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1.
Catheter Cardiovasc Interv ; 102(1): 56-63, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37172209

RESUMO

BACKGROUND: Aortocoronary dissection is a potentially serious complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We examined the incidence, mechanisms, treatment, and outcomes of aortocoronary dissection among 12,117 CTO PCIs performed between 2012 and 2022 in a large multicenter CTO PCI registry. RESULTS: The incidence of aortocoronary dissection was 0.2% (n = 27). Most aortocoronary dissections occurred in the right coronary artery (96.3%, n = 26). The baseline clinical characteristics of patients with and without aortocoronary dissection were similar, except for dyslipidemia, which was less common in patients with aortocoronary dissection (70.4% vs. 86.0%; p = 0.019). The retrograde approach was used more commonly among cases complicated by aortocoronary dissection (59.3% vs. 31.0%; p = 0.002). Technical (74.1% vs. 86.6%; p = 0.049) and procedural (70.4% vs. 85.2%; p = 0.031) success rates were lower among aortocoronary dissection cases, with a similar incidence of in-hospital major adverse cardiovascular events (3.7% vs. 2.0%; p = 0.541). Of the 27 patients with aortocoronary dissection, 19 (70.4%) were treated with ostial stenting and 8 (29.6%) were treated conservatively without subsequent adverse clinical outcomes. No patients required emergency surgery. Follow-up was available for 22 patients (81.5%): during a mean follow up of 767 (±562) days, the incidence of in-stent restenosis was 11.1% (n = 3). CONCLUSIONS: Aortocoronary dissection occurred in 0.2% of CTO PCIs performed by experienced operators, was associated with lower technical and procedural success, and was treated most commonly with ostial stenting. None of the patients required emergency cardiac surgery.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Fatores de Risco , Oclusão Coronária/diagnóstico por imagem , Oclusão Coronária/etiologia , Oclusão Coronária/terapia , Angiografia Coronária , Resultado do Tratamento , Sistema de Registros , Doença Crônica
2.
Clin Exp Hypertens ; 43(2): 169-174, 2021 Feb 17.
Artigo em Inglês | MEDLINE | ID: mdl-33028113

RESUMO

OBJECTIVE: Atherosclerosis is a chronic, progressive, inflammatory disease. Recognition of subclinical atherosclerotic vascular changes before clinical manifestation in an asymptomatic population is important for risk stratification and optimal management, which finally leads to the prevention of cardiovascular disease. We aimed to determine the risk of premature subclinical atherosclerosis by evaluating epicardial adipose tissue thickness (EATT) and arterial stiffness parameters in patients with ankylosing spondylitis (AS). METHODS: We performed a prospective study of 60 consecutive patients meeting modified New York criteria for AS compared to 60 controls matched for age and sex. Patients with traditional cardiovascular risk factors were excluded. Arterial stiffness parameters and EATT (examined via echocardiography) values of all patients and control groups were measured. RESULTS: There was no difference between basal characteristic and echocardiographic parameters in patients with AS and in the control group. EATT and pulse wave velocity (PWV) were higher in the AS patients compared to the control group. EATT was 5.74 ± 1.22 mm and 4.91 ± 1.21 mm (p < .001) and PWV was 9.90 ± 0.98 m/s and 6.46 ± 0.83 m/s (p = .009) in the AS and control groups, respectively. Also, PWV was significantly correlated with EATT, age, and central blood pressure in patients with AS. CONCLUSIONS: EATT and PWV, markers of atherosclerosis and cardiovascular disease, were significantly higher in patients with AS than the control group. In addition, in this study, it has been shown that there is a significant relationship between PWV and EATT in patients with AS.


