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Tanısal Egzersiz Elektrokardiyografi Testi Yapılan Hastalarda Serum Tiyol Disulfid Dengesi ve Endokan Düzeyleri

Yıl 2017, Cilt: 20 Sayı: 3, 217 - 223, 03.12.2017

Öz

Giriş: İnflamasyon ve oksidatif stres artmış kardiyovasküler risk ile ilişkilidir.
Duke koşu bandı skoru ve kalp hızı toparlanması (KHT) gibi egzersiz
elektrokardiyografi (EKG) testinden türetilen parametreler prognostik öneme
sahiptir ve kardiyovasküler risk tahmini için kullanılabilir. Endokan ve
tiyol/disülfid dengesi, inflamatuvar ve oksidatif durumu yansıtan yeni
biyolojik belirteçlerdir. Bu çalışmanın amacı, bir egzersiz EKG testi yapılan
hastalarda serum tiyol/disülfid dengesi ve endokan düzeylerini araştırmak ve bu
belirteçlerin Duke treadmill skoru ve KHT ile ilişkisini değerlendirmektir.



Hastalar ve
Yöntem:
Tanısal egzersiz EKG testi yapılan hastalar Duke skoru
ve KHT’ye göre iki gruba ayrıldı. Yüksek Duke skoru-orta/düşük Duke skoru
grupları ile künt ve normal KHT grupları arasında serum endokan düzeyleri ve
tiyol/disülfid dengesi karşılaştırıldı.



Bulgular: Serum endokan düzeyleri, Duke treadmill skoru ve KHT’ye göre gruplar
arasında benzerdi. Tiyol /disülfid oranı, azalmış KHT’li hastalarda normal
KHT’li hastalara göre anlamlı derecede düşüktü. Yüksek/Duke skoru olan
hastalarda, düşük/orta Duke skoru olan hastalara göre, serum nativ tiyol
düzeyleri, total tiyol düzeyleri ve total tiyol/disülfid oranı anlamlı olarak
yüksekti. Doğal tiyol düzeyleri ve total tiyol düzeyleri Duke skoru ile anlamlı
korelasyon göstermekteydi. Çok değişkenli regresyon analizinde, azalmış
KHT’inin bağımsız öngördürücüleri hipertansiyon ve diyabet varlığı; düşük/orta
Duke skorunun bağımsız öngördürücüleri ise hipertansiyon varlığı ve düşük
endokan düzeyleridir.



Sonuç: Serum tiyol düzeyleri Duke
skoru ile ilişkilidir ve düşük endokan seviyeleri düşük/orta Duke skoru ile
ilişkilidir.

