Evaluation of blood pressure response during dobutamine stress echocardiography in patients without cardiovascular diseases.

Dobutamine stress echocardiography (DSE) is a diagnostic tool for determining coronary artery disease. Considering hypotension and hypertension as important complications of DSE, we aimed to evaluate the blood pressure (BP) responses during DSE. Patients without known cardiovascular diseases who underwent DSE were included. We excluded patients who had hypertension, diabetes mellitus, a known history of cardiovascular diseases, and those taking vasoactive medications. Systolic (SBP) and diastolic (DBP) blood pressure were recorded at baseline and peak stress. We included 688 patients with an age of 57.9 ± 12.01 years. During DSE, SBP (+19.72 ± 26.51 mm Hg, p < 0.001), DBP (+5.52 ± 17.35 mm Hg, p < 0.001), and HR (+54.05 ± 22.45 bpm, p < 0.001) significantly increased from baseline to peak stress. The normal cut-off value was measured between 101-210 mm Hg for SBP and 50-121 mm Hg for DBP. According to this normal cutoff, 11 (1.3%) and 30 (4.4%) patients had hypotensive and hypertensive SBP and 15 (2.2%) and 21 (3.1%) patients had hypotensive and hypertensive DBP, respectively. The hypotensive response was correlated with baseline SBP (r = 0.6, p = 0.001) and atropine (r = -2.18, p = 0.043), and the hypertensive response was correlated with baseline SBP (r = 0.048, p < 0.001). Baseline BP and atropine consumption were the independent variables associated with the outside-the-normal range of blood pressure responses.

Successful Thrombolytic Therapy Using Ultraslow Low-Dose Infusion During Pregnancy for Mitral Mechanical Valve Thrombosis: A Case Series and Review of the Literature.

According to the modified World Health Organization (WHO) classification, pregnant women with mechanical valves face a very high risk of complications (Risk Category III). Mechanical valve thrombosis is a serious complication that significantly increases during pregnancy due to multiple mechanisms. Thrombolytic therapy has recently been used as a first-line treatment for mechanical valve thrombosis during pregnancy. However, the consensus regarding the optimal treatment strategy, type, dose and route of administration was unclear. We present three cases of mechanical mitral valve thrombosis during pregnancy treated successfully with repeated doses of ultraslow infusion of low-dose tissue-type plasminogen activator (t-PA) alteplase. We also present a review of the literature on this subject. LEARNING POINTS: Pregnancy in women with mechanical heart valves significantly increases the risk of maternal mortality or severe morbidity.Non-compliance with anticoagulant therapy and/or less frequent monitoring of therapeutic levels during pregnancy can result in serious complications such as valve thrombosis and thromboembolism.Thrombolytic therapy with low-dose tissue-type plasminogen activator can be an attractive alternative to surgical valve replacement and medical treatment in appropriately selected pregnant women with thrombosis of a mechanical valve.

The Effects of Urolithin B and Auraptene on Quinolinic Acid-induced Toxicity in the SH-SY5Y Neuroblastoma Cell Line.

The pathological accumulation of quinolinic acid (QA) is often associated with neuritis and neuronal cell death in several neurodegenerative diseases, through the overproduction of free radicals. Urolithin B and auraptene have been reported to exert potent antioxidant effects - however, little is known about the protective effects of these compounds against QA-induced neurotoxicity. Therefore, this study aimed to explore the in vitro protective effects of urolithin B and auraptene against QA-induced neurotoxicity in the SH-SY5Y neuroblastoma cell line. The MTT assay was used to evaluate cell viability, and flow cytometry was carried out to evaluate effects on the cell cycle and apoptosis. The intracellular levels of reactive oxygen species (ROS) were also determined. Our findings showed that auraptene at non-toxic concentrations had no protective effect on QA-induced toxicity. However, urolithin B at concentrations of 0.6 µM and 2.5 µM enhanced the viability of cells treated with QA. Moreover, while the percentage of apoptotic cells (i.e. in the sub-G1 phase) was shown to significantly increase after QA treatment, pre-treatment with urolithin B reduced the number of these apoptotic cells. Furthermore, urolithin B, as an antioxidant, also significantly reduced QA-induced ROS production. Our findings suggest that urolithin B may possess potent antioxidant and neuroprotective effects against QA-induced neurotoxicity that merit further investigation.