Search

SUMMARY OBJECTIVE: Different parameters on electrocardiograms (ECG) have been investigated to predict arrhythmia and mortality in patients with acute pulmonary embolism (APE). The acute effect of thrombolytic therapy (TT) on these parameters has not been investigated yet. METHODS: We examined the data of 83 patients who were evaluated as high-risk APE and discharged from the hospital after TT. First, the high-risk APE patients’ ECGs were compared with healthy control subjects (n = 55). After their admission and 24 hours later, the ECGs of patients with APE were compared. Heart rate, P-wave morphology, QRS duration, QT distance, Tp-e, and the index of cardiac electrophysiological balance (iCEB) were analyzed. RESULTS: Although P maximum was not different between the groups’ ECGs, heart rate, QT, QTc (corrected QT) interval, Tp-e intervals, Tp-e/QT ratio, and P wave dispersion were significantly higher in the APE group ( P values < 0.031). iCEB or iCEBc (corrected iCEB) values were lower in APE group ( P < 0.001). After TT, we determined a decrease in heart rate, Tp-e interval, and Tp-e/QT ratio ( P < 0.001). Although we detected a decrease in the QT and QTc interval and QT dispersion (QTd), QTd had no statistical significance (respectively P -value 0.013, 0.029, and 0.096). The iCEB and iCEBc levels were lower after TT ( P -value was 0.035 and 0.044 respectively). CONCLUSION: The QT, QTc, Tp-e interval, Tp-e/QTc ratio, iCEB, and iCEBc values significantly decreased after TT. It may be thought that effective TT causes partial improvement in ventricular repolarization in an early period. RESUMO OBJETIVO: Diferentes parâmetros de eletrocardiograma (ECG) têm sido investigados para predizer mortalidade e arritmia em pacientes com embolia pulmonar aguda (EPA). O efeito agudo da terapia trombolítica (TT) nesses parâmetros ainda não foi investigado. MÉTODOS: Examinamos os dados de 83 pacientes avaliados com EPA de alto risco e que receberam alta hospitalar após TT. Primeiramente, comparamos os ECGs dos pacientes com EPA de alto risco com os de indivíduos saudáveis (n = 55). Os ECGs dos pacientes com EPA foram comparados logo após a internação e 24 horas mais tarde. A frequência cardíaca, a morfologia da onda P, a duração do QRS, o intervalo QT, Tp-e e o índice de equilíbrio eletrofisiológico cardíaco (iCEB) foram analisados. RESULTADOS: Embora o valor máximo de P não tenha sido diferente entre os grupos no ECG, a frequência cardíaca, QT, intervalo QTc (QT corrigido), intervalos Tpe, razão TP-e/QT e dispersão da onda P foram significativamente mais elevados no grupo de EPA (valores de P < 0,031). Os valores do iCEB ou iCEBc (iCEB corrigido) foram inferiores no grupo de APE (P < 0,001). Após a TT, observamos uma diminuição da frequência cardíaca, do intervalo TP-e e da razão TP-e/QT ( P < 0,001). Apesar de termos observado uma diminuição do intervalo QT e QTc e da dispersão do QT (QTd), o valor de QTd não apresentou uma diferença estatisticamente significativa (respectivamente, valor de P 0,013, 0,029 e 0,096). Os níveis do iCEB e iCEBc foram menores após a TT (valor de P 0,035 e 0,044, respectivamente). CONCLUSÃO: Os valores de QT, QTc, intervalo Tp-e, razão Tp-e/QTc, iCEB e iCEBc diminuíram significativamente após TT. Pode-se concluir que a TT eficaz causa uma melhora parcial da repolarização ventricular no período inicial.

SUMMARY OBJECTIVE Recent studies have linked malnutrition with undesirable outcomes in cardiovascular diseases. However, the underlying mechanism is unknown. Contrast-induced acute kidney injury (CI-AKI) increased cardiovascular mortality after percutaneous coronary intervention (PCI). This study hypothesizes that prognostic nutritional index (PNI) plays a role in the development of CI-AKI in patients with acute coronary syndrome undergoing emergency PCI. METHODS This study enrolled 551 patients. PNI was determined as 10× serum albumin (g/dL)+0.005×total lymphocyte count (mm3). CI-AKI was characterized as the increase in serum creatinine ≥0.3 mg/dL level within 48 h after PCI. Patients were classified as either CI-AKI (+) or CI-AKI (−). RESULTS CI-AKI has occurred in 72 of 551 patients (13.1%). PNI was significantly lower in the CI-AKI (+) group than in the CI-AKI (-) group (44.4±6.6 versus 47.2±5.8, p

