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1.
Exp Clin Transplant ; 18(Suppl 1): 60-63, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32008497

RESUMO

OBJECTIVES: Kidney transplant started at Baskent University Konya Hospital in July 2016. In this study, we compared the causes of brain death and the organ donation rates in our center between 2013 and 2016 versus between 2016 and 2019. MATERIALS AND METHODS: Patient files and records were analyzed retrospectively. Age, biologic sex, cause of brain death, and organ donation rates of patients diagnosed with brain death were examined and compared. RESULTS: The number of patients who were diagnosed with brain death and became deceased donors at our center increased 4-fold during the period from 2016 to 2019 compared with that shown from 2013 to 2016. In addition, organ donation rates increased to 71.4%, which is much higher than the average in Turkey (24%-28%). Between 2013 and 2016, trauma was the leading cause of brain death (42.8%), whereas between 2016 and 2019 cerebral hemorrhages rose to first place with a rate of 89.3%. In 2018 and 2019, there were 199 and 62 brain deaths, respectively, reported in our organ donation coordination region with an approximate organ donation rate of 25%. In our center, 12 patients were diagnosed with brain death in 2018 and 8 of these patients (66.7%) became donors; 6 brain deaths were diagnosed in 2019, and 4 patients (66.7%) became donors. Since we started kidney transplant at our center in 2016, the number of patients diagnosed with brain death has increased significantly. CONCLUSIONS: Establishing a healthy communication with relatives of patients and having a dedicated organ transplant center are important reasons for our much higher organ donation rates compared with the general rate in Turkey. A healthy communication is the most effective way to establish trust with next-of-kin and the general public.

2.
Aging Clin Exp Res ; 32(1): 93-98, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30707356

RESUMO

BACKGROUND: Hypertension is an important risk factor for cardiovascular diseases and cognitive function. Blood pressure (BP) variability has been associated with cognitive dysfunction, but data are sparse regarding the relationship between BP variability and cognitive function in geriatric patients with well-controlled BP. AIM: The aim of this study was to demonstrate the relationship between blood pressure variability and cognitive functions in geriatric hypertensive patients with well-controlled BP. METHOD: We analyzed 435 hypertensive patients (167 male, 74.9 ± 8.3; 268 female, 76.1 ± 8.6) treated at least with one antihypertensive drug. All patients underwent ambulatory BP monitoring and the standardized mini mental test (sMMT). RESULTS: We divided the weighted standard deviation (SD) of systolic BP (SBP) as a measure of BP variability into quartiles. The top quartile group (≥ 18.5 mmHg) had a significantly lower total sMMT score (23.3 ± 3.2, p < 0.001). According to the results of multivariate logistic regression analysis for sMMT, the SD of 24-h SBP was related to sMMT (p = 0.007, 95% confidence interval - 0.301 [- 0.370 to - 0.049]). DISCUSSION: Although there are some inconsistencies among the studies investigating the relationship between blood pressure variability and cognitive functions in elderly patients, we demonstrated the relationship between increased 24-h blood pressure variability and cognitive functions assessed with sMMT in geriatric population with well-controlled BP. CONCLUSION: The increased blood pressure variability was associated with poorer cognitive functions in geriatric hypertensive patients with well-controlled blood pressure.

3.
Angiology ; 71(1): 56-61, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31416325

RESUMO

The SYNTAX score (SS) and SS II, which include additional clinical parameters, are widely used today for deciding revascularization following coronary angiography. We investigated the association between the presence and severity of carotid artery disease (CrAD) using the SS and SS II in 287 patients who underwent coronary artery bypass grafting. We based this investigation on the known association between coronary artery disease and CrAD. A significant association was observed between the groups with and without CrAD in terms of SS II values (28.4 ± 9.6 vs 21.4 ± 7.7, respectively; P < .001). A significant difference was also observed when stenosis was classified according to severity as <50%, 50% to 70%, and >70% (P < .001). The results indicated a positive correlation between the presence and severity of CrAD as SS II increased (r = 0.187, P = .005). According to the results of multivariate logistic regression analysis, the SS II was an independent predictor of CrAD.


