Vitamin D Düzeyinin İnvaziv Elektrofizyolojik Parametrelere ve Atriyal Fibrilasyon İndüklenebilirliği’ne Etkisi

Deficiencies of Vitamin D (VitD) has been associated with coronary heart disease, hypertension and left ventricular hypertropy. However its effects on cardiac conduction system and atrial fibrillation (AF) predisposition have not been studied yet. In this study we aim to evaluate the effects of VitD on invasive electrophysiologic parameters and AF inducibility. Materials and Methods: This retrospective crosssectional study included 135 patients. Study population was divided into three group as VitD sufficient, VitD insufficient and VitD deficient according to baseline vitD levels. Patients’ invasive electrophysiologic parameters and induced AF episodes were recorded. Results: Corrected sinus node recovery time, baseline cycle length, atrial-His interval, His-ventricular interval and Wenckebach cycle length were lengthened in vitD deficient group but they didn’t reach statistical significance. The rate of AF inducibility was twice as likely in VitD deficient group than sufficient group, however, it also didn’t reach statistical significance. Conclusion: Baseline VitD levels were not associated with cardiac electrophysiologic parameters and AF inducibility. To demonstrate the role of VitD in cardiac conduction system and AF inducibility thoroughly, further studies such as addressing VitD replacement are warranted.Amaç: Vitamin D (vit D) eksikliği, koroner kalp hastalığı, hipertansiyon ve sol ventrikül hipertrofisi ile ilişkili bulunmuştur. Ancak kardiyak iletim sistemi ve atriyal fibrilasyon (AF) yatkınlığına etkisi henüz araştırılmamıştır. Bu çalışmada, VitD'nin invaziv elektrofizyolojik parametreler ve AF indüklenebilirliği üzerindeki etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: Bu retrospektif kesitsel çalışma 135 hastayı içermektedir. Çalışma popülasyonu, temel vitD düzeylerine göre VitD yeterli, VitD yetersiz ve VitD eksikliği olmak üzere üç gruba ayrıldı. Hastaların invaziv elektrofizyolojik parametreleri ve uyarılan AF epizodları kaydedildi. Bulgular: Düzeltilmiş sinüs nodu iyileşme zamanı, bazal döngü uzunluğu, atriyal-His aralığı, His-ventriküler aralık ve Wenckebach siklus uzunluğu, vitD eksikliği olan grupta uzamış, ancak istatistiksel olarak anlamlı bulunmamıştır. AF indüklenebilirlik oranı, VitD eksikliği olan grupta, yeterli gruba göre iki kat daha fazlaydı., ancak istatistiksel olarak anlamlı değildi. Sonuç: Bazal VitD seviyeleri kardiyak elektrofizyolojik parametreler ve AF indüklenebilirliği ile ilişkili değildi. VitD'nin kardiyak iletim sistemindeki rolünü ve AF'nin indüklenebilirliğini tam olarak göstermek için VitD replasmanını da içeren daha ileri çalışmalar gereklidir

Postoperatif Kalıcı Kalp Pili İmplantasyonu

[No abstract available

Hipertiroidiye bağlı geri dönüşümlü birinci derece atriyoventriküler blok

Hyperthyroidism often causes tachyarrhythmias. Reversible atrioventricular block caused by hyperthyroidism is a rare occurrence. In this paper a case of atrioventricular block due to hyperthyroidism that recovered after antithyroid drug treatment has been presented.Hipertiroidi çoğunlukla taşiaritmilere neden olmak-tadır. Hipertiroidiye bağlıgeri dönüşümlüatriyoventriküler (AV) blok nadirdir. Bu yazıda, hipertiroidizmin neden olduğu ve antitiroid tedaviyle düzelen atriyoventriküler bloklu olgu sunuldu

The association between thrombotic and inflammatory biomarkers and lower-extremity peripheral artery disease

