiographic septal and posterior wall thickness more than 12 mm. The mean aortic valve area was 0.78 +/- 0.26 cm2. Peak and mean transvalvular gradients were 92 +/- 16 and 48 +/- 7, respectively. In group I, corrected TFC, Cx, and RCA frame counts were significantly higher than those of group II (24.6 +/- 2.1 vs 21.8 +/- 2.2 frames/s, P < 0.05; 24.4 +/- 1.7 vs 22.8 +/- 2.4 frames/s. P < 0.05; 23.2 +/- 2.0 vs 21.4 +/- 1.8 frames/s, P < 0.05, respectively). Coronary blood flow velocity is decreased in patients with aortic stenosis compared with patients having normal coronary arteries, probably due to microvascular dysfunction.

Aortic Valve Stenosis↗

P wave duration and dispersion in multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) has been reported to be associated with extensive autonomic dysfunction as well as to involve the cardiovascular system. In this study we compared P wave duration and dispersion (PWD) of MS patients to healthy control subjects. METHOD: Thirty-one MS patients (mean age 35 +/- 9 years) and 33 healthy control subjects (mean age 34+/-7 years) were included in the study. Twelve-lead surface ECG recording (paper speed of 50 mm/s) was obtained from all participants. The change in maximum and minimum P wave duration was measured manually and the difference between the two values was defined as PWD. RESULTS: There was no difference between the two groups in terms of baseline demographic characteristics. Maximum P wave duration was higher in MS patients than controls (126 +/- 6 vs. 122 +/- 5 ms, p = 0.004). Minimum P wave duration was found to be similar in MS patients and healthy controls (72 +/- 8 vs. 75 +/- 8 ms, p = 0.2). Mean PWD value of MS patients was also found to be higher than those of controls (53 +/- 10 vs. 47 +/- 10 ms, p = 0.01). CONCLUSION: P wave duration and PWD was found to be statistically different in patients with MS and control subjects.

Adult↗

Heart rate variability in patients with essential hyperhidrosis: dynamic influence of sympathetic and parasympathetic maneuvers.

BACKGROUND: Essential hyperhidrosis has been associated with an increased activity of the sympathetic system. In this study, we investigated cardiac autonomic function in patients with essential hyperhidrosis and healthy controls by time and frequency domain analysis of heart rate variability (HRV). METHOD: In this study, 12 subjects with essential hyperhidrosis and 20 healthy subjects were included. Time and frequency domain parameters of HRV were obtained from all of the participants after a 15-minute resting period in supine position, during controlled respiration (CR) and handgrip exercise (HGE) in sitting position over 5-minute periods in each stage. RESULTS: Baseline values of HRV parameters including RR interval, SDNN and root mean square of successive R-R interval differences, low frequency (LF), high frequency (HF), normalized unit of high frequency (HFnu), normalized unit of low frequency (LFnu), and LF/HF ratio were identical in two groups. During CR, no difference was detected between the two groups with respect to HRV parameters. However, the expected increase in mean heart rate (mean R-R interval) did not occur in hyperhidrotic group, whereas it did occur in the control group (Friedman's P = 0.000). Handgrip exercise induced significant decrease in mean R-R interval in both groups and no difference was detected between the two groups with respect to the other HRV parameters. When repeated measurements were compared with two-way ANOVA, there was statistically significant difference only regarding mean heart rate in two groups (F = 6.5; P = 0.01). CONCLUSION: Our overall findings suggest that essential hyperhidrosis is a complex autonomic dysfunction rather than sympathetic overactivity, and parasympathetic system seems to be involved in pathogenesis of this disorder.

Analysis of Variance↗

Cigarette smoking and heart rate variability: dynamic influence of parasympathetic and sympathetic maneuvers.

