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It was previously observed that two dimensional (2D) Doppler derived and real-time three-dimensional (RT-3D) directly measured valve areas were smaller than reported manufacturer sizes. It may be helpful to obtain the ranges of inner diameters (IDs) and the geometric orifice area (GOA) during evaluation of prosthetic mitral valves. In this study, we aimed to provide reference dimensional parameters of bileflet mitral mechanical prosthetic valves. Patients with recent mitral valve replacement were examined by 2D and RT-3D transesophageal echocardiography (TEE) in the early postoperative period when the presence of pannus overgrowth was unlikely. Measurements of 2D IDs, 3D hinge to hinge (HHD) and edge to edge diameters (EED) and 3D GOA were obtained and compared with reported manufacturer sizes and areas. This study enrolled 126 patients with mitral prosthetic valves (38 ATS, 42 Carbomedics, 46 St. Jude Medical, all bileaflet). The measured 2D and 3D IDs and GOA were significantly smaller than reported manufacturer sizes in the majority of the valve sizes. This RT-3D TEE-guided study provides ranges of reference values for directly measured IDs and GOA of the three most commonly used mechanical mitral prosthetic valve types for the first time in a relatively large series.

Because the phenomenon of no reflow has a poor prognosis in ST-segment elevation myocardial infarction (STEMI) patients and the atherogenic index of plasma (AIP) has been shown to be a strong predictor of coronary heart disease, we aimed to investigate the relationship between AIP and no-reflow in patients with acute STEMI who underwent primary percutaneous coronary intervention (PCI). A total of 763 consecutive STEMI patients (648 men; mean age 58 ± 12 years) who underwent primary PCI were recruited for this study. The patients were classified into a reflow group (n = 537) and a no-reflow group (n = 226) according to the postprocedural angiographic features of thrombolysis in the myocardial infarction flow of the infarct-related artery. The AIP value was significantly higher in the no-reflow group than in the reflow group [0.50 (0.38-0.65) vs. 0.39 (0.25-0.49) p < .001], and AIP was found to be an independent predictor of no-reflow development. The best cut-off value of AIP for predicting no-reflow was 0.54, with sensitivity of 46.02 and specificity of 84,73. In addition, the predictive power of AIP was greater than that of triglycerides and high-density lipoprotein cholesterol based on a receiver operator curve comparison. The AIP was independently associated with no-reflow in patients with STEMI after primary PCI. This might be a superior indicator compared to traditional lipid profiles.

Serum uric acid (SUA) level was shown in various studies to be related to the presence of coronary artery disease and subsequent cardiovascular events. The aim of the present study was to evaluate the association of SUA with SYNTAX score II (SSII) and the long-term prognosis of patients with stable angina pectoris who underwent percutaneous revascularization due to multivessel disease (MVD) and/or unprotected left main disease (UPLMD). Two-hundred and ninety patients with MVD and/or UPLMD who were treated consecutively with percutaneous coronary intervention (PCI) were included in the present study. The study population was divided into high SSII (n: 145; SSII > 32.9) and low SSII (n: 145; SSII ≤ 32.9) according to the median SSII value. The SUA value was significantly higher in the high SSII group than in the low SSII group (5.53 ± 1.95 vs. 6.07 ± 1.88; p = 0.001) and was found to be an independent predictor of high SSII (OR 1.306; 95% CI 1.119-1.525; p = 0,001). Twenty-eight patients (9.7%) died during the long-term follow-up, and SUA and SSII were additionally found to be independent predictors of long-term mortality (HR 1.245, 95% CI 1.046-1.482, p = 0.014; HR 1.042, 95% CI 1.007-1.079, p = 0.018, respectively). In the present study, SUA level was demonstrated to be associated with high SSII and long-term mortality in patients with MVD and/or UPLMD who were treated with PCI.

SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion. The patients were divided into three groups according to increased SS-II value: low (n:562; SS-II ≤ 24.6); intermediate (n:563; 24.6 < SS-II < 34.4); and high tertile (n:583; SS-II ≥ 34.4). In-hospital and long term mortality rate from all causes (0 vs. 0.5 vs. 10.6% and 1.8 vs. 3.2 vs. 18.1% respectively, p ≤ 0.001) were significantly increased with SS-II tertiles and SS-II was found to be independent predictor of in-hospital and long term mortality (HR: 1.076 95% CI 1.060-1.092, p < 0.001) and (HR: 1.070 95% CI 1.050-1.090, p < 0.0001). The predictive power of SS-II, SS, and TRS were compared by ROC curve and decision curve analysis. SS-II surpassed SS and TRS in long-term and in-hospital mortality prediction. SS-II is a powerful tool to predict in-hospital and long-term mortality from all causes in STEMI patients treated with p-PCI.

The dependences of the two-dimensional to three-dimensional growth (2D-3D) critical transition thickness on the composition for GeSiSn films with a fixed Ge content and Sn content from 0 to 16% at the growth temperature of 150 °С have been obtained. The phase diagrams of the superstructure change during the epitaxial growth of Sn on Si and on Ge(100) have been built. Using the phase diagram data, it becomes possible to identify the Sn cover on the Si surface and to control the Sn segregation on the superstructure observed on the reflection high-energy electron diffraction (RHEED) pattern. The multilayer structures with the GeSiSn pseudomorphic layers and island array of a density up to 1.8 × 10 12  cm -2 have been grown with the considering of the Sn segregation suppression by the decrease of GeSiSn and Si growth temperature. The double-domain (10 × 1) superstructure related to the presence of Sn on the surface was first observed in the multilayer periodic structures during Si growth on the GeSiSn layer. The periodical GeSiSn/Si structures demonstrated the photoluminescence in the range of 0.6-0.85 eV corresponding to the wavelength range of 1.45-2 μm. The calculation of the band diagram for the structure with the pseudomorphic Ge 0.315 Si 0.65 Sn 0.035 layers allows assuming that photoluminescence peaks correspond to the interband transitions between the X valley in Si or the Δ 4 -valley in GeSiSn and the subband of heavy holes in the GeSiSn layer.

Even though the relationship between syntax score (SS) and coronary no-reflow phenomenon has been studied, the relation between SS and syntax score II (SS II) in patients with no-reflow phenomenon is unknown. We aimed to define the relationship between coronary no-reflow phenomenon and SS II as compared with SS. This study enrolled 193 patients undergoing primary percutaneous coronary intervention for ST elevation myocardial infarction in whom 42 patients developed the no-reflow phenomenon. SS and SS II were calculated in all patients. Bland Altman analysis was used to compare receiver-operating characteristic (ROC) curve analysis results. SS and SS II values were significantly higher in the no-reflow group than the reflow group (28.3 ± 5.5 vs. 18.8 ± 10.1; p < 0.001 and 42.5 (22.1-58.5) vs. 26.1 (13-49.8); p < 0.001 respectively). SS II value >32.3 yielded an area under the curve value of 0.881 (95% CI 0.820-0.942; p < 0.001) and independently predicted no-reflow with a sensitivity of 88% and a specificity of 80% (OR 1.150, 95% CI 1.047-1.263, p = 0.003). Comparison of ROC curve results with Bland Altman analysis showed that area under curve of SS II was larger than that of SS (0.881 vs. 0.785, p = 0.01). SS II may be a more useful tool than SS for prediction no-reflow phenomenon after primary percutaneous coronary intervention in patients with ST elevation myocardial infarction.

Kounis syndrome or allergic angina is defined as the coincidental occurrence of chest pain and allergic reactions accompanied by clinical and laboratory findings of classical angina pectoris. It is triggered by the action of potent vasoactive and inflammatory mediators, which are released from the mast cells during the allergic reaction. Epinephrine is a life-saving medication in anaphylaxis; however, it can aggravate ischemia and induce coronary vasospasm and arrhythmias. Here, we present a patient with Kounis syndrome that was caused by intramuscular injection of procaine penicillin G, and in whom epinephrine administration for treatment of laryngeal edema had provoked severe myocardial ischemia.