BACKGROUND: Atrial fibrillation (AF) prevalence in patients with acute myocardial infarction (MI) ranges from 3% to 25%. However demographic, clinical, and angiographic characteristics of AF patients who admitted with de novo MI are unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. METHODS: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to presenting cardiac rhythm. RESULTS: A total of 1793 patients were screened and 1626 were included in the study. The mean age was 61.5 (12.5) years. 70.7% of patients were men. The prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p

Eventhough acute carotid stent thrombosis is a rare complication of carotid arterystenting (CAS), it can cause fatal thromboembolic events. There are limitednumbers of techniques that can be applied during such emergencies. In thisstudy, we report a case in which the sandwich technique was successfullyperformed in the acute in-stent thrombosis. Conclusively, in-proceduralin-stent thrombosis following CAS must be rapidly evaluated and treated,allowing the efficient prevention of catastrophic events. Thus, sandwich stenttechnique is a rapid and efficient method for treating acute in-stentthrombosis., Akutkarotis arter stent (KAS) trombozu nadir bir komplikasyon olmasına rağmen fataltromboembolik olaylara neden olabilir. Akut olaylarda uygulanabilecek sınırlısayıda teknik olmakla birlikte bu olgu bildirimizde akut KAS trombozunda başarılıbir şekilde uygulanan “sandviç stent tekniğini” sunmaktayız. Prosedürel akutKAS trombozu hızlı ve etkin bir şekilde değerlendirilerek tedavi edilmesigereken bir durumdur. Bu olgumuzda kullandığımız teknik böyle katastrofikdurumlarla başetmede hızlı ve güvenli alternatif bir yöntem olarakkullanılabilir.

Takotsubo cardiomyopathy (TCMP) is characterised by a temporary aneurysm of the left ventricular apex in individuals without significant stenosis of the coronary arteries. It is extremely rare to see it combined with a thrombus. In this case report, we present a 57-year-old female patient with TCMP in whom apical thrombus was treated with short-term warfarin use.

In athletes, left ventricular hypertrophy is a physiological response upon routine active sports. If the hypertrophic cardiomyopathy is not diagnosed and treated, it can lead to sudden deaths in athletes. Not so much data is known whether or not it is favorable to use of Tp-e values in order to reflect the arrhythmia risks in asymptomatic elite cyclists. The aim of this study is to examine the risks of regular bike sport on potential arrhythmia in healthy active elite cyclists and veterans by using non-invasive cardiac tests. Study groups were: healthy volunteers (group 1, n=28, mean age 35.8±4.6), active cyclists (group 2, n=27, mean age 21±3.0), veteran cyclists (group 3, n=27, mean age 29.5±7.1 yr). All groups were underwent cardiological examinations, 12 derivation ECG records, transthoracic echocardiography investigations. Tp-e interval, Tp-e dispersion, corrected Tp-e interval, QT interval and Tp-e/QT ratio were calculated from ECG records. Tp-e intervals were measured with Tangent method, corrected Tp-e interval were measured with Bazett formula. Mean Tp-e interval results were as follows according to groups 1, 2, 3; 75.0±9.3, 88.1±7.0, 83.2±8.8 ms, respectively. The Tp-e interval, cTp-e interval, Tp- dispersion, QT interval, and SLI values were significantly higher in active cyclists than the veteran cyclists and the control group (p

