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The electrocardIographIc and echocardIographIc
predIctors of the supraventrIcular arrhythmIas In patIents wIth
mItral valve prolapse
Akçay M, Yüce M, Pala S, Akçakoyun
M, Ergelen M, Kargın R, Emiroğlu Y, Özdemir N, Kaymaz C, Özkan M.
It is stated that the supraventicular
arrythmias (SVA) in patients with mitral valve prolapse (MVP) are seen often.
It has been demonstrated that while the increase in the QT dispersion and
the decrease in the heart rate variability (HRV) are related to the
ventricular tachycardia, the increase in the P wave dispersion (PD) is
linked to the supraventricular arrhythmia. We aimed to investigate the
clinical, echocardiographic, PD and HRV parameters of the classical MVP
patients with and without SVA.
20 patients of the similar age and sex with the
classical MVP with SVA (Female 8, Male12 , average age 40±12) and 20
classical MVP patients without SVA (Female 13, Male 7, average age 37±15)
were included in the study. PD was obtained through the electrocardiographic
(ECG) analysis manually taken at a speed of 50 mm/second. Besides the
routine measurements with the transthoracic echocardiography, the length and
thickness of the mitral valve and its annulus circumference was measured and
then mitral regurgitation (MR) was graded. Obtained from the 24 hour Holter
analysis, the time domain and frequency domain analysis was conducted.
In comparison with the cases
with the SVA, PD was significantly increased in those without arrhythmia,
(53±14 ms and 42±15ms, p= 0.0215). In echocardiographic measurements, only
the severity of MR in the cases with arrhythmia was high (2.8±0,7 and
2.35±0.7, p= 0.049). Furthermore, supraventricular cases were related to the
increase in the square root of the sum of the squares of the differences
between the RR cycles (rMSSD), total power, the lowest frequency "ultra low"
and the low frequency which were obtained from HRV analysis (p<0.05). In the
analysis of the logistic regression, PD was observed as the only independent
predictor of the SVA.
In patients with MVP, the
SVA was found to be linked to the MR severity, the increase in PD and HRV.
Besides, of all these parameters, only the PD turned out to be the
independent predictor of the SVA.
Key Words: Mitral
valve prolapse, Supraventricular arrhythmia, P wave dispersion and heart
rate variability
MIcrovascular dysfunctIon In patIents wIth coronary artery
ectasIa
Sezen Y, Güntekin Ü, Kaya
Z, Yıldız A, Demirbağ R.
Coronary artery
ectasia (CAE) is defined as diffuse or segmental dilatation
in main coronary arteries of at least 1.5 times compared to
normal coronary artery segments. Although essential
pathology is in the main coronary arteries, findings of
recent studies suggest microvascular dysfunction in CAE. In
this study, we aimed to investigate the existence of
microvascular dysfunction in patients KAE with myocardial
blush score (MBS).
Forty
patients with diffuse CAE in all three coronary arteries and
51age-matched consecutive cases with normal coronary
arteries were included in the study. Demographic and
clinical parameters were noted besides evaluation of
coronary angiographies. To investigate microvascular
dysfunction MBS of study population was calculated and the
association of MBS and clinical and angiographic variables
was assessed.
Demographic,
biochemical and clinical parameters were similar in both CAE
and control groups. In patients with CAE, MBS-left anterior
descending artery, MBS-left circumflex artery and MBS-right
coronary artery values were significantly lower than in the
control group (p value <0.001; 0.028 and <0.001 respectively).
In the correlation analysis, MBS was found to be correlated
with the presence of CAE, blood glucose and urea. Regression
analysis showed that the presence of CAE is the only
significant predictor of MBS (p=0.004, ß regression
coefficient=-0.422).
n this study,
we have demonstrated decreased MBS in patients with CAE
which reflects the dysfunction of microvascular bed.
Findings of the present study suggest presence of
abnormalities in patients with CAE in the coronary
microvascular bed besides the well-known pathological
changes in major coronary arteries.
Seytahunova. E.D., Bebezov İ.H., Abdramanov K.A., Cooshov K.T.
Kochak A.
Cardiovascular disease,
health, social and economic terms has led to major social
problems: they cause death of more than 15 million people
around the world each year. Ischemic heart disease (IHD), in
the premature death of adult humans, early disability has
become the most problems in the developed countries.
According to
the experiment carried out by Russian Federation
Prophylactic Scientific Research Center in 2007, more than
10 million people who were up to 35 were found to have CAD (coronary
artery disease).
Different
centers still continue scientific research studies on the
treatment of CAD (Coroner Artery Disease). Special attention
is given to the surgical treatment of CAD. Heart-lung
machine with a coronary artery by-pass (CAB) surgery has
gained immense popularity around the world, now this kind of
treatment of CAD is perceived to be a 'gold standart.
The clinical
results of Coronary artery by-pass (CAB) surgery and its
high reliability are known to everyone. Also it has been
proved by randomized studies. First CAB carried in 1990 in
our country, but the number of operations does not increase.
In this regard our people do not have enough information and
we think that ignorance is caused by the mentality of our
people.
