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BACKGROUND: Doxorubicin (DOX) is generally recognized to have important cardiotoxic side effects. Studies are contradictory about the interaction between hyperbaric oxygen (HBO2) therapy and doxorubicin-induced cardiomyotoxicity. Recent data suggests that HBO2 therapy can lead to preconditioning of myocardium while generating oxidative stress. Herein we have investigated the effect of HBO2 therapy in a DOX-induced cardiomyocyte injury animal model. METHODS: Twenty-one rats were divided into three equal groups as follows: 1) Group 1 is a control group (without any intervention), used for evaluating the basal cardiac structures and determining the normal value of cardiacs and serum oxidative markers; 2) Group 2 is the doxorubicin group (single dose i.p. 20 mg/kg doxorubicin) for detecting the cardiotoxic and systemic effects of doxorubicin; 3) Group 3 is the doxorubicin and HBO2 group (100% oxygen at 2.5 atmospheric for 90 minutes, daily), for evaluating the effect of HBO2 in doxorubicin induced cardiotoxicity. At the end of the protocols, the hearts were harvested and blood samples (2 ml) were obtained. RESULTS: The doxorubicin treated animals (Group 2) had increased oxidative stress markers (both cardiac and serum) and severe cardiac injury as compared to the basal findings in the control group. Nevertheless, the highest cardiac oxidative stress index was detected in Group 3 (control vs. Group 3, p = 0.01). However, histological examination revealed that cardiac structures were well preserved in Group 3 when compared with Group 2. CONCLUSIONS: Our results suggest that HBO2 preconditioning appears to be protective in the doxorubicin-induced cardiotoxicity model. Future studies are required to better elucidate the basis of this preconditioning effect of HBO2.
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BACKGROUND: Penetrating cardiac injury (PCI) has highly mortal outcome. Therefore, management of this emergency situation is extremely important. The present study is an investigation of main factors that can affect mortality and morbidity in PCI. METHODS: Records of 112 patients who were admitted to emergency department with PCI in the last decade were evaluated retrospectively. Demographic data, initial approach, transfer duration and conditions, vital status and findings, type of injury, localization, characteristics, and type of surgical application were recorded. RESULTS: Demographic findings (age, sex, cause of injury) were not found to be significant factors affecting mortality. Early mortality (1-week observation period) occurred in 14 (12.5%) patients. Method of transfer to hospital (under medical team supervision by ambulance, or without supervision), transfer duration, initial vital findings upon arrival (blood pressure, rhythm, breathing, consciousness), operation timing (elective or emergency), and injuries to additional organs were determined to be important predictors of survival. CONCLUSION: Cardiac injury is highly mortal emergency situation. Expert medical management is important for survival. However, basic first aid measures and immediate hospital transfer are as important as expert clinical management.
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Lesiones Cardíacas/epidemiología , Lesiones Cardíacas/terapia , Heridas Penetrantes/epidemiología , Heridas Penetrantes/terapia , Adulto , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Estudios Retrospectivos , Resultado del Tratamiento , Adulto JovenRESUMEN
INTRODUCTION: Hyperbaric oxygen (HBO) treatment is steadily increasing as a therapeutic modality for various types of diseases. Although good clinical outcomes were reported with HBO treatment for various diseases, the multisystemic effects of this modality are still unclear. This study aimed to investigate the renal effects of HBO experimentally. MATERIALS AND METHODS: Fourteen New Zealand White rabbits were divided into 2 groups randomly as the control group and the study group. The study group received HBO treatment for 28 days (100% oxygen at 2.5 atmospheres for 90 minutes daily) and the control group was used to obtain normal renal tissue of the animal genus. After the intervention period, venous blood samples were obtained, and renal tissue samples were harvested for comparisons. RESULTS: Normal histological morphology was determined with Masson trichrome staining and periodic acid-Schiff staining in the control group. Atrophic glomerular structures, vacuolated tubule cells, and degeneration were detected in the renal samples of the study group with Masson trichrome staining. Additionally, flattening was observed on the brush borders of the proximal tubules, and tubular dilatation was visualized with periodic acid-Schiff staining. The histopathologic disruption of renal morphology was verified with detection of significantly elevated kidney function laboratory biomarkers in the study group. CONCLUSIONS: Our findings suggests that HBO has adverse effects on renal glomerulus and proximal tubules. However, the functional effects of this alteration should be investigated with further studies.