Systemic lupus erythematosus (SLE) is characterized by chronic inflammation. Plasma atherogenic index (PAI) is a valuable marker for the cardiovascular disease and cardiac risk. The aim of this study was to evaluate the role and clinical use of PAI in atherosclerosis and the cardiac risk in SLE patients.We included 56 female SLE patients who were selected according to the American College of Rheumatology (1997) diagnosis criteria. Furthermore, we selected age-and body mass index (BMI)-matched 56 female healthy individuals. PAI was measured as a logarithmic value of triglyceride to high-density cholesterol ratio. We used carotid intima media thickness (cIMT) as an inflammatory marker because of its widespread use. The lipid and other biochemical parameters of patient and control groups were examined.The PAI and cIMT values of SLE patients were 0.04±0.23 and 0.78±0.18 mm, respectively. Besides, for the control group, the PAI value was -0.09±0.20 and cIMT value was 0.50±0.15 mm (p=0.002, p0.001; respectively). There was a strong correlation between cIMT and PAI (r=0.273, p=0.003). According to the multiple logistic regression analysis, we found that PAI value is an independent factor for cIMT in SLE patients (odds ratio: 2.6, 95 % confidence interval; 1.506-4.374; p=0.029).We determined that PAI can be used as an independent indicator for subclinical atherosclerosis in SLE patients.Sistemik lupus eritematozus (SLE), kronik inflamasyon ile karakterize bir hastalıktır. Plazma aterojenik indeks (PAI), kardiyovasküler hastalık ve kardiyak risk için değerli bir belirteçtir. Bu çalışmanın amacı PAI’in SLE hastalarında aterosklerozu ve kardiyak riski değerlendirmekteki rolü ve klinik kullanılabilirliliğini araştırmaktır.Amerikan Romatoloji Koleji (1997) tanı kriterlerine göre değerlendirilen 56 kadın SLE hastası dahil edildi. Ayrıca yaş ve vucüt kitle indeksi uyumlu 56 kadın sağlıklı kişi seçildi. PAI, trigliserit’in yüksek yoğunluklu kolesterole oranı logartimik ölçümüdür. Karotis intima medya kalınlığı (KIMK) inflamatuvar belirteç olarak yaygın olarak kullanıldığından, bu işareti bu çalışmada kullandık. Hasta ve kontrol gruplarının lipid ve diğer biyokimyasal parametreleri incelendi.Hasta grubunda PAI 0,04±0,23, KIMK 0,78±0,18 mm, kontrol grubunda PAI −0,09±0,20, KIMK 0,50±0,15 mm olduğu tespit edildi. Hasta grubunda PAI ve KIMK’ın kontrol grubuna kıyasla yüksek olduğu görüldü (sırasıyla p=0,002, p0,001). SLE hastaları içerisine KIMK ile PAI arasında pozitif korelasyon olduğu görüldü (r=0,273, p=0,003). Multipl logistik regresyon analize göre PAI, KIMK için bağımsız risk faktörü olarak değerlendirildi (Olasılık oranı: 2,6, Güven aralığı %95 1,506–4,374, p=0,029).Bu çalışma bize PAI’nın SLE hastalarında subklinik aterosklerozun değerlendirilmesinde kullanılabilecek bağımsız bir belirteç olabileceğini düşündürdü.

WOS: 000175545800001, PubMed: 12041885, It is known that the QT interval is longer in women than men. Estrogen is reported to account for the QT interval prolongation in several studies conducted with hormone replacement therapy (HRT) in postmenopausal women. Along with this, there are conflicting data as regards the effects of HRT on QT interval and dispersion. Moreover, there is no evidence about the effect of HRT on exercise QT parameters. We compared QT parameters obtained from Surface electrocardiograms during resting and peak exercise before and after 6 months of HRT consisting of estrogen Plus progesterone in healthy postmenopausal women. Twenty-four healthy postmenopausal women were given 0.625 mg/day conjugated estrogens and 2.5 mg/clay medroxyprogesterone acetate for 6 months. Exercise stress testing using the Bruce protocol was performed before and after HRT. QT maximum, minimum, dispersion and corrected QT maximum, minimum and dispersion were calculated during testing and peak exercise. HRT resulted in a significant increase in estradiol plasma levels from 24+/-10 pg/mL to 117+/-66 pg/mL (P

Electrocardiogram (ECG) is widely used in the diagnosis of myocardial infarction (MI). It mostly gives important hints to detect the infarct-related artery (IRA). The changes in the morphology and in the position of the heart cause changes in ECG as well. Though ECG is used for the diagnosis of MI, it is not sufficient on its own in detecting the location of the underlying lesion. The pathologies changing the morphology of the heart, such as the atrial septal defect (ASD), increase the margin of error of ECG. We report a rare case; falsely positive ECG for anteroseptal MI in patient with ASD admitted with acute coronary syndrome. Coronary angiography revealed right coronary artery (RCA) lesion in the patient with acute MI who was found to have ST elevation in both precordial and inferior derivations. As a potential cause of mismatch between IRA and infarct location at ECG, echocardiography showed right ventricle dilatation related with cribriform ASD. It was percutaneously closed at 30 days after MI. Therefore, when observed a mismatch between IRA and infarct location at ECG, a detailed examination should be performed to determine potential causes of the mismatch.