analysis

Background: Literature on ACL injury is limited when assessing for the presence and interaction of multiple risk factors simultaneously. Identifying risk factor interaction may increase the impact of prevention programmes to target ACL injury reduction. The aim of this study was to retrospectively assess ACL injured female athletes to identify which modifiable and non-modifiable risk factors were present at the time of injury. Method: Seventeen female athletes who had sustained a non-contact ACL injury were interviewed retrospectively to assess for the presence of reported risk factors for ACL injury. Result: This retrospective analysis ACL injury cases highlighted a number of factors which were present with high frequency across this group of cases. All had non-contact ACL injury occurring during cutting or landing, which suggests a predisposing deficit in neuromuscular control. This poor neuromuscular control could be exacerbated by the presence of fatigue identified within the cohort. This poor control could be further influenced by the fact a majority of athletes had another significant injury in the 12 weeks prior to ACL injury. The restriction to training could have either decreased fatigue resistance, or potentially changed their movement pattern because of the method of injury management undertaken. Conclusion: This case series provides insight into the interaction of risk factors for ACL injury in sportswomen, with the presence of another injury disrupting training, decreasing the athletes work capacity and fatigue resistance, being compounded perceived or actually elevated levels of fatigue, leading to the potential for abhorrent movement patterns and increased injury risk.

Time-efficient screening of lower extremity biomechanics to identify potential injurious movement patterns is crucial within athletic medicine settings. When considering biomechanical risk factors for anterior cruciate ligament injuries, several screening tests have been used to assess dynamic knee valgus. Current methods involving 3-dimensional motion capture systems are considered gold standard for such assessment; however, these methods are time consuming and require expensive materials. This study investigated the use of 2-dimentional kinematic evaluation during a standardized vertical jump athletic assessment to screen for potential lower extremity risk of injury. 50 collegiate athletes, 25 male and 25 female, from various sports participated in the study. The vertical jump was chosen because it is a common performance evaluation test that is regularly performed several times a year, providing consistent opportunities for screening while not creating additional obligations for the student athletes. Results showed that the 2-dimentional evaluation method had strong correlations (P<0.0001) with the gold standard 3-dimensional evaluation, suggesting that an accelerated 2-dimentional screening process can be used as a first step to screen for potential injurious lower extremity movement patterns.

Background: There is paucity in studies reporting long-term results following anterior cruciate ligament (ACL) rupture. A UK national ligament registry (NLR) designed to collect demographic, clinical and outcome data on patients undergoing ACL reconstruction was launched in 2013. There was therefore an emergent question on the role of such registry as an additional source of evidence. Study aims: A framework analysis aimed to provide a basis for the evaluation of outcomes following ACL management and formulate a structure of the evidence, which can be derived from the registry. Methods: A systematic approach was adopted to select relevant studies. Qualitative thematic and meta-narrative analyses were conducted. Level-1 registry data were recorded for all primary ACL reconstruction procedures from January to June 2016. Registry data content and validity were evaluated. Results: Seven studies were suitable for analyses yet none defined the pattern of meniscal injury following initial treatment. When reported the incidence varied markedly between 23% and 80%. There was evidence of collection of at least one principal outcome measure in at least 85% of participants across all studies. Thematic analysis identified four key domains of outcome measures (1) intervention selection, (2) Knee stability evaluation, (3) Patient reported outcomes, (4) Radiographic evaluation and risk of secondary osteoarthritis. Graft choice, rate of meniscal and chondral injuries and cumulative risk of revision surgery had incomplete and inconsistent reports. Comparison of demographic and clinical data with the first registry report demonstrated: predominately younger patient population; older female patients at time of intervention; and higher incidence of meniscal tears. Conclusions: Registry data driven quality and research improvement open a new paradigm in ACL reconstruction evidence base and future practice. Early observations have consolidated the importance of associated meniscal injuries in the management of ACL rupture. Further work is needed to improve registry data completeness, accuracy and validity. A proposed data migration process using available technologies can help harmonise data collection without the added burden on clinical services.