Assuntos
Tecido Adiposo , Hipertensão , Pericárdio , Espondilite Anquilosante , Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/patologia , Aterosclerose/diagnóstico , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Biomarcadores , Pressão Sanguínea , Espessura Intima-Media Carotídea , Ecocardiografia/métodos , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/diagnóstico , Hipertensão/etiologia , Hipertensão/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pericárdio/diagnóstico por imagem , Pericárdio/patologia , Estudos Prospectivos , Análise de Onda de Pulso , Medição de Risco , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/fisiopatologia , Rigidez Vascular
3.
BMC Cardiovasc Disord ; 14: 130, 2014 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-25260530

RESUMO

BACKGROUND: Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that correlates with cardiac events. This study assessed the association between NLR and the presence of chronic coronary total occlusion (CTO). METHODS: The study population included 225 patients, a control group (n = 75), a coronary artery disease group (n = 75), and a CTO group (n = 75). NLR was compared in the three groups. RESULTS: NLR levels were significantly higher in the CTO than in the other two groups (p < 0.001). Bivariate correlation analysis showed a positive correlation between NLR and SYNTAX Score, and multivariate logistic regression analysis found that NLR was an independent predictor of CTO. ROC analysis showed that an NLR cut-off of 2.09 could distinguish between patients with and without CTO (AUC = 0.74; 95% CI, 0.68-0.81), with a specificity of 69.3% and a sensitivity of 61%. CONCLUSION: NLR may be useful as a marker of CTO.


Assuntos
Oclusão Coronária/imunologia , Linfócitos/imunologia , Neutrófilos/imunologia , Idoso , Área Sob a Curva , Estudos de Casos e Controles , Doença Crônica , Angiografia Coronária , Oclusão Coronária/sangue , Oclusão Coronária/diagnóstico por imagem , Feminino , Humanos , Modelos Logísticos , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Fatores de Risco
4.
Scand Cardiovasc J ; 48(4): 197-201, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24978862

RESUMO

INTRODUCTION: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a variety of clinical features. Cardiac involvement is present in more than half of the patients with SLE. Fragmentation of QRS (fQRS) is presumed marker of cardiovascular risk and has not been previously evaluated in SLE. METHODS: A total of 56 women previously diagnosed with SLE were recruited. In addition, a control group consisting of 51 healthy people was formed. QRS complexes were also evaluated in terms of fragmentations. All patients with SLE and control subjects underwent transthoracic echocardiographic examination. Erythrocyte sedimentation rate and C-reactive protein levels were also obtained. RESULTS: Frequency of fQRS was higher in patients with SLE (41% vs. 21%, p = 0.03). Left ventricular posterior wall thickness and mass index were higher in the patients with SLE. CRP levels and age were significantly higher, and disease duration was significantly longer in the fQRS(+) group (p = 0.02, 0.01, and 0.006, respectively). CONCLUSION: A careful cardiovascular evaluation and follow-up is essential to continuously improve survival in SLE. For this purpose, fQRS may be used for the early detection in patients with SLE.


Assuntos
Arritmias Cardíacas/etiologia , Sistema de Condução Cardíaco/fisiopatologia , Lúpus Eritematoso Sistêmico/complicações , Potenciais de Ação , Adulto , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/fisiopatologia , Biomarcadores/sangue , Sedimentação Sanguínea , Proteína C-Reativa/análise , Estudos de Casos e Controles , Ecocardiografia , Eletrocardiografia , Feminino , Humanos , Lúpus Eritematoso Sistêmico/sangue , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/fisiopatologia , Pessoa de Meia-Idade , Valor Preditivo dos Testes
5.
Ann Noninvasive Electrocardiol ; 19(4): 374-82, 2014 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24597863

RESUMO

OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic disease that affects many organ systems and manifests a broad spectrum of laboratory and clinical features. SLE patients have an increased risk of developing cardiovascular disease. The aim of this study was to evaluate inhomogeneities of repolarization by using Tpeak -Tend (Tp-e) interval and Tp-e/QT ratio were measured from the 12-lead surface electrocardiogram (ECG) in patients with SLE. MATERIAL AND METHOD: This study included 69 SLE patients (69 females; mean age 35.8 ± 10.2) and 57 control subjects (57 females; mean age 34.5 ± 8.9). Transthoracic echocardiographic examination was done in all participants. QT parameters, Tp-e intervals and Tp-e/QT ratio were measured from the 12-lead ECG. These parameters were compared between groups. RESULTS: No statistically significant difference was found between two groups in terms of basic characteristics. Diastolic function parameters were similar between the two groups (P > 0.05). In electrocardiographic parameters analysis, QT dispersion (QTd) and corrected QT dispersion (cQTd) were significantly increased in SLE patients compared the control group (49.5 ± 16.4 ms vs. 32.8±11.7 ms and 56.7 ± 19.5 ms vs. 36.4 ± 13.1 ms, all P value < 0.001). Tp-e interval and Tp-e/QT ratio were also significantly higher in SLE patients (82.8 ± 18.9 vs. 72.4 ± 17.6 and 0.22 ± 0.05 vs. 0.19 ± 0.05, P = 0.002 and P = 0.001, respectively). Tp-e interval and Tp-e/QT were positively correlated with disease duration (r = 0.29, P = 0.01 and r = 0.24, P = 0.04, respectively). CONCLUSION: Our study revealed that QTd, cQTd, Tp-e interval and Tp-e/QT ratio increased in patients with SLE. Also, Tp-e interval and Tp-e/QT were positively correlated with disease duration.