BACKGROUND: Cigarette smoking has been associated with increased activity of the sympathetic nervous system. In this study, we investigated cardiac autonomic function in heavy smokers and nonsmoker controls by analysis of heart rate variability (HRV). METHOD: Twenty-four long-term heavy smokers (men) and twenty-two nonsmoker subjects (hospital staff) were included to study. Time domain [mean R-R interval (RR), the standard deviation of R-R interval index (SDNN), and the root mean square of successive R-R interval differences (RMSSD)] and frequency domain [high frequency (HF) low frequency (LF), and LF/HF ratio] parameters of HRV were obtained from all participants after 15 minutes resting period in supine position (S), during controlled respiration (CR), and handgrip exercise (HGE) over 5-minute periods. RESULTS: Baseline SDNN and RMSSD values were found to be lower in smokers than in nonsmokers. (64+/-10 vs 78+/-22, P<0.05 and 35+/-12 vs 54+/-30 ms, P<0.05). Baseline LF/HF ratio was also found to be higher in smokers than in nonsmokers (1.3+/-0.6 vs 0.9+/-0.5 ms, P<0.05). The other HRV parameters including R-R interval, LF, and HF were not significantly different. During CR, expected increase in RR, SDNN, and RMSSD did not occur in smokers, while it did occur in nonsmokers. Most HRV indices were significantly affected by HGE in both groups. In addition, the duration of smoking was found to be inversely correlated with RMSSD and HF and positively correlated with LF/HF ratio. CONCLUSION: Vagal modulation of the heart is blunted in heavy smokers, particularly during a parasympathetic maneuver. Blunted autonomic control of the heart may partly be associated with adverse event attributed to cigarette smoking.

Adult↗

Peripheral vascular endothelial function in essential hyperhidrosis.

BACKGROUND: Essential hyperhidrosis, a disorder of the eccrine sweat glands, is associated with sympathetic overactivity and the aim of the present study was to determine endothelium-dependent vasodilator function in patients with this condition. METHODS AND RESULTS: Using high-resolution ultrasound, the diameter of the brachial artery at rest and during reactive hyperemia (flow-mediated dilatation, %FMD endothelial-dependent stimulus to vasodilatation), as well as after sublingual administration of nitroglycerin (%NTG endothelium-independent vasodilatation) was measured in 18 subjects (mean age 27+/-5 years) with essential hyperhidrosis and 24 healthy control subjects (mean age 29+/-5 years). Baseline brachial artery diameter and FMD were comparable in both groups (BAD: 4.1+/-0.7 mm vs 4.3+/-0.5 mm (control), p = 0.8; FMD: 5.6+/-1.9% vs 6.7+/-2.2%, p=0.1). The time-averaged flow velocity during peak reactive hyperemia was similar in the 2 groups (75+/-11 cm/s vs 72+/-10 cm/s, p = 0.5), nor did NTG-induced dilatation in the patients with essential hyperhidrosis differ significantly from that in healthy control subjects (12.8+/-2.7% vs 14.0+/-3.6%, p = 0.3). CONCLUSION: These findings suggest that endothelium-dependent dilatation of large conduit arteries is preserved in essential hyperhidrosis and it seems to be a localized disorder of the eccrine sweat glands rather than a generalized disorder involving vascular endothelium.

Adult↗

The changes in circulating levels of vasoactive intestinal polypeptide during exercise and its reproducibility for detection of myocardial ischemia.

Vasoactive intestinal polypeptide (VIP) contributes to the regulation of coronary vasomotor tone and circulating levels of VIP have been reported to increase during acute myocardial infarction. However, the changes in VIP concentration during exercise-induced ischemia have not been studied yet. Therefore, we sought to determine whether circulating levels of VIP change during treadmill exercise testing and whether they could be used as a marker of exercise-induced myocardial ischemia. Twenty-nine subjects with definitive positive (group-I) and 20 subjects (group-II) with negative results on treadmill exercise testing were included in this study. In order to assess circulating levels of VIP, blood samples were collected in both groups before exercise, at 5 minutes of exercise, at peak exercise, and at 10 minutes in the recovery period. There were no differences between the two groups with respect to the baseline demographics of age, sex, heart rate, or blood pressure. The metabolic equivalents (METs) values, peak heart rate achieved, peak systolic-diastolic blood pressure, and exercise duration did not differ between the two groups. No significant differences were found in the circulating levels of VIP at any stage of the exercise between the two groups (10.5 +/- 2.5 versus 11.0 +/- 3.5 pmol/L, P = 0.5, 10.6 +/- 2.3 versus 10.6 +/- 3.3 pmol/L, P = 0.9, 10.9 +/- 3.1 versus 11.5 +/- 3.4 pmol/L, P = 0.5, and 10.7 +/- 1.8 versus 11.7 +/- 4.1 pmol/L, P = 0.3, respectively). There was no relationship between the circulating level of VIP and exercise-induced myocardial ischemia, and therefore it could not be used as a marker of exercise-induced myocardial ischemia.

