Association of Significant Mitral Regurgitation and Left Ventricular Dysfunction With ALCAPA Syndrome in a Young Patient

Anomalous origin of the left coronary artery from pulmonary artery (ALCAPA) is not a common anomaly in adulthood. Its early diagnosis requires physician suspicion and the early treatment of disease can prevent its serious side effects. In this article, we presented a young female with pansystolic murmur and heart failure with final diagnosis of ALCAPA syndrome

Effect of hemodialysis on pulmonary function tests and plasma endothelin levels

End-stage renal disease (ESRD) is a complex illness that involves different organs including the lungs. We studied the pulmonary function tests, arterial blood gases (ABG) and plasma endothelin-1 (ET-1) levels to check whether there is any change in their levels after hemodialysis (HD) in patients with ESRD. In this cross-sectional study (from July 2009 to April 2010), 20 patients with ESRD were evaluated. ABG, spirometric parameters and plasma ET-1 were measured before and after HD in these patients. Student′s t-test was performed to clarify the differences and Pearson′s test was used for correlations. P <0.05 was considered statistically significant. Significant reduction was seen in oxygen saturation (O 2 sat), partial pressure of carbon-dioxide (PaCO 2 ) and oxygen (PaO 2 ) after a HD session (P <0.001). Also, improvement was seen in all spirometric parameters except forced expiratory volume (FEV1)/forced vital capacity (FVC) after HD. Plasma ET-1 levels decreased signi-ficantly after HD. Mean ET-1 before HD was 6.88 + 5.81 pg/mL while it was 3.91 + 2.76 pg/mL after HD (P = 0.009). Based on the plasma levels of ET-1, the patients were divided into two groups. The mean level of ET-1 was higher in the first group. Significant increase was seen in spirometric parameters in the second group. Our study suggests that, in patients with ESRD, plasma ET-1 level is higher than in the normal population, and this is closely related to deterioration of pulmonary function tests. Significant reduction of plasma ET-1 may be an important factor in the improvement of spiro-metry parameters after HD

Myocardial and Vascular Involvement in Patients with Takayasu Arteritis: A Cardiovascular MRI Study

We aimed to explore the cardiovascular magnetic resonance (CMR) of Takayasu arteritis (TA) and its cardiovascular complications. CMR was conducted on 37 TA patients and 28 healthy individuals. We evaluated the CMR findings and adverse cardiovascular complications at the time of the CMR (ACCCMR). After 8 to 26 months, the major adverse cardiac and cerebrovascular events (MACCEs) were evaluated. The TA included 25 women (67.6%), aged 36 ± 16 years old, and 28 age- and sex-matched healthy controls. Left ventricular (LV) ejection fraction was significantly lower in the TA group than in the control group (51 ± 9% vs. 58 ± 1.7%; p p CMR was seen in 13 TA patients (35.1%), with the most common cardiac complication being myocarditis (16.2%). During a median follow-up of 18 months (8–26 months), nine patients developed MACCEs, of which the most common was cerebrovascular accident in five (13.5%). The LVGLS of the CMR had the strongest association with complications. Myocardial strain values, especially LVGLS, can reveal concurrent and future cardiovascular complications in TA patients