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Platelets have a central role in many cardiovascular events. Tirofiban is a glycoprotein (GP) IIb/IIIa receptor inhibitor that prevents platelet aggregation. In this report, it was aimed to review the thrombocytopenia induced by tirofiban treatment and other causes of thrombocytopenia. Key words: Tirofiban, Thrombocytopenia, GP IIb/IIIa İnhibitors, Trombositler birçok kardiyovasküler olayda merkezi role sahiptirler. Tirofiban, trombosit agregasyonunu önleyen bir glikoprotein (GP) IIb/IIIa reseptör inhibitörüdür. Bu olguda tirofiban tedavisi sonrası gelişen trombositopeni ve trombositopeni yapan diğer nedenlerin gözden geçirilmesi amaçlandı. Anahtar kelimeler: Tirofiban, Trombositopeni, GP IIb/IIIa İnhibitörleri

Aim: Although previous studies have shown a significant association between coronary risk factors or carotid atherosclerosis and valvular calcifications, there is conflicting evidence about which clinical cardiovascular risk factors are related to valvular calcifications.We aimed to evaluate the cardiovascular risk factors and carotid intima media thicknesses in patients with single and double valve calcifications in whom echocardiography has been performed prior to elective coronary angiography. Materials and Methods: 100 patients having double valve calcifications (aortic valve calcification and mitral annular calcification; 47 female and 53 male; mean age 68.1±8.7 years) and 90 patients having single valve calcification (aortic valve calcification; 29 female and 61 male; mean age 62.8±9.8 years) were enrolled into the study. All patients underwent transthoracic echocardiography, carotis ultrasonography and coronary angiography. Results: Age, female gender and hypertension were found to be significantly higher in patients with double valve calcifications (p=0.0001, 0.038 and 0.027; respectively). In means of hyperlipidemia, smoking, diabetes mellitus, body mass index, coronary artery disease and carotis intima media thickness, no significant difference was observed between the both groups. Age and female gender were found to be independent predictors in patients with double valve calcifications. Conclusion: These data have suggested that aortic and mitral valve calcifications may have different pathogenetic mechanisms and mitral annular calcification may also have some additional pathogenetic factors. Key words: Aortic Valve Calcification; Mitral Annular Calcification; Carotis Intima Media Thickness; Cardiovascular Risk Factors., Amaç: Önceki çalışmalarda, kapak kalsifikasyonları ile koroner arter hastalığı veya karotid aterosklerotik hastalık arasındaki yakın ilişki gösterilmiş olmasına rağmen, hangi klinik kardiyovasküler risk faktörlerinin kapak kalsifikasyonları ile ilişkili olduğu hakkında çelişkiler mevcuttur. Bu çalışmada, elektif koroner anjiyografi öncesi ekokardiyografi yapılan tek kapak ve çift kapak kalsifikasyonlu hastalarda kardiyovasküler risk faktörlerini ve karotis intima media kalınlıklarını değerlendirmeyi amaçladık. Gereç ve Yöntem: Çalışmaya çift kapak kalsifikasyonu olan 100 hasta (aort kapak kalsifikasyonu ve mitral annüler kalsifikasyon; 47 kadın ve 53 erkek; ortalama yaş 68,1±8,7 yaş) ve tek kapak kalsifikasyonu olan 90 hasta (aort kapak kalsifikasyonu; 29 kadın ve 61 erkek; ortalama yaş 62,8±9,8 yaş) alındı. Tüm hastalara transtorasik ekokardiyografi, karotis ultrasonografi ve koroner anjiyografi yapıldı. Bulgular: Yaş, kadın cinsiyet ve hipertansiyon çift kapak kalsifikasyonu olan hastalarda anlamlı olarak daha yüksek bulundu (sırasıyla; p=0,0001, p=0,038 ve p=0,027). Her iki grup arasında hiperlipidemi, sigara içimi, diyabetes mellitus, vücut kitle indeksi, koroner arter hastalığı ve karotis intima media kalınlığı yönünden anlamlı farklılık bulunmadı. Çift kapak kalsifikasyonu olan hastalarda, yaş ve kadın cinsiyet bağımsız belirleyiciler olarak bulundu. Sonuç: Bu veriler, aort ve mitral kapak kalsifikasyonlarının farklı patojenik mekanizmaları olabileceğini ve mitral annüler kalsifikasyon gelişiminde ayrıca bazı ek faktörlerin rol oynayabileceğini düşündürmektedir. Anahtar kelimeler: Aort Kapak Kalsifikasyonu; Mitral Annüler Kalsifikasyon; Karotis İntima Media Kalınlığı; Kardiyovasküler Risk Faktörleri.

BackgroundWhite-coat hypertension (WCH) is a disease based on the disparity of a patient-s blood pressure measurements between the physician-s office and the patient-s home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH.MethodsIn total, this study included 37 WCH (17 women, 20 men, mean age 48.45.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.97.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions.ResultsLA diameters were significantly higher in the patients compared with the controls (37 +/- 2.8 vs. 35 +/- 3.1mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1 +/- 6.9 vs. 35.5 +/- 3.7ml, P