However,
coronary artery by-pass surgery on the one hand
comprehensive studies to be taken also on getting better
result in survive, in prevention of complications and after
surgery.
RelatIonshIp between plasma braIn natrIüretIc peptIde levels and
left ventrIcular dIastolIc functIons and left ventrIcular mass
Index In patIents wIth prImary hypertensIon
Kayhan Altuner T, Akar Bayram N, Uçar Ö, Canbay A, Sakallı M,
Diker E, Aydoğdu S.
It is well known that plasma brain
natriuretic peptide (BNP) levels are elevated in patients with systolic
dysfunction. The role of BNP in predicting diastolic functions in
hypertensive patients is unclear yet. The aim of the present study is to
evaluate the relationship between plasma BNP levels and left ventricular
diastolic functions and left ventricular mass index in patients with primary
hypertension. We also aimed to test the usability of BNP in detecting
diastolic dysfunction.
Seventy patients (44 female,
26 male, mean age 58.72±11.81) with primary hypertension were enrolled in
the study. All patients went into a detailed two dimensional, M-mode and
Doppler echocardiography after obtaining venous blood samples for
measurement of plasma BNP levels. Diastolic functions were evaluated by
transmitral and pulmonary venous pulsed wave Doppler echocardiography. Left
ventricular mass index was calculated by using Devereux formula.
Diastolic dysfunction was
present in 37 of 70 patients. Plasma BNP levels were significantly higher in
patients with diastolic dysfunction than in patients without diastolic
dysfunction (92.18±52.35 pg/ml vs 28.81±25.01 pg/ml, p=0.001). Left
ventricular mass index was also significantly higher in the diastolic
dysfunction group (113.23±41.14 g/m² vs 84.16±25.43 g/m², p=0.001). There
was a positive correlation between left ventricular mass index and plasma
BNP levels (r=0.27,p=0.02).
In patients with primary
hypertension, plasma BNP levels can be used as a biochemical marker of
diastolic dysfunction.
In the
modern management of patients presenting with acute coronary
syndromes (ACS), early invasive management and prompt
revascularization have emerged as important goals for
improving patient outcomes. Among patients ultimately
undergoing revascularization, coronary artery bypass
grafting remains a common revascularization option despite
recent advances in interventional cardiology. However,
surgical revascularization is associated with greater delays
when compared with percutaneous coronary intervention. We
aimed to evaluate surgical treatment in patients with ACS in
this review.
SImultaneous percutaneous coronary InterventIon and
percutaneous patent foramen ovale closure
Saatçi Yaşar A, Bilen E, Bilge M,
İpek G, Yüksel İ.Ö.
Percutaneous
transcatheter closure of patent foramen ovale has been shown
to prevent recurrence in patients with cryptogenic stroke.
We report a case of a 58-year-old woman who presented with
an ischemic stroke. Transesophageal echocardiography showed
a patent foramen ovale and atrial septal aneurysm. Coronary
angiography revealed severe stenosis of the right coronary
artery and circumflex artery. We achieved successful
myocardial revascularization with coronary stent
implantation to both vessels. Subsequently, the patent
foramen ovale was closed under both transesophageal
echocardiography and fluoroscopic guidance. No complications
were observed in relation to both procedures. Our report
underlines the feasibility and the benefit of this combined
approach: percutaneous coronary intervention and
transcatheter treatment of patent foramenovale during the
same session.
Percutaneous transcatheter closure of double atrIal
septal defects wIth double Amplatzer Septal Occluder devIces
Ülgen S.M, Göktekin Ö,
Kaya Z, Kayrak M.
Atrial septal defect (ASD) is
the most common form of congenital heart disease in adults.
Early diagnosis and appropriate treatment may prevent many
complications related to ASD. There are basically 2 options
for treatment: surgical or percutaneous transcatheter
closure with percutaneous closure currently the standard
technique for the majority of patients with ASD.
Percutaneous closure of single ASD is based on a solid body
of knowledge, however, the literature is inadequate on the
subject of percutaneous closure of multiple ASDs whereas
various percutaneous technique.
In our case,
two ASDs were closed simultaneously with separate Amplatzer
Septal Occluder (ASO) devices. We conclude that percutaneous
closure of multiple ASDs with simultaneous double ASO
devices is safe and effective a method as the percutaneous
closure of single ASD.
IntermeDIate atrIoventrIcular septal defect In a baby wIth OHDO
syndrome
Güvener M, Uçar İ.H, Akbulut B, Oc M, Tok M, Oc B, Yılmaz M.
The Ohdo syndrome is
characterized by blepharophimosis, ptosis, abnormal ears,
and mental retardation. This report describes a child with
the Ohdo syndrome who, in addition, has atrio-ventricular
canal defect. Our patient was 16 months boy with
blepharophimosis, bilateral microphthalmia, hypogonadism,
other minor anomalies, and mental retardation.
Atrioventricular septal defect with small interchordal and
interventricular communication was corrected with a dacron
patch. After surgery there was no neurologic deficit or
complication.