Assuntos
Sistema de Condução Cardíaco/fisiopatologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Adulto , Ecocardiografia , Eletrocardiografia , Feminino , Humanos
6.
Med Sci Monit ; 20: 2074-81, 2014 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-25351260

RESUMO

BACKGROUND: We investigated the relationship between peripheral neuropathy and parameters of arterial stiffness and carotid intima media thickness (CIMT) in patients with type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: The study included 161 patients (80 females and 81 males), 69 of whom had peripheral neuropathy. All patients underwent 24-h blood pressure monitoring, and arterial stiffness parameters were measured. The CIMT was measured using B-mode ultrasonography and patients also underwent transthoracic echocardiographic examination. RESULTS: Patients with peripheral neuropathy, compared with those without it, were older (54.68±8.35 years vs. 51.04±7.89 years; p=0.005) and had T2DM for longer periods (60 vs. 36 months; p=0.004). Glycated hemoglobin (HbA1c) values (8.55±1.85 mg/dL vs. 7.30±1.51 mg/dL; p<0.001), pulse wave velocity (PWV) (7.74±1.14 m/s vs. 7.15±1.10 m/s; p=0.001), CIMT (anterior 0.74±0.15 mm vs. 0.67±0.13 mm; p=0.01), and left ventricular mass (LVM) index (98.68±26.28 g/m2 vs. 89.71±19.70 g/m2; p=0.02) were all significantly increased in the group with peripheral neuropathy compared to the group without peripheral neuropathy. We determined that duration of diabetes, HbA1c, and LVM index were predictors of peripheral neuropathy. CONCLUSIONS: A significant relationship was found between diabetic neuropathy and increased PWV, a parameter of arterial stiffness, as well as CIMT, a marker of systemic atherosclerosis. Diabetic peripheral neuropathy may be a determinant of subclinical atherosclerosis in T2DM.


Assuntos
Artérias Carótidas/patologia , Neuropatias Diabéticas/patologia , Túnica Íntima/patologia , Rigidez Vascular , Monitorização Ambulatorial da Pressão Arterial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
8.
J Clin Ultrasound ; 42(4): 252-5, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24150976

RESUMO

A free-floating thrombus in the left atrium is very rare in mitral stenosis. Such a thrombus can lead to sudden circulatory arrest and syncope or can cause severe cerebral or peripheral thromboembolic events. Clinical diagnosis is difficult, but left atrial thrombus should be suspected if patients with mitral stenosis and atrial fibrillation have intermittent or changing murmurs, emboli, or syncope. We describe the case of a patient with mild mitral stenosis under warfarin therapy, and a left atrial pedunculated thrombus discovered during the investigation for syncope attacks.


