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Amaç: Çalışmamızın amacı, obez ve nonobez obstrüktif uyku apne sendromu (OUAS) hastalarında; doku doppler (DD) ekokardiyografi ile sağ ventrikül sistolik ve diyastolik fonksiyonlarının ve pulmoner arter basınçlarını (PAB) karşılaştırmaktı.Gereç ve Yöntem: Çalışmamıza Uyku Laboratuarında polisomnografik inceleme yapılmış ve orta ya da ağır OUAS tanısı konmuş 35 nonobez ve 34 obez olmak üzere 69 hasta alındı. Tüm hastalarda M-mode, iki boyutlu inceleme, renkli akım Doppler ve Doku Dopler yardımıyla sol ventrikül ve sağ ventrikül boyutları, sol atrium (LA) ve sağ atrium (RA) boyutları, sol ventrikül ve sağ ventrikül sistolik ve diyastolik fonksiyonları ve sistolik PAB’ ları ölçüldü.Bulgular: Her iki grupta da RV diyastolik fonksiyonlarında bozulma saptanmış olup, obez grupta anlamlı olarak daha fazla bozulma saptanmıştır (lateral triküspit annuler bölge geç diyastolik miyokardial hız A’a: nonobez hastalarda 0.13 ±0.03 ve obez hastalarda 0.11±0.04). Obez grupta ortalama sistolik PAB anlamlı olarak daha yüksek bulunmuştur (Sırasıyla 31.2±5.6 ve 27.1±5.8).Sonuç: Obstrüktif Uyku Apne Sendromu kardiyovasküler morbidite ve mortaliteyi arttırır. Çalışmamızda orta ve ağır OUAS hastalarında doku doppler incelemesi ile SV ve RV diyastolik fonksiyonlarında bozulma saptanmıştır. Obezite OUAS‟tan bağımsız olarak bu bozukluğa katkıda bulunmaktadır., Purpose: The aim of our study was to compare the right ventricular systolic and diastolic functions and pulmonary artery pressure (PAP) in obese and non-obese patients with obstructive sleep apnea syndrome (OSAS) by tissue Doppler imaging (TDI) echocardiography.Materials and Methods: This study was conducted with 69 patients, 34 obese and 35 non-obese, diagnosed moderate or severe OSAS by an overnight polysomnographic sleep study. In all patients, LV (left ventricle) and RV (right ventricle) size, left atial (LA) and RA (right atrial) dimensions, LV and RV systolic and diastolic functions and systolic PAPs were measured by M-mode, two-dimensional analysis, color flow Doppler and TDI.Results: RV diastolic dysfunction was detected in both groups; this impairment was significantly higher in the obese group (lateral tricuspid late diastolic myocardial annular zone velocity A'a: 0.13 ± 0.03 in non-obese patients and 0.11 ± 0.04 in obese patients). The mean systolic PAP was significantly higher in obese patients (31.2±5.6, 27.1±5.8, respectively)Conclusion: Obstructive Sleep Apnea Syndrome increases cardiovascular morbidity and mortality. In our study,left ventricul and right ventricul diastolic dysfunction was determined by tissue Doppler imaging in patients with moderate and severe Obstructive Sleep Apnea Syndrome. Obesity contributes to this impairment regardless of Obstructive Sleep Apnea Syndrome .

Background Atherosclerosis is a complex inflammatory process in which inflammatory markers are involved. Although pentraxin 3 (PTX-3), a newly identified inflammatory marker, was associated with adverse outcomes in stable angina pectoris, no association between PTX-3 and the complexity of coronary artery disease (CAD) has been reported. Thus, the aim of the present study was to assess the association between the level of PTX-3 and the complexity and severity of CAD assessed with SYNTAX and Gensini scores in patients with stable angina pectoris. Methods The study population consisted of 2 groups: 161 patients with anginal symptoms and evidence of ischemia who underwent coronary angiography and 50 age- and sex- matched control subjects without evidence of ischemia were included. Patients were grouped into 3 groups according to the complexity and severity of coronary lesions assessed by the SYNTAX score (30 patients with a SYNTAX score of 0 were excluded). Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Results The PTX-3 levels demonstrated an increase from low to high SYNTAX groups ( r = 0.72, P < 0.001). Whereas the low SYNTAX group had statistically significantly higher PTX-3 levels when compared with the control group (0.50 ± 0.01 vs 0.24 ± 0.01 ng/mL, P < 0.001), the hs-CRP levels were not different (0.81 ± 0.42 vs 0.86 ± 0.53 mg/dL, P = 0.96). However, the intermediate SYNTAX group had higher hs-CRP levels compared with the low SYNTAX group (1.3 ± 0.66 vs 0.86 ± 0.53 mg/dL, P = 0.002). Serum PTX-3 levels and hs-CRP levels were correlated with the SYNTAX scores and Gensini scores (for SYNTAX: r = 0.87 [ P < 0.001] and r = 0.36 [ P = 0.01]; for Gensini: r = 0.75 [ P < 0.001] and r = 0.27 [ P = 0.002], respectively), and according to the results of univariate and multivariate analyses, for “intermediate and high” SYNTAX scores, age, diabetes mellitus, low-density lipoprotein cholesterol, hs-CRP, and PTX-3 were found to be independent predictors, whereas for the presence of “high” SYNTAX score only PTX-3 was found to be an independent predictor. The receiver operating characteristic curve analysis further revealed that the PTX-3 level was a strong indicator of high SYNTAX score with an area under the curve of 0.91 (95% confidence interval, 0.86-0.96). Conclusions Pentraxin 3, a novel inflammatory marker, was more tightly associated with the complexity and severity of CAD than hs-CRP and was found to be an independent predictor for high SYNTAX score.

Objectives: Cardiac syndrome X (CSX) is a clinical entity that is defined as normal coronary arteries with angina pectoris and objective sins of ischemia. The correlation between CSX and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) is well established, however an association with pentraxin- 3 (PTX-3) has not been examined. The aim of this study was to investigate the association between PTX-3 and CSX. Study design: A total of 122 patients (58 female, 64 male, mean age 49.6+-5.8 years) with suspected of coronary artery disease (CAD) were included in the study. Those with evidence of ischemia (50 patients with positive treadmill tests, 32 patients with positive myocardial perfusion scintography) underwent coronary angiography (82 patients). Patients with a normal angiogram were considered the CSX group (n=41) and patients with coronary lesions were referred to as the CAD group (n=41). Patients without signs of ischemia served as the control group. Serum PTX-3 and hs-CRP levels were measured in all patients. Results: The CSX group had significantly increased PTX-3 levels relative to the control group (0.46+-0.16 vs. 0.23+-0.09 ng/ml, p

Background Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population. Methods and Results One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow ≤2 or TIMI flow 3 with final myocardial bush grade ≤2 after PCI) and electrocardiographically (ST resolution Conclusions In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.

We report a patient with coronary artery by-pass grafting who was admitted to our hospital due to acute occlusive thrombosis of prosthetic mitral valve. His INR level was subtherapeutic. The diagnosis was made with transthorasic echocardiography. Fibrinolytic therapy was given to him and a successful clinical result was obtained.