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Increased
QT dIspersIon In patIents wIth Isolated coronary artery ectasIa
Biçer A, Turhan H, Aras D, Topaloğlu S, Başer K, Şaşmaz H, Korkmaz Ş.
Coronary artery ectasia (CAE) has been
characterized by localized or diffuse lesions of the epicardial coronary
arteries with a luminal dilation exceeding >=1.5 fold of normal adjacent
segment. In the present study, we planned to determine corrected QT
dispersion (QTcD) as a possible indicator of increased risk for ventricular
arrhythmias and sudden cardiac death in patients with isolated CAE.
The study included 54
consecutive patients with isolated CAE (Group I) and age and gender matched
54 control subjects with normal coronary arteries (NCA) (Group II). Coronary
diameters were measured as the maximum diameter of the ectasic segment by
use of a computerized quantitative coronary angiography analysis system. QT
dispersion was defined as the difference between the maximum and minimum QT
interval measurements and corrected QT (QTc) was calculated according to
Bazett's Formula.
No statistically significant
difference was detected when maximum QTc interval of all subjects were
compared (433±32 ms vs 424±25 ms respectively, p>0.05). However, minimum QTc
interval of patients with ectasia was found to be significantly lower than
those of control subjects (371±23 ms vs 395±31 ms respectively, p=0.005).
Consequently, QTcD (QTcmax - QTcmin) was detected to be significantly higher
in ectasia group than in control group (62±19 ms vs 29±10 ms respectively,
p<0.0001).
In the present study, the
patients with CAE have increased QTcD compared with subjects with NCA. This
finding has suggested that patients with CAE have increased risk of
ventricular arythmia, cardiac morbidity and mortality.
Slow coronary flow Its relatIon wIth left
ventrIcular dIastolIc functIon
Ekiz Ö, Avşar Ö,
Batryaliev T.
Normal coronary
arteries and chest pain have a good prognosis, but we don't
know the prognosis and clinically importance of the patient
who have a slow coronary flow (SCF). We investigate this
study the effect of SCF to left ventricular diastolic
dysfunction.
We study the
patients who have not hypertension and diabetes mellitus
and diagnosis coronary slow flow 41 patients (mean age49±8)
and normal coronary flow 63 patient (mean age 50±9) using
the TIMI frame count. The diastolic functions measured
conventionally and tissue doppler imaging technique. Mitral
E and A wave velocity, mitral E/A ratio, deceleration time (DZ),
isovolemic relaxation time (IVRZ), lateral and septal anulus
Sm, Em, Am maximum velocity and Em/Am ratio measured.
The
demographic data's are similar for both groups. We found
significant increase in mitral A wave velocity, IVRZ, DZ, Am
and significant decrease in mitral E wave velocity, mitral
E/A ratio, lateral and septal anulus Em velocity and Em/Am
ratio the YKA patients group. No significant difference in
lateral and septal anulus Sm value.
In this
study we found the patient who have SCF, the diastolic
dysfunction are more frequently. This founds see us the
prognosis of SCF is different and poor from syndrome x and
increased cardiovascular mortality.
Fundamental reasons for fallIng short of achIevIng
the desIred goal In the treatment of patIents wIth dyslIpIdemIa In
perspectIve of a clInIcal study
Yeter E, Durmaz T, Keleş
T, Akçay M, Bayram Akar N, Özdemir L, Kurt K, Bozkurt E.
Depending on their
potential risks, dyslipidemia patients were divided into
three groups based on the ATP III criteria. Their treatment
plans vary depending on this classification. Having been
evaluated at the outpatient clinic, sometimes patients are
treated disregard their risk value. In other occasions,
patients who need treatment aren't treated, while other
groups of patients are given unnecessary treatment. On
the other hand, only drug treatment is administered to
some group of patients without sufficiently emphasizing on
the need for change of life style.This study was conducted
to cast light on such questions like; what is the ratio of
patients where the desired treatment goal is successfully
achieved? What are the fundamental reasons for failing to
achieve the desired treatment level among those who received
drug treatment?
Onehundred
thirty nine patients with dyslipidemia who applied to the
outpatient clinic in our hospital were included into the
study. Patients who received less than two months of
treatment for dyslipidemia were excluded from the study.
Patients were assigned into different risk groups according
to the ATP III classification. The treatment goal was
defined. Patients, to whom the treatment fell short of
achieving the desired result, were asked for the reason why
success could not be achieved and their answers were
recorded.
It has been
observed that success was achieved in 55% of the patients
who were included in the study. Whereas, among the
unsuccessful cases, 20.1% of the patients did not comply to
take their medicine regularly, 4.3% did not see their
doctors for a check up orderly, 11.5% did not watch their
diet, 2.2% gave up taking their medicine because of side
effects, 18.7% did not perform the recommended exercises
regularly, 10.1% insufficient dose of medicine was
administered, 2.2% were proved to have used the wrong
medicine for the indication.