Assuntos
Trombose Coronária/diagnóstico por imagem , Trombose Coronária/cirurgia , Idoso , Anticoagulantes/uso terapêutico , Fibrilação Atrial/complicações , Fibrilação Atrial/tratamento farmacológico , Trombose Coronária/complicações , Diagnóstico Diferencial , Ecocardiografia Transesofagiana/métodos , Feminino , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/cirurgia , Humanos , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/tratamento farmacológico , Síncope/complicações , Síncope/tratamento farmacológico , Varfarina/uso terapêutico
9.
Turk Kardiyol Dern Ars ; 42 Suppl 2: 56-67, 2014 Oct.
Artigo em Turco | MEDLINE | ID: mdl-25693363

RESUMO

Hypercholesterolemia is a major risk factor for atherosclerosis. Low-density lipoprotein cholesterol (LDL-C) lowering drugs reduce cardiovascular morbidity and mortality. However, many individuals treated with statins do not achieve their target levels of LDL-C. So, there is great need for new drugs to reduce cholesterol in those patients who have not achieved target levels with statins as well as those who are statin intolerant. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a novel agent, which plays an important role in the regulation of cholesterol metabolism. It increases degradation of the low-density lipoprotein receptor, modulates cholesterol metabolism, and transport. This review will address new therapeutic strategies targeting PCSK9, including monoclonal antibodies, small interfering RNAs, and other small molecule inhibitors.


Assuntos
Hipercolesterolemia/tratamento farmacológico , Pró-Proteína Convertases/metabolismo , Serina Endopeptidases/metabolismo , Anticorpos Monoclonais/uso terapêutico , Anticolesterolemiantes/uso terapêutico , LDL-Colesterol/sangue , Humanos , Hipercolesterolemia/sangue , Pró-Proteína Convertase 9
10.
Turk Kardiyol Dern Ars ; 41(6): 541-4, 2013 Sep.
Artigo em Turco | MEDLINE | ID: mdl-24104983

RESUMO

A 24-year-old female underwent implantation of a right-sided dual chamber permanent pacemaker for cardioinhibitory syncope with active fixation atrial lead. Five days after the procedure, the patient developed pleuritic chest pain and difficulty in breathing. Minimal pericardial effusion and right hemopneumothorax were found. The atrial active screw-in lead was visualized just above the right atrial appendage with its helix perforating the right atrial wall, pericardium and pleura, reaching the right mid-lobe. Lead extraction was performed, and a passive bipolar atrial lead was implanted during the same session without any problems.


Assuntos
Átrios do Coração/lesões , Traumatismos Cardíacos/etiologia , Marca-Passo Artificial/efeitos adversos , Implantação de Prótese/efeitos adversos , Adulto , Átrios do Coração/cirurgia , Traumatismos Cardíacos/cirurgia , Humanos , Adulto Jovem
11.
J Cardiovasc Dev Dis ; 10(7)2023 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-37504531

RESUMO

Background: Atrial fibrillation (AF) remains the most common arrhythmia following mitral valve surgery. Although numerous clinical and laboratory indicators and possible mechanisms of postoperative AF (PoAF) have been described, the role of microvascular dysfunction in pathogenesis has not been assessed. We aimed to evaluate the association between microvascular dysfunction and PoAF in patients undergoing isolated mitral valve replacement. Methods: 188 patients undergoing mitral valve replacement were included in this retrospective study. Demographic characteristics of the patients were recorded. Angiographic assessment of microvascular perfusion was performed using the myocardial blush grading technique for each patient. Univariate and multivariate logistic regression analyses were utilized to determine predictors of PoAF. Results: Of 188 patients (56.69 ± 8.9 years, 39.4% male) who underwent mitral valve replacement, 64 (34%) patients developed PoAF. In the PoAF group, a lower basal hemoglobin level (12.64 ± 0.89 vs. 14.46 ± 0.91 g/dL; p < 0.001), a higher left atrial diameter [5.9 (5.2-6.47) vs. 4.9 (4.5-5.8) cm; p < 0.001], and a lower total blush score (TBS) (8.33 ± 0.84 vs. 8.9 ± 0.31; p < 0.001) were detected. Multivariate logistic regression analysis revealed that preoperative LA diameter (OR:2.057; 95% CI: 1.166-3.63; p = 0.013), preoperative hemoglobin (OR:0.12; 95% CI: 0.058-0.245; p < 0.001), and abnormal TBS (OR:15.1; 95% CI: 1.602-142.339; p = 0.018) were independent predictors of PoAF. Conclusions: Our findings demonstrated that TBS at the preoperative period was an independent predictor of PoAF in patients undergoing isolated mitral valve replacement.

