Evaluation of Trastuzumab-induced early cardiac dysfunction using two-dimensional Strain Echocardiography

Abstract Aim: Trastuzumab, a chemotherapeutic agent used in the treatment of breast cancer. has been shown to induce subclinical left ventricular (LV) dysfunction during a three to six month period as evidenced by strain echocardiographic examination without any change occurring in the ejection fraction of LV. The present study evaluated the presence of subclinical LV dysfunction using strain echocardiography 1 day and 7 days after the initiation of trastuzumab therapy. Material and methods: The patients with breast cancer receiving adjuvant trastuzumab therapy underwent 2-dimensional, tissue Doppler, and strain echocardiographic examination at baseline and 1 day and 7 days after therapy. LV global longitudinal strain (GLS), global circumferential strain (GCS) values, and other echocardiographic parameters were calculated. Results: A total of 40 females, mean age 50±10 years, were evaluated. Of these patients, 97% received anthracycline and 73% received radiotherapy before the initiation of trastuzumab therapy. No change was observed in any of the echocardiographic parameters 1 day after the initiation of trastuzumab therapy (p>0.05). The LV ejection fraction, tissue Doppler parameters, and GCS values did not show any changes 7 days after the initiation of therapy, whereas significant decreases were observed in GLS value (19.2±4.0% vs. 17.2±3.4, p=0.001) and systolic annular velocity of the lateral LV wall (S' velocity) (10.5±3.2 vs. 8.6±2.2, p=0.002). Conclusion: Trastuzumab therapy is associated with subclinical LV dysfunction as early as 7 days after initiation of the therapy as evidenced by the decreases in GLS value of LV and systolic annular velocity of the lateral LV wall

Transjugular closure of secundum atrial septal defect in a patient with interrupted inferior vena cava

In this case, we report a successful closure of secundum atrial septal defect in a 32-year-old female patient with an interrupted inferior vena cava (IVC). Interrupted IVC was detected coincidentally during right heart catheterization. The defect was successfully closed through transjugular vein approach as an alternative to surgery

Nontraumatic muscular hematoma of lower extremity in a patient using warfarin and its relationship with VKORC1, CYP2C9 gene polymorphism

Warfarin is the most frequently used oral anticoagulant agent today. Warfarin response can be affected by environmental factors such as dietary habits and drugs as well as genetic factors, and this might increase bleeding risk. In this article, we report a 79-year-old male patient who developed nontraumatic hematoma of left lower extremity despite using low-dose warfarin, and whose genetic analyses revealed CYP2C9*2*3, VKORC1 AA and VKORC1 TT gene polymorphisms

Regional Differences in the Prevalence of Hypertension in Turkey

Hypertension is the leading cause of death among the different cardiovascular risk factors. Studies have found that differences in the prevalence of hypertension exist depending on gender, age, race, socio-demographic characteristics and geographical location. In this study, we aimed to determine the prevalence of hypertension according to gender and regional distribution during the last five years in Turkey. The diagnosis of essential hypertension in individuals was determined from across the country based on data from 2009-2013 obtained from Social Security Insurance. From the data of this study, the prevalence of hypertension was found to be significantly greater for both sexes in the Black Sea Region for all the years surveyed. The prevalence of hypertension in women was found to be higher than men in all geographic areas (p [Med-Science 2015; 4(3.000): 2488-97

In-Hospital cost comparison of transcatheter closure versus surgical closure of secundum atrial septal defect

Introduction: We compared transcatheter and surgical closure of secundum atrial septal defects (ASDs) in terms of cost in this study. Materials and Methods: Between 2006 and 2015, 291 consecutive patients having secundum ASD, in whom percutaneous or surgical closure was performed, were included in this study. We compared the in-hospital cost of transcatheter versus surgical ASD closure in these patients. Results: We collected totaly 291 patients, 214 transcatheter and 77 surgical closure procedures, retrospectively. Patients with a surgical closure had a longer length of stay (11.8 ± 3.8 days vs. 2.8 ± 1.6 days, P < 0.001). There was no in-hospital mortality in two groups. Costs denominated in Turkish lira (TL) and United States Dollar (USD) of transcatheter closure were higher than that of surgical closure (TL 10955.6 ± 183.4 vs. TL 6016.7 ± 371.9 P < 0.001; USD 6531.2 ± 149.62 vs. USD 3896.2 ± 234.7 P < 0.001). The cost of percutaneous ASD closure increase does not correlate with the dollar rate on the annual basis. This with the supplier firms has excessive profits in the first year of the study. Conclusion: Compared with other countries with regard to cost, transcatheter ASD closure is a more expensive treatment than surgical closure in our country

Galectin-3 levels in patients with hypertrophic cardiomyopathy and its relationship with left ventricular mass index and function.

Objective: Cardiac fibrosis is an important contributor to adverse left ventricular (LV) remodeling and arrhythmias in patients with hypertrophic cardiomyopathy (HCM). Galectin-3 (Gal-3) is a novel marker of cardiac fibrosis and inflammation. In this study, we investigated Gal-3 levels in patients with HCM and controls and assessed the relationship between Gal-3 level and echocardiographic indices using strain echocardiography in patients with HCM

Evaluation of subclinical myocardial dysfunction using speckle tracking echocardiography in patients with radiographic and non-radiographic axial spondyloarthritis

Objective: To evaluate whether there is any difference between radiographic axial spondyloarthritis (r-axSpA), also termed ankylosing spondylitis (AS), and non-radiographic (nr-) axSpA, with respect to subclinial myocardial dysfunction using speckle tracking echocardiography (STE)