Assuntos
Estenose das Carótidas/diagnóstico por imagem , Angiografia Coronária , Ponte de Artéria Coronária , Doença da Artéria Coronariana/cirurgia , Ultrassonografia Doppler em Cores , Idoso , Estenose das Carótidas/complicações , Ponte de Artéria Coronária/efeitos adversos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Resultado do Tratamento
4.
Coron Artery Dis ; 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31658143

RESUMO

OBJECTIVE: Contrast-induced nephropathy (CIN) is among the serious complications of invasive cardiovascular procedures that are performed with the administration of contrast agents. We investigated the role of the inflammatory markers in predicting CIN in acute coronary syndrome patients. METHODS: This study included 232 consecutive patients with acute coronary syndrome who underwent emergency angiography at our center. RESULTS: There were 38 (19.1%) patients in the CIN group (mean age: 62.4 ± 10.2; 68.4% male), and 162 patients in the non-CIN group (mean age: 62.1 ± 11.5; 60.5% male). In the CIN positive group, serum gamma-glutamyl transferase (GGT) (P < 0.001), uric acid (P < 0.001), high sensitivity C-reactive protein (P < 0.001), the neutrophil-to-lymphocyte ratio (P = 0.02) were higher, whereas vitamin D (P < 0.001), hemoglobin (P < 0.001) and baseline glomerular filtration rate (P = 0.011) were lower compared with the CIN negative group. The receiver operating characteristic analysis showed that the cutoff point of GGT was 56 U/L for predicting CIN with a 84.2% sensitivity and a 72.2% specificity (area under the curve = 0.879, P < 0.001). The predictive value of GGT was the highest compared other inflammatory markers for CIN (area under the curve = 0.879). CONCLUSION: Our study showed that the levels of GGT, high sensitivity C-reactive protein, vitamin D, uric acid and neutrophil-to-lymphocyte ratio were the effective factors in development of CIN. The level of GGT was found as the most effective factor in prediction of the development of CIN.

5.
Medicine (Baltimore) ; 98(39): e17297, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574853

RESUMO

As a modifiable risk factor for cardiovascular disease, presence of hypertension (HT) necessitates the awareness of asymptomatic organ damage (AOD). The aim of this study was to measure plasma micro RNA-21 (miR-21) and the parameters that reflect AOD such as carotid intima-media thickness (CIMT), microalbuminuria (MAU) in hypertensive patients compared with healthy controls. In addition, the aim of this study was to evaluate plasma miR-21 levels in HT patients with AOD.This study was designed as a cross-sectional observational study. The study includes 2 groups: 32 patients with HT and 32 healthy controls. First, we compared these 2 groups. Then, to underline the relationship between plasma miR-21 and HT, hypertensive patients were divided into 2 groups: with AOD and without AOD.Sixteen patients with HT had AOD. MiR-21 levels significantly correlated with clinical systolic and diastolic blood pressure, MAU, C-reactive protein, and CIMT. CIMT, miR-21, and MAU levels were significantly higher in patients with AOD.Our study showed increased miR-21 levels in HT patients with AOD.


Assuntos
Albuminúria , Doenças Cardiovasculares , Hipertensão , MicroRNAs/sangue , Adulto , Albuminúria/diagnóstico , Albuminúria/etiologia , Doenças Assintomáticas/epidemiologia , Pressão Sanguínea/fisiologia , Proteína C-Reativa/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Espessura Intima-Media Carotídea , MicroRNA Circulante/análise , Correlação de Dados , Estudos Transversais , Feminino , Humanos , Hipertensão/complicações , Hipertensão/diagnóstico , Hipertensão/genética , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Turquia/epidemiologia
6.
Angiology ; 70(9): 860-866, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31170823

RESUMO

New-onset atrial fibrillation (NOAF) has been associated with poor outcome in patients with acute coronary syndromes (ACSs). The objective of this study was to investigate the relationship between the development of NOAF and severity of coronary artery disease using the SYNTAX score (SS) and SYNTAX score II (SSII) in patients with non-ST-segment elevation ACS (NSTE-ACS) who were treated with percutaneous coronary intervention (PCI). A total of 662 patients with NSTE-ACS were consecutively enrolled. The incidence of NOAF was 11.4% among the patients with NSTE-ACS. Mean age was significantly higher in NOAF group (P = .011). White blood cell count, peak troponin I, high sensitivity C-reactive protein, uric acid, left atrial volume index, and ratio between early mitral inflow velocity and mitral annular early diastolic velocity were significantly higher in NOAF group (respectively, P = .024, P = .017, P = .002, P = .009, P = .025, P < .001, and P < .001). The hemoglobin, ejection fraction, and post PCI thrombolysis in myocardial infarction grade <3 were significantly lower in NOAF group (P = 001, P = .010, P = .038). The SS and SSII were significantly higher in NOAF group (all P < .001). According to the results of multivariate logistic regression analysis, the SSII was correlated with NOAF (P < .001) in the study groups. We demonstrated that high SSII is significantly associated with NOAF.