Lower-extremity peripheral artery disease (LEAD) is associated with increased rates of mortality and morbidity. The aim of this study was to evaluate the associations among inflammatory and thrombotic markers and lower-extremity peripheral disease. A total of 280 patients were enrolled in this study. Of these patients, 152 patients had LEAD on peripheral angiography that was performed because of suspected lower-extremity peripheral disease based on history, physical examination, and non-invasive tests. The control group consisted of 128 patients without LEAD on peripheral angiography. Patients with LEAD were classified according to trans-atlantic inter-society consensus (TASC) II classification. Subsequently, patients in TASC A to B were defined as having mild to moderate peripheral artery disease, and those in TASC C to D were defined as having advanced peripheral artery disease. Thrombotic and inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the high-sensitivity C (hs-C) reactive protein level, the monocyte-to-high-density lipoprotein-cholesterol ratio, the fibrinogen to albumin ratio (FAR), and whole-blood viscosity at high shear rate (HSR) and low shear rate (LSR), were evaluated in this population. The NLR, the monocyte-to-high-density lipoprotein-cholesterol ratio, the FAR, and whole-blood viscosity, both at a LSR and a HSR, were significantly higher in patients with lower-extremity peripheral disease compared with patients without lower-extremity peripheral disease. We determined that lower-extremity peripheral disease severity was correlated with the NLR, monocyte-to-high-density lipoprotein-cholesterol ratio, FAR, whole-blood viscosity at LSR, and whole-blood viscosity at HSR (r = 0.719, P =.004; r = 0.25, P =.008; r = 0.691, P =.002; r = 0.546, P <.001; and r = 0.448, P =.001, respectively). However hs-C reactive protein levels were similar between patients with or without LEAD (2.47 ± 1.32 1.61 ± 0.91 P =.685). In addition, there was no correlation between the severity of LEAD and hs-C reactive levels. In this study, we determined that the levels of inflammatory and thrombotic biomarkers are elevated in peripheral artery disease, and these levels predict disease severity. © 2020 Medicalhelplines.com Inc and John Wiley & Sons Lt

Safen Ven Greft Perkütan Koroner Girişimlerinde İlaç Kaplı Stentlerle Çıplak Metal Stentlerin Uzun Dönem Sonuçları: Tek Merkez Deneyimi

Objective: There is controversery data about the use of drug-eluting stents versus bare-metal stents in saphenous vein graft lesions. Our purpose was to compare the outcomes of patients receiving drug-eluting stents or bare-metal stents in saphenous vein graft percutaneous coronary interventions. Material and Method: All patients undergoing saphenous vein graft percutaneous coronary intervention with a drug-eluting stent or bare-metal stent alone from January 2013 to December 2017 at our center were assessed retrospectively. Major adverse cardiac events including myocardial infarction, target vessel revascularization and death were recorded at follow up period. Results: Ninety two patients included the study. Of these,72 patiens received a drug eluting stent and 20 patients had a bare metal stent. The median follow-up was 29 (range 0-66) months. There were no different outcomes for myocardial infarction, death and target vessel revascularization between drug eluting stent and bare metal stent. The rate of major adverse cardiac event -free survival was %71.3 in the drug eluting stent group and %71.8 in the bare metal stent group (p =0.660). Conclusion: There was no significant difference in long-term outcomes between drug eluting stent and bare metal stent in saphenous vein graft percutaneous coronary interventions in our real world experience. However, more cases and long-term follow-up are warranted.Amaç: Safen ven greft lezyonlarında ilaç kaplı ya da çıplak metal stent kullanımıyla ilgili sonuçlar tartışmalıdır. Bizim çalışmamızın amacı çıplak metal stent ve ilaç kaplı stent kullanılan safen ven greft perkütan koroner girişim sonuçlarını karşılaştırmaktı. Gereç ve Yöntem: Merkezimizde Ocak 2013-Aralık 2017 tarihleri arasında ilaç kaplı veya çıplak metal stent ile safen ven greft perkütan koroner girişim yapılmış tüm hastalar retrospektif olarak değerlendirildi. Miyokard infarktüsü, hedef damar revaskülarizasyonu ve ölümü içeren majör kardiyak olaylar açısından karşılaştırma yapıldı. Bulgular: Çalışmaya 92 hasta dahil edildi. 72 hastada ilaç kaplı stent ve 20 hastada çıplak metal stent kullanılmıştı. Ortalama takip süresi 29 (0-66) aydı. İlaç kaplı stent ve çıplak metal stent arasında myokard infarktüsü, ölüm ve hedef damar revaskülarizasyonu açısından fark yoktu. Olaysız sağkalım oranı her iki grupda benzerdi. (%71.3 ilaç kaplı stent grubu, %71.8 çıplak metal stent grubu, p =0.660). Sonuç: Gerçek yaşam verilerimizde safen ven greft perkütan koroner girişimlerinde ilaç kaplı stentlerle çıplak metal stentler arasında uzun dönem klinik sonuçlarda anlamlı bir fark yoktu. Bununla birlikte, daha fazla vaka ve uzun süreli takipler gereklidir