Thrombus in transit causing acute massive pulmonary emboli treated successfully with reteplase administration

Acute pulmonary thromboembolism (PTE) is a leading cause of mortality and morbidity. Observation of the right atrial thrombi is a rare condition, which usually accompanies to massive PTE. Urgent treatment strategies for rapid thrombus removal are mandatory in patients presenting with acute massive PTE. In this paper, we present a patient admitting with acute massive PTE to our emergency department, in whom concomitant right atrial thrombus was successfully treated with reteplase

Ductus arteriosus aneursym causing hoarseness which is the best treatment option; surgery or endovascular?

WOS: 000392631500025PubMed ID: 27665349

Giant Tricuspid Valve Endocardilis.

13th International Congress of Update in Cardiology and Cardiovascular Surgery (UCCVS) -- MAR 23-26, 2017 -- Cesme, TURKEYWOS: 000407309200093

Frailty is Independently Associated with Short Term Mortality and Hospitalization Due Heart Failure in the Elderly

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400108…Turkish Soc Cardio

Cardiac Diastolic Function Is Impaired at Rest and Worsens With Exercise in Otherwise Healthy Individuals With Insulin Resistance

WOS: 000358558400018PubMed ID: 25902882Insulin resistance (IR) is a pathophysiological condition and is associated with cardiovascular risk factors including heart failure. However, studies demonstrating myocardial abnormalities in the early phases of IR are limited. The aim of this study was to investigate myocardial function in otherwise healthy individuals with IR. Individuals with IR who were free of cardiovascular risk factors and healthy controls were included. Stress echocardiography with tissue Doppler imaging (TDI) was performed. Systolic and diastolic TDI waves were compared in both groups. A total of 77 individuals (51 with IR and 26 controls) were included in our study. The tissue early flow (e')/atrial contraction (a') ratio at rest was significantly lower in the IR group (P = 0.003). The annular early flow (E)/e' ratio, a predictor of left ventricular filling pressure, was similar in both groups at rest (P = 0.522). After exercise, e'/a' impairment became more prominent in the IR group (P < 0.001); whereas the E/e' ratio was also significantly lower (7.6 +/- 1.8 versus 6.7 +/- 0.9; P = 0.007) in the IR group. Myocardial involvement seems to occur in patients with IR, before the appearance of other cardiovascular risk factors. Exercise induced diastolic worsening may be a predictor of reduced compliance and increased ventricular stiffness. More detailed prospective studies are required for more precise results

Effect of Vitamin D Treatment on Glycemic Control, Diastolic Functions, and Carotid Intima-Media Thickness in Patients with Type 2 Diabetes Mellitus

WOS: 000473267000005Objective: The purpose of this study was to investigate the influence of 25(OH)D3 levels on glycemic control, diastolic functions, and carotid intima-media thickness in patients with Type 2 diabetes mellitus. Material and Methods: Patients admitted to the endocrinology department, with the diagnosis of Type 2 diabetes mellitus, who were under follow-up for at least six months and also had 25(OH)D3 deficiency [25(OH)D3 levels <20 ng/mL] were included in this study. D3 supplement (50.000 IU) was administered to the patients every month up to six months. Carotid intima-media thickness was measured using the B-mode ultrasonography. Diastolic function was evaluated using the tissue doppler imaging by measuring tissue e wave/tissue a wave (e'/a') and annular E wave/tissue e wave (E/e') ratios. All the evaluations were made at baseline and at six months after vitamin D3 supplementation. Results: A total of 45 (27 females, 18 males; mean age: 56.2 +/- 7.8 years) patients were included in this study. The mean duration of diabetes was 8.5 +/- 6.8 (ranging from 7.0 to 9.0 years) years. It was found that even after D3 supplementation, fasting plasma glucose and Hemoglobin A1C levels did not change, yet, the carotid intimamedia thickness reduced (788 +/- 100 mu m vs. 745 +/- 116.8 mu m; p=0.009). Diastolic function parameters e'/a' (0.79 +/- 0.21 vs. 0.89 +/- 0.26; p=0.03) and E/e' (7.27 +/- 1.81 vs. 6.52 +/- 1.65; p=0.048) also improved significantly after the therapy. Conclusion: Vitamin D supplementation, in patients with Type 2 diabetes mellitus, who are also having vitamin D deficiency, seems to be beneficial in reducing the thickness of carotid intima-media, which is a well-known cardiovascular risk predictor, and in improving diastolic functions by vitamin D repletion. Further prospective well-designed studies with a larger patient population are needed to lead a firm conclusion in this regard