12.
Rev Assoc Med Bras (1992) ; 69(1): 78-84, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36629645

RESUMO

OBJECTIVE: Myocardial infarction has unfavorable effect on structural and functional properties of the myocardium, referred to as cardiac remodeling. Left ventricular mass, left ventricular mass index, and relative wall thickness are important predictors of cardiac remodeling. In this study, we investigated the effect of candesartan treatment in comparison with zofenopril treatment on echocardiographic indices of cardiac remodeling in post myocardial infarction patients. MATERIAL AND METHODS: In this prospective study, patients who underwent successful percutaneous coronary intervention were randomly assigned to a candesartan or zofenopril treatment. After randomization, echocardiographic indices of cardiac remodeling including left ventricular mass, left ventricular mass index, and relative wall thickness were evaluated before the start of treatment along with 1- and 6-month follow-ups. RESULTS: According to our study, candesartan group showed significant reduction of estimated left ventricular mass and left ventricular mass index at 6-month follow-up visit compared to baseline values (199.53±38.51 g vs. 212.69±40.82 g; 99.05 g/m2 (90.00-116.5) vs. 106.0 g/m2 (96.0∼123.00), p<0.05, respectively). This trend was also observed in zofenopril group during the 6-month period (201.22±40.07 g vs. 207.52±41.61 g; 101.0 g/m2 (92.25-111.75.0) vs. 104.50 g/m2 (95.0∼116.75), p<0.05, respectively). Although both classes of drugs had favorable effects on post-myocardial infarction cardiac remodeling, the absolute benefit was more prominent in candesartan group as compared to zofenopril group (p<0.05). CONCLUSION: Our results suggest that candesartan treatment following myocardial infarction may potentially be useful in terms of improving post-myocardial infarction cardiac remodeling.


Assuntos
Infarto do Miocárdio , Remodelação Ventricular , Humanos , Estudos Prospectivos , Infarto do Miocárdio/tratamento farmacológico , Ecocardiografia
13.
Am J Cardiol ; 206: 221-229, 2023 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-37717475

RESUMO

Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving in different parts of the world. We examined the clinical and angiographic characteristics and procedural outcomes of 1,079 consecutive CTO PCIs performed in 1,063 patients at 10 centers in the Middle East, North Africa, Turkey, and Asia regions between 2018 and 2022. The mean age was 61 ± 10 years and 82% of the patients were men. The prevalence of diabetes (49%) and previous PCI (50%) was high. The most common target vessel was the right coronary artery (51%), followed by the left anterior descending artery (33%) and the circumflex artery (15%). The mean Japanese CTO score was 2.1 ± 1.2 and mean PROGRESS-CTO (Prospective Global Registry for the Study of Chronic Total Occlusion Intervention) score was 1.2 ± 1.0. The technical and procedural success rates were high (91% and 90%, respectively) with a low incidence (1.6%) of in-hospital major adverse cardiac events. The incidence of perforation was 4.6% (n = 50): guidewire exit was the most common mechanism of perforation (48%) and 14 patients required pericardiocentesis (28%). Antegrade wire escalation was the most common crossing strategy used (91%), followed by retrograde approach (24%) and antegrade dissection and re-entry (12%). Median contrast volume, air kerma radiation dose, and fluoroscopy time were 300 (200 to 400) ml, 3.7 (2.0 to 6.3) Gy, and 40 (25 to 65) minutes, respectively. In conclusion, high success and acceptable complication rates are currently achieved at experienced centers in the Middle East, North Africa, Turkey, and Asia regions using a combination of crossing strategies.


