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Aims: The aim of this study is to investigate the effect of mitral stenosis (MS) on left atrial (LA) function using two-dimensional speckle tracking echocardiography (2DSTE)., Methods and Results: The study subjects consisted of 52 patients with asymptomatic MS and 52 control subjects. LA function was assessed using prototype speckle tracking software and manual tracking method. Maximal LA volume (LAVmax) and minimal LA volume (LAVmin) and LA volume before atrial contraction (LAVpre-a) were measured. Using these volumes, LA reservoir, conduit and booster pump fuction parameters were calculated. Indexed LAVmax, LAVmin, and LAVpre-a measurements via speckle tracking were highly correlated with manual tracing methods in both groups. Expansion index (67.8 ± 36.4 vs. 148.3 ± 44.2), diastolic emptying index (37.7 ± 12.9 vs. 58.0 ± 8.5), passive emptying (37.3 ± 14.1 vs. 70.4 ± 10.4) and passive emptying index (13.3 ± 6.3 vs. 41.3 ± 10.6) were decreased significantly in MS patients (P < 0.001). In contrast active emptying index (62.6 ± 4.1 vs. 29.5 ± 10.1) increased in MS group (P < 0.001) while active emptying (28.1 ± 13.0 vs. 28.3 ± 6.9) remained same among both groups., Conclusions: This is the first study relating LA volumes and function assessed by 2DSTE to MS. 2D speckle tracking analysis of LA volume is relatively easy and provides more detailed information regarding the changes in LA volumes during the cardiac cycle., (© 2012, Wiley Periodicals, Inc.)

No-reflow is of prognostic value in ST-segment elevation myocardial infarction (STEMI) but has not been extensively investigated in young patients. Young patients with STEMI admitted within 12 hours from symptom onset and treated by primary percutaneous coronary intervention (pPCI) were recruited. Patients were classified into 2 groups based on postintervention thrombolysis in myocardial infarction (TIMI) flow grade; no-reflow: TIMI flow grade 0, 1 or 2 (group 1; n = 27; 21 men, mean age: 42 ± 4 years); and angiographic success: TIMI flow grade 3 (group 2; n = 118; 110 men, mean age: 43 ± 4 years). Adjusted odds ratios were 13.79 for female gender (P < .001; confidence interval [CI] = 1.88-101.26), 2.09 for pain to balloon time (P < .017; CI = 1.14-3.812), 12.29 for high TIMI thrombus grade (P = .012; CI = 1.74-86.94), 0.04 for tirofiban use (P < .001; CI = 0.01-0.22), 5.19 for mean platelet volume (MPV; P < .001; CI = 2.44-11.01), and 1.008 for platelet–lymphocyte ratio (PLR; P = .034; CI = 1.001-1.016). In conclusion, female gender, pain to balloon time, high TIMI thrombus grade, tirofiban, MPV, and PLR were independent predictors of no-reflow in young patients with STEMI after pPCI. [ABSTRACT FROM AUTHOR]

Background: Mitral valve prolapse (MVP) is the most common valvular heart disease and characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole. There are two types of MVP, broadly classified as classic (thickness ≥5 mm) and non-classic (thickness <5 mm) according to the morphology of the leaflets. We aimed to investigate elastic properties of the aorta in young male patients with classical and non-classical MVP. Material/Methods: In the present study, 63 young adult males (mean age: 22.7 ± 4.2) were included. Patients were divided into classic MVP ( n = 27) and non-classic MVP ( n = 36) groups. Aortic strain, aortic distensibility and aortic stiffness index were calculated by using aortic diameters obtained by echocardiography and blood pressures measured by sphygmomanometer. Results: There was no significant difference between the groups in terms of age, body mass index, left ventricular mass and ejection fraction. When comparing the MVP group it was found that aortic strain and aortic distensibility were increased ( p = 0.0027, p = 0.016, respectively) whereas the aortic stiffness index was decreased ( p = 0.06) in the classical MVP group. Conclusion: We concluded that the elastic properties of the aorta is increased in patients with classic MVP. Further large scale studies should be performed to understand of morphological and physiological properties of the aorta in patients with MVP. [ABSTRACT FROM AUTHOR]

