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PredIctIng the rIsk of dIlatatIon syndrome In non-rheumatIc
myocardItIs
Arystanova A, Batyraliev T, Fettser
D, Preobrazhensky D, Niyazova-Karben Z, Avsar Ö, Belenkov Y.
Diagnosis and early identification of non-rheumatic
myocarditis (NM) complication in the form of dilatation syndrome (DS)
remains relevant and unresolved problem of modern cardiology. The aim
of the research was the developing of multifactor models to predict the
risk of DS in patients with NM.
187 patients with NM at the
age of 20 - 58 years were evaluated (mean age 37,3±0,6 years). Depending on
the natural history of disease and the severity of heart failure (HF)
patients were randomized into 2 categories: I (n=95) NM complicated by HF II
FC and II(n=92) - NM with HF III FC.
Based on the multivariative
analysis of the received data (ECG, DopplerEcho; inflammation markers: CRP,
ESR, WBC, leukogram; immunological: CD3, CD4, CD8, CD16, CD72, CD95,
circulating immune complex (CIC), antigen-binding lymphocyte (ABL), Nitro
Blue Tetrazolium Reduction Test (NBTR-test) and enzyme immunoassay tests (proANP,
proBNP, fibronectin (FN), myoglobin) were formed 6 basic models.
On the basis of
multifactorial analysis models of diagnostic criteria and factors predicting
the risk of DS in NM were developed. The greatest contribution is set by NUP,
FN, apoptosis of cardiomyocytes, cytokines, ABL of myocardial specificity,
parameters of diastolic dysfunction of the heart and remodeling. All
presented models depending on the availability of these or other factors may
be proposed and used as a diagnostic algorithms of determine the probabi-lity
of DS in patients with NM.
AssocIatIon of serum paraoxanase
actIvIty, oxIdatIve stress markers and severe LMCA lesIons
Sezen Y, Baş M.M, Polat M,
Biçer Yeşilay A, Altıparmak H.İ, Küçükdurmaz Z, Taşkın A,
Güntekin Ü, Yıldız A, Demirbağ R, Aksoy N.
Patients with
significant left main coronary artery (LMCA) stenosis have a
special significance since LMCA supplies wide myocardial
area and LMCA stenosis can accompany multi-vessel disease
and accordingly appropriate primary and secondary
therapeutic options should be identified and applied
ultimately. The association of serum oxidative parameters
and serum paraoxonase activity (SPA) with the presence of
LMCA stenosis is unknown. Consequently the aim of this study
is to investigate serum oxidative parameters and SPA in
patients with severe LMCA lesions, in coronary artery
disease (CAD) patients without LMCA stenosis and in cases
with normal coronary artery (NCA).
Twenty-five
patients with >50% LMCA stenosis (LMCA+ group), 25 CAD
patients without LMCA stenosis (LMCA- group), and 25
patients with NCA (NCA group) were included. Height, weight
and blood pressure of all subjects were measured with
standard methods. Severity of CAD was evaluated with Gensini
score in LMCA+ and LMCA- groups. Total antioxidant status
(TAS), total oxidant status (TOS), and SPA were studied by
calorimetric methods from serum samples at the end of the
study. Biochemical parameters including lipid profile, serum
glucose, urea and creatinine were recorded. Groups were
analyzed with one way ANOVA and chi square tests with regard
to parametric and nonparametric variables, respectively.
TAS was
similar among groups (ANOVA p=0.05). The highest TOS was in
the LMCA+ group whereas the owest TOS was in the NCA group (ANOVA
p=0.027). The highest OSI was in the LMCA+ group and there
was statistically significant difference between groups with
regard to OSI (ANOVA p=0.008). Lowest and highest SPA was
detected in the LMCA+ and in the NCA groups (ANOVA p=0.001)
respectively.
Findings of
the present study suggest that decreased SPA and increased
oxidative stress might be associated with the presence of
LMCA stenosis beyond the presence of CAD.
EvaluatIon of aortIc stIffness In
patIents wIth obesIty and hypertensIon
Sürücü H, Boz H, Tatlı E, Meriç M.
The present study was
aimed to evaluate abnormalities in function of ascending
aorta (Ao) in patients with obesity and/or hypertension by
using both pulsed-wave tissue Doppler imaging (pw-TDI) and
standard echocardiography (s-ECHO).
Patients
receiving beta-blocker treatment were excluded from the
study population (reported normal coronary angiography
findings). Non-obese (BMI < 27) subjects without
hypertension constituted as control group (Group 1, n=24).
Obese patients (BMI > 27) were allocated to two groups
according to without (Group 2, n=22), or with hypertension (Group
3, n=66). Pw-TDI parameters were obtained from anterior Ao
wall and results were compared to s-ECHO.
When aortic
s-ECHO parameters were investigated, it was shown that
aortic strain (AS) and aortic distensibility (AD) were only
different between Group 1 and 3 (p=0.001and p<0.001,
respectively). AS and AD were lower in Group 3. But, early
diastolic velocity of aortic pw-TDI (Ea-aorta) was higher in
Group 1 compared to Groups 2 and 3 (p=0.011 and p<0.001,
respectively). And also, it was higher in Group 2 compared
to 3 (p=0.014). Ao diameters and left ventricular (LV)
stroke volume were not different among the groups.
Since
patients receiving beta-blocker treatment were excluded and
there was no differences LV stroke volume and aortic
dimensions among the groups, it can be said that our study
results are independent from these variability. In our study
results, pw-TDI can be suggested as a more sensitive
diagnostic method compared to s-ECHO in the detection of
increased aortic stiffness in both obese and hypertensive
patients.