Kaynakça

  • 1. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34:2949-3003.
  • 2. Comini MA. Measurement and meaning of cellular thiol: disulphide redox status. Free Radic Res 2016;50:246-71.
  • 3. Sen CK, Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr 2000;72(Suppl 2):653S-669S.
  • 4. Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med 2013;65:244-53.
  • 5. Kalinina EV, Chernov NN, Novichkova MD. Role of glutathione, glutathione transferase, and glutaredoxin in regulation of redox-dependent processes. Biochemistry (Mosc) 2014;79:1562-83.
  • 6. Kondo N, Nakamura H, Masutani H, Yodoi J. Redox regulation of human thioredoxin network. Antioxid Redox Signal 2006;8:1881-90.
  • 7. Abid MR, Yi X, Yano K, Shih SC, Aird WC. Vascular endocan is preferentially expressed in tumor endothelium. Microvasc Res 2006;72:136-45.
  • 8. Sarrazin S, Adam E, Lyon M, Depontieu F, Motte V, Landolfi C, et al. Endocan or endothelial cell specific molecule-1 (ESM-1): a potential novel endothelial cell marker and a new target for cancer therapy. Biochim Biophys Acta 2006;1765:25-37.
  • 9. Ates I, Kaplan M, Inan B, Alisik M, Erel O, Yilmaz N, et al. How does thiol/disulphide homeostasis change in prediabetic patients? Diabetes Res Clin Pract 2015;110:166-71.
  • 10. Ates I, Ozkayar N, Altay M, Yilmaz FM, Topcuoglu C, Alisik M, et al. Is disulphide/thiol ratio related to blood pressure in masked hypertension? Clin Exp Hypertens 2016;38:150-4.
  • 11. Kundi H, Ates I, Kiziltunc E, Cetin M, Cicekcioglu H, Neselioglu S, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med 2015;33:1567-71.
  • 12. Celik T, Balta S, Karaman M, Ahmet Ay S, Demirkol S, Ozturk C, et al. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: comparative effects of amlodipine and valsartan. Blood Press 2015;24:55-60.
  • 13. Kose M, Emet S, Akpinar TS, Kocaaga M, Cakmak R, Akarsu M, et al. Serum endocan level and the severity of coronary artery disease: a pilot study. Angiology 2015;66:727-31.
  • 14. Kundi H, Gok M, Kiziltunc E, Topcuoglu C, Cetin M, Cicekcioglu H, et al. The Relationship between serum endocan levels with the presence of slow coronary flow: a cross-sectional study. Clin Appl Thromb Hemost 2017;23:472-7.
  • 15. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014;47:326-32.
  • 16. Jolly MA. Exercise electrocardiographic testing. In: Griffin BP (ed). Manual of Cardiovascular Medicine. 4th ed. Philadelphia LWW: 2013:768-90.
  • 17. Chaitman BR. Exercise stress testing. In: Libby P, Bonow RO, Mann DL, Zipes DP (eds). Braunwald’s heart disease a textbook of cardiovascular medicine 8ht ed. Philadelphia: Saunders Elsevier, 2008:195-226.
  • 18. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;352:1951-8.
  • 19. Mark DB, Shaw L, Harrell FE Jr, Hlatky MA, Lee KL, Bengtson JR, et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med 1991;325:849-53.
  • 20. Myers J, Tan SY, Abella J, Aleti V, Froelicher VF. Comparison of the chronotropic response to exercise and heart rate recovery in predicting cardiovascular mortality. Eur J Cardiovasc Prev Rehabil 2007;14:215-21.
  • 21. Gunaydin ZY, Bektas O, Gurel YE, Karagoz A, Kaya A, Kiris T, et al. The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease. Kardiol Pol 2016;74:127-34.
  • 22. Schwartz PJ, La Rovere MT, Vanoli E. Autonomic nervous system and sudden cardiac death. Experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 1992;85(Suppl 1):I77-91.
  • 23. Palatini P. Exercise testing in asymptomatic subjects: from diagnostic test to prognostic tool? Eur Heart J 2008;29:1803-6.
  • 24. Siti HN, Kamisah Y, Kamsiah J. The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review). Vascul Pharmacol 2015;71:40-56.
  • 25. Luo C, Li Y, Liu D, Hu C, Du Z. The association of brachial flow-mediated dilation and high-sensitivity C-reactive protein levels with Duke treadmill score in patients with suspected microvascular angina. Exp Clin Cardiol 2012;17:197-201.
  • 26. Yurtdas M, Yaylali YT, Aladag N, Ozdemir M, Ceylan Y, Gencaslan M, et al. Heart rate recovery after exercise and its relation with neutrophil-to-lymphocyte ratio in patients with cardiac syndrome X. Coron Artery Dis 2014;25:485-92.
  • 27. Balta S, Mikhailidis DP, Demirkol S, Ozturk C, Celik T, Iyisoy A. Endocan: A novel inflammatory indicator in cardiovascular disease? Atherosclerosis 2015;243:339-43.
  • 28. Cox LA, van Eijk LT, Ramakers BP, Dorresteijn MJ, Gerretsen J, Kox M, et al. Inflammation-induced increases in plasma endocan levels are associated with endothelial dysfunction in humans in vivo. Shock 2015;43:322-6.
  • 29. Rodrigues KF, Pietrani NT, Bosco AA, Sousa LP, Ferreira CN, Sandrim VC, et al. Endocan: a new biomarker associated with inflammation in type 2 diabetes mellitus? Diabetes Metab Res Rev 2015;31:479-80.
  • 30. Kundi H, Balun A, Cicekcioglu H, Karayigit O, Topcuoglu C, Kilinckaya MF, et al. Admission endocan level may be a useful predictor for in-hospital mortality and coronary severity index in patients with ST-segment elevation myocardial infarction. Angiology 2017;68:46-51.
  • 31. Altintas N, Mutlu LC, Akkoyun DC, Aydin M, Bilir B, Yilmaz A, et al. Effect of CPAP on new endothelial dysfunction marker, endocan, in people with obstructive sleep apnea. Angiology 2016;67:364-74.
  • 32. Cremers CM, Jakob U. Oxidant sensing by reversible disulphide bond formation. J Biol Chem 2013;288:26489-96.
  • 33. Kundi H, Erel O, Balun A, Cicekcioglu H, Cetin M, Kiziltunc E, et al. Association of thiol/disulphide ratio with syntax score in patients with NSTEMI. Scand Cardiovasc J 2015;49:95-100.
  • 34. Altiparmak IH, Erkus ME, Sezen H, Demirbag R, Kaya Z, Sezen Y, et al. Evaluation of thiol levels, thiol/disulphide homeostasis and their relation with inflammation in cardiac syndrome X. Coron Artery Dis 2016;27:295-301.