Aged↗

Plasma nitric oxide level and its role in slow coronary flow phenomenon.

Previous studies have suggested that microvascular abnormalities and endothelial dysfunction cause slow coronary flow (SCF). The objective of this study was to assess the plasma nitric oxide (NO) level and determine its role in the pathogenesis of SCF phenomenon. Thirty-six patients with SCF (group 1) and otherwise patent coronary arteries and 34 subjects with normal coronary flow (group 2) were included in the study. Coronary flow was quantified according to the TIMI Frame Count (TFC) method. Brachial artery endothelium-dependent flow-mediated dilatation (FMD) and nitroglycerin (NTG)-induced endothelium-independent dilatation were studied in both groups. In addition, plasma NO levels were measured and their contribution to FMD was determined. The sex, age, body mass index, arterial blood pressure, and heart rate distributions were similar in both groups. TFC was significantly higher in group 1 compared to group 2 for each artery. The plasma NO level was lower in patients with SCF than in control subjects (18.4 +/- 4.4 versus 25.2 +/- 6.3 micromol/L P = 0.001). FMD was significantly smaller in group 1 than in group 2 (4.0 +/- 3.2% versus 10.6 +/- 5.8%, P = 0.0001). The percent NTG-induced dilatation was similar in the two groups (16.8 +/- 1.1% versus 17.1 +/- 1.1%, P = 0.42). In group 1, the plasma NO level was correlated with percent of FMD. Also, the plasma NO level was inversely correlated with TFC for each artery. Reduced NO bioactivity as well as impaired FMD support the presence of endothelial damage in the pathogenesis of SCF phenomenon.

Adult↗

Comparison of the predictors for atrial rhythm disturbances between trained athletes and control subjects.

Atrial rhythm disturbances, particularly atrial fibrillation (AF), are frequently encountered in trained athletes. P wave dispersion (PWD) is a recent electrocardiographic (ECG) marker that reflects velocity of atrial impulse propagation. However, it remains unknown whether the P wave duration and PWD are different between athletes and sedentary controls. In this study we therefore determined the P wave duration and PWD, markers for conduction abnormalities, in trained athletes and controls. Fifty athletes and sex and age-matched 40 healthy sedentary controls were included in the study. All of the athletes were the members of a local athletic college and they were regularly maintaining their sportive activities; the duration of athletic competition was 7.7 +/- 3.3 years and the average athletic time was 10.1 +/- 1.6 hours/week. The 12-lead surface ECG was obtained from each subject in the supine position. The P wave duration was measured, and the difference between the maximum and minimum P wave duration was defined as the PWD. Distribution of sex, age, body mass index, blood pressure was similar in athletic groups and controls. Heart rate was significantly lower in the athletes than in the controls (66 +/- 7 vs 73 +/- 9 beats/min, p < 0.05). Maximum and minimum P wave durations were not statistically different in athletic group and controls (115 +/- 6 vs 114 +/- 4 ms and 74 +/- 8 vs 74 +/- 7 ms, respectively). In addition, PWD did not differ significantly in both groups (41 +/- 6 vs 40 +/- 7 ms, respectively). Thus, athlete's heart is not associated with prolonged P wave duration and increased PWD, indicating that P wave duration or PWD could not be used as a predictor for AF developed in trained athletes.

Adult↗