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WOS: 000429627900018, PubMed ID: 29521321, …

Amaç:Miyokard infarktüsü (MI) geçiren hastalarda, egzersiz temelli rehabilitasyon, tedavinin önemli bir parçasıdır. Çalışmamızın amacı, MI geçiren hastalarda, hastanede yapılan kardiyak rehabilitasyon ile ev egzersiz programının kardiyak parametreler üzerindeki etkisini karşılaştırmaktı. Yöntem: Çalışmaya 1 ay öncesinde MI geçiren stabil 35 hasta alındı. Hastalar rastgele iki gruba randomize edildi: aerobik egzersiz eğitimi grubu (I), ev egzersiz grubu (II). Grup I, hastanede 6 haftalık aerobik egzersiz programına katıldı. Grup II için evde aşamalı fiziksel aktivite programı öngörüldü. Bulgular: Grup I'de, ejeksiyon fraksiyonu (EF), altı dakika yürüme testi (6-DYT), kol ergometresi testi, VO2max ve anaerobik zaman (AT) değerlerinde artış olduğu bulundu. Aynı zamanda grup II'deki 6-DYT, kol ergometresi testi ve AT değerlerinde de anlamlı artışlar vardı. Kol ergometresi testi değerlerindeki değişim oranı, hastane grubunda daha yüksekti. Sonuçlar: Hastanede yapılan egzersiz programına katılamayacak düşük veya orta riskli hastalar için, evde yapılan egzersiz programları, iyi bir alternatif olabilir., Background: Exercise-based rehabilitation is an important part of treatment patients following myocardial infarction. Objective: The aim of our study was to compare the effects of exercise therapy on cardiopulmonary parameters by prescribing hospital-based cardiac rehabilitation, home-based exercise program in patients with previous myocardial infarction. Method: We studied 35 post-myocardial infarction patients having a 1-month myocardial infarction history with a stable disease. The patients were randomly assigned to 2 groups as follows: aerobic exercise training group (I), homebased exercise group (II). The group I participated in the aerobic exercise program at the hospital for 6 weeks. Group II was prescribed a home-based gradual physical activity program. Results: It was found that there were significant increases in the values of ejection fraction (EF), the six-minutes-walk test (6-MWT), arm ergometer test, VO2max, anaerobic time in group I. It was also found that there were significant increases in the values of 6-MWT, arm ergometer test, and anaerobic time in group II. The ratio of change in arm ergometer test values was higher in the hospital group. Conclusions: Home-based exercise programs can be a good alternative for patients with low or moderate risk who can't attend hospital-based exercise programs.