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Oxigenoterapia Hiperbárica/efectos adversos , Riñón , Insuficiencia Renal , Animales , Modelos Animales de Enfermedad , Riñón/efectos de los fármacos , Riñón/patología , Riñón/fisiopatología , Pruebas de Función Renal/métodos , Conejos , Insuficiencia Renal/sangre , Insuficiencia Renal/etiología , Insuficiencia Renal/patología , Estadística como AsuntoRESUMEN
INTRODUCTION: Oesophagoscopy is usually a safe procedure to localise and remove ingested foreign bodies, however, unexpected complications may develop during this procedure. In this case report we discuss iatrogenic aortic injury, which developed during oesophagoscopy, and its immediate treatment. CASE REPORT: A six-year-old male patient was admitted to hospital with symptoms of having ingested a foreign body. Oesophagoscopy was carried out and the foreign body was visualised at the second constriction of the oesophagus. During this procedure, profuse bleeding occurred. Subsequently, a balloon dilator was placed to control bleeding in the oesophagus. Thoracic contrast tomography revealed thoracic aortic injury. Open surgical aortic repair was immediately carried out on the patient and the oesophageal hole was primarily repaired. The patient was discharged on postoperative day 15 with a total cure. CONCLUSION: Although oesophagoscopy is a safe, easily applied method, it should be kept in mind that fatal complications may occur during the procedure. This procedure should be done in high-level medical centres, which have extra facilities for managing complications.
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Aorta Torácica/lesiones , Perforación del Esófago/etiología , Esofagoscopía/efectos adversos , Cuerpos Extraños/cirugía , Enfermedad Iatrogénica , Lesiones del Sistema Vascular/etiología , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/cirugía , Aortografía/métodos , Oclusión con Balón , Niño , Angiografía por Tomografía Computarizada , Perforación del Esófago/diagnóstico por imagen , Perforación del Esófago/cirugía , Cuerpos Extraños/diagnóstico por imagen , Hemorragia/etiología , Humanos , Masculino , Técnicas de Sutura , Toracotomía , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico por imagen , Lesiones del Sistema Vascular/cirugíaRESUMEN
OBJECTIVE: Previous studies show that serum fibrinogen levels are established risk factors for coronary artery disease (CAD) and that serum albumin levels are of a higher specificity and sensitivity in ST-elevation myocardial infarction (STEMI). In this study, we sought to evaluate the association between fibrinogen to albumin ratio (FAR) and the extent and severity of CAD evaluated by TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries (SYNTAX) Score (SS) in patients with STEMI. METHODS: A total of 278 patients with STEMI were included in the study. FAR was calculated using specified variables. The extent and severity of CAD were evaluated using the SS. The patients were divided into low- (SS <22) and high- (SS ≥22) risk groups. A Spearman rank correlation coefficient analysis was used for the relationship between FAR and SS. The cutoff points for sensitivity and specificity of FAR in predicting SS were estimated by performing a receiver operator characteristic curve analysis. RESULTS: There were significant differences in the mean age (P=.016), admission serum albumin (P=.041), serum fibrinogen (P<.001), FAR (P<.001), and SS risk groups. Positive correlation was detected between FAR and SS (r=0.458, P<.001). A cutoff level of >87 FAR predicted SS (sensitivity, 70%; specificity, 70%), and an area under the curve of 0.758 serum fibrinogen and albumin level was an independent predictor for SS in patients with STEMI (b=0.039; 95% confidence interval, 0.016-0.062; P=.001 and b=-6.906; 95% confidence interval, -12.284 to -1.527; P=.013, respectively). CONCLUSION: In the present study, we showed that FAR is significantly related to SS in predicting the severity of CAD in patients with STEMI.