Background: Psoriasis vulgaris is associated with an increased risk of atherosclerosis. Carotid intima-media thickness (cIMT) may predict atherosclerosis. Aims: We assessed the correlation between bilirubin (a potent endogenous antioxidant) levels and cIMT in patients with psoriasis vulgaris. We also compared the levels of serum total bilirubin (TBil) and its fractions in control subjects and patients with psoriasis. Methods: We enrolled 115 participants (60 patients with psoriasis vulgaris and 55 control subjects). The levels of indirect bilirubin were calculated as the difference between TBil and direct bilirubin values. cIMT was measured in both common carotid arteries. Results: TBil levels were lower in patients with psoriasis than in the control group [median (range) 0.55 (0.30-1.23) vs. 0.59 (0.30-1.44) mg/dL] as were indirect bilirubin [0.43 (0.22-1.00) vs. 0.48 (0.25-1.12) mg/dL] and direct bilirubin [0.10 (0.01-0.23) vs. 0.13 (0.03-0.32) mg/dL]. Only direct bilirubin differed significantly ( p = 0.0002) but the number of patients with higher values of TBil and indirect bilirubin were significantly greater in the control group ( p = 0.0019 by the Fisher's test). The patients with psoriasis had a significantly greater cIMT compared with control subjects (0.54 ± 0.08 vs. 0.50 ± 0.07 mm, p = 0.005). High-sensitivity C-reactive protein levels were higher in patients with psoriasis compared with controls (2.95 ± 3.50 and 0.99 ± 0.72 mg/L, p < 0.001). There was a negative correlation between cIMT and TBil levels ( r = −0.383, p < 0.01). The results of the correlations were reinforced by multiple regression analysis. Conclusion: To our knowledge, this is the first study to assess the association between TBil and cIMT in patients with psoriasis. Our results support the concept that psoriasis vulgaris is associated with an increased risk of atherosclerosis. [ABSTRACT FROM AUTHOR]

We herein report a case of large right atrial thrombus at the junction of inferior vena cava and right atrium using multimodality imaging. When a right‐sided cardiac mass is encountered, it is important to clarify the type of the mass. Atrial myxoma, thrombus, vegetation, metastatic tumors, and primary benign or malignant tumors should be considered in the differential diagnoses of intraatrial masses. However, it is usually hard to make an accurate diagnosis before surgery. [ABSTRACT FROM AUTHOR]

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The bicuspid aortic valve is known to be the most common congenital cardiac malformation, with an approximate incidence rate of 1-2% in the general population. Most patients are unaware of the disease until the onset of infective endocarditis, which is a life-threatening complication that may affect a heart valve or other cardiac structures at the site of endothelial damage. A 22-year-old man presented to our internal medicine clinic with a complaint of acute onset dyspnea and fatigue. His body temperature was 38 °C. A diastolic murmur was detected at the right sternal border. Two-dimensional transthoracic echocardiography revealed severe aortic insufficiency, and two-dimensional transesophageal echocardiography showed that the aortic valve was bicuspid. There was also a flail lesion extending the left ventricular outflow tract, resulting in pathological coaptation and severe aortic insufficiency. The patient was referred to our cardiovascular department for surgery. We herein present this case of a bicuspid aortic valve complicated by infective endocarditis due to the underlying disease of chronic otitis media related to a rare pathogen: Alloiococcus otitidis. The patient underwent a successful aortic valve replacement surgery due to aortic insufficiency following infective endocarditis. He was discharged on the 16th postoperative day in good condition. [ABSTRACT FROM AUTHOR]

Atrioventricular valve parachute deformity was generally seen in the mitral position, which is called parachute mitral valve. Parachute deformity is also seen in the tricuspid position, but this has rarely been reported as sporadic cases. All of these cases were associated with other congenital defects, such as double outlet right ventricle, left to right shunt. We herein present two- and three-dimensional echocardiographic features of a parachute tricuspid valve in a patient with atrial septal defect and prominent eustachian valve. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 55 year old woman with mitral stenosis was seen in follow-up following a mitral balloon valvuloplasty which had been performed two weeks earlier. A discussion of a mitral anterolateral papillary muscle rupture which was found in the patient after a physical examination is presented.

Mini-Abstract: Hypertrophic cardiomyopathy (HCM) is characterized by hypertrophy of the left ventricle, with variable clinical manifestations and morphologic and hemodynamic abnormalities. False tendons (FTs) are discrete, fibromuscular structures of varying length and thickness that tranverse either left and right ventricular cavities. Left and right ventricular FTs were giving a false impression of HCM. Misdiagnosis of HCM can lead to undue anxiety, unnecessary medication, and further evaluation. Three-dimensional (3D) transthoracic echocardiography is additive to conventional two-dimensional imaging in these patients in terms of 3D perspective and anatomically correct examination. We present a 32-year-old male who was misdiagnosed as asymetrical septal hypertrophy. [ABSTRACT FROM AUTHOR]

Atrial fibrillation is the most common chronic arrhythmia and is associated with increased left atrial thrombus. Its presence and location have important implications in deciding on the therapeutic approach. Echocardiography is essential in establishing the diagnosis in patients with cardiac masses. Because the source of left atrial thrombus is often appendage, it may not be identified by transthoracic echocardiography. We herein demonstrated a huge left atrial appendix thrombus that was identified by transthorasic echocardiography easily. [ABSTRACT FROM AUTHOR]