Serum Thiol/Disulfide Homeostasis and Endocan Levels in Patients Who Underwent Diagnostic Exercise Electrocardiography Test

Yıl 2017, Cilt: 20 Sayı: 3, 217 - 223, 03.12.2017

Öz

Introduction:
Inflammation
and oxidative stress are associated with increased risk of cardiovascular
diseases. Parameters derived from exercise electrocardiography (ECG) test, such
as Duke treadmill score and heart rate recovery (HRR), have prognostic
importance and can be used to predict cardiovascular risk. Endocan and
thiol/disulfide homeostasis are emerging biomarkers that reflect the
inflammatory and oxidative status. The aim of this study was to investigate
serum thiol/disulfide homeostasis and endocan levels in an exercise ECG testing
patient cohort and to evaluate the association of these markers with Duke
treadmill score and HRR.



Patients
and Methods:
Patients who underwent diagnostic exercise ECG test were
divided into two groups according to Duke treadmill score and HRR. Serum
endocan levels and thiol/disulfide homeostasis were compared between high and
low/intermediate Duke treadmill score groups and blunted and normal HRR groups.



Results: Serum
endocan levels were similar between the groups according to Duke treadmill
score and HRR. Thiol/disulfide ratio was significantly lower in patients with
blunted HRR than in those with normal HRR. Serum native thiol levels, total
thiol levels, and total thiol/disulfide ratio were significantly elevated in
patients with a high Duke treadmill score than in those with low/intermediate
Duke treadmill score. Native thiol levels and total thiol levels were
significantly correlated with Duke treadmill score. Multivariate regression
analysis revealed that hypertension and diabetes were independent predictors of
blunted HRR, whereas hypertension and low endocan levels were those of
low/intermediate Duke treadmill score.



Conclusion: Serum thiol levels are
correlated with Duke treadmill score, and low endocan levels are associated
with low/intermediate Duke treadmill score.