Objective The aim of this study was to evaluate left atrial (LA) volume and function using real time three-dimensional echocardiography (RT3DE) in patients with cardiac syndrome X (CSX). Methods Fifty patients with CSX (28 females; mean age 50.9±10.9 years) and 50 age- and gender-matched healthy controls (30 females; mean age 52.3±9.8 years) who had negative treadmill exercise test and normal coronary arteries on invasive coronary angiography were included in the study. Comprehensive two-dimensional (2D), pulsed and tissue Doppler, speckle tracking echocardiography, and RT3DE for the assessment of LA dynamics were performed in all study participants. Results Cardiac syndrome X and control groups have similar clinical characteristics regarding age, sex, body mass index, hypertension, diabetes, and smoking habit. 2D echocardiographic parameters were also similar between groups. Pulsed- and tissue Doppler parameters, IVRT, A, and Am values, were higher in CSX group, while Em, E/A, and Em/Am ratios were higher in the control group reflecting mild diastolic dysfunction. Regarding RT3DE parameters, LA maximum volume, minimum volume, volume before atrial contraction, LA maximum volume index, total and active stroke volumes were found to be increased in CSX patients. However, LA total stroke fraction, passive stroke volume, passive stroke fraction, peak systolic, and diastolic longitudinal strains were found to be lower in CSX patients. Conclusion The main finding of this study was that CSX patients had altered LA booster pump, reservoir, and conduit functions. This finding may have clinical implications for early detection of abnormal LA dynamics in CSX patients.

Behçet disease (BD) is a multisystemic disorder characterized by endothelial dysfunction and inflammation. Monocyte to high-density lipoprotein cholesterol ratio (MHR) is a recently emerged indicator of inflammation and oxidative stress. Sixty patients with BD and 50 control individuals were included to investigate the relationship between MHR and endothelial dysfunction. Endothelial function was assessed by flow- and nitroglycerin-mediated dilatation technique (FMD and NMD, respectively). Serum high-sensitivity C-reactive protein (hsCRP) levels were measured in all study participants. The MHR and hsCRP levels were significantly higher in patients with active BD than in controls. Brachial artery FMD was significantly lower in patients with active BD than in controls. Brachial artery NMD was similar between groups. There was a strong inverse correlation between MHR and FMD and a strong positive correlation between MHR and serum hsCRP levels. Thus, elevated MHR may be a useful marker reflecting impaired endothelial function and systemic inflammation in patients with BD.

Objective To evaluate left atrial (LA) volume and functions in obese subjects using real time three-dimensional echocardiography (RT3DE) and also the relationship between LA mechanical functions and N-terminal pro-atrial natriuretic peptide (NT-proANP). Methods This study included 40 obese (26 females and 14 males, mean age 51.9 years) and 40 normal weight subjects (23 females and 16 males, mean age 53.5 years) with normal coronary angiograms. All the study participants underwent RT3DE to assess LA volume and mechanical function. Plasma NT-proANP was determined by ELISA method. Results There was no significant difference between groups in left ventricular (LV) diameters and ejection fraction, which reflect LV systolic function. However, transmitral deceleration time, isovolumetric relaxation time, and peak late diastolic tissue Doppler velocity values, which reflect LV diastolic function, were found to be significantly higher in obese subjects when compared with controls. LA maximum volume (LAVmax), LAVmax index (LAVI), LA minimal volume (LAVmin), before atrial contraction volume (LAVpreA), LA active emptying volume, LA total emptying volume, and LA active emptying fraction, which reflect LA reservoir and pump functions, were also higher in obese subjects when compared with controls. LA passive emptying fraction was significantly lower in obese subjects than in controls. NT-proANP levels were similar between groups. There were positive correlations between NT-proANP level and LAVI, LAVmax, LAVmin, LAVpreA, and LA total and active emptying volumes. Conclusions Left atrial mechanical functions and volumes are impaired in obese subjects. These findings may be regarded as early markers of subclinical cardiac failure in obese subjects who have not yet exhibited any clinical evidence of cardiovascular disease.

Objective: The aim of this study was to evaluate left ventricular (LV) systolic strain by speckle tracking echocardiography (STE) and real-time three-dimensional echocardiography (3-DE) for the early detection of myocardial dysfunction in patients with cardiac syndrome X (CSX). Methods: We compared 34 patients with CSX (18 females, mean age 47.9±10.0 years) with 41 healthy persons as a control group (23 females, mean age 50.6±9.9 years). Inclusion criteria for CSX were typical angina, a positive exercise ECG stress test, and angiographically documented normal coronary arteries. Exclusion criteria for both groups were hypertension, valvular heart disease, cardiomyopathies, inflammatory diseases, myocarditis, vasculitis, arthropathies, Tietze's syndrome, gastrointestinal diseases, aortic diseases, hormone replacement therapy, arrhythmias, liver diseases, and alcohol use. All subjects underwent two-dimensional STE and 3-DE to assess resting LV function. STE measures were taken from the basal septum, mid-septum, apical septum, apex, apicolateral, mid-lateral, basal lateral, anteroseptal, anterior, anterolateral, inferolateral, inferior, and inferoseptal walls. Student's t-test, Mann–Whitney U test, and chi-square test were used to statistically analyze data. Results: LV echo ejection fraction (EF) and systolic wave peak velocity were similar for both groups. Regional mean longitudinal strain (-17.7±2.5% vs. -19.8±1.8%; p

Objective: Non-dipper hypertension is associated with an increased cardiovascular morbidity and mortality. Besides this, the left atrial (LA) size and functions are accepted to be prognostic factors in various cardiovascular diseases. In this study, we aimed to evaluate the effect of non-dipper hypertension on LA volume and functions using real-time three-dimensional echocardiography (RT3-DE). Methods: Forty dipper and 52 non-dipper hypertensives enrolled in this prospective cross-sectional study. Patients with any comorbidities that have a potential for causing structural cardiac alterations were excluded. Two-dimensional echocardiography (2-DE) and RT3-DE were performed to assess LA volumes and functions. The statistical tests used in this study were Shapiro–Wilk's test, Student's t-test, Mann–Whitney U test, chi-square test, Spearman's test, and Pearson's correlation test. Results: LA minimal volume, LA volume before LA contraction, and LA total systolic volume were higher in non-dipper hypertensives than in dipper hypertensives (p