Assuntos
Síndrome Coronariana Aguda/etiologia , Fibrilação Atrial/etiologia , Doença da Artéria Coronariana/etiologia , Infarto do Miocárdio/etiologia , Síndrome Coronariana Aguda/complicações , Adulto , Fatores Etários , Idoso , Fibrilação Atrial/terapia , Proteína C-Reativa/metabolismo , Doença da Artéria Coronariana/complicações , Feminino , Humanos , Contagem de Leucócitos/métodos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Intervenção Coronária Percutânea/métodos
7.
Int J Mol Sci ; 19(12)2018 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-30501029

RESUMO

(1) To investigate the role of azurocidin, an antimicrobial protein, in patients with ST segment elevation myocardial infarction (STEMI). (2) This single-center prospective observational study included patients with STEMI and healthy age- and sex-matched control subjects. Baseline demographic, clinical and biochemical data were compared between the two groups. Azurocidin levels at baseline were determined using an enzyme-linked immunosorbent assay. Multivariate linear regression analysis with enter method was used to test the association between azurocidin and independent variables, such as the thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score, global registry of acute coronary events score, Killip class, C-reactive protein (CRP), and creatinine kinase-myocardial band (CK-MB). (3) A total of 76 patients with STEMI and 30 healthy control subjects were enrolled in the study. Mean ± SD azurocidin levels were significantly higher in patients compared with healthy controls (18.07 ± 13.99 versus 10.09 ± 5.29 ng/mL, respectively). In a receiver-operating characteristic curve analysis, an azurocidin cut-off level of >11.46 ng/mL had 74% sensitivity and 58% specificity in predicting myocardial infarction. Azurocidin levels had a positive correlation with TIMI score (r = 0.651). In multivariate linear regression analysis, the TIMI score was an independent predictor of the azurocidin level. (4) Azurocidin is an infection marker that may be important in patients with STEMI.


Assuntos
Peptídeos Catiônicos Antimicrobianos/sangue , Proteínas de Transporte/sangue , Inflamação/sangue , Infarto do Miocárdio com Supradesnível do Segmento ST/sangue , Idoso , Biomarcadores , Proteínas Sanguíneas , Ecocardiografia , Feminino , Humanos , Inflamação/patologia , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Estudos Prospectivos , Curva ROC , Infarto do Miocárdio com Supradesnível do Segmento ST/patologia
8.
Thorac Surg Clin ; 28(3): 415-428, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30054079

RESUMO

Recognizing and acting early on airway compromise reduces morbidity and mortality in patients with airway obstruction. Causes include foreign bodies, toxic/hot fumes, difficult intubation, laryngeal spasm, and tumors. Before definitive control of the airway is possible, provide 100% oxygen with a tightly fitting mask to optimize body oxygen stores. Pulse oximetry is a poor indicator of airway compromise; a decreasing arterial hemoglobin oxygen saturation is a late sign of impending hypoxemia. Basic airway maneuvers improve the patency of an obstructed airway. Getting help from an anesthetist early is a priority.


Assuntos
Obstrução das Vias Respiratórias/terapia , Obstrução das Vias Respiratórias/etiologia , Humanos , Intubação Intratraqueal/efeitos adversos , Reflexo/fisiologia , Fenômenos Fisiológicos Respiratórios , Sistema Respiratório/anatomia & histologia , Traqueia/anatomia & histologia
9.
Angiology ; 69(2): 158-163, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28592149

RESUMO

Syntax score (SS) and Gensini score (GS) are used to determine the complexity and severity of coronary artery disease. Although there are some studies indicating the individual relationship of these scoring systems with the carotid intima-media thickness (cIMT) and epicardial fat tissue (EFT), there was no previous study that compared the SS and GS in that respect. We aimed to assess the relationship of SS and GS with predictors of atherosclerosis. We enrolled 522 patients. There were positive correlations between GS and SS tertiles with cIMT and EFT. According to multivariate linear regression analysis for GS, EFT (ß: 0.035, t: 2.63, and P = .49) and cIMT (ß: 0.339, t: 2.97, and P = .053) were not independently associated. For SS, EFT (ß: 0.009, t: 6.5, and P = .006) and cIMT (ß: 1.2, t: 10.1, and P = .001) were independently and significantly associated. We showed that the SS is significantly associated more with surrogate markers of atherosclerosis such as EFT and cIMT than the GS.