As people get older, chronic diseases become an important reason of disability while a decline in physical functions is related to aging among the elders, which may lead to dependency and isolation of the older adults. Body asymmetry and imbalance body alignment can bring added stress to the joint structures that can cause dysfunction of the joint, ligaments, tendons, bursas, and related muscles, which in return brings about problem while walking or during activities of daily living. Joint Functional Screening (JFS) is a systemic clinical examination with clinical reasoning of the entire human joints body, with or without causative limitation to derive a holistic analysis of musculoskeletal system. JFS profile helps to assess body disorder of older people. This clinical screening include documentation of balance of the body, lower and upper body strength, joints flexibility, body composition, and body alignment. This is an innovation build to profile a normal musculoskeletal state to decode any anomaly in an otherwise a normal subject, who might be preparing to take up any activities in one’s lifespan that could elicit an injury which could be prevented. JFS could be a useful tool for physiotherapists, exercise therapist or even the personal trainers to screen a body prior to rehabilitative or an exercise program; and this clinical screening is presently a best guidance to prevent risk of fall or injury among individual healthy people and older adult.

Background: With the development of sports science and badminton equipment, the roles of badminton shoes, such as to alter lower - extremity biomechanical parameters, prevent sports injuries and enhance performance, were confirmed by a mass of studies. Methods: In this study, a serial of methods including literature review, visualization analysis, mathematical statistics, are used to describe the progresses of the badminton shoes relate to exercise in some training aspects, which can be searched by CNKI and SCOPUS databases. Results: Among the exiting research, most mainly focused on evaluation and design of badminton shoes, sports injuries and performance, some have tested and verified the roles mechanism of badminton shoes. However, there are still some disadvantages to can’t ignore, such as the quantities of studies the designed level and the mechanism exploration. Conclusions: To sum up, the roles of the badminton shoes in sports training still need to be explored and confirmed.

High blood pressure under medical palance is associated with a variety of circulatory diseases, and it has been estimated that over 12% of all deaths in the world is directly or remotely connected with hypertension. It is said that one out of every five persons, can expect to have high blood pressure at one time or the other, during one’s life time. Based on hemodynamic equation, the mean arterial pressure is equal to cardiac out-put, times resistance (p means=Q x R). Hence hypertension is usually as a result of either an increased cardiac output and/or an increased resistance. The most common form of high blood pressure in humans is called “essential hypertension”, while is said to have no known cause. However this research aims at showing how a 12-week moderate exercise with bicycle egometer (i.e., use of non-pharmacologic approach to reduce the resting heart rate and blood pressure of 6 volunteer retired civil servants from Anambra state civil service and 6 retired academic staff of Nnamdi Azikiwe university in Awka. The paired T-test analysis of data obtained revealed a statistical significant effect of the moderate 12-week exercise on bicycle egometer, on the resting heart rate and blood pressure of the experimental group of the respondents. Hence it could be concluded that the administration of moderate exercise on bicycle egometer could be an effective use of non-pharmacologic intervention in the control and prevention of high blood pressure or hypertension among the elderly.

This paper analyses the effect of virtual reality visualization (VRV) on climbers, with respect to the traditional visualization methodology. The study sample was made up of 21 novel climbers: Control Group CG (N=7), Traditional Visualization Group TVG (N=7) and Virtual Reality Group VRG (N=7). In order to implement the mental imagery through virtual reality, a 360º Ricoh Theta S camera and a pair of Woxter Neo VR1 goggles were used. The data analysis was carried out with a simple ANOVA of three means. No statistically significant differences were found. The results are discussed and future lines of research are established.

Hand-to-hand bioelectrical impedance (HH BIA) is a low-cost method to estimate percent body fat (%BF). The BIA method is consistently reliable, but questions on validity remain. We have observed anecdotally that elbow position can render consistently different measures of %BF while using HH BIA, thus leading to the question: Does elbow angle influence the validity of measures derived using HH BIA? The purpose of this study was to assess the effect of elbow position (i.e., IN=flexed to 90° versus OUT=fully extended) on the reliability of HH BIA on 44 male and 24 female healthy adults (age=21±2 yrs, BMI=23±3). An additional aim was to assess the validity of the HH BIA %BF on a subset of subjects (n=12) using air displacement plethysmography (BOD POD®) as the criterion measure. The IN position was ~4%BF lower than the OUT position for HH BIA (p=0.05, effect size=0.67). Measures of %BF for both trials for the IN [intraclass correlation coefficient (ICC)=0.99, coefficient of variation (CV)=2.99%] and OUT (ICC=0.99, CV=1.48%) conditions were highly reliable. On the subsample, the OUT (18.3±6.7 %BF) position exceeded both the IN (14.5±7.4 %BF) and the BOD POD® (16.1±7.8 %BF) measures (p<0.05); however, IN and BOD POD® measures of %BF did not differ (p=0.21). These findings support that HH BIA is a reliable measure at both elbow positions; however, %BF estimations vary considerably (~4%) with respect to the criterion measure depending on elbow position. The OUT position was found to overestimate criteria %BF. Further research may reveal an optimum elbow angle position for HH BIA estimates of %BF.