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Enfermedad de la Arteria Coronaria/sangre , Fibrinógeno/metabolismo , Infarto del Miocardio con Elevación del ST/sangre , Infarto del Miocardio con Elevación del ST/diagnóstico , Albúmina Sérica/metabolismo , Factores de Edad , Anciano , Enfermedad de la Arteria Coronaria/complicaciones , Stents Liberadores de Fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Intervención Coronaria Percutánea , Estudios Prospectivos , Factores de Riesgo , Infarto del Miocardio con Elevación del ST/terapia , Sensibilidad y EspecificidadRESUMEN
Chronic venous insufficiency (CVI) is a progressive inflammatory disease. Because of its inflammatory nature, several circulating markers were investigated for predicting disease progression. We aimed to investigate simple inflammatory blood markers as predictors of clinical class and disease severity in patients with CVI. Eighty patients with CVI were divided into three groups according to clinical class (grade 1, 2 and 3) and score of disease severity (mild, moderate and severe). The basic inflammatory blood markers [neutrophil, lymphocyte, mean platelet volume (MPV), white blood cell (WBC), platelet, albumin, D-dimer, fibrinogen, fibrinogen to albumin ratio, and neutrophil to lymphocyte ratio] were investigated in each group. Serum neutrophil, lymphocyte, MPV, platelet count, D-dimer and neutrophil to lymphocyte ratio levels were similar among the groups (Pâ>â0.05). Although the serum WBC levels were significant in the clinical severity groups (Pâ<â0.05), it was useless to separate each severity class. However, albumin, fibrinogen and the fibrinogen to albumin ratio were significant predictors of clinical class and disease severity. Especially, the fibrinogen to albumin ratio was detected as an independent indicator for a clinical class and disease severity with high sensitivity and specificity (75% sensitivity and 87.5% specificity for clinical class and 90% sensitivity and 88.3% specificity for disease severity). Serum fibrinogen and albumin levels can be useful parameters to determine clinical class and disease severity in patients with CVI. Moreover, the fibrinogen to albumin ratio is a more sensitive and specific predictor of the progression of CVI.
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Fibrinógeno/metabolismo , Albúmina Sérica/metabolismo , Insuficiencia Venosa/sangre , Insuficiencia Venosa/diagnóstico , Adulto , Biomarcadores/sangre , Plaquetas/metabolismo , Plaquetas/patología , Enfermedad Crónica , Progresión de la Enfermedad , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Humanos , Recuento de Leucocitos , Linfocitos/metabolismo , Linfocitos/patología , Masculino , Volúmen Plaquetario Medio , Persona de Mediana Edad , Neutrófilos/metabolismo , Neutrófilos/patología , Recuento de Plaquetas , Pronóstico , Estudios Prospectivos , Sensibilidad y Especificidad , Índice de Severidad de la Enfermedad , Insuficiencia Venosa/patologíaRESUMEN
OBJECTIVE: Deep venous thrombosis (DVT) is a life-threatening and morbid pathology. This study aimed to investigate the efficacy of an early thrombolysis procedure using a rotator thrombolysis device. METHODS: Sixty-seven patients with acute proximal DVT were enrolled in the study. Patients' data were recorded retrospectively. Initially, an infrarenal retrievable vena cava filter was placed through the femoral vein. Then, a rotator thrombolysis device and a thrombolytic agent injection were applied to the occluded segments of the deep veins by puncturing the popliteal vein. RESULTS: The identified reasons were trauma (43.3%), pregnancy (20.9%), undiagnosed (11.9%), major surgical operation (10.5%), immobilization (7.5%), and malignancy (5.9%). Immediate total recanalization was conducted in all patients, and the leg diameters returned to normal ranges in the early postoperative period. Hospital mortality or severe complications were not detected. CONCLUSION: New thrombolytic devices seem to reduce in-hospital mortality risks and may potentially decrease post-thrombotic morbidity.
