The effects of successful percutaneous mitral balloon valvuloplasty on acute and intermediate term aortic stiffness.

AIM: The aim of this study was to evaluate the effects of percutaneous mitral balloon valvuloplasty (PMBV) on short- and intermediate-term aortic stiffness in patients with mitral stenosis. MATERIALS AND METHODS: This prospective study included 56 patients with critical mitral stenosis in normal sinus rhythm (68% female; mean age: 42 ± 11 years) and 37 healthy controls. Aortic stiffness was measured using transthoracic echocardiography before PMBV, and 24-48 hours and 1 year post procedure. RESULTS: Aortic strain and distensibility were significantly higher in the patients with mitral stenosis, both after PMBV and 1 year post procedure, whereas the aortic stiffness index (ASI) was significantly lower. There was also a significant decrease in mitral mean gradient (MMG) and systolic pulmonary artery pressure (sPAP) after PMBV, based on echocardiography and catheterization. Mitral valve area (MVA) significantly increased after PMBV. There was a significant correlation between change in ∆MVA and ∆MMG and aortic elastic properties. There was a significantly negative correlation between the ∆MVA and ∆∆ aortic stiffness (r = -0.62, P < 0.001), and a significantly positive correlation between ∆MMG and ∆ASI (r = 0.60, P < 0.001). CONCLUSION: Mitral valve stenosis was associated with impaired aortic stiffness and following PMBV, aortic stiffness decreased during both the acute period and the intermediate period.

Determinants of iatrogenic femoral pseudoaneurysm after cardiac catheterization or percutaneous coronary intervention via the femoral artery.

OBJECTIVE: This study aimed to define the prevalence and predictors for pseudoaneurysm after coronary angiography, cardiac catheterization and percutaneous coronary interventions (PCIs) performed via the femoral artery. METHODS: The study included 8469 patients enrolled between January 2007 and December 2009 on whom cardiac catheterization, coronary and/or peripheral angiography and PCIs via the femoral artery were performed. All data, including clinical characteristics and complications, were obtained retrospectively from patient chart records. RESULTS: Pseudoaneurysm was detected in 65 (0.76%) patients. Pseudoaneurysm was ascertained more frequently in patients with a history of coronary artery disease (0.9% vs. 0.4%; p=0.012), in females than in males (1.4% vs. 0.5%; p<0.001), in patients older than 65 years (1.2% vs. 0.6%; p=0.002), in patients with a history of femoral artery intervention (1.2% vs. 0.6%; p=0.01), in hypertensives than in normotensives (1.3% vs. 0.5%; p<0.001), in patients taking low molecular weight heparin (1.0% vs. 0.2%; p<0.001), in patients taking clopidogrel (1.0% vs. 0.4%; p=0.007), and in patients with chronic renal disease (3.8% vs. 0.7%; p<0.001). There was no statistically significant trend (1.2% vs. 0.7%; p=0.053) towards more pseudoaneurysm formation in emergent interventions than in elective procedures. CONCLUSION: Patients with a higher risk of pseudoaneurysm development following intervention via the femoral artery should be specified and extra attention given during the intervention. These patients should be informed of the increased risk of this complication and its results, and should be under close follow-up concerning development of iatrogenic femoral pseudoaneurysm.

Spatial, temporal, and vertical variability of nutrients in the Southeastern Black Sea.

In this study, the nutrient concentrations along the coastal region of the Southeastern Black Sea were evaluated based on temporal, spatial, and vertical distributions. The water samples were collected seasonally in 2013 from 432 depths covering 55 stations. The nutrient concentrations showed significant spatial and temporal variations that declined abruptly from shore to offshore. The stations near the river discharge had the highest silicate, nitrate, and total dissolved inorganic nitrogen (DIN). The highest nitrate concentrations were determined within the oxycline layer and nitrite within the suboxic layer, while phosphate, ammonium, silicate, and DIN were within the anoxic layer. The findings of this study evinced that the Southeastern Black Sea possessed lower contents of nitrate (mean ± s.d., 0.58 ± 1.17 µM), phosphate (0.12 ± 1.00 µM), than the literature values reported for the western Black Sea, but consistent to the eastern Black Sea. However, the silicate concentrations of the study area were consistent with the western Black Sea while higher than the eastern Black Sea. The Trophic Index showed that two stations located on the coast of the Samsun and Giresun were at increased risk of eutrophication due to intensive urban and industrial inputs. This study provides detailed insights on the nutrient status of the coastal Southeastern Black Sea, which should facilitate the development of long-term monitoring programs concerning environmental aspects of marine and coastal planning.

Comparison of serum levels of inflammatory markers and allelic variant of interleukin-6 in patients with acute coronary syndrome and stable angina pectoris.

OBJECTIVES: Although the relationship between atherosclerosis and inflammatory cells has been recognized in recent years, the effect of interleukin-6 (IL-6) genetic variants associated with atherosclerosis is still controversial. Therefore, we investigated the association between IL-6 polymorphism and levels of IL-6 in patients with coronary artery disease (CAD). METHODS: We conducted a case-control study on 294 unrelated participants who were referred to the cardiology department of the university hospital for coronary angiography because of suspected ischemic heart disease. Group I comprised patients with clinically acute coronary syndrome, and group II comprised patients (individuals matched for age and sex) with clinically stable angina pectoris; both groups were categorized, based on their angiographic findings, as either having angiographically documented less extensive CAD (1 vessel narrowed) or extensive CAD (> or =2 vessels narrowed). They were studied to examine effect of the IL-6 gene variants in CAD. Genotyping was determined by polymerase chain reaction. RESULTS: The IL-6 G/C-174 polymorphism was found in 19 of 106 (18%) in group I and in four of 188 (2%) in group II (P<0.001). Median IL-6 levels were significantly higher in group I (6.7+/-13.6 pg/ml) than in group II (4.1+/-3.8 pg/ml) (P<0.05). In addition, high sensitivity C-reactive protein levels were significantly higher in group I (8.2+/-6.2 mg/dl) than in group II (4.6+/-3.4 mg/dl) (P<0.001). CONCLUSION: These results demonstrated that the presence of the IL-6 G/C-174 polymorphism and increased IL-6 and high sensitivity C-reactive protein levels are strongly associated with the inflammatory system and the course of clinical and hemodynamically significant CAD.