مجله پزشکی دانشگاه علوم پزشکی تبریز
سال سی و سوم شماره 1 (پیاپی 91، فروردین و اردیبهشت 1390)

It is assumed that left atrial (LA) volume provides more accurate prognostic information about patients with acute myocardial information (AMI), because it presents severity of diastolic function impairment by the time. The aim of this study was to evaluate the effect of left atrium size on patient's outcome after acute myocardial infarction.

In this cohort study 100 patients with AMI during admission were entered into the study. The patients were followed up for 9 months. Their one month survival rate was evaluated. Demographic, atherosclerotic risk factors, arrhythmic and mechanical side effects of MI were recorded. Moreover, echocardiographic indices such as systolic and diastolic function and left atrial volume were evaluated.

In our study patients with higher LA volume index (>32 mL/m2) had more mortality rate (6/22, 27.3%) compared to patients with lower LA index (1/78, 1.3%) (P= 0.001). There was no statistically significant difference in mortality rate considering gender and age of the patients (P>0.05). In univariate analysis, there was no statistically significant difference in mortality rate with regard to hypertension, diabetes mellitus, cigarette smoking and dyslipidemia. However mortality rate was significantly higher in ST segment elevation MI, diastolic dysfunction, restrictive pattern, left ventricular ejection fraction less than 40% and LA volume index ≥32 mL/m2. In multivariate analysis (logistic regression), only LA volume index ≥32 mL/m2 was an independent predictor of increased mortality rate after AMI (P= 0.008).

LA volume index is an independent predictor of poor prognosis in patients with AMI, even after adjustment with clinical predictors and conventional indices of echocardiography.

Leptin is a peptide hormone and product of obesity gene which has effects on the food intake, regulation of the body adipose tissue and action of insulin. The aim of this study was to evaluate the relationship between leptin and indicators of the obesity, lipid profile, energy and macronutrients intake among apparently healthy and young subjects.

In this cross-sectional study seventy eight subjects (37 males and 41 females) aged 20 to 32 years old were evaluated with respect to the anthropometric indices (waist circumference, body mass index, waist to hip ratio and waist to stature ratio), energy and macronutrients intake (by means of 3-day food record), fasting lipid profiles and blood sugar, leptin and insulin levels.

Females had significantly higher level of circulating leptin than the males (P<0.001); however circulating insulin (P=0.001) and insulin resistance (P=0.019) were higher in males. There was significant relationship between obesity indicators and leptin levels. However, after adjusting for confounders, only waist circumference, body mass index and total cholesterol had significant relationship with serum leptin level. There were no significant differences for energy intake from the macronutrients between the both genders. Conclusion Circulating leptin levels elevate with obesity in males and the body mass index is the best predictor of leptin.