Assuntos
Oclusão Coronária , Intervenção Coronária Percutânea , Masculino , Humanos , Pessoa de Meia-Idade , Idoso , Feminino , Turquia/epidemiologia , Intervenção Coronária Percutânea/efeitos adversos , Estudos Prospectivos , Resultado do Tratamento , Oclusão Coronária/diagnóstico , Oclusão Coronária/epidemiologia , Oclusão Coronária/cirurgia , Fatores de Risco , Ásia , Angiografia Coronária , África do Norte/epidemiologia , Sistema de Registros , Doença Crônica
15.
Med Princ Pract ; 20(5): 464-9, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21757938

RESUMO

OBJECTIVE: In this study, our aim was to evaluate the effect of a higher dose of atorvastatin on the recurrence rate of atrial fibrillation (AF) after electrical cardioversion (EC) in addition to antiarrhythmic therapy. SUBJECTS AND METHODS: 48 patients with persistent AF were included in this study. The patients were randomized to an atorvastatin 40-mg treatment group and a control group. Atorvastatin was started 3 weeks before EC and was continued for 2 months after EC. EC was performed using biphasic shocks after 3 weeks of treatment with the orally administered anticoagulant warfarin. Lipid and inflammatory parameters (high-sensitivity C-reactive protein, white blood cell count and fibrinogen level) were evaluated at the baseline and before EC. The endpoint of this study was electrocardiographically confirmed recurrence of AF of >10 min. RESULTS: There were no significant differences in baseline characteristics and lipid and inflammatory marker levels between the treatment and control groups. Total cholesterol and low-density lipoprotein levels were significantly decreased in patients taking atorvastatin for 2 months compared with baseline values (174 ± 31 vs. 129 ± 25 mg/dl, p = 0.001, and 112 ± 23 vs. 62 ± 20 mg/dl, p = 0.001, respectively), while no significant change occurred in control patients (168 ± 26 vs. 182 ± 29 mg/dl, p = 0.07, and 99 ± 18 vs. 108 ± 26 mg/dl, p = 0.1, respectively). At the end of the 2-month follow-up period, 9 patients (20.5%) experienced AF recurrence, and there was no significant difference in AF recurrence rate between the treatment and control groups (26 vs. 13%; p = 0.2). CONCLUSION: Atorvastatin therapy prior to EC does not prevent the recurrence of arrhythmia in patients with persistent AF who are receiving antiarrhythmic therapy.


Assuntos
Antiarrítmicos/administração & dosagem , Anticolesterolemiantes/administração & dosagem , Fibrilação Atrial/prevenção & controle , Cardioversão Elétrica/métodos , Ácidos Heptanoicos/administração & dosagem , Pirróis/administração & dosagem , Análise de Variância , Antiarrítmicos/uso terapêutico , Anticolesterolemiantes/uso terapêutico , Anticoagulantes/uso terapêutico , Atorvastatina , Fibrilação Atrial/tratamento farmacológico , Fibrilação Atrial/patologia , Proteína C-Reativa , Doença Crônica , Cardioversão Elétrica/instrumentação , Feminino , Fibrinogênio/análise , Indicadores Básicos de Saúde , Ácidos Heptanoicos/uso terapêutico , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pirróis/uso terapêutico , Prevenção Secundária , Fatores de Tempo , Varfarina/uso terapêutico
16.
Surg Radiol Anat ; 32(5): 437-45, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19953251

RESUMO

PURPOSE: We aimed to compare the myocardial bridges (MBs) both in the coronary angiography and cadavers. METHODS: Morphological (length, thickness, deepness, the angle between the long axis of vessel and location) and angiographic properties (length, degree of systolic obstruction, frequency) of the MBs were evaluated in 50 adult cadaver hearts and in 1,321 cineangiograms. RESULTS: Myocardial bridges were observed in 32 of the cadaver hearts (64%) and 100 of cineangiograms (7.57%). It was observed that MBs caused significant coronary stenosis in 34 of 100 individuals leading to the prevalence of significant MB to be (2.5%) in angiography. The MBs that are above the left anterior descending artery in cadaver were classified as superficial MB (77.4%) and deep MB (22.6%). In cineangiogram, the average length of MB (MBL) was determined as 10.32 +/- 4.62 mm. CONCLUSION: The presence of MB, MBL and degree of luminal narrowing were not associated with the age and gender. Deepness and thickness were a major determinant of significancy of systolic obstruction by MBs.