Assuntos
Aterosclerose/diagnóstico , Biomarcadores/análise , Doença da Artéria Coronariana/diagnóstico , Pericárdio/diagnóstico por imagem , Tecido Adiposo/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/etiologia , Espessura Intima-Media Carotídea/estatística & dados numéricos , Doença da Artéria Coronariana/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Índice de Gravidade de Doença
10.
J Int Med Res ; 46(3): 1121-1129, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29198139

RESUMO

Objective The vessels involved in the microcirculation are too small to be visualized by conventional angiography and no tools are currently available that can directly evaluate the coronary microcirculation. This study evaluated the coronary clearance frame count (CCFC) in patients with cardiac syndrome X (CSX). Methods The retrospective study enrolled patients with angina, who had a positive nuclear imaging test and normal coronary angiography; and a control group consisting of patients who underwent an angiogram to exclude coronary artery disease. Thrombosis in myocardial infarction frame count (TFC) and CCFC for each coronary artery (left anterior descending coronary artery [LAD], circumflex coronary artery [CFX] and right coronary artery [RCA]) were calculated offline. Results A total of 71 patients with CSX and 61 control patients were enrolled in the study. No significant differences were found between the two groups regarding the baseline demographic and clinical variables. The TFC of LAD, CFX and RCA were similar between the two groups. The mean CCFC-LAD, CCFC-CFX and CCFC-RCA were significantly longer in the CSX group compared with the control group. Conclusion CCFC is a simple, quantitative and highly reproducible method that might be used as a marker of coronary microvascular dysfunction.


Assuntos
Angiografia Coronária/métodos , Vasos Coronários/diagnóstico por imagem , Angina Microvascular/diagnóstico por imagem , Infarto do Miocárdio/diagnóstico por imagem , Trombose/diagnóstico por imagem , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/fisiologia , Estudos de Casos e Controles , Vasos Coronários/fisiopatologia , Feminino , Humanos , Masculino , Microcirculação/fisiologia , Angina Microvascular/fisiopatologia , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Estudos Retrospectivos , Trombose/fisiopatologia
11.
Turk Kardiyol Dern Ars ; 45(8): 702-708, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29226890

RESUMO

OBJECTIVE: The pathophysiological mechanism of in-stent restenosis (ISR) is different from atherosclerosis of native coronary arteries. The aim of this study was to evaluate the relationship between ISR and the extent of coronary artery disease (CAD), and to identify other risk factors associated with ISR in ST-segment elevation myocardial infarction (STEMI) patients. METHODS: A total of 372 consecutive patients presenting with first acute STEMI who were successfully treated with primary percutaneous coronary intervention within 12 hours from the onset of symptoms and who had an angiographic follow-up at 3 months were included in the study. The extent of CAD was calculated using the Gensini score. RESULTS: The incidence of ISR observed in our group of patients was 23.4% (n=87). The mean Gensini score was significantly higher in patients with ISR when compared with group without restenosis (69 [range: 51-90] vs 42 [range: 32-61]; p<0.001). The presence of diabetes mellitus, left ventricular ejection fraction (LVEF), and low-density lipoprotein cholesterol (LDL-C) level differed significantly between the 2 groups (p<0.05 for all). Stent diameter and stent length were found to be significantly different between the ISR group and the no-restenosis group (p<0.05 for both). In multivariate logistic regression analysis, the Gensini score, stent diameter, stent length, LVEF, and LDLC were independently associated with ISR. CONCLUSION: Despite the differences in the underlying pathophysiological mechanism of ISR and native coronary atherosclerosis, patients with a greater extent of CAD should be considered candidates for future stent restenosis.