Kaynakça

  • 1. Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J 2013;34:2949-3003.
  • 2. Comini MA. Measurement and meaning of cellular thiol: disulphide redox status. Free Radic Res 2016;50:246-71.
  • 3. Sen CK, Packer L. Thiol homeostasis and supplements in physical exercise. Am J Clin Nutr 2000;72(Suppl 2):653S-669S.
  • 4. Turell L, Radi R, Alvarez B. The thiol pool in human plasma: the central contribution of albumin to redox processes. Free Radic Biol Med 2013;65:244-53.
  • 5. Kalinina EV, Chernov NN, Novichkova MD. Role of glutathione, glutathione transferase, and glutaredoxin in regulation of redox-dependent processes. Biochemistry (Mosc) 2014;79:1562-83.
  • 6. Kondo N, Nakamura H, Masutani H, Yodoi J. Redox regulation of human thioredoxin network. Antioxid Redox Signal 2006;8:1881-90.
  • 7. Abid MR, Yi X, Yano K, Shih SC, Aird WC. Vascular endocan is preferentially expressed in tumor endothelium. Microvasc Res 2006;72:136-45.
  • 8. Sarrazin S, Adam E, Lyon M, Depontieu F, Motte V, Landolfi C, et al. Endocan or endothelial cell specific molecule-1 (ESM-1): a potential novel endothelial cell marker and a new target for cancer therapy. Biochim Biophys Acta 2006;1765:25-37.
  • 9. Ates I, Kaplan M, Inan B, Alisik M, Erel O, Yilmaz N, et al. How does thiol/disulphide homeostasis change in prediabetic patients? Diabetes Res Clin Pract 2015;110:166-71.
  • 10. Ates I, Ozkayar N, Altay M, Yilmaz FM, Topcuoglu C, Alisik M, et al. Is disulphide/thiol ratio related to blood pressure in masked hypertension? Clin Exp Hypertens 2016;38:150-4.
  • 11. Kundi H, Ates I, Kiziltunc E, Cetin M, Cicekcioglu H, Neselioglu S, et al. A novel oxidative stress marker in acute myocardial infarction; thiol/disulphide homeostasis. Am J Emerg Med 2015;33:1567-71.
  • 12. Celik T, Balta S, Karaman M, Ahmet Ay S, Demirkol S, Ozturk C, et al. Endocan, a novel marker of endothelial dysfunction in patients with essential hypertension: comparative effects of amlodipine and valsartan. Blood Press 2015;24:55-60.
  • 13. Kose M, Emet S, Akpinar TS, Kocaaga M, Cakmak R, Akarsu M, et al. Serum endocan level and the severity of coronary artery disease: a pilot study. Angiology 2015;66:727-31.
  • 14. Kundi H, Gok M, Kiziltunc E, Topcuoglu C, Cetin M, Cicekcioglu H, et al. The Relationship between serum endocan levels with the presence of slow coronary flow: a cross-sectional study. Clin Appl Thromb Hemost 2017;23:472-7.
  • 15. Erel O, Neselioglu S. A novel and automated assay for thiol/disulphide homeostasis. Clin Biochem 2014;47:326-32.
  • 16. Jolly MA. Exercise electrocardiographic testing. In: Griffin BP (ed). Manual of Cardiovascular Medicine. 4th ed. Philadelphia LWW: 2013:768-90.
  • 17. Chaitman BR. Exercise stress testing. In: Libby P, Bonow RO, Mann DL, Zipes DP (eds). Braunwald’s heart disease a textbook of cardiovascular medicine 8ht ed. Philadelphia: Saunders Elsevier, 2008:195-226.
  • 18. Jouven X, Empana JP, Schwartz PJ, Desnos M, Courbon D, Ducimetiere P. Heart-rate profile during exercise as a predictor of sudden death. N Engl J Med 2005;352:1951-8.
  • 19. Mark DB, Shaw L, Harrell FE Jr, Hlatky MA, Lee KL, Bengtson JR, et al. Prognostic value of a treadmill exercise score in outpatients with suspected coronary artery disease. N Engl J Med 1991;325:849-53.
  • 20. Myers J, Tan SY, Abella J, Aleti V, Froelicher VF. Comparison of the chronotropic response to exercise and heart rate recovery in predicting cardiovascular mortality. Eur J Cardiovasc Prev Rehabil 2007;14:215-21.