According to
the ATP III criteria, these results of the study show that
success has been achieved in only half of the patients
treated. It is clear that a significant number of the
patients to whom the treatment did not work either they have
not used their medicine regularly or failed to make the
necessary adjustment to their life styles. We would like to
present these preliminary results to the attention of
doctors who are engaged in the treatment of dyslipidemia
patients.
Key Words: Dislipidemia, Diet, Exercise, Side effect
The evaluatIon of myocardIal dysfunctIon of cIrrhotIc patIents by tIssue
doppler echocardIography
Arhan M, İbiş M, Keleş T,
Durmaz T, Gölbaşı Z, Eskioğlu E.
Functional and structural
cardiovascular disorders in cirrhotic patients are thoroughly investigated
complications which has complex mechanisms. We aimed to determine the
cardiac dysfunction of cirrhotic patients by tissue doppler echocardiography
technique.
Twenty two patients with non-alcoholic
cirrhosis who have not been applied invasive or surgical procedures for
portal hypertension were enrolled in the study. Evaluation with
echocardiography and tissue doppler echocardiography did not show
significant differences between patients with or without ascites.
Transmitral flow atrial filling velocity (A) values were significantly high
in patients with Child C when compared with Child A (p<0.05). E/A value was
significantly lower in patients with Child C (p<0.05). Posterior IVS AM,
lateral wall AM, lateral mitral annulus AA and posterior wall AM values were
significantly higher in Child C patients compared with Child A (p<0.05).
In conclusion, our findings
support theories that propose the presence of myocardial dysfunction during
early phases of diastolic filling and increase in atrial support for
compensation in Child C patients.
Approach to patIents wIth postoperatIve atrIal
fIbrIllatIon
Güneş Y, Doğan S.M, Tuncer M.
Atrial
fibrillation (AF) is one of the most frequent arrhythmias
following cardiothoracic surgery and, can cause hemodynamic
instability, prolonged hospital stay and increased costs,
and predisposes to cerebrovascular incidents. There is no
consensus regarding management of postoperative AF (POAF).
The current therapeutic strategies in the management of POAF
include prophylactic use of pharmacologic agents in the
perioperative period to prevent the occurrence of AF and use
of rate-controlling medications to control ventricular
response, and if spontaneous conversion does not occur, use
of pharmacologic or electrical cardioversion with or without
concomitant anticoagulant therapy. Here we reviewed current
management modalities for POAF.
Fallot tetralogy and systemIc to pulmonary artery collateral cIrculatIon
from rIght Internal mammarIan artery: A very rare anatomIcal varIatIon
Yılmaz M, Uçar İ.H, Güvener M, Karagöz
T, Çeliker A, Demircin M.
The pulmonary blood
supply in patients with pulmonary hypoplasia or atresia and
ventricular septal defect is highly variable. Patients with
tetralogy of Fallot, pulmonary hypoplasia or atresia, and
diminutive pulmonary arteries are high risk group for
correct approach. This report describes a child with
tetralogy of Fallot and pulmonary hypoplasia in whom the
pulmonary blood flow was provided from different sources.
Pulmonary blood supply from right internal mammarian artery
is a very rare anatomical variation.
Key Words:
Tetralogy of fallot, Pulmonary hypoplasia, Major aorta
pulmanary collateral artery
Double cardIac valves endocardItIs In patIent havIng permanent
hemodIalysIs catheter
Özcan T, Rencüzoğlu İ,
Seyis S, Acele A, Çiçek D, Çamsarı A, Cin V.G.
Infective endocarditis is a
bacterial infection consisted of embolic events, endocardial
vegetation and symptoms of systemic infection of
endocardium. The most prominent clinical findings are fever,
and general illness. Fifty nine year old patient admitted to
our clinic with complains of breathless, fever, pretibial
edema and fatique. The patient had subclavian hemodialysis
catheter for a year because of chronic renal insufficiency
and has undergone dialysis three times for a week.
We report the case of infective endocarditis due to
metisilin resistant coagulase negative Staphylococcus
infection diagnosed by transthoracic echocardiography and
laboratory examinations.
Successful management of bIventrIcular thrombI wIth
antIcoagulatIon In a patIent wIth perIpartum cardIomyopathy
Güntekin Ü, Tuncer M,
Gümrükçüoğlu A.H, Şimşek H, Güneş Y.
Here we present a case
of peripartum cardiomyopathy complicated with biventricular
thrombi. Thrombi were regressed in size after one day of
heparin treatment and no thrombi was detected on 2-D
echocardiography after 2 weeks of warfarin treatment.