Assuntos
Doença da Artéria Coronariana , Reestenose Coronária , Infarto do Miocárdio , Idoso , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/cirurgia , Reestenose Coronária/complicações , Reestenose Coronária/epidemiologia , Reestenose Coronária/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/epidemiologia , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Estudos Retrospectivos
12.
Korean Circ J ; 47(6): 929-938, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29171209

RESUMO

BACKGROUND AND OBJECTIVES: Functional capacity varies significantly among patients with heart failure with reduced ejection fraction (HFrEF), and it remains unclear why functional capacity is severely compromised in some patients with HFrEF while it is preserved in others. In this study, we aimed to evaluate the role of pulmonary artery stiffness (PAS) in the functional status of patients with HFrEF. METHODS: A total of 46 heart failure (HF) patients without overt pulmonary hypertension or right HF and 52 controls were enrolled in the study. PAS was assessed on parasternal short-axis view using pulsed-wave Doppler recording of pulmonary flow one centimeter distal to the pulmonic valve annulus at a speed of 100 mm/sec. PAS was calculated according to the following formula: the ratio of maximum flow velocity shift of pulmonary flow to pulmonary acceleration time. RESULTS: PAS was significantly increased in the HFrEF group compared to the control group (10.53±2.40 vs. 7.41±1.32, p<0.001). In sub-group analysis of patients with HFrEF, PAS was significantly associated with the functional class of the patients. HFrEF patients with poor New York Heart Association (NYHA) functional capacity had higher PAS compared those with good functional capacity. In multivariate regression analysis, NYHA class was independently correlated with PAS. CONCLUSION: PAS is associated with functional status and should be taken into consideration as an underlying pathophysiological mechanism of dyspnea in patients with HFrEF.

14.
Med Princ Pract ; 26(5): 447-450, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28965111

RESUMO

OBJECTIVE: The purpose of this study was to assess the impact of the presence of peripheral arterial disease (PAD) on left ventricular (LV) function in patients with coronary artery disease (CAD) presenting with acute coronary syndrome (ACS). SUBJECTS AND METHODS: The medical records of the patients who were referred to Ankara Bayindir Hospital, Ankara, Turkey, due to a first episode of ACS were reviewed. Patients with concomitant PAD and CAD (group 1) were compared with those who had CAD only (group 2). The Mann-Whitney U and χ2 tests were used to compare continuous and categorical variables, respectively. RESULTS: Baseline demographic data of 53 patients with PAD + CAD (42 men and 11 women; mean age 62.5 ± 9.5 years) and a group of 60 patients with CAD only (41 men and 19 women; mean age 59.9 ± 9.8 years) were similar, except for the serum creatinine level which was higher in group 1 than in group 2 (1.32 ± 0.34 vs. 1.03 ± 0.22 mg/dL, p < 0.001). Patients with CAD + PAD had significantly higher Gensini scores (62.6 ± 19.7 vs. 41.4 ± 26.8, p = 0.004) and more 3-vessel disease than patients with CAD alone (62.2 vs. 31.6%, p < 0.045). There was a significant difference between the 2 groups regarding the LV ejection fraction at the time of the diagnosis (52.0 ± 8.2% in the CAD + PAD group and 43.7 ± 13.3% in the CAD-alone group; p = 0.017). CONCLUSION: CAD concomitant with PAD was associated with preserved LV function at early stages of diagnosis in patients with ACS.


Assuntos
Síndrome Coronariana Aguda/fisiopatologia , Doença da Artéria Coronariana/fisiopatologia , Doença Arterial Periférica/fisiopatologia , Função Ventricular Esquerda/fisiologia , Síndrome Coronariana Aguda/epidemiologia , Idoso , Doença Crônica , Comorbidade , Doença da Artéria Coronariana/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Hipertensão/epidemiologia , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença , Fumar/epidemiologia , Turquia
15.
Interv Neuroradiol ; 23(6): 636-643, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28956512