  • 21. Gunaydin ZY, Bektas O, Gurel YE, Karagoz A, Kaya A, Kiris T, et al. The value of the Duke treadmill score in predicting the presence and severity of coronary artery disease. Kardiol Pol 2016;74:127-34.
  • 22. Schwartz PJ, La Rovere MT, Vanoli E. Autonomic nervous system and sudden cardiac death. Experimental basis and clinical observations for post-myocardial infarction risk stratification. Circulation 1992;85(Suppl 1):I77-91.
  • 23. Palatini P. Exercise testing in asymptomatic subjects: from diagnostic test to prognostic tool? Eur Heart J 2008;29:1803-6.
  • 24. Siti HN, Kamisah Y, Kamsiah J. The role of oxidative stress, antioxidants and vascular inflammation in cardiovascular disease (a review). Vascul Pharmacol 2015;71:40-56.
  • 25. Luo C, Li Y, Liu D, Hu C, Du Z. The association of brachial flow-mediated dilation and high-sensitivity C-reactive protein levels with Duke treadmill score in patients with suspected microvascular angina. Exp Clin Cardiol 2012;17:197-201.
  • 26. Yurtdas M, Yaylali YT, Aladag N, Ozdemir M, Ceylan Y, Gencaslan M, et al. Heart rate recovery after exercise and its relation with neutrophil-to-lymphocyte ratio in patients with cardiac syndrome X. Coron Artery Dis 2014;25:485-92.
  • 27. Balta S, Mikhailidis DP, Demirkol S, Ozturk C, Celik T, Iyisoy A. Endocan: A novel inflammatory indicator in cardiovascular disease? Atherosclerosis 2015;243:339-43.
  • 28. Cox LA, van Eijk LT, Ramakers BP, Dorresteijn MJ, Gerretsen J, Kox M, et al. Inflammation-induced increases in plasma endocan levels are associated with endothelial dysfunction in humans in vivo. Shock 2015;43:322-6.
  • 29. Rodrigues KF, Pietrani NT, Bosco AA, Sousa LP, Ferreira CN, Sandrim VC, et al. Endocan: a new biomarker associated with inflammation in type 2 diabetes mellitus? Diabetes Metab Res Rev 2015;31:479-80.
  • 30. Kundi H, Balun A, Cicekcioglu H, Karayigit O, Topcuoglu C, Kilinckaya MF, et al. Admission endocan level may be a useful predictor for in-hospital mortality and coronary severity index in patients with ST-segment elevation myocardial infarction. Angiology 2017;68:46-51.
  • 31. Altintas N, Mutlu LC, Akkoyun DC, Aydin M, Bilir B, Yilmaz A, et al. Effect of CPAP on new endothelial dysfunction marker, endocan, in people with obstructive sleep apnea. Angiology 2016;67:364-74.
  • 32. Cremers CM, Jakob U. Oxidant sensing by reversible disulphide bond formation. J Biol Chem 2013;288:26489-96.
  • 33. Kundi H, Erel O, Balun A, Cicekcioglu H, Cetin M, Kiziltunc E, et al. Association of thiol/disulphide ratio with syntax score in patients with NSTEMI. Scand Cardiovasc J 2015;49:95-100.
  • 34. Altiparmak IH, Erkus ME, Sezen H, Demirbag R, Kaya Z, Sezen Y, et al. Evaluation of thiol levels, thiol/disulphide homeostasis and their relation with inflammation in cardiac syndrome X. Coron Artery Dis 2016;27:295-301.
Toplam 34 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri
Bölüm Orijinal Araştırmalar
Yazarlar

Emrullah Kızıltunç

Burcu Uğurlu Ilgın Bu kişi benim

Harun Kundi Bu kişi benim

Hülya Çiçekçioğlu Bu kişi benim

Canan Topçuoğlu Bu kişi benim

Mustafa Çetin Bu kişi benim

Ender Örnek Bu kişi benim

Yayımlanma Tarihi 3 Aralık 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 20 Sayı: 3

Kaynak Göster

Vancouver Kızıltunç E, Uğurlu Ilgın B, Kundi H, Çiçekçioğlu H, Topçuoğlu C, Çetin M, Örnek E. Serum Thiol/Disulfide Homeostasis and Endocan Levels in Patients Who Underwent Diagnostic Exercise Electrocardiography Test. Koşuyolu Heart Journal. 2017;20(3):217-23.