Assuntos
Cineangiografia/métodos , Angiografia Coronária/métodos , Ponte Miocárdica/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pesos e Medidas Corporais/métodos , Cadáver , Estenose Coronária/diagnóstico por imagem , Estenose Coronária/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ponte Miocárdica/complicações , Adulto Jovem
17.
Turk Kardiyol Dern Ars ; 38(2): 131-4, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20473018

RESUMO

Several studies have compared the efficacy of elective coronary artery stenting and coronary artery bypass grafting (CABG) in patients with unprotected left main coronary artery (ULMCA) disease. However, a definite reperfusion modality has yet to be established in ST-elevation myocardial infarction (STEMI) due to acute total occlusion of ULMCA, which has catastrophic clinical results. We presented five patients (3 males, 2 females; mean age 59 years; range 53 to 67 years) with acute anterior STEMI and angiographically documented acute total occlusion of ULMCA. On presentation, all the patients had chest pain and four patients were in cardiogenic shock. All the patients were taken to the catheterization room with minimum delay. Intra-aortic balloon counterpulsation was used during coronary angiography in all the patients. Three patients underwent PCI and, after balloon predilatation, bare-metal stents were implanted and TIMI III flow was achieved. One patient who had atrial fibrillation on admission died on the 14th day of hospitalization after PCI due to pump failure. After diagnostic coronary angiography, two patients were submitted to surgery for emergency CABG. They both died, one within two hours of admission during preparation of the surgical team, and the other on the third postoperative day. Both were in cardiogenic shock on admission.


Assuntos
Vasos Coronários/cirurgia , Infarto do Miocárdio/cirurgia , Idoso , Angiografia Coronária/métodos , Doença da Artéria Coronariana/etiologia , Doença da Artéria Coronariana/cirurgia , Vasos Coronários/fisiopatologia , Emergências , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/complicações , Taquicardia Ventricular/etiologia
18.
Adv Prev Med ; 2020: 4637043, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32908709

RESUMO

INTRODUCTION: Plasma neutrophil gelatinase-associated lipocalin (NGAL) levels in acute myocardial infarction (AMI) patients are markedly higher. In addition, plasma NGAL levels were increased in patients with acute and chronic heart failure as a complication of myocardial infarction. In this study, we investigated whether there is a difference between the prognostic use of plasma NGAL levels in ST-elevation myocardial infarction (STEMI) patients with preserved and reduced left ventricular ejection fraction (LVEF). METHODS: 235 consecutive STEMI patients were enrolled in the study. Patients were divided into groups according to LVEF. Plasma NGAL, troponin I, creatine kinase MB (CKMB), and C-reactive protein (CRP) were measured. Finally, the study population examined with 34 reduced LVEF and 34 preserved LVEF consisted of a total of 68 patients (12 females; mean age, 61.5 ± 14.7). All patients were followed up prospectively for 6 months. This study group was divided into two subgroups as the patients who died (n = 14) and survived (n = 34), and plasma NGAL levels of the groups were compared. RESULTS: The median of NGAL was 190.08 ng/ml. Age, troponin I, CKMB, CRP, glomerular filtration rate, and creatinine were higher in reduced LVEF groups. Plasma NGAL levels were also higher in reduced LVEF than in preserved LVEF, but statistically not significant (p=0.07). Plasma NGAL levels were significantly higher in death patients than in survived patients (p < 0.001). In ROC curve analysis, the level to detect isolated cardiovascular mortality with a sensitivity of 86% and a specificity of 77% was 190 ng/mL for NGAL. CONCLUSION: Plasma NGAL levels can be used to predict cardiovascular mortality in STEMI patients.