RESUMO

Background Cerebral vasospasm (CV) is a major cause of delayed morbidity and mortality in patients with subarachnoid hemorrhage (SAH). Various cerebral protectants have been tested in patients with aneurysmal SAH. We aimed to research the success rate of treatment of CV via intra-arterial milrinone injection and aggressive pharmacological therapy for refractory CV. Methods A total of 25 consecutive patients who received intra-arterial milrinone and nimodipine treatment for CV following SAH between 2014 and 2017 were included in the study. Patients who underwent surgical clipping were excluded. Refractory vasospasm was defined as patients with CV refractory to therapies requiring ≥3 endovascular interventions. Overall, six patients had refractory CV. Long-term neurological outcome was assessed 6-18 months after SAH using a modified Rankin score and Barthel index. Results The median modified Rankin scores were 1 (min: 0, max: 3) and Barthel index scores were 85 (min: 70, max: 100) From each vasospastic territory maximal 10-16 mg milrinone was given to patients; a maximum of 24 mg milrinone was given to each patient in a session and a maximum of 42 mg milrinone was given to a patient in a day. Both milrinone and nimodipine were given to three patients. There was a large vessel diameter increase after milrinone and nimodipine injections. No patient died due to CV; only one patient had motor dysfunction on the right lower extremity. Conclusion Higher doses of milrinone can be used effectively to control refractory CV. For exceptional patients with refractory CV, high dose intra-arterial nimodipine and milrinone infusion can be used as a rescue therapy.


Assuntos
Milrinona/administração & dosagem , Nimodipina/administração & dosagem , Hemorragia Subaracnóidea/complicações , Vasodilatadores/administração & dosagem , Vasoespasmo Intracraniano/tratamento farmacológico , Vasoespasmo Intracraniano/etiologia , Angiografia Digital , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Quimioterapia Combinada , Feminino , Humanos , Infusões Intra-Arteriais , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento , Vasoespasmo Intracraniano/diagnóstico por imagem
16.
Turk Kardiyol Dern Ars ; 45(4): 348-354, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28595205

RESUMO

OBJECTIVE: Atherosclerosis can contribute to renovascular disease, and high cholesterol level is an independent risk factor for disease progression. Renal frame count (RFC) is an objective angiographic method of measuring macrovascular blood flow in the main renal artery and its segmental branches. The aim of the present study was to demonstrate relationship between serum lipid parameters and RFC. METHODS: In this cross-sectional study, 116 hypertensive patients were allocated into 2 groups according to serum low-density lipoprotein (LDL) levels. Group 1 comprised 60 patients with LDL <130 mg/dL and Group 2 consisted of 56 individuals with LDL ≥130 mg/dL. The patients were also divided into 2 groups according to total cholesterol (TC) levels (52 patients in group with TC <200 mg/dL and 64 patients in group with TC ≥200 mg/dL). RESULTS: Group 2 had higher mean RFC than Group 1 (p<0.001). RFC of both kidneys in Group 2 was significantly higher than results in Group 1 (p<0.001 and p=0.023, respectively). We found similar significant results in comparison of TC-based patient groups. RFC had positive correlation with smoking, TC, and LDL (r=0.326, p=0.035; r=0.393, p=0.010; and r=0.386, p=0.012, respectively). In multivariate linear regression analysis, LDL, TC, smoking, and creatinine clearance were independent predictors of RFC. CONCLUSION: In conclusion, in hypertensive patients with normal renal function, LDL, TC, and smoking may be predictors of RFC and aggressive risk factor modification may help to reduce the risk of renal failure.


Assuntos
Hipertensão , Rim , Lipoproteínas LDL/sangue , Idoso , Angiografia , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Hipertensão/sangue , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Rim/irrigação sanguínea , Rim/diagnóstico por imagem , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Artéria Renal/diagnóstico por imagem , Artéria Renal/fisiopatologia
17.
J Heart Valve Dis ; 26(1): 22-31, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28544828

RESUMO

Aortic regurgitation (AR) is characterized by the backflow of blood from the aorta to the left ventricle. Acute AR typically causes severe pulmonary edema and hypotension, and is a surgical emergency. In chronic AR, however, compensatory mechanisms can clinically compensate for years, with normal left ventricular function and no symptoms. While the hemodynamic mechanisms of chronic AR on the left ventricle are well described, the hemodynamic mechanisms of acute AR are not clear. Most of the literature on acute AR includes either small series or case reports. During the past decade the number of transcatheter aortic valve replacements (TAVRs) performed has increased dramatically, and TAVR is now an accepted treatment option for patients with severe aortic stenosis who are not surgical candidates or are at high risk for surgery. However, potential acute mild to severe AR occurring after TAVR seems a new and common cause of AR. Since more than mild AR increases the risk of mortality, the quantification of AR severity is a major challenge after TAVR. More accurate, reproducible and quantitative criteria need to be developed to assess and highlight the unknowns of acute AR. Information relating to the pathophysiology and hemodynamics of acute AR and TAVR-related acute AR, respectively, are collated in this review.