CONTEXT AND OBJECTIVE: The location of embolism is associated with clinical findings and disease severity in cases of acute pulmonary embolism. The level of gamma-glutamyl transferase increases under oxidative stress-related conditions. In this study, we investigated whether gamma-glutamyl transferase levels could predict the location of pulmonary embolism. DESIGN AND SETTING: Hospital-based cross-sectional study at Cumhuriyet University, Sivas, Turkey. METHODS : 120 patients who were diagnosed with acute pulmonary embolism through computed tomography-assisted pulmonary angiography were evaluated. They were divided into two main groups (proximally and distally located), and subsequently into subgroups according to thrombus localization as follows: first group (thrombus in main pulmonary artery; n = 9); second group (thrombus in main pulmonary artery branches; n = 71); third group (thrombus in pulmonary artery segmental branches; n = 34); and fourth group (thrombus in pulmonary artery subsegmental branches; n = 8). RESULTS : Gamma-glutamyl transferase levels on admission, heart rate, oxygen saturation, right ventricular dilatation/hypokinesia, pulmonary artery systolic pressure and cardiopulmonary resuscitation requirement showed prognostic significance in univariate analysis. The multivariate logistic regression model showed that gamma-glutamyl transferase level on admission (odds ratio, OR = 1.044; 95% confidence interval, CI: 1.011-1.079; P = 0.009) and pulmonary artery systolic pressure (OR = 1.063; 95% CI: 1.005-1.124; P = 0.033) remained independently associated with proximally localized thrombus in pulmonary artery. CONCLUSIONS : The findings revealed a significant association between increased existing embolism load in the pulmonary artery and increased serum gamma-glutamyl transferase levels. RESUMO CONTEXTO E OBJETIVO : A localização da embolia está associada com os resultados clínicos e a gravidade da doença do embolismo pulmonar agudo (EPA). O nível de gama-glutamil transferase (GGT) aumenta em condições relacionadas com estresse oxidativo. Investigou-se se os níveis de GGT podem prever a localização do EPA. TIPO DE ESTUDO E LOCAL : Estudo observacional transversal na Universidade Cumhuriyet, Sivas, Turquia. MÉTODOS : Avaliamos 120 pacientes diagnosticados com EPA após a realização de angiografia pulmonar assistida por tomografia computadorizada. Eles foram divididos em dois grupos principais (localização proximal e distal) e depois em subgrupos de acordo com a localização do trombo da seguinte forma: primeiro grupo (trombo na artéria pulmonar [AP] principal, n = 9); segundo (trombo no ramo da AP principal; n = 71); terceiro grupo (trombo na segmentar da AP; n = 34); quarto grupo (trombo na subsegmentar da AP; n = 8). RESULTADOS : Na análise univariada, os níveis de GGT tiveram significado prognóstico em relação à admissão, pulsação arterial, saturação de oxigênio, dilatação do ventrículo direito/hipocinesia, pressão sistólica da artéria pulmonar (PSAP) e necessidade de ressuscitação cardiopulmonar. O modelo de regressão logística multivariada demonstrou que o nível de GGT na admissão (razão de possibilidades, OR: 1,044; 95% intervalo de confiança, CI: 1,011-1,079; P = 0,009) e PSAP (OR: 1,063, 95% CI: 1,005-1,124; P = 0,033) permaneceram independentemente associados com trombo localizado proximalmente na AP. CONCLUSÕES : Os resultados demonstraram associação significativa entre aumento da carga existente de embolia da AP e aumento dos níveis séricos da GGT.

Objective: In heart failure (HF) patients, functional capacity has been demonstrated to be a marker of poor prognosis, independent of left ventricular ejection fraction (EF). Lymphocyte count is currently recognized in certain risk stratification scores for chronic HF, and severe HF is associated with lymphocytopenia. However, no data exists on the association between lymphocyte count and functional capacity in patients with stable HF. This study aimed to assess the relationship between lymphocyte count and New York Heart Association (NYHA) functional capacity in systolic HF outpatients.

SUMMARYThis paper reports the clinic course of a patient with postinfarction ventricular septal defect (VSD). At the period to surgery, the patient received levosimendan for cardio-protection. During the levosimendan infusion, the hemodynamics of the patient worsened. The impairment of hemodynamics and mortality of the patient might be responded to the increase of the amount of left to right shunt, which had possibly occurred due to levosimendan treatment.Keywords: Levosimendan, acute myocardial infarction, ventricular septal defect, shuntÖZETBu yazı, akut miyokard infarktüsü sonrası ventriküler septal defekt (VSD) gelişen birhastanın klinik seyrini içermektedir. Cerrahiyi bekleme sürecinde, hastaya kardiyak koruma amacıyla levosimendan infüzyonu başlandı. İnfüzyon esnasında hastanın hemodinamisi kötüleşti. Hemodinamideki bozulmanın, levosimendan tedavisine sekonder soldan sağa şant miktarının artışına bağlı olabileceği düşünüldü.Anahtar sözcükler: Levosimendan, akut miyokard infarktüsü, ventriküler septal defekt, şant, Bu yazı, akut miyokard infarktüsü sonrası ventriküler septal defekt (VSD) gelişen birhastanın klinik seyrini içermektedir. Cerrahiyi bekleme sürecinde, hastaya kardiyak koruma amacıyla levosimendan infüzyonu başlandı. İnfüzyon esnasında hastanın hemodinamisi kötüleşti. Hemodinamideki bozulmanın, levosimendan tedavisine sekonder soldan sağa şant miktarının artışına bağlı olabileceği düşünüldü