Conventional fixed or removable prostheses for the treatment of tooth loss, bone loss continues to be linked to years in edentulous regions. Functional stimulation of bone re-formed implant treatment alternatives eliminated this possibility. In this case report, patient with an old anterior fixed prosthetic restoration, presented implication of implant supported prosthetic restoration and the clinical results are discussed. Congenitally corrected transposition of the great arteries is a rare congenital heart disease usually diagnosed during childhood. These patients are rarely asymptomatic. Therefore, they remain undiagnosed until adulthood . It may be associated with congenital anomalies such as ventricular septal defect, atrial septal defect and pulmonary stenosis. We presented a case of congenitally corrected transposition of the great arteries associated with ventricular septal defect, atrial septal defect, pulmoner stenosis, and complete atrioventricular block in an adult asymptomatic patient. [ABSTRACT FROM AUTHOR]

The article offers information on a study on right ventricular (RV) functions in pulmonary embolism (PE). It was found in the study that by several noninvasive methods including computed tomography, radionuclide methods and magnetic resonance imaging, the right ventricular function can be assessed. It also informs that echocardiography can be considered as a diagnostic tool for testing RV function of the patients.

The article presents a case study of a 25-year-old-male patient with palpitation and shortness of breath. Topics discussed include sinus rhythm, parachute mitral valve (PMV) and dilated coronary sinus (CS) revealed in electrocardiogram and echocardiography, application of three-dimensional transthoracic echocardiography (3D TTE) for revealation of morphological features and use of 3D- echocardiography for treating cardiac abnormalities.

The article presents a case study of a 78 year old man who was referred for transthoracic echocardiography. Transesophageal echocardiography was performed and it showed lipomatous hypertrophy of internal septum (LHAS). Three dimensional transesophageal echocardiography showed morphological features of pathology. Photographic images of the examination are also shown. Brief information on LHAS is also presented.

(Echocardiography 2012;29:E24-E25) [ABSTRACT FROM AUTHOR]

A letter to the editor commenting on the article "Right Ventricular Function After Aortic Valve Replacement: A Pilot Study Comparing Surgical and Transcatheter Procedures Using 3D Echocardiography" by researcher C. Keyl and colleagues is presented.

A letter to the editor is presented in response to the article published in the echocardiography periodical "Echocardiography" "Tricuspid annular plane systolic excursion and its association with mortality in critically ill patients" on the role of tricuspid annular plane systolic excursion in right ventricular assessment for critically ill patients.

The article presents case study of a 24-year-old male who was admitted to the clinic after suffering with congestive heart failure, and states that transthoracic echocardiography of the patient was performed and the patient was found to be suffering with Behcet's disease.

The article presents case study of a 20-year-old man who was admitted in the hospital due to extensive lesions on his hands. It states that the patient was suffering with cutaneous xanthoma on various parts of the body including the back of the hands, knees and elbows , and mentions that total cholestrol of the patient was tested. It discusses that the patient was diagnosed with familial hypercholesterolemia (FH) and patient's Transthoracic echocardiography (TTE) was also done.

The article presents the case of a 20-year-old man who complained of presyncope and cold hands. It shows the four-chamber view of transthoracic echocardiography revealing the descending aorta at the back of the left atrium and the suprasternal view demonstrating an enlarged artery in the proximal descending aorta. It explains why a right-sided aortic arch with an aneurysm of the aberrant subclavian artery is a rare congenital anomaly.

The article describes a case of mediastinal lung herniation in a 26-year-old male patient with Scimitar syndrome.

A letter to the editor is presented in response to the article "Percutaneous Device Closure for Secundum-type Atrial Septal Defect: Short and Intermediate-term Results" by Abdi et al., in the November 2012 issue.

Various photograph are presented of a 23-year-old male who underwent a three-dimensional echocardiography of a coronary artery, which detected the absence of left main trunk with subaortic membrane.

The article presents a case study of an asymptomatic 21-year-old man isolated with parachute tricuspid valve through three-dimensional echocardiography (3D TTE).

Long period of professionally training may induce adaptive changes in left ventricle (LV) dimensions in young sportsmen. Those changes may differ according to the type and frequency of training. In this study we aimed to evaluate the echocardiographic left ventricular parameters according the type of training especially in adult trainers. We retrospectively evaluated the parameters of LV recorded during the outpatient echocardiographic examination of adult sportsmen. Study groups were designed as the subjects who train sportive activity at least 2 or three times a week for a period of 1 hour and but differ in type of exercise content. Clinical features (age, weight, height, body mass index, systolic and diastolic blood pressure), end-diastolic and end-systolic diameters of LV, left atrium (LA), LV mass and mass index, LV ejection fraction (EF) were compared among groups. Age, weight, and height, BMI were not different among groups. Parameters of left ventricle were not different among groups. However left atrial diameter (35.9±2.0 vs 36.8±2.1, p=0.046) was significantly increased in isometric typed trainers. Diastolic diastolic pressure (72.4±3.6 vs 77.2±4.2, p=0.000) was significantly lowered in strength typed sportmen. Regular sports training may not induce pronounced changes in LV dimensions except physiologically left atrial dilatation observed in adult strength sports trainers. Strength sports training was favorably lowered diastolic blood pressures in adults. Regular exercise training combined strength and endurance sports would provide the maximum gain and healthier life for adults. [ABSTRACT FROM AUTHOR]