Incremental value of live/real time three-dimensional transesophageal echocardiography over the two-dimensional technique in the assessment of a tuberculoma involving the left atrium and appendage.

Intracardiac tuberculomas are extremely rare, and cardiac involvement in tuberculosis accounts for only 0.5% of extrapulmonary tuberculosis. We report for the first time incremental value of live/real time three-dimensional transesophageal echocardiography over two-dimensional transesophageal echocardiography in the assessment of a tuberculoma involving the left atrium and left atrial appendage.

Assessment of Prognostic Value of Neutrophil to Lymphocyte Ratio and Platelet to Lymphocyte Ratio in Patients with Pulmonary Embolism.

BACKGROUND: Acute pulmonary embolism is a serious medical condition that has a substantial global impact. Inflammation plays a role in the pathophysiology and prognosis of acute pulmonary embolism (APE). The aim of the present study was to investigate the prognostic value of admission parameters for complete blood count (CBC) in APE. METHODS: A total of 203 patients who were hospitalized with diagnosed APE were retrospectively enrolled in the study. Clinical data, PESI scores, admission CBC parameters, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were all recorded. The clinical outcomes of study subjects were determined by the reported patient 30-day mortality and long-term mortality. RESULTS: During a median follow-up period of 20 months [interquantile range 17], 34 subjects in the study population (17%) died. NLR and PLR levels were significantly higher in patients who died within the 30 days (n = 14) [9.9 (5.5) vs. 4.5 (4.1), p = 0.01 and 280 (74) vs. 135 (75), p = 0.01, respectively] and during the long-term follow-up (n = 20) [8.4 (2.9) vs. 4.1 (3.8), p = 0.01 and 153 (117) vs. 133 (73), p = 0.03, respectively] when compared to the patients that survived. In Cox regression analysis, age, systolic blood pressure, systolic pulmonary arterial pressure, PESI scores (HR 1.02 95%CI 1.01-1.04, p = 0.01), elevated levels of NLR (HR 1.13 95%CI 1.04-1.23, p = 0.01) and PLR (HR 1.002 95%CI 1.001-1.004, p = 0.01) were independently correlated with total mortality. CONCLUSIONS: Admission NLR and PLR may have prognostic value in patients with APE.

Assessment of Short-term Blood Pressure Variability in Patients With Ascending Aortic Dilatation.

BACKGROUND: Blood pressure variability (BPV) is a novel parameter related to adverse cardiovascular findings and events, especially in hypertensive patients. The aim of the present study was to investigate the relationship between short-term BPV and ascending aortic dilatation (AAD). HYPOTHESIS: Hypertensive patients with AAD may exhibit higher short-term BPV compared to hypertensive patients with normal diameter ascending aorta and BPV may be correlated with aortic sizes. METHODS: Seventy-six hypertensive patients with AAD and 181 hypertensive patients with a normal-diameter ascending aorta were retrospectively enrolled in the study. Clinical data, echocardiographic characteristics, and 24-hour ambulatory blood pressure monitoring characteristics were compared between the 2 groups. Standard deviation (SD) and Δ of BP were used as parameters of BPV. RESULTS: Although 24-hour mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similar between the 2 groups, the SD of SBP and SD of DBP values were significantly higher in AAD patients (17.2 ± 6.8 vs 13.8 ± 3.5, P < 0.01; and 12.1 ± 5.1 vs 10.7 ± 3.1, P = 0.02, respectively). Daytime SD of SBP values were higher in AAD patients, whereas nighttime SD of SBP values did not differ between groups. In multivariate linear regression analysis, 24-hour SD of SBP, 24-hour Δ SBP, daytime SD of SBP, daytime Δ SBP, and left ventricular mass index were independently correlated with aortic size index. CONCLUSIONS: Our study revealed higher levels of short-term BPV in hypertensive patients with AAD. This conclusion warrants further study.

Assessment of electrocardiographic parameters in patients with electrocution injury.

BACKGROUND: Electrocution injury (EI) is a major problem in developing countries. The aim of this study is to investigate the effect of EI on electrocardiographic (ECG) parameters. METHODS: A total of 43 patients hospitalized with diagnosis of EI were prospectively enrolled. Admission ECGs were compared with follow-up ECGs obtained one month after the event. RESULTS: Maximum P wave duration (Pmax), minimum P wave duration (Pmin), P wave dispersion (PWD), PR interval, QRS complex duration, corrected QT duration (QTc), QT dispersion (QTD), T peak to T end (Tp-e) interval were longer and Tp-e interval/QT and Tp-e interval/QTc ratios were higher on admission ECGs compared to follow-up ECGs. Frontal QRS-T angle and frequency of patients with fragmented QRS were also higher on admission ECGs. CONCLUSION: Our study revealed that EI causes significant deterioration of admission ECG parameters. The clinical use of these parameters in prediction of arrhythmias after EI warrants further studies.