WOS: 000310542300010, PubMed ID: 22983154, Background: Depression has been found to be a predictor of rehospitalization and mortality in heart failure (HF). Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in HF. Objective: We aimed to investigate the association of depression with serum PTH levels in patients with systolic HF. Methods: A total of consecutive 100 outpatients with systolic HF having left ventricular ejection fraction (LVEF) < 40%, were prospectively studied. All patients underwent laboratory tests, including brain natriuretic peptide (BNP) and PTH analyses. The patients were asked to complete the Beck Depression Inventory-II (BDI). Results: Fifty-one patients (51%) were shown to have poor BDI score (BDIS > 18). Patients with poor BDI score had significantly higher PTH levels compared to those with good BDIS (133 +/- 46 pg/ml vs. 71 +/- 26 pg/ml, p < 0.001). In multivariable logistic regression model, PTH level (Odds ratio (OR) = 1.035, p = 0.003), LVEF (OR = 0.854, p = 0.004), NYHA functional class III/IV (OR = 28.022, p = 0.005), C-reactive protein (CRP) (OR = 1.088, p = 0.020), and presence of pretibial edema (OR = 12.341, p = 0.033) were found to be independent predictors of moderate to severe depression after adjustment of other potential confounders. Conclusion: Systolic HF patients with moderate to severe depression had higher serum levels of PTH and CRP, poor functional status and lower LVEF. The association of depression with such parameters might explain the contribution of depression to hospitalization and mortality in HF. (Arq Bras Cardiol 2012;99(4):915-923)

WOS: 000307716100013, PubMed ID: 22641390, Background: Levosimendan, a calcium sensitizer, increases the sensitivity of the heart to calcium, thus increasing myocardial contractility without a rise in intracellular calcium. It was recently shown that levosimendan is beneficial in improving renal function. However, it remains to be established that the beneficial effect is differentially related to renal status during index event. Objective: The purpose of the current study was to determine whether levosimendan could improve renal outcome in acute decompensated heart failure patients with and without worsening renal function. Methods: Forty-five consecutive patients who had a reduced glomerular filtration rate and had at least two consecutive data regarding renal function prior to administration of levosimendan were enrolled in the study. Patients were classified into two groups as those with and without worsening renal function based on an increase in serum creatinine >0.3 mg/dL. Results: A significant improvement was noted in renal function in patients with worsening renal function (serum creatinine from 1.4 +/- 0.16 to 1.21 +/- 0.23 mg/dL, p=0.001 and glomerular filtration rate level from 48.9 +/- 15 to 59.3 +/- 21.8 mL/min/m(2), p=0.011), while there was no significant improvement in those without worsening renal function (serum creatinine from 1.29 +/- 0.33 to 1.37 +/- 0.66 mg/dL, p=0.240 and glomerular filtration rate level from 53.7 +/- 17.6 to 52.9 +/- 21.4 mL/min/m(2), p=0.850). Conclusion: Levosimendan appears to provide a renal-enhancing effect in patients with severe, acute decompensated systolic heart failure and worsening renal function. Consideration of this differential effect might help obtain beneficial renal outcomes. (Arq Bras Cardiol 2012;98(6):537-543)

WOS: 000288492000010, PubMed ID: 21243282, BACKGROUND AND AIM: The multi-drug resistant-1 (MDR-1) gene is located on human chromosome 7 and encodes a glycosylated membrane protein that is a member of the ATP-binding cassette transporters superfamily. The aim of the study was to reveal the role of the C3435T MDR-1 gene polymorphism in chronic obstructive pulmonary disease. METHOD: DNA samples from 41 patients with chronic obstructive pulmonary disease and 50 healthy control participants were used to compare MDR-1 gene profiles. Genotyping assays were performed using the StripAssay technique that is based on reverse-hybridization. RESULTS: The T allele polymorphism in the MDR-1 gene located at position 3435 in exon 26 was shown to correlate with chronic obstructive pulmonary disease. CONCLUSION: These preliminary results suggest that the T allele polymorphism of the MDR-1 gene is associated with chronic obstructive pulmonary disease.