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Vena Femoral , Fibrinolíticos/administración & dosificación , Vena Ilíaca , Terapia Trombolítica/instrumentación , Trombosis de la Vena/tratamiento farmacológico , Adulto , Estudios Transversales , Diseño de Equipo , Femenino , Vena Femoral/diagnóstico por imagen , Mortalidad Hospitalaria , Humanos , Vena Ilíaca/diagnóstico por imagen , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Flebografía , Vena Poplítea , Punciones , Estudios Retrospectivos , Factores de Riesgo , Terapia Trombolítica/efectos adversos , Terapia Trombolítica/mortalidad , Factores de Tiempo , Resultado del Tratamiento , Filtros de Vena Cava , Trombosis de la Vena/diagnóstico por imagen , Trombosis de la Vena/etiología , Trombosis de la Vena/mortalidad , Adulto JovenRESUMEN
OBJECTIVE: Ginseng is a traditional herbal medicinal product widely used for various types of diseases because of its cellular protective effects. Possible protective effects of ginseng were investigated in blood, cardiac and renal tissue samples and compared with common anti-aggregant agents in an animal ischaemia-reperfusion (I/R) model. METHODS: Twenty rats were equally divided into four different groups as follows: control group (I/R-induced group without drug use), group I (acetylsalicylic acid-administered group), group II (clopidogrel bisulfate-administered group), group III (ginsenoside Rb1-administered group). For the groups assigned to a medication, peripheral I/R was induced by clamping the femoral artery one week after initiation of the specified medication. After reperfusion was initiated, cardiac and renal tissues and blood samples were obtained from each rat with subsequent analysis of nitrogen oxide (NOx), malondialdehyde (MDA), paraoxonase 1 (PON1) and prolidase. RESULTS: NOx levels were similar in each group. Significant decrements were observed in serum PON1 levels in each group when compared with the control (p < 0.05). Serum MDA levels were significantly lower in groups II and III (p < 0.05). Ameliorated renal prolidase levels were detected in study groups (p < 0.05) and recovered cardiac prolidase levels were obtained in groups II and III (p < 0.05). CONCLUSION: These findings indicate that ginseng extracts may have a potential beneficial effect in I/R injury. However, more comprehensive studies are required to clarify the hypothetical cardiac, renal and systemic protective effects in reperfusion-induced oxidative damage.
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Aspirina/farmacología , Ginsenósidos/farmacología , Panax/química , Extractos Vegetales/farmacología , Inhibidores de Agregación Plaquetaria/farmacología , Sustancias Protectoras/farmacología , Daño por Reperfusión/prevención & control , Ticlopidina/análogos & derivados , Animales , Arildialquilfosfatasa/sangre , Biomarcadores/sangre , Clopidogrel , Dipeptidasas/sangre , Modelos Animales de Enfermedad , Arteria Femoral/cirugía , Ginsenósidos/aislamiento & purificación , Riñón/efectos de los fármacos , Riñón/metabolismo , Ligadura , Malondialdehído/sangre , Miocardio/metabolismo , Óxido Nítrico/sangre , Estrés Oxidativo/efectos de los fármacos , Fitoterapia , Extractos Vegetales/aislamiento & purificación , Plantas Medicinales , Sustancias Protectoras/aislamiento & purificación , Ratas , Daño por Reperfusión/sangre , Daño por Reperfusión/etiología , Ticlopidina/farmacologíaRESUMEN
Type A aortic dissection is an emergency condition that requires immediate surgery. Graft replacement of the ascending aorta is the main treatment for this disorder. However, after ascending aortic replacement, the dissection flap may progress to the distal side (to the descending aorta) and a new intimal tear may develop. In this study, we report on a 66-year-old woman who had a history of ascending aortic replacement six months earlier. She was admitted to hospital with a new onset of back pain. Computed tomography revealed a new dissection tear originating from the distal side of the subclavian artery orifice. Thoracic endovascular dissecting aneurysm repair (TEVDAR) was carried out on the patient. Additional complications were not observed in the postoperative period. Complete cure was provided and the patient was discharged on the fourth day after the operation. TEVDAR may be safe and effective in preventing progression of the aortic flap and the formation of a new intimal tear in type A aortic dissections. Optional hybrid interventions could ameliorate the outcomes in aortic dissection cases.
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Aneurisma de la Aorta Torácica/cirugía , Disección Aórtica/cirugía , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Anciano , Disección Aórtica/diagnóstico por imagen , Disección Aórtica/etiología , Aneurisma de la Aorta Torácica/diagnóstico por imagen , Aneurisma de la Aorta Torácica/etiología , Aortografía/métodos , Femenino , Humanos , Reoperación , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
BACKGROUND: The aim of this study was to compare the two different directions of tumescent solution delivery (from distal to proximal knee to the saphenofemoral junction [SFJ] or proximal to distal SFJ to the knee) in terms of differences in tumescent volume, number of punctures, and pain and comfort scores of patients. METHODS: A total of 100 patients were treated with endovenous laser ablation (EVLA) under local anesthesia between August 2013 and October 2013. These 100 patients were divided into two groups. In group 1, tumescent solution was delivered in a proximal to distal direction. In group 2, the tumescent solution was delivered in a distal to proximal direction. In each group, the great saphenous vein (GSV) diameter, delivered total energy, treated GSV length, delivered tumescent volume, number of punctures, and pain and comfort scores were recorded for each patient. RESULTS: All patients were treated unilaterally. EVLA was performed with 100% technical success in all patients. There was no difference statistically between group 1 and group 2 according to GSV diameter, delivered total energy, and treated GSV length. Average tumescent volume, number of punctures, and pain scores in group 2 were lower than in group 1 (p = 0.0001; p < 0.05). Also, the average comfort score was higher in group 2 than in group 1 (p = 0.0001; p < 0.05). CONCLUSIONS: We believe that delivering the tumescent solution in a distal to proximal direction increases the comfort of both patient and surgeon with lower tumescent volume during the EVLA of the GSV.
