0528: The role of brain natriuretic peptide and cystatin C in the evaluation of left ventricular diastolic dysfunction: correlation with echocardio-graphic indexes after myocardial infarction

BackgroundThe utility of Brain Natriuretic Peptide (BNP) and cystatin C for detecting left ventricular (LV) diastolic dysfunction after myocardial infarction (MI) in patients without heart failure symptoms still unclear. In this study, we investigated the relation between BNP, serum cystatin C levels and LV diastolic dysfunction after MI in patients without systolic dysfunction.MethodsWe studied 127 patients without renal dysfunction after first acute coronary syndrome (ACS). LV diastolic function was assessed with conventional Doppler, by means of mitral inflow and with tissue Doppler echo-cardiography by means of mitral annulus. The ratio of early diastolic transmitral E wave velocities to tissue Doppler mitral annulus early diastolic E’ wave velocities (E/E’), was used to detect LV filling pressures. Patients were divided in three groups according to E/E’ ratios<10 (group I), E/E’ ratios “between” 10 and 15 (group II) and E/E’ ratios>15 (group III). Plasma concentrations of BNP and serum cystatin C were measured at admission.ResultsThe BNP and serum cystatin C levels were positively correlated significantly with E/E’ ratio (r=0.786, P<0.001 and r=0.458, p=0.02). Patients with elevated LV end diastolic pressure (LVEDP), defined as E/E’>15 had highest BNP (321±75pg/mL) and cystatin C (1.1±0.2mg/L) levels. E/E’ 10 to 15 group had a mean BNP level of 151±28pg/mL and a mean cystatin C value of 0.78±0.1mg/L, and those with E/E’<10 had a mean BNP value of 69±20pg/ mL. A BNP value of 89pg/mL had a sensitivity of 84% and a specificity of 69% for predicting E/E’>15.ConclusionThe assessment of the blood concentration of BNP and cystatin C is of potential value for identification of those patients after myocardial infarction to detect early cardiovascular changes, especially LV diastolic dys-function

A continuous murmur following a nonpenetrating chest trauma

AbstractWe reported a rare case of non-penetrating chest trauma-induced fistula from the right sinus of Valsalva to the right heart chambers. The ruptured sinus of Valsalva aneurysm was diagnosed preoperatively and operated on successfully. The rarity of this case highlights the need for a precise preoperative diagnosis, the role of transthoracic echocardiography, and the importance of a prompt surgical management

Failure analysis of shot–sleeves used in brass high pressure die–casting process

A failure investigation has been conducted on a two cases of shot-sleeve used in brass–die casting and made up of AISI H10 tool steels to study their failure mechanisms. The chemical composition of the shot–sleeves material and the hardness profiles were evaluated. A preliminary examination of shot–sleeves reveal the presence of cracks network on their inner surfaces which proves that thermal fatigue was probably the main cause of their failure. A Meticulous investigation of these damaged surfaces reveal the presence of an additional small zone cited in the vicinity of the plunger entry side. This zone presents several scratches sign of abrasive wear. Then, the measurement of the cracks length and their linear density along longitudinal and transversal cuts of the damaged shot–sleeve sample are carried out. Results show that the observed cracks network can be divided into two zones. The first one was the most damaged in terms of cracks density and length given that it is the first zone which enter in contact with the molten metal. However, the cracks network examined in the second zone appears to be superficial

Cardiac tamponade and paroxysmal third-degree atrioventricular block revealing a primary cardiac non-Hodgkin large B-cell lymphoma of the right ventricle: a case report

<p>Abstract</p> <p>Introduction</p> <p>Primary cardiac lymphoma is rare.</p> <p>Case Presentation</p> <p>We report the case of a 64-year-old non-immunodeficient Caucasian man, with cardiac tamponade and paroxysmal third-degree atrioventricular block. Echocardiography revealed the presence of a large pericardial effusion with signs of tamponade and a right ventricular mass was suspected. Scanner investigations clarified the sites, extension and anatomic details of myocardial and pericardial infiltration. Surgical resection was performed due to the rapid impairment of his cardiac function. Analysis of the pericardial fluid and histology confirmed the diagnosis of non-Hodgkin large B-cell lymphoma. He was treated with chemotherapy.</p> <p>Conclusion</p> <p>The prognosis remains poor for this type of tumor due to delays in diagnosis and the importance of the site of disease.</p

Insights into the mechanisms governing P01 scorpion toxin effect against U87 glioblastoma cells oncogenesis

The emerging concept of small conductance Ca2+-activated potassium channels (SKCa) as pharmacological target for cancer treatment has significantly increased in recent years. In this study, we isolated the P01 toxin from Androctonus australis (Aa) scorpion venom and investigated its effect on biological properties of glioblastoma U87, breast MDA-MB231 and colon adenocarcinoma LS174 cancer cell lines. Our results showed that P01 was active only on U87 glioblastoma cells. It inhibited their proliferation, adhesion and migration with IC50 values in the micromolar range. We have also shown that P01 reduced the amplitude of the currents recorded in HEK293 cells expressing SK2 channels with an IC50 value of 3 pM, while it had no effect on those expressing SK3 channels. The investigation of the SKCa channels expression pattern showed that SK2 transcripts were expressed differently in the three cancer cell lines. Particularly, we highlighted the presence of SK2 isoforms in U87 cells, which could explain and rely on the specific activity of P01 on this cell line. These experimental data highlighted the usefulness of scorpion peptides to decipher the role of SKCa channels in the tumorigenesis process, and develop potential therapeutic molecules targeting glioblastoma with high selectivity

Midventricular Obstructive Hypertrophic Cardiomyopathy during Pregnancy Complicated by Pulmonary Embolism: A Case Report

Hypertrophic cardiomyopathy (HCM) with midventricular obstruction (MVO) is a rare condition occurring in 1% of HCM patients. It is characterized by asymmetric left ventricular hypertrophy with MVO and elevated intraventricular pressure gradients. Pulmonary embolism has been associated with mid-ventricular obstructive HCM. Briefly, this case presents an unusual clinical scenario where a young pregnant woman suffering from hypertrophic obstructive cardiomyopathy presents with dyspnea hemodynamic compromise related to pulmonary embolism illustrating hemodynamic challenges created by pregnancy and surgery. We concluded that simple measures such as communication between the cardiology and obstetric teams, understanding of the hemodynamic changes, anesthetic planning, and monitoring were paramount for the success in our patient