The factors effectIng the groIn hematoma after
electIve percutaneous CORONARY INTERVENTIONS
Açıkel A, Atar İ,
Bozbaş H, Aydınalp A, Bilgi M, Yıldırır A, Özin B, Müderrisoğlu
H.
In this prospective study our aim was
to evaluate factors affecting the development of femoral hematoma and sheath
removal time in patients undergoing elective percutaneous coronary
intervention. The study included 85 patients in whom elective percutaneous
transluminal coronary angiography and/or coronary stenting was performed.
Under hemodynamic monitorization of all patients during removal of femoral
sheath by manual pressure application, the time of sheath
removal and changes in blood pressure and pulse during sheath removal were
recorded. The relationship between the development of femoral hematoma and
the age, sex, body weight and height of the patient, hypertension, diabetes
mellitus, dyslipidemia, smoking, presence of family history, number of
previous interventions in the blood vessel, intervention region and time,
arterial sheath diameter, atropine requirement was evaluated.
Femoral hematoma development
was significantly associated with the length of sheath removal time
(p=0,046), bleeding in the groin before sheath removal (p=0,031), placement
of femoral vein sheath (p=0,009), greater number of needle insertion during
the procedure (p=0,01) and high blood pressure before sheath removal
(p=0,029). In addition, among factors increasing the sheath removal time,
female sex, bleeding in the groin before sheath removal and vazovagal
hypotension requiring atropine were found to be significantly high (p<0.05).
Close evaluation and
monitorization for these factors is required in all stages of intervention
in patients undergoing elective percutaneous coronary intervention and with
risk of hematoma development.
Percutaneous coronary InterventIons
wIth DES ImplantatIon or coronary artery bypass graftIng?
ChoosIng the optImal method of treatment for
patIents wIth multIvessel coronary artery dIsease
Batyraliev T, Fettser D, Arystanova
A, Preobrazhenskiy D, Besnili F, Belenkov Y.
Coronary
artery bypass surgery (CABG) has historically always been
the method of choice of revascularization in patients with
multivessel coronary artery disease (CAD). However, over the
last decade, the arsenal of devices and techniques in
interventional cardiology has undergone significant changes
for the better. So in clinical practice were introduced
special stiff guidewires, devices for passage of chronic
occlusion of coronary artery (CA), new techniques of
bifurcational stenting of CA, method of retrograde approach
has become widely used. Routine use of drug-eluting stents
(DES), led to a dramatic reduction in the frequency
of restenosis and frequency of subsequent
revascularization of target lesions in patients. All this
greatly influenced the results of PCI by reducing the
frequency of major adverse cardiac events (MACE), increasing
the frequency of successful interventions and improve
clinical outcomes. In this regard, PCI has become more
widely used in patients with multivessel CAD, creating a
competition for CABG. In this given review examined several
clinical studies in which the results of PCI with DES
implantation are compared with CABG in patients with
multivessel CAD.
RIght
ventrIcular InfundIbular aneurysm after balloon valvotomy for
pulmonary valve stenosIs
Yılmaz M, Güvener M, Tok M, Uçar
İ.H, Özkan M, Demircin M.
Pulmonary valve
stenosis causes cyanosis and heart failure. Surgery or
balloon valvotomy effectively uses to relief right
ventricular outflow obstruction. Surgical treatment can
performed at low risk, either as a closed procedure or open
valvotomy with cardiopulmonary bypass. The balloon valvotomy
technique has less invasive nature for the patient, lower
hospital cost, and shorter hospital stay. In this case
report a 20 mouths-old girl with iatrogenic right
ventricular infundibular aneurysm who treated with right
ventricular patch.
Key Words:
Pulmonary valvuler stenosis, Right ventricular aneurysm,
Balloon valvotomy
Unusual case of renal artery stenosIs,
what Is the dIagnosIs?
Sarı M, Kılıç H,
Akdemir R.
Renal vascular disease,
although rare, is one of the more common and potentially
reversible and curable cause of hypertension and renal
dysfunction. The two most common causes of renal vascular
disease is atherosclerosis (%70) and fibromuscular dysplasia
(%25). We reported an unusual case of a young woman
presented with abrupt onset, poorly controlled hypertension
without any other atherosclerosis risk factors, was
associated with stenosis in the middle of the right renal
artery. This stenosis was not consistent with characteristic
form of fibromuscular dysplasia on angiography. We could not
differentiate this stenosis was caused by either a focal
fibromuscular dysplasia or an unusual atherosclerotic
disease. We treated successfully by direct percutaneous
coronary stent implantation with no
complication. She had relief of hypertension. But we are
interest in other authors what are thinking of about this
renal artery stenosis was caused by which. What is the
correct diagnosis? Is the treatment of choice true?
EllIs-van Creveld Syndrome asocIated wIth
EbsteIn’s anomaly
Güvener M, Akbulut B,
Öç B, Özsoy F, Uçar İ.H, Öç M, Paşaoğlu İ.
Ellis-van Creveld
syndrome is a rare autosomal recessive chondrodysplasia
characterized by chondroectodermal dysplasia, congenital
cardiac defects and is particularly characterized by
extremity anomalies. The gene that causes ectodermal
dysplasia is located in the short arm of the fourth
cromosome characterized by extremity shortening, polydactyly,
dystrophy in finger nails, malformation in hand and wrist
joints. Congenital cardiac defects are seen some of the
patients. Endocardial cushion defects and ASD in the form of
a single atrium is the most common form. We present a case
with Ellis-van Creveld Syndromee associated with Ebstein
anomaly and surgical treatment.