Predictors of the paroxysmal atrial fibrillation recurrence following cryoballoon-based pulmonary vein isolation: Assessment of left atrial volume, left atrial volume index, galectin-3 level and neutrophil-to-lymphocyte ratio

Background: Cryoballoon-based pulmonary vein isolation (PVI) is a treatment option for atrial fibrillation (AF). Left atrial volume (LAV) and left atrial volume index (LAVi) are important parameters for long term success of PVI. Galectin-3 (Gal-3) and neutrophil to lymphocyte ratio (N/L ratio) are biomarkers to demonstrate the cardiac fibrosis and remodelling. Methods: 50 patients with symptomatic PAF despite ≥1 antiarrhythmic drug(s), who underwent PVI were enrolled. LAV, LAVi, Gal-3 and N/L ratio were calculated before ablation and after ablation at 6 and 12 months. According to AF recurrence patients were divided into two groups, recurrent AF (n = 14) and non-recurrent AF (n = 36). Results: In both groups (recurrent and non-recurrent), initial and 12 months follow-up LAV values were 41.39 ± 18.13 ml and 53.24 ± 22.11 ml vs 48.85 ± 12.89 ml and 42.08 ± 13.85 (p = 0.037). LAVi were 20.9 ± 8.91 ml/m2 and 26.85 ± 11.28 ml/m2 vs 25.36 ± 6.21 and 21.87 ± 6.66 (p = 0.05) for recurrent and non-recurrent AF groups, respectively. In both groups PVI had no significant effect on serum Gal-3 levels and N/L ratio during 12 months follow-up. The comparison between two groups at the end of 12th month showed Gal-3 values of 6.66 ± 4.09 ng/ml and 6.02 ± 2.95 ng/ml (p = 0.516), N/L ratio values of 2.28 ± 1.07 103/μl and 1.98 ± 0.66 103/μl (p = 0.674). Conclusion: LAV and LAVi are useful to predict the remodelling of the left atrium and AF recurrence after cryoballoon-based PVI. However, biomarkers such as Gal-3 and N/L ratio are not associated with AF recurrence. Keywords: Cryoballoon-based pulmonary vein isolation, Left atrial volume, Galectin-3, Left atrial remodellin

Predictors of Anticoagulant Treatment in Patients With Nonvalvular Atrial Fibrillation: Results From Atrial Fibrillation in Turkey: Epidemiologic Registry

The aim of the study was to assess the factors associated with the anticoagulation treatment in patients with atrial fibrillation (AF). A total of 2242 consecutive patients who had been admitted with AF on their electrocardiogram were included in the study. After excluding valvular AF, 1745 patients with nonvalvular AF were analyzed. Mean CHA2DS2-VASc score [cardiac failure, hypertension, age >= 75 (doubled), diabetes, stroke (doubled), vascular disease, age 65 -74 and sex category (female)], frequency of persistent/permanent AF, hypertension, diabetes mellitus (DM), stroke history, body mass index, and left atrial diameter were significantly higher in patients receiving anticoagulant therapy. Stroke history, persistent/permanent AF, hypertension, DM, age, heart failure, and left atrial diameter were independent predictors of warfarin prescription. Labile international normalized ratio was the only independent negative predictor of effective treatment with warfarin. In this study, we demonstrated that stroke history, persistent/permanent AF, hypertension, DM, and left atrial diameter were positive predictors, whereas advanced age and heart failure were negative predictors of oral anticoagulant use in patients with nonvalvular AF