Anthropometric characteristics, represent one of the most important subsystems within the “system” of man, and which can be in affected by physical exercises in the direction of the desired transformation. Very often the anthropometric parameters (height and weight) are used in the assessment of the morphological status of an individual, and on the basis of the results of Body Mass Index (BMI) bring certain estimates and conclusions. BMI as a statistical measures, is used in many public health campaigns as an approximate measure of the ideal body mass and the degree of nutrition of a population. The main goal of the research was to determine and analyze differences in BMI parameters between male and female students, aged 18±0.5 years, and determine the trend of changes. Using the T-test module, the obtained results confirmed that there are statistically significant differences in body height (t=8,17; p<0.001) and body weight (t=5,29; p<0.001), while in BMI values there are not statistically significant differences (t=-0.68, p>0.001). Based on BMI values, a positive trend of somatic changes of both poles is evident.

Purpose: Monolayer passage of chondrocytes results in dramatic phenotypic changes. This “de-differentiation” is expected to restore the chondrogenic properties such as “re-differentiation” in autologous chondrocyte implantation (ACI). The purpose of this study was to compare the chondrogenic re-differentiation potential of chondrocytes, from osteoarthritis (OA) patients and young adult patients, after monolayer culture. Methods: Chondrocytes from five old patients with knee OA (OAC) and five young patients with recurrent shoulder dislocation (non-OAC) were used. The chondrocytes from passages 1 to 3 were analyzed for the expression of cell surface markers (CD73, CD90, CD105, and CD44) by flow cytometric analysis. Chondrocytes of passage 4 were cultured as pellets for re-differentiation and evaluated histologically. Real-time PCR were performed to measure the chondrogenic related genes transcriptional levels. Results: OAC and non-OAC had comparable positive ratios for CD44, CD73, CD90, and CD105. The expression of CD105 was upregulated from passage 1 to passage 3 in OAC, and it increased at the same level as in non-OAC during passage 2 and 3. The expression of COL2 decreased from passage 1 to passage 3 in both the groups. There were no statistical differences in the Bern Scores between OAC and non-OAC. Conclusion: The chondrocytes from OA patients and young adult patients had chondrogenic re-differentiation potential. The changes in cell surface markers and chondrogenic related genes showed similarity for both the groups. Our findings suggest that OAC can become the cell source for ACI.

Background: Epidemiological studies report that females experience greater rates of concussion when compared with males. Biomechanical factors may result in greater post-impact head velocities and accelerations for a given force for females when compared with males. Purpose: To quantify the magnitude, frequency, duration and distribution of impacts to the head and body in rugby league match activities for females versus males. Design: Prospective descriptive epidemiological study. Methods: 21 female and 35 male amateur rugby league players wore wireless impact measuring devices (X2Biosystems; xPatch) behind their right ear over the mastoid process during match participation across a single season. All impact data were collected and downloaded for further analysis. Results: Male amateur rugby league players experienced more head impacts than female amateur rugby league players (470 ±208 vs. 184 ±18; t(12)=-3.7; p=0.0028; d=1.94) per-match over the duration of the study. Male amateur rugby league players recorded a higher median resultant Peak Linear Acceleration (PLA(g)) (15.4 vs. 14.6 g; F(824,834)=51.6; p<0.0001; t(1658)=-3.3; p=0.0012; d=0.10) but a lower median resultant Peak Rotational Acceleration (PRA(rad/s2) (2,802.3 vs. 2,886.3 rad/s2; F(831,827)=3.1; p<0.0001; t(1658)=5.7; p<0.0001; d=0.13) when compared with female amateur rugby league players Conclusion: Females recorded lower median values for PLA(g) and Head Impact Telemetry severity profile (HITSP) for all positional groups but had a higher PRA(rad/s2) for Hit-up Forwards (HUF) and Outside Backs (OSB’s) when compared with male HUF and OSB’s. Females also recorded more impacts to the side of the head (48% vs. 42%) and had a higher 95th percentile resultant PRA(rad/s2) (12,015 vs. 9,523 rad/s2) to the top of the head when compared with male rugby league players.