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Anestésicos Locales/administración & dosificación , Procedimientos Endovasculares/métodos , Terapia por Láser/métodos , Dolor/prevención & control , Vena Safena/cirugía , Várices/cirugía , Adulto , Procedimientos Endovasculares/efectos adversos , Femenino , Humanos , Terapia por Láser/efectos adversos , Masculino , Persona de Mediana Edad , Dolor/diagnóstico , Dolor/etiología , Dimensión del Dolor , Satisfacción del Paciente , Estudios Prospectivos , Punciones , Resultado del Tratamiento , Várices/diagnósticoRESUMEN
The aim of this study was to investigate whether anticoagulant and antiaggregant agents have protective effects against oxidative damage induced by peripheral ischemia-reperfusion (I/R). Groups were created as follows: control group, I/R group (sham group), I/R plus acetylsalicylic acid (Group I), I/R+clopidogrel (Group II), I/R+rivaroxaban (Group III), I/R+bemiparin sodium (Group IV), and I/R+enoxaparin sodium (Group V). In Groups I, II, III, IV, and V, drugs were administered daily for 1 week before I/R creation. Peripheral I/R was induced in the I/R groups by clamping the right femoral artery. The rats were sacrificed 1 hour after reperfusion. Nitrogen oxide levels, malondialdehyde (MDA) levels, paraoxonase-1 (PON1) activity, and prolidase activity were evaluated in both cardiac and renal tissues. There was no significant difference in nitrogen oxide levels between the groups. However, cardiac and renal MDA were significantly higher and PON1 activity was markedly lower in the I/R groups compared with the control group (p<0.05). Although elevated prolidase activity was detected in both the cardiac and renal tissue of the I/R groups, only the sham group and Group V had significantly higher renal prolidase activity (p<0.05). Group V had significantly higher cardiac MDA, PON1, prolidase levels, and renal prolidase activity compared with the sham group (p<0.05). Significant improvement in renal MDA levels was only observed in Group III, and marked improvement was observed in the cardiac MDA levels of Group II when compared with the sham group (p<0.05). Thromboprophylactic agents appear to provide partial or prominent protection against I/R injury.
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Anticoagulantes/uso terapéutico , Cardiotónicos/uso terapéutico , Daño por Reperfusión/tratamiento farmacológico , Animales , Anticoagulantes/farmacología , Arildialquilfosfatasa/metabolismo , Aspirina/farmacología , Aspirina/uso terapéutico , Cardiotónicos/farmacología , Clopidogrel , Dipeptidasas/metabolismo , Evaluación Preclínica de Medicamentos , Enoxaparina/farmacología , Enoxaparina/uso terapéutico , Arteria Femoral/patología , Heparina de Bajo-Peso-Molecular/farmacología , Heparina de Bajo-Peso-Molecular/uso terapéutico , Miembro Posterior/irrigación sanguínea , Riñón/efectos de los fármacos , Riñón/metabolismo , Masculino , Malondialdehído , Morfolinas/farmacología , Morfolinas/uso terapéutico , Miocardio/metabolismo , Óxido Nítrico/metabolismo , Estrés Oxidativo , Ratas Sprague-Dawley , Daño por Reperfusión/metabolismo , Rivaroxabán , Tiofenos/farmacología , Tiofenos/uso terapéutico , Ticlopidina/análogos & derivados , Ticlopidina/farmacología , Ticlopidina/uso terapéuticoRESUMEN
OBJECTIVE: Mesenteric arteries release C-type natriuretic peptide (CNP), which hyperpolarises vascular smooth muscle. We measured the levels of this peptide after inducing mesenteric ischaemia over a series of time intervals, so as to determine its predictive value in demonstrating the severity of ischaemia in a rat model. METHODS: A total of 32 rats were allocated to four groups containing eight rats each. Basal CNP reference levels were measured in the control group, which was not exposed to any intervention. In groups I, II and III, mesenteric ischaemia was induced over three, six and nine hours, respectively, and plasma CNP levels were measured afterwards. Mesenteric ischaemia was induced by clamping the superior mesenteric artery. RESULTS: In comparison with the controls (2.38 ± 0.18 pg/ml), CNP levels were relatively lower in group I (2.54 ± 0.42 pg/ml). However, significant increases in plasma CNP levels were observed over longer periods of ischaemia in group II, at 5.23 ± 0.22 pg/ml, and in group III, at 6.19 ± 0.67 pg/ml (p < 0.05). A significant direct relationship was determined between plasma CNP levels and prolonged intervals of mesenteric ischaemia (R = 0.56, p < 0.001). CONCLUSION: Measuring plasma CNP levels in patients with acute mesenteric ischaemia may be beneficial in estimating the time period over which the ischaemic injury has occurred.
