Sexual Functions Following Cardiac Resynchronization Therapy: Evaluation of Male Patients and Their Partners.

INTRODUCTION: Sexual functionality, a critical component of health-related quality of life, can decline for various reasons, including heart failure (HF). Our purpose was to prospectively evaluate male patients with HF scheduled for cardiac resynchronization therapy (CRT) in terms of sexual function, erectile function, and alterations in hormonal and biochemical parameters. In addition, we sought to determine the sexual functioning of the partners of these patients. METHODS:  The study enrolled 103 male patients and their partners. The International Index of Erectile Function-5 (IIEF-5) was administered to all males and the Arizona Sexual Experience Scale (ASEX) questionnaire was completed by all participants, at baseline and three months after CRT. RESULTS:  The ASEX scores of patients and partners demonstrated significant declines from baseline to post-intervention analysis. The IIEF-5 scores of patients showed a significant increase from baseline to post-intervention (p=0.001 for all). CONCLUSION:  We conclude that sexual dysfunction is experienced by the partners of male patients with erectile dysfunction before CRT and that reversal of erectile problems with CRT yields improvements in both male and female sexual functions.

Emergent surgical treatment of lethal valve dysfunction during pregnancy in a last-trimester patient.

A mechanical heart valve thrombosis during pregnancy is one of the most lethal conditions to experience due to its detrimental effects on both mother and fetus. Cardiac surgery during pregnancy is reserved for cases where medical treatment fails due to harmful maternal and fetal effects. A 24-year-old female in the 38th week of pregnancy was admitted to the emergency room with aggravated dyspnea, tachypnea, and palpitations. She had 2 previous cardiac operations in her medical history. A stuck mechanical valve was diagnosed in the mitral position via transthoracic echocardiography, which had resulted from her decision to cease taking warfarin when planning to become pregnant. In pregnant patients who have prosthetic mechanical valve thrombosis, surgical approach should be considered depending on the conditions of the mother and the baby. When emergency delivery of the baby is feasible, emergent surgical treatment should be utilized for patients who are in critical condition.

Assessment of the relationship between aortic stiffness and left ventricular functions with echocardiography in patients with Sjögren's syndrome.

BACKGROUND AND AIM: Capable of multi-organ involvement in Sjogren's syndrome (SS), cardiac findings of pulmonary effusion, left ventricular diastolic dysfunction and pulmonary hypertension are seen in patients with SS. Aortic stiffness (AS) reflects the mechanical tension and elasticity of the aorta. In this study, our aim is to determine if there is any differences in AS and left ventricular function between patients diagnosed as SS and healthy control groups. METHODS AND RESULTS: We enrolled 50 patients with SS and 47 healthy volunteers with similar demographic characteristics. It was found that isovolumetric relaxation time (IVRT) and deceleration time (DT) were significantly longer and early diastolic wave (E) was significantly lower in patients with SS, but there was no difference in the other parameters. When tissue Doppler echocardiography (TDE) findings were compared between the two groups, it was found that myocardial systolic wave (Sm), myocardial early diastolic wave (Em) and Em/Am ratio were significantly lower, and myocardial isovolumetric relaxation time (IVRTm) and myocardial performance index (MPI) values were significantly higher in patients with SS. A significant positive correlations between aortic strain and Sm (r = 0.35, P < 0.001), Em (r = 0.42, P < 0.001) and Em/Am (r = 0.26, P = 0.008) and negative correlations in IVRTm (r = -0.36, P < 0.001) and MPI (r = -0.24, P = 0.01) were detected. A significant positive correlation between aortic distensibility and Sm (r = 0.36, P < 0.001), Em (r = 0.44, P < 0.001), Em/Am (r = 0.26, P = 0.009) and negative correlation of IVRTm (r = -0.22, P = 0.02) were determined. CONCLUSION: There is a significant relationship between AS and left ventricular diastolic dysfunction in patients with SS in this study. The parameters of aortic elasticity measured by 2D echocardiographic methods can be beneficial in predicting early cardiovascular risk in SS.

Assessment of left ventricular functions in patients with Sjögren's syndrome using tissue Doppler echocardiography.

AIM: In our study, we aimed to evaluate left ventricular function in patients with Sjögren syndrome (SS) using tissue Doppler echocardiography (TDE) and myocardial performance index (MPI) in addition to conventional echocardiographic methods. METHODS: We evaluated 50 patients with SS and 48 healthy volunteers with similar demographic characteristics. Systolic and diastolic functions of the left ventricle were analyzed with standard two-dimensional (2D) echocardiography, M-mode echocardiography, pulsed-wave (PW) Doppler and tissue Doppler imaging. RESULTS: Septal part of the mitral annulus PW TDE showed that systolic myocardial wave (Sm), early diastolic myocardial wave (Em), late diastolic myocardial wave (Am) and Em/Am ratios are significantly lower, and myocardial isovolumetric relaxation time (IVRTm) and MPI values are significantly higher in patients with SS. Lateral site of the mitral annulus PW TDE showed that Em, Sm and Em/Am ratios are significantly lower, and IVRTm and MPI values are significantly higher in patients with SS compared with healthy controls. CONCLUSION: In this study, it was shown that both left ventricle systolic and diastolic functions of patients with SS were disturbed.