Badminton is a sport that requires a player to perform while being still, as well as in motion. Stability is the ability to maintain or control joint movement or joint position, in the static as well as dynamic state. Improvement in stability could help maintain body control and proper posture positions during play. Accordingly, the study was proposed to analyze stability in junior badminton players and understand its importance. A total of 106 players from South Asia between the ages of 8 and 15 years were analyzed. Prokin 252N and Balance trunk MF systems of Tecnobody Italy were used in the assessment and static, dynamic, and pelvic stability was recorded. The variables used were gender, age, body mass index, and experience in years, level at which they play, current pain, and clicks & catches in the past 1 year. Our study showed that there was significant difference in pelvic stability in terms of age and level at which players compete. There were a variety of other factors which do not affect stability. There needs to be a greater focus on stability training as part of the development of junior badminton players.

Purpose: Here, we report the complications of endoprosthesis with threaded cups according to our application in cases of complicated acetabulum (hip revisions and femoroacetabular impingement (FAI)). Methods: A total of 504 patients was analyzed, including 189 men and 315 women. For re-implanted patients (n = 49), the mean time to re-implantation was 6.3 years and the average age at re-implantation was 54.7 years. For censored patients (n = 455), the mean time to censoring was 5.5 years and the average age of the implant was 55.7 years. Among the patients that were censored, 77 died and 378 patients did not experience an event necessitating re-implantation. Results: For the total study population, the Kaplan-Meier estimate of 5 year survival is 0.94 and of 10 year survival is 0.85. 90% of the implants survived 7 years, 80% of the implants survived almost 12 years and 70% of implants survived almost 15 years. Kaplan-Meier survival analysis suggests that men have higher survival than women. Age of the patient at the time of implant was not a statistically significant factor for re-implantation (p value = 0.21) but sex was (p value = 0.02). Women had 2.25 times more risk of being re-implanted than men. Conclusions: In our case series, the failure rate, as a result of aseptic loosening, was 7.4% (n = 51). More than half the failure cases (56%) required re-implantation. Over one-third (37%) of the primary arthrosis cases, were found to be FAI, lessening the frequency of diagnosis of the former. In our clinic, the threaded cup seems to be indispensable in hip revision surgery and in treating FAI.

Through cultural consciousness, the characteristics of traditional Chinese sports culture in the new period are analyzed and studied, and the traditional Chinese sports culture in the new period has the following six characteristics: 1. Sports social model of “etiquette” 2. Sports personality model of the gentleman’s way; 3. The sports behavior mode of the golden mean; 4. The social nature of sports of socialism with Chinese characteristics; 5. Sports cultural nature of emotional culture; 6 limited competitive sports competition.

The anthropometric characteristics are decisive for an optimal physical level and, therefore, a good level in the game; and they can be different depending on the game position. The aim of this study was to identify the physical characteristics, body composition and somatotype of professional soccer players and to verify differences according to their playing positions: goalkeepers, defenders, forwards and midfielders. The measurements were performed on 57 male players of a soccer team of the Spanish Football League One. Twenty seven anthropometric variables were measured (height and body weight, four bone breadths, eleven girths and ten skinfolds) and the Bioelectrical Impedance Analysis was also performed. The percentage of body fat has been determined from 11 different equations. Goalkeepers showed the highest weight (80.2 ± 3.2 kg), supraespinal (10.5 ± 3.8 mm) and abdominal (15.6 ± 3.5 mm) skinfolds than others positions. In relation to body fat percentages, similar results were obtained from the equations of Jackson-Pollock (from 3 and 7 skinfolds), Carter, Withers, and Heyward and Stolarczyk (mean value 7.8 ± 1.5%). Higher results were obtained from the other equations applied. Differences among positions were also found concerning body composition; goalkeepers showed the highest body fat percentage (9.4 ± 1.4%). Mean somatotype was also different among positions; goalkeepers and forwards presented a balanced mesomorph somatotype while defenders and midfielders showed an ecto-mesomorph one. The differences in morphological characteristics according to the team position were notice only in goalkeepers, especially regarding their weight, abdominal and supraespinale skinfolds and the percentage of fat tissue.