Amaç: Çalışmamızın amacı akut koroner sendrom nedeniyle hastaneye kabul sırasındaki gama-glutamil transferaz (GGT) düzeyleri ile kalp yetersizliği nedeniyle hastaneye yatışlar arasında ilişki olup olmadığını araştırmaktır. Çalışma planı: Çalışmaya akut koroner sendrom ile başvurup ejeksiyon fraksiyonu (EF) %45’in altında olan 123 hasta alındı. Hastalar 15±10 ay takip edildi. Hastaların kabul sırasındaki GGT düzeyleri ile izleme süresinde kalp yetersizliği nedeniyle hastaneye yatışları arasındaki ilişki incelendi. Bulgular: İzleme süresi olan 15±10 ay içinde 23 hasta (%18.7) kalp yetersizliğine bağlı olarak hastaneye yatırıldı. ROC (receiver operating characteristics) eğrisi analizi yöntemi ile hastaneye yatışı öngördüren GGT kesim değeri 49 IU/L olarak saptandı (%81.7 duyarlılık ve %65.2 özgüllük). Tek değişkenli Cox orantısal risk analizinde, GGT düzeyinin >49 IU/L olması, hipertansiyon ve hiperlipidemi, sol ventrikül ejeksiyon fraksiyonu (SVEF), orta-ciddi mitral yetersizliği varlığı, alanin aminotransferaz seviyesi ve antitrombosit ilaç kullanımı anlamlı bulundu. Çok değişkenli Cox orantısal risk modelinde, kalp yetersizliği nedeniyle hastaneye yatış ile ilişkili bağımsız risk faktörleri olarak ilk kabul sırasında GGT >49 olması (risk oranı [RO] 2.663, p=0.047), hipertansiyon varlığı (RO 4.107, p=0.007) ve SVEF (RO 0.911, p=0.002) parametreleri saptandı. Sonuç: Akut koroner sendromlu hastalarda kabul GGT düzeyleri takipte kalp yetersizliğine bağlı hastaneye yatışlar ile ilişkilidir. Bu hastalar daha yakın takip edilmeli ve tedavileri optimal düzeyde ayarlanmalıdır. Objectives: Our aim was to determine whether there is a relationship between admission gamma-glutamyltransferase (GGT) and subsequent heart failure hospitalizations in pa- tients with acute coronary syndrome. Study design: We selected 123 patients with newly diag- nosed acute coronary syndrome of ejection fraction (EF) 49 IU/L on admission, presence of hyper- tension and hyperlipidemia, left ventricular ejection fraction (LVEF), right ventricular dysfunction, moderate-to-severe mitral regurgitation, alanine aminotransferase level, and antiplatelet agent usage were found to have prognostic sig- nificance in univariate Cox proportional hazards analysis. In multivariate Cox proportional-hazards model, increased GGT >49 IU/L on admission (hazard ratio [HR] 2.663, p=0.047), presence of hypertension (HR 4.107, p=0.007), and LVEF (HR 0.911, p=0.002) were found to be independent factors to predict new-onset heart failure requiring hospitalization. Conclusion: Hospitalization in heart failure was associated with increased admission GGT levels. Increased admission GGT level in acute coronary syndrome with heart failure should be monitored closely and treated aggressively.

YILMAZ, MEHMET BIRHAN/0000-0002-8169-8628; Turgut, Okan/0000-0002-6847-3029; YILMAZ, Mehmet Birhan/0000-0002-8169-8628; YILMAZ, MEHMET BIRHAN B/0000-0002-8169-8628; Zorkun, Cafer/0000-0002-6726-0478 WOS: 000338107900028 PubMed: 25075399 …