Assuntos
Insuficiência da Valva Aórtica , Estenose da Valva Aórtica , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Substituição da Valva Aórtica Transcateter , Valva Aórtica , Hemodinâmica , Humanos , Desenho de Prótese , Fatores de Risco , Resultado do Tratamento
18.
Cardiol J ; 24(4): 364-373, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28353313

RESUMO

BACKGROUND: Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder among reproductive-aged women. It is known to be associated with cardiovascular diseases. The aim of this study was to determine and compare the echocardiographic data of patients according to the phenotypes of PCOS. METHODS: This study included 113 patients with PCOS and 52 controls. Patients were classified into four potential PCOS phenotypes. Laboratory analyses and echocardiographic measurements were performed. Left ventricular mass was calculated by using Devereux formula and was indexed to body surface area. RESULTS: Phenotype-1 PCOS patients had significantly higher homeostasis model assessment - insu-lin resistance (HOMA-IR) (p = 0.023), free testosterone (p < 0.001), LDL cholesterol levels (p < 0.001) and free androgen index (p < 0.001) compared with the control group. There were significant differences between groups regarding the septal thickness, posterior wall thickness, Left ventricular ejection frac-tion, E/A ratio and left ventricular mass index (for all, p < 0.05). PCOS patients with phenotype 1 and 2 had significantly higher left ventricular mass index than the control group (p < 0.001). In univariate and multivariate analyses, PCOS phenotype, modified Ferriman-Gallwey Score and estradiol were found as variables, which independently could affect the left ventricular mass index. CONCLUSIONS: This study showed that women in their twenties who specifically fulfilled criteria for PCOS phenotype-1 according to the Rotterdam criteria, had higher left ventricular mass index and decreased E/A ratio, which might be suggestive of early stage diastolic dysfunction. (Cariol J 2017; 24, 4: 364-373).


Assuntos
Ecocardiografia Doppler , Síndrome do Ovário Policístico/complicações , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda , Adulto , Biomarcadores/sangue , Glicemia/análise , Estudos de Casos e Controles , LDL-Colesterol/sangue , Estudos Transversais , Diástole , Estradiol/sangue , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Modelos Lineares , Análise Multivariada , Fenótipo , Síndrome do Ovário Policístico/sangue , Síndrome do Ovário Policístico/diagnóstico , Síndrome do Ovário Policístico/fisiopatologia , Valor Preditivo dos Testes , Fatores de Risco , Testosterona/sangue , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia , Adulto Jovem
19.
Anatol J Cardiol ; 17(6): 483-489, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28315571

RESUMO

OBJECTIVE: We aimed to evaluate the relationship of micronucleus (MN) frequency and nuclear division index (NDI) with SYNTAX and Gensini scores and thrombolysis in myocardial infarction (TIMI) frame counts of coronary arteries in patients undergoing coronary angiography. METHODS: In a single-center prospective observational study, a total of 63 individuals, 48 consecutive patients with coronary artery disease (CAD) and 15 healthy people were included. Before coronary angiography (exposure to X-ray), blood samples were collected for lymphocyte cultures, MN and NDI measurements. According to the SYNTAX and Gensini scores, patients were allocated into two groups. Group 1 and 2 included the patients with SYNTAX scores <22 and ≥22 points, respectively. Similarly, groups according to Gensini scores included the ones <23 and ≥23 points. MN test was used for in vitro studies in human peripheral lymphocytes. Binucleated lymphocytes were calculated for each patient. RESULTS: MN frequency was significantly higher in group 2 than group 1 and in group 1 than control group (p<0.001). NDI was significantly higher in control group than group 1 and in group 1 than group 2 (p=0.003). MN frequency had positive but moderate correlation with SYNTAX and Gensini scores and TFCs of left anterior descending (LAD), circumflex and right coronary arteries (r=0.394, p=0.003; r=0.458, p<0.001; r=0.425, p<0.001; r=0.469, p<0.001; and r=0.475, p<0.001, respectively). CONCLUSION: We can conclude that as the degree of atherosclerosis increases and coronary flow worsens, MN frequency increases and NDI decreases. Our results may help to elucidate the relationship of DNA damage in pathophysiology of atherosclerosis and endothelial dysfunction in patients with stable CAD.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Índice de Gravidade de Doença , Estudos de Casos e Controles , Divisão do Núcleo Celular , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
20.
Int. j. cardiovasc. sci. (Impr.) ; 30(1): f:32-l:41, jan.-fev. 2017. tab, graf
Artigo em Português | LILACS | ID: biblio-833655