Background: Left atrial volume (LAV) has been established as a sensitive marker of left ventricular (LV) diastolic function and as an independent predictor of mortality in patients with acute myocardial infarction (AMI). LA remodeling and its determinants in the setting of AMI have not been much studied. Methods: We studied 53 patients with anterior AMI and a relatively preserved LV systolic function, who underwent complete reperfusion and received guidelines guided antiremodeling drug management. LA and LV remodeling were assessed using 2D echocardiography at baseline and 6 months. LAV indexed for BSA (LAVi) was used as the index of LA size and further LA remodeling. Results: LAVi increased signifi cantly at 6 months compared to baseline [28.1 (23.0-34.5) vs 24.4 (19.5- 31.6) ml/m2, p=0.002] following LV end diastolic-volume index change [56.8 (47.6-63.9) vs 49.5 (42.0-58.4) ml/m2, p=0.0003]. Other standard LV diastolic function indices did not show any signifi cant change. Univariateanalysis showed a strong positive correlation of LAVi change with BNP levels at discharge, LV mass index and LV volumes indices change, throughout the follow up period. Multivariate regression analysis revealed that BNP plasma levels was the most important independent predictor of LA remodeling (b-coef.=0.630, p=0.001). Conclusions: Despite current antiremodeling strategies in patients with AMI, LA remodeling is frequently asssociated with LV remodeling. Additionally LAVi change in the mid-term reflects better than standard echocardiographic indices LV diastolic filling impairment.

Introduction: Hypertensive cardiopathy is the target organ lesion caused by arterial hypertension (HTN) that exhibits the highest morbidity and mortality rates. Although the importance of hemodynamic overload exerted by HTN on the onset of cardiopathy is well established, several non-hemodynamic factors may contribute significantly to its development. Objective: To evaluate the influence of different non-hemodynamic risk factors in the development of hypertensive cardiopathy. Methods: A prospective cohort study was carried out in hypertensive patients assisted at the specialized arterial hypertension physicians’ office of the “Carlos Manuel de Céspedes” Specialty Policlinic attached to the General University Hospital, Bayamo Municipality, Granma Province, Cuba from January 5, 2006 to December 31, 2015. The study included 18-to-55-year-old hypertensive patients with a stage 1 arterial hypertension diagnosis for less than a year1. Results: The multivariate analysis showed a significant and independent relation among the majority of the factors studied and the risk of developing cardiopathy. The major factor was C-reactive protein (HR: 5.020; IC 95%: 3.383-7,448; p<0.005) followed by microalbuminuria (HR: 2.649; IC 95%: 1.932-3.631; p<0.005). The area under the model ROC curve was 0.887 (p<0,005). Conclusions: The results showed that it is possible to estimate the risk of developing hypertensive cardiopathy with the application of the regression model to major risk factors.

Objectives: The prime focus of the present study was to evaluate the most occluded coronary artery (OCA) among non-ST elevated myocardial infarction (NSTEMI) patients, and risk factors associated with occluded and non-occluded NSTEMI. Also, major adverse cardiovascular event (MACE) were evaluated among patients during index hospitalization. Methods: A retrospective, cross-sectional study was conducted in Multan Institute of Cardiology, Pakistan between 1st February, 2017, and 31st September, 2017. The data were collected from medical records of the outpatients and inpatients who were index hospitalized. Data were analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) And Microsoft Excel (MS Office 2010). Results: Among 624 patients, angiographic findings revealed that 63.9% were suffering from non-occlusive NSTEMI while 36.1% of the patients had occluded NSTEMI. In occluded NSTEMI patients, 30.3% were having single vessel occlusion while 5.8% were having multi-vessel occlusion. Also, 49.8% were having occlusion of right coronary artery (CA) while 44% were having occluded left anterior descending (LAD) artery. Multivariate analysis revealed that age (p=0.001) and left ventricular ejection fraction (LVEF) (p=0.001) had a statistically significant association. The incidence of MACE was high among non-OCA patients as compared to OCA patients but no statistically significant association was found (p=0.44). Conclusions: Angiography confirmed that most of the NSTEMI patients had OCA. But the MACE rate was not significantly differ among OCA and non-OCA patients. The risk factors associated with OCA were low LVEF and age.