19.
J Clin Lipidol ; 14(3): 361-370.e2, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32423761

RESUMO

BACKGROUND: Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening disease due to high serum low-density lipoprotein (LDL) cholesterol levels. LDL cholesterol-lowering interventions are fundamental for patients with HoFH. OBJECTIVE: It was aimed to investigate the association between the mental status of patients with HoFH and healthy lifestyle behaviors. METHODS: This subgroup analysis of the A-HIT1 population included the data of patients aged ≥18 years with a clinical diagnosis of HoFH undergoing therapeutic LDL apheresis. Besides the demographic and clinical characteristics of patients, healthy lifestyle behaviors were assessed, and psychiatric symptoms were screened by Symptom Check List (SCL-90-R). RESULTS: The highest percentage for pathology was observed in dimensions of obsessive-compulsive, somatization, interpersonal sensitivity, and depression in SCL-90-R. Patients with any cardiovascular condition have more psychiatric symptoms in different fields of SCL-90-R. The outcomes of the correlative analysis indicated that lower the age of the first coronary event better the psychiatric status, probably denoting a better adaptation to disease and its treatment. Among 68 patients, 36 patients were not exercising regularly. Patients with regular physical activity had significantly lower scores in most dimensions of SCL-90-R and there was no association between regular physical activity and other investigated variables. The strongest predictor of regular exercising was global severity index of SCL-90-R. CONCLUSION: In the HoFH population, there was a high prevalence of mental disturbances. Better psychiatric status was associated with regular exercising. Therefore, assessing the mental status of patients with HoFH and referring patients in need, to a psychiatrist, may improve the outcome of patients.


Assuntos
Exercício Físico , Homozigoto , Hiperlipoproteinemia Tipo II/fisiopatologia , Hiperlipoproteinemia Tipo II/psicologia , Saúde Mental , Sistema de Registros , Inquéritos e Questionários , Adulto , Anticolesterolemiantes/uso terapêutico , LDL-Colesterol/sangue , Feminino , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Fenótipo
20.
Anatol J Cardiol ; 22(5): 240-249, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31674929

RESUMO

OBJECTIVE: Endocan, chemerin, and galectin-3 are discrete biomarkers associated with cardiovascular diseases and acting through different pathophysiological pathways. The aim of this study is to investigate and compare the effects of high doses of atorvastatin and rosuvastatin on serum endocan, chemerin, and galectin-3 levels in patients with acute myocardial infarction (AMI). METHODS: Sixty-three patients with AMI were randomized to receive atorvastatin (80 mg/day) or rosuvastatin (40 mg/day) after percutaneous revascularization. Serum levels of endocan, chemerin, and galectin-3 were evaluated at baseline and after 4-week therapy. RESULTS: Endocan levels were not decreased statistically significantly with atorvastatin 80 mg, but rosuvastatin 40 mg markedly decreased the levels of endocan according to baseline [from 110.27 (86.03-143.69) pg/mL to 99.22 (78.30-122.87) pg/mL with atorvastatin 80 mg and from 110.73 (77.28-165.22) pg/mL to 93.40 (70.48-115.13) pg/mL with rosuvastatin 40 mg, p=0.242 for atorvastatin 80 mg and p=0.014 for rosuvastatin 40 mg]. Chemerin levels significantly decreased in both groups according to baseline [from 264.90 (196.00-525.95) ng/mL to 135.00 (105.95-225.65) ng/mL with atorvastatin 80 mg and from 309.95 (168.87-701.27) ng/mL to 121.25 (86.60-212.65) ng/mL with rosuvastatin 40 mg, p<0.001, respectively, for both groups]. Galectin-3 levels did not change markedly with atorvastatin 80 mg, but they decreased with rosuvastatin 40 mg [from 17.00 (13.10-22.25) ng/mL to 19.30 (15.25-23.45) ng/mL with atorvastatin 80 mg, p=0.721, and from 18.25 (12.82-23.82) ng/mL to 16.60 (10.60-20.15) ng/mL with rosuvastatin 40 mg, p=0.074]. There were no significant between-group differences in terms of absolute and percentage changes of endocan, chemerin, and galectin-3 at 4 weeks. CONCLUSION: We reported that both statins similarly decreased the endocan levels, whereas rosuvastatin seems to have more prominent effects on the reduction of the chemerin and galectin-3 levels in patients with AMI.


Assuntos
Atorvastatina/farmacologia , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Infarto do Miocárdio/sangue , Rosuvastatina Cálcica/farmacologia , Angioplastia , Biomarcadores/sangue , Proteínas Sanguíneas , Quimiocinas/sangue , Quimiocinas/efeitos dos fármacos , Feminino , Galectina 3/sangue , Galectina 3/efeitos dos fármacos , Galectinas , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Proteínas de Neoplasias/sangue , Proteínas de Neoplasias/efeitos dos fármacos , Proteoglicanas/sangue , Proteoglicanas/efeitos dos fármacos , Resultado do Tratamento
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