Left Atrial Mechanical Function and Aortic Stiffness in Middle-aged Patients with the First Episode of Atrial Fibrillation

Background： In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial （LA） mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with tile first episode of nonvalvular atrial fibrillation （AF）. Methods： This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Kos.;uyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1^st month （mostly in the first 2 weeks） following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results： Pulse wave analysis showed no significant differences between tile AF patients and healthy controls with respect to PWV （ 10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s： P = 0.370）, augmentation pressure （9.6 ± 7.4 mmHg vs. 9. 1± 5.7 mmHg; P = 0.740）, and aortic pulse pressure （AoPP; 40.4 ± 14.0 mmHg vs. 42. 1 ±7.6 mmHg, P = 0.550）. The first LA positive peak of strain was inversely related to the augmentation pressure （r 0.30; P = 0.02） and aortic systolic pressure （r - 0.26, P - 0.04）. Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement （45.1± 14.1 mmHg） showed a significant increase compared with AoPP at the first measurement （39.0 ±10.6 mmHg, P = 0.028）, which was also higher than that of healthy controls （42.1 ± 7.6 mmHg, P = 0.000）. Conclusion： The association between aortic stiffness with reduced atrial strain anti the key role of AoPP in the development olAF should be considered when treating nonvalvular AF patients with normal LA sizes.

Evaluation of cardiovascular risk in patients with Parkinson disease under levodopa treatment

BackgroundLevodopa 是在有 Parkinson 疾病(PD ) 的病人的中间的治疗的不可缺少的选择。因为 L-dopa 治疗被显示增加浆液 homocysteine 层次，为心血管的混乱的一个著名风险因素，有在 L-dopa 治疗下面的 PD 的病人将在为未来的增加的风险心血管的事件。这研究的目的是在 levodopa treatment.MethodsThe 学习下面与 PD 在病人评估心血管的风险人口在 L-dopa 治疗下面与自发的 PD 由 65 个病人组成了。控制组包括了 32 年龄，性匹配没有认知衰落的个人。Echocardiographic 大小，浆液 homocysteine 层次和主动脉的有弹性的参数与 PD 和 controls.ResultsAs 在病人之间被作比较 L-dopa 治疗的一个期望的特征， Parkinson 组有显著地更高的 homocystein 层次(15.1 ±；3.9 µ； mol/L 对 11.5 ±；3.2 µ； mol/L， P = 0.02 ) 。当时，大动脉的膨胀性在有 PD 的病人是显著地更低的与控制相比(4.8 ±；1.5 dyn/cm 2 对 6.2 ±；1.9 dyn/cm 2, P = 0.016 ) 。另外，有 PD 的病人有更高大动脉的紧张和大动脉的僵硬索引(13.4%±；6.4% 对 7.4%±；3.6% ， P <；0.001 和 7.3 ±；1.5 对 4.9 ±；1.9， P <；0.001 分别地) 。而且，浆液 homocysteine 层次被发现断然与大动脉的僵硬索引被相关，在浆液 homocysteine 的大动脉的膨胀性和层次之间有否定关联(r = 0.674， P <；0.001；r =−； 0.602， P <；0.001，分别地) 有在 L-dopa 治疗下面的 PD 的 .ConclusionsThe 病人增加了大动脉的僵硬并且与健康个人相比损害了心脏舒张的功能。提高的浆液 homocysteine 层次可以是可能的 pathophysiological 机制。