Background: Vascular closure devices are routinely used following femoral artery access to perform percutaneous coronary interventions (PCI). A number of devices are available on the market. We have reported previously on our experience of the Mynx device following diagnostic coronary angiography. Aims: To assess the success and complication rates of the Mynx device used in all-comers in the context of PCI within a single cardiac centre. Methods: Retrospective analysis of data available for patients who underwent PCI via the femoral route and received a Mynx device at a single tertiary centre. Results: The device was used to achieve haemostasis in 113 patients following PCI. In all cases weight-adjusted Heparin as well as dual antiplatelet therapy (Aspirin and Clopidogrel/ Ticagrelor) was administered as per PCI protocol. The device was successfully deployed in 111 cases (98.2%). The were 2 cases of device failure, one due to operator error and the other due to Mynx grip balloon bursting during device deployment. In 15 cases (13.2%; 9 male and 6 female) there were reports of small haematomas (<2cm) or oozing resulting in application of manual pressure or Femstop (St. Jude). A further patient required ultrasound-guided compression of the artery due to a large retroperitoneal bleed resulting from access complications. A larger proportion of the cases with complications were done as PPCI (44% vs 33%). The group with complications had higher systolic BP (140mmHg vs 128mmHg; P<0.05) and MABP (97mmHg vs 75mmHg; P<0.05) as compared with the group without any complications. Conclusion: The Mynx closure device is safe and easy to use in the context of PCI, in both the elective and emergency (PPCI) settings. Complication rates, predominately minor, can be minimised in experienced hands.

Background: An increasing body of evidence indicates that inflammatory activation profoundly impacts the electrophysiological properties of cardiomyocytes. A marker of systemic inflammation such as C-reactive protein(CRP), is associated with all parameters of the Mtabolic syndrome(MetS) and that may result in adverse cardiac events via multiple effects, ultimately resulting in a prolongation of Action Potential duration (APD), and thereby of the QTC (QT corrected) interval on ECG. Objective: We sought to investigate the influence of CRP levels on the prevalence of prolonged QT-dispersion and prolonged Tpeak-Tend –dispersion in the patients with MetS. Methods: We conducted a multicenter observational cross-sectional study. The study population consisted of 200 patients with MetS, stratified in two groups:103 participants (50 females and 53 males) with level of CRP>3mg/l, and 97 participants (47 females and 50 males) with level of CRP<3mg/l), who attended outpatient visits at general cardiology Health Care Clinics during 1 calendar year. For the analysis of the ECG, we performed a manual measurement of the values using a digital caliper with measuring range of 0-150 mm, 0.01 mm resolution, and 0-100 ± 0.02 mm accuracy. QT interval dispersion was obtained by the difference between the maximum and the minimum QT intervals found in the 12-lead electrocardiogram. The Tpeak-Tend interval was obtained from the difference between QT interval and QTpeak interval. Results: Prolonged QTC. dispersion, was found in 51.4% of participants with level of CRP>3mg/l and in 32.9% of with level of CRP<3mg/l, the differences were statistically significant. (p=0.004). The results showed that 51.4% participants with level of CRP>3mg/l had a prolonged Tpeak-Tend interval, and 32.9% of participants with level of CRP<3mg/l had prolonged Tpeak-Tend interval. Difference were statistically significant.( p=0.04). There were significant association of increased levels of CRP and QTC-dispersion (OR = 2.486, 95% CI 1.389-4.446).There were significant association of increased levels of CRP with Tpeak-Tend Dispersion (OR=2.239,95%CI 1.262-3.976). Prolonged QTC max. Interval OR=2.236,%CI 1.246-4.014),Prolonged Tp-Te-interval. (OR=2.367, 95%CI 1.327-4.222), also there were significant association of increased levels of CRP with BMI. (OR=1.154, 95%CI 1.095-1.227) and significant association of increased levels of CRP with presence of uncontrolled glicemia.(OR=1.779, 95%CI 1.014-3.12). Conclusion: We think we proved the hypothesis that patients with MetS and high level of CRP have higher prevalence of QT- dispersion and Tpeak-Tend dispersion than patients with MetS and lower level of CRP. These findings have both epidemiological and clinical relevance, also these findings might lend further insight into potential mechanisms by which MetS is associated with adverse cardiac events.