RESUMO

Fundamento: Até o momento, diversos escores de risco baseados em pacientes foram estabelecidos para a predição de mortalidade em pacientes com infarto do miocárdio com supradesnivelamento do segmento ST (IAMCSST). O escore de Gensini foi originalmente desenvolvido para quantificar a gravidade de doença arterial coronariana (DAC). Objetivos: Avaliar a associação entre a gravidade de DAC avaliada pelo escore de Gensini e mortalidade intra-hospitalar em pacientes com IAMCSST submetidos à intervenção coronária percutânea primária (ICP-P). Métodos: Foram incluídos 539 pacientes com IAMCSST, submetidos à ICP-P dentro das primeiras 12 horas do início dos sintomas. A gravidade da DAC foi expressa como a soma do escore de Gensini para cada lesão. Variáveis demográficas, anamnese e características clínicas dos pacientes, bem como eventos hospitalares significativos, foram obtidos de relatórios médicos. Resultados: Dos 539 pacientes, 416 (77,2%) eram do sexo masculino, e a idade média era 59,14 ± 12,68 anos. A taxa de mortalidade intra-hospitalar foi de 5,4% (29 pacientes, 16 homens). A taxa de mortalidade foi de 10,5% em pacientes do sexo feminino e 3,8% em pacientes do sexo masculino (P=0,004). Os escores de Gensini médios mostraram-se significativamente diferentes na comparação entre pacientes que sobreviveram (54,54 ± 26,34) e aqueles que foram a óbito (80,17 ± 26,51) (P = 0,001). O modelo de análise multivariada de regressão de Cox de risco proporcional revelou que o escore de Gensini (P = 0,037), o sexo feminino (P = 0,039), níveis séricos de ureia (P = 0,041), níveis de ácido úrico (P = 0,008) e FEVE (P = 0,001) estavam independentemente associados à mortalidade intra-hospitalar em pacientes com IAMCSST submetidos à ICP-P. Conclusões: O escore de Gensini está independentemente associado à mortalidade intra-hospitalar em pacientes com IAMCSST tratados com ICP-P. Portanto, o escore pode ter um papel importante na estratificação de risco de pacientes com IAMCSST


Background: To date, several validated patient-based risk scores have been established to predict mortality and morbidity in patients presenting with ST-segment elevation myocardial infarction (STEMI). The Gensini score was originally developed to quantify the severity of coronary artery disease (CAD). Objectives: We intend to assess the association between severity of CAD assessed by Gensini score and in-hospital mortality in patients with STEMI undergoing primary percutaneous coronary intervention (P-PCI). Methods: A total of 539 patients presenting with acute STEMI, who underwent P-PCI within the first 12 hours from the onset of symptoms, were included. The severity of CAD was expressed as the sum of the Gensini scores for each lesion. Patients' demographic variables, medical histories and clinical features, as well as in hospital major adverse events were obtained from the medical reports. Results: Of these 539 patients, 416 (77.2%) were male and mean age was 59.14 ± 12.68 years. In-hospital mortality rate was 5.4% (29 patients; 16 men). Mortality rate was 10.5% in female patients and 3.8% in males (P = 0.004). Mean Gensini scores were significantly different in the comparison between patients who survived (54.54 ± 26.34) and those who died (80.17 ± 26.51) (P = 0.001). The multivariable Cox proportional hazards regression analysis model revealed that the Gensini score (P = 0.037), female gender (P = 0.039), serum urea levels (P = 0.041), uric acid levels (P = 0.008) and LVEF (P = 0.001) were independently associated with in-hospital mortality in patients with STEMI undergoing P-PCI. Conclusion: The Gensini score is independently associated with in-hospital mortality in STEMI patients treated with P-PCI. Therefore, it might play an important role in risk stratification of STEMI patients


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Interpretação Estatística de Dados , Mortalidade Hospitalar , Infarto do Miocárdio , Intervenção Coronária Percutânea/métodos , Angiografia Coronária/métodos , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/diagnóstico , Análise Multivariada , Estudos Retrospectivos , Fatores de Risco
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