Introduction: Vitamin D deficiency(VDD) is a common condition in all ages worldwide, especially in winter, and causes several adverse cardiovascular outcomes. Although there is conflicting information about the causes of adverse cardiac events in VDD, the accepted leading cause is a pathogenic relationship with hyperparathyroidism. Aim: We aim to demonstrate hyperparathyroidism’s effects, if present, on endothelial and diastolic functions using echocardiography, carotid, and brachial tissue Doppler imaging (tDi) in premenopausal women with VDD independent from confounding risk factors. Methods: Our study is a cross-sectional, observational study investigating premenopausal women aged 18-50 who applied to internal medicine department. The patients are divided into two groups according to parathyroid hormone(PTH) levels (Normal PTH 41 patients, abnormal PTH 27 patients). Study groups are analyzed for basal characteristics, standard echocardiographic evaluation, carotid, and brachial artery tDi features. Results: There were no significant differences in age, height, weight, body mass index(BMI), and blood pressures between the groups (all p values>0.05). The rate of severe VDD was 76%. In terms of diastolic parameters, prolongation of A wave durations and decreased E/A ratio were observed in the secondary hyperparathyroidism (p values 0.042 and 0.031, respectively). Also, carotid IMT is significantly higher in secondary hyperparathyroidism(p=0.034). Conclusion: Our study showed that high PTH levels have adverse effects on diastolic(A wave, E/A ratio) and endothelial functions(carotid IMT) in premenopausal women diagnosed with VDD, even in the absence of other confounding risk factors. We can state that our study’s findings will contribute to the literature and are predictive for future studies.

Introduction: Several homeostatic changes like an increase in sympathoadrenal response and oxidative stress occur in hypoglycemia. As a result of these findings, an increase in inflammation and pre-atherogenic factors is observed and these changes may lead to endothelial dysfunction. Aim: Our study aims to reveal possible cardiac risks (systolic-diastolic functions and endothelial dysfunctions) in patients who have applied to the emergency department with hypoglycemia. Methods: This cross-sectional, case-control study included 46 hypoglycemia patients who admitted to the emergency with symptoms compatible with hypoglycemia and diagnosed with hypoglycemia and 30 healthy volunteers. All patients were evaluated with baseline echocardiography, tissue-doppler imaging(carotid and brachial artery). Also, the fasting blood tests of the patients referred to the internal medicine department were examined. Results: There were no differences between the groups regarding age, weight, body mass index, and systolic blood pressure. Total cholesterol, LDL, HDL, Vitamin B12, TSH, and fasting blood glucose levels were similar in the groups’ blood tests (all p values>0.05). We observed a statistically significant decrease in diastolic dysfunction parameters: E/A and E/e’ ratios (respectively, p=0.020 and 0.026). It was shown that insulin resistance was influential in forming these considerable differences. The patient group observed that the carotid intima-media thickness was more remarkable(p=0.001), and the brachial flow-mediated dilatation value was smaller(p=0.003), giving an idea about endothelial functions.

Aim Doppler echocardiography has become the standard imaging modality for diastolic function and provide pathophysiological insight into systolic and diastolic heart failure. In this study we aimed to obtain normal echocardiographic Doppler parameters of healthy Turkish population. Methods Among 31 collaborating institutions from all regions of Turkey, 1154 healthy volunteers were enrolled in this study. Predefined protocols were used for all participants during echocardiographic examination and The American Society of Echocardiography and European Association of Cardiovascular Imaging recommendations were used for echocardiographic Doppler measurements. Results A total of 967 healthy participants were enrolled in this study after applying exclusion criteria. Echocardiographic examination was obtained from all subjects following predefined protocols. Mitral E wave velocity and E/A ratio were higher in females and decreased progressively in advancing ages. E wave deceleration time and A wave velocity were increased with aging. Assessment of tissue Doppler velocities showed that left ventricular lateral e’, septal e’ and septal s’ were higher in younger subjects and in females. E/e’ ratio was increased progressively with advancing decades. Right ventricular e’and s’ were decreased but a’ was increased with increasing age. Septal e’ lower than 8 cm/s was 1.9% in the fifth decade and 13.7% in ages older than 50-years. The E/e’ ratio greater than 15 (and also 13) was not found. Conclusion This study, for the first time, provides echocardiographic reference ranges for normal cardiac Doppler data in healthy Turkish population which will be useful in routine clinical practice as well as in future clinical trials.