Because in-stent restenosis due to excessive neointimal proliferation within stent, local radiation therapy could retard proliferation response and reduce the chance of recurrence and the need of revascularization. In this study, we aimed to estimate long term results of intracoronary brachytherapy treatment.

The study population included 30 patients with in-stent restenosis and denova lesions that are performed intracoronary brachytherapy between January 2000 and August 2001. There were 16 patients (53%) in de novo group and mean age was: 61.3±8.6, 14 patients (47%) in in-stent restenosis group and mean age was 58.0±10.5. We investiga-ted clinical outcomes for in-patient period and out-patient long term period.

Study population consisted of 21 male and mean age was 60.2±9.4 years. Revascularization therapies (percutaneous coronary intervention for 9 patients, coronary artery by-pass grafting for 3 patients) were required in 12 patients (40%) during median 7 years follow-up period. Seven patients were hospitalized with diagnose of acute coronary syndrome and 5 patients with diagnose of acute myocardial infarction. During the follow-up period, there were 6 deaths (20%) that were because of cardiovascular reasons in 3 patients (10%) and because of cerebrovascular event, pulmonary cancer, and chronic kidney disease in remaining 3 patients.

Intracoronary brachytherapy procedure didn't reach to the expected benefits in preventing in-stent restenosis and treating denova lesions. Our findings supported this knowledge with the evidence of high revascularization requirement and high mortality rate in this long term clinical study.,

Key Words: Intracoronary brachytherapy, De novo lesion, In-stent restenosis, Revascularization

A total of 104 patients who had atrial fibrillation more than 3 months were enrolled in the study. Before the direct current cardioversion, transoesophageal and transthoracic echocardiography were carried out for all the patients. Also blood samples were obtained from each patient for determination of hsCRP. At the end of the first month electrocardiographies were evaluated for the rhythm of the patients.

After the direct current cardioversion, 78 patients (81.25%) had sinus rhythm. There was no relationship between the success of cardioversion and left ventricular ejection fraction, left atrial dimension, body mass index in patients whose rhythm was sinus or not. But the mean level of hsCRP was significantly low in patients whose rhythm was sinus after cardioversion (3.9±3.1 mg/L vs. 26.8±45.1 mg/L; p=0.02). At the end of the first month the mean level of hsCRP was lower in patients whose rhythm were sinus when compared with patients whose rhythm was not sinus. But this difference was not statistically significant (3.1±2.39 mg/L vs. 12.6±27.2 mg/L; p=0.062). Furthermore, there was no significant correlation between the other parameters and restoration of the sinus rhythm.

A  total  of  50  newly  diagnosed  hypertensive  patients  were  enrolled  in  this study whose came to our hospital cardiology clinic with varied complain.  Twelve-lead electrocardiographs were obtained and Qtc maximum, Qtc minimum and Qtc dispersion calculated. Transthorasic echocardiographic  examination was  performed  at  rest, conventional diastolic dysfunction parameters (E and A wave, E / A ratio, Dt, IVRT) were obtained. Patients wad divi-ded into two group with (average 54.26±11.24 ages, 9 females, 13 males) and without diastolic dysfunction (average 47.59±9.85 ages, 18 women, 10 men) 

In diastolic dysfunction group E velocity (0.59±0.09 m/sec against 0.80±0.15 m/sec p < 0.0001) and E/A ratio (0.73±0.13 against 0.78± 0.16, p < 0.0001) were found to be smaller, IVRT  (124.09±7.34 m/sec against 94.09±12.59 m/sec, p< 0.0001) and Dt (288.63±29.96 m/sec against 94.09±12.59 m/sec, p < 0.0001) were found to be longer. Qtc max (430.00±34.64 msec, against 440.90±23.68 msec, p> 0.05) Qtc min (377.27±31.65 msec against 383.63±18.90 msec, p> 0.05) and Qtc dispersion (58.18±15.79 msec against 58.18±15.92 msec, p> 0.05) were not  found statistical difference with and without diastolic dysfunction respectively.  

There were not significant differences Qtc maximum, Qtc minimum and Qtc dispersion with or without  LVDD, there were significant differences at diastolic dysfunction parameters in two groups.  

Fifty-six (56) patients (20 male, 36 female) were enrolled in this study. C-reactive peptide (CRP) and fasting blood glucose (FBG) levels were higher in the patients with MetS. As to HRV parameters, mean heart rate (HR), LF and LF/HF ratio were higher; SDNN, RMSSD, PNN50 and HF were lower in the patients with MetS. Correlation analysis showed that SDNN was correlated with waist circumference (WC) (r=-0.4, p=0.001) and FBG (r=-0.3, p=0.03); LF was correlated with WC (r=0.6, p=0.001) and FBG (r=0.5, p=0.001); HF was correlated with WC (r=-0.4, p=0.003), CRP (r=-0.3, p=0.02) and FBG (r=-0.4, p=0.04); LF/HF was correlated with WC (r=0.6, p=0.001), CRP (r=0.3, p=0.01) and FBG (r=0.6, p=0.001). Regression analysis demonstrated that the only independent factor affecting SDNN was WC (ß=-0.4, p=0.02);  independent factors affecting LF/HF were FBG (ß=0.3, p=0.02) and WC (ß=0.4, p=0.01).

As a result, HRV decreased, sympathetic activity increased and sympathovagal balance impaired in the patients with MetS. Although most of the components of the MetS are correlated with HRV parameters, waist circumference and fasting blood glucose are two independent parameters affecting HRV. The decreased HRV and impaired sympathovagal balance may partly responsible for the increased sudden death risk in the patients with MetS.

We briefly review the effects of humoral and autacoidal mediators on pulmonary vascular tone; discuss whether they regulate the low vascular tone of the normal, adult pulmonary circulation and the increased pulmonary vascular resistances associated with airway hypoxia, lung injury, and pulmonary microembolism.

The pulmonary vasculature responds to a multitude of constrictor and dilator mediators, but the exact physiologic and pathologic significance of such responsiveness is unknown. Further careful studies with specific mediator receptor blockers and synthesis inhibitors are required to determine if dilators play a role in maintaining the low vascular tone of the normal pulmonary circulation; and if constrictors contribute to either the onset or the maintenance of the pulmonary hypertension associated with chronic airway hypoxia, lung injury, and pulmonary microembolism.

The mechanism of hypoxic pulmonary vasoconstriction in chronic pulmonary hypertension is unknown, but the apparent difliculty in establishing their importance emphasizes that mediators of vascular cell synthesis, and secretion may be at least as important in the etiology of the increased vascular resistance as the mediators of vascular tone.

Key Words: Hypoxic pulmonary vasoconstriction, Pulmonary artery pressure, Pulmonary circulation

Left ventricle aneurysms are commonly encountered in clinical practise . They are generally localized  in apical,anterior or posterior walls of the left ventricle ,and generally emerge as a consequence of  myocardial infarction. Clinical states affecting mortality and morbidity like congestive heart  failure, ventricular arrythmia and thromboembo-lic complications may be seen due to aneurysm.

Key Words: Left ventricle aneurysm, Myocardial infarction