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Isquemia Mesentérica/sangre , Péptido Natriurético Tipo-C/sangre , Animales , Isquemia Mesentérica/diagnóstico , Ratas , Ratas Sprague-Dawley , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
We analyzed cases of re-exploration for bleeding after 19,680 open heart operations performed between January 1995 and January 2009 to determine the risk factors for mortality and morbidity. Half of the 282 patients reexplored had nonsurgical causes of bleeding. The patients were grouped according to the timing of reoperation, early re-exploration being on the day of the operation. Mortality, total morbidity, and the need for transfusion of any blood product were compared between the early and late re-exploration groups. Most patients (77.7%) were reexplored early. Overall mortality was 8.5% (24 patients). Mortality, total morbidity, renal, gastrointestinal, neurologic and infectious complications, and low cardiac output differed significantly between the 2 groups. Significant predictors of mortality were old age, female sex, left ventricular dysfunction, noncoronary operations, and delayed reoperation. Predictors of morbidity were old age, preoperative dialysis, tobacco use, chronic lung disease, and delayed reoperation. No factors were found to be associated with the need for transfusion.
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Procedimientos Quirúrgicos Cardíacos/efectos adversos , Hemorragia Posoperatoria/cirugía , Adulto , Factores de Edad , Anciano , Transfusión Sanguínea , Procedimientos Quirúrgicos Cardíacos/mortalidad , Distribución de Chi-Cuadrado , Enfermedad Crónica , Femenino , Humanos , Modelos Logísticos , Enfermedades Pulmonares/complicaciones , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Hemorragia Posoperatoria/etiología , Hemorragia Posoperatoria/mortalidad , Diálisis Renal/efectos adversos , Reoperación , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores Sexuales , Fumar/efectos adversos , Factores de Tiempo , Resultado del Tratamiento , TurquíaRESUMEN
BACKGROUND: Mitral stenosis (MS) is a common cause of atrial fibrillation (AF). Oxidative stress and inflammation factors were shown to be involved in atrial remodeling. The study aim was to compare the oxidative parameters and prolidase activity in severe MS patients with and without AF. METHODS: The study population was comprised of 33 patients with MS and sinus rhythm (group I), 27 patients with MS and AF (group II), and 25 healthy controls (group III). Plasma prolidase activity, total antioxidant capacity (TAC), total oxidative status (TOS), and oxidative stress index (OSI) were determined. Additionally, we measured tissue TOS and TAC in patients with mitral valve replacement. RESULTS: TAC and OSI were higher, but TOS and prolidase were lower in patients with MS than control (all p <0.001). These parameters were similar in group I and group II (ANOVA p >0.05). Tissue TAC was significantly lower in group II than group I (0.015 +/- 0.01 vs. 0.026 +/- 0.01 mmol Trolox equiv/L, p = 0.014), tissue TOS was similar between groups I and II (0.24 +/- 0.06 vs. 0.22 +/- 0.05 mmol Trolox equiv/L, p = 0.161). Presence of AF was correlated with systolic blood pressure, left atrial diameter, plasma TAC, tissue TAC, plasma TOS, plasma OSI, and plasma prolidase activity. Tissue TAC level (beta = -0.435, p = 0.006) and left atrial diameter (beta = 0.460, p = 0.003) were independently related with presence of AF in patients with MS. CONCLUSIONS: This study suggested that the presence of AF in patients with severe MS may be associated with the plasma prolidase activity, tissue and plasma oxidative parameters.