Can a patient with pulmonary hypertension travel safely by plane?

Air travel is known as the safest way of transportation. Therefore, patients with health problems prefer to travel by air; however, those with heart or lung issues, who do not have any problems under normal conditions, may experience some problems in high altitude and different environmental conditions. In this review, we have described the points to be considered during air travel in patients with pulmonary hypertension

Effects of glomerular filtration rate on the severity of coronary heart disease

Objective: Chronic kidney disease (CKD) is considered to beone of the most common risk factors for cardiovascular diseases.Glomerular filtration rate (GFR) is the best method oftesting level of kidney function and determining stage of kidneydisease. The aim of this study was to examine the impactof renal function on severity of coronary heart disease (CHD).Methods: The present study included 918 patients undergoingelective coronary angiography. GFR was evaluated bysimplified Modification of Diet in Renal Disease (MDRD) formula(mL/min/1.73 m2). The extent and severity of CHD wereevaluated according to SYNTAX score.Results: According to SYNTAX score, 416 patients had normalcoronary arteries or nonsignificant CHD (control group),267 had mild CHD (SYNTAX score: 1–22), 129 had moderateCHD (SYNTAX score: 23–32), and 106 had severe CHD(SYNTAX score: ?33). Estimated GFR values (median [25th–75th percentiles]) were 99.00 (83.00–116.00) in the controlgroup, 85.00 (73.00–101.00) in the mild CHD group, 87.00(73.25–101.75) in the moderate CHD group, and 81.00(65.00–101.00) in the severe CHD group. According to Spearman’srank correlation analysis, a negative correlation foundbetween MDRD and SYNTAX score was statistically significant(p<0.001, r=-0.268).Conclusion: Renal function is an important predictor of presenceand severity of angiographic CHD in patients without severerenal impairment. Negative correlation between MDRDand SYNTAX score was determined. This simple biochemicaltest can be used in determining risk of cardiovascular diseaseaside from other risk factors during routine clinical practice

Çift girişli sol ventriküllü olguda klasik Glenn ameliyatı: 20 yıllık takip

Functional univentricular heart is a rare and complex congenital anomaly. The prognosis is usually poor without any surgical intervention and long-term survival is rare. In this article, we report a 57-year-old female case with a double inlet left ventricle with valvular pulmonary stenosis, left anterior rudimentary right ventricle, ventricular septal defect, discordant ventriculoatrial connection, patent foramen ovale and Glenn shunt who was followed for 20 years. Cardiac catheterization revealed a classic Glenn shunt anatomy. The patient is currently under follow-up with medical treatment

Epicardial adipose tissue thickness can be used to predict major adverse cardiac events

Objective Increase in epicardial adipose tissue (EAT) thickness is associated with subclinical and manifest coronary artery disease. In addition, it is associated with the severity and extent of coronary atherosclerosis. We aimed to investigate whether increased EAT thickness is associated with adverse cardiovascular outcomes. Patients and methods Two hundred consecutive patients who were admitted with stable angina pectoris, unstable angina pectoris or acute myocardial infarction (MI), and had undergone coronary angiography were included and followed for revascularization, nonfatal MI, hospitalization for heart failure and cardiovascular death for 26 (5–30) months. Results There were significantly more revascularizations, nonfatal MI and cardiovascular death in patients with an initial EAT thickness more than 7mm (P<0.001 for all). Significant predictors of cardiovascular death were identified as an EAT thickness more than 7mm [hazard ratio (HR) 1.9, 95% confidence interval (CI) 0.4–8.3, P=0.039] and diabetes (HR 3.42, 95% CI 0.7–17.5, P=0.014) in the multivariate Cox regression analysis. Event-free survival for cardiovascular death in the EAT up to 7mm group was 97.9%, whereas it was 90.7% in the EAT more than 7mm group (P=0.021). In addition, significant predictors of MI were identified as an EAT thickness more than 7mm (HR 2.4, 95% CI 0.6–10.0, P=0.021) and diabetes (HR 3.4, 95% CI 1.0–11.2, P=0.04). Event-free survival for MI in the EAT up to 7mm group was 96.4%, whereas it was 68.2% in the EAT more than 7mm group (P=0.001). Conclusion Increase in EAT thickness independently predicts adverse cardiac events including MI and cardiovascular death. Coron Artery Dis 26:686–691 Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserve

Shone's complex with dextrocardia and situs inversus totalis: a case report

Parachute mitral valve complex is an unusual congenital anomaly that has been described by Shone et al. It is characterized by a parachute deformity of the mitral valve associated with additional forms of left heart anomalies, such as aortic valvular stenosis and coarctation of the aorta. A 21-year-old female who was referred to our department because of progressive dyspnea on effort and at rest and minimal cyanosis is presented in this case report. On cardiac auscultation, the patient had a grade III/VI pansystolic murmur best heard at the lower left sternal border. The chest X- ray demonstrated dextrocardia and mild cardiomegaly. Echocardiographic evaluation revealed Shone's complex, including parachute mitral valve anomaly

The relationship between serum uric acid levels and angiographic severity of coronary heart disease

Background: Many studies have shown that the serum uric acid (SUA) level is associated with atherosclerosis. Aim: To determine the relationship between the SUA level and the presence and severity of coronary heart disease (CHD). Methods: A total of 705 patients who underwent coronary angiography were included in this study. All patients were assessed for the presence of cardiovascular risk factors and ongoing medications. SUA levels were measured in all patients before the procedure after 12 h of fasting. The severity of CHD was assessed by the SYNTAX score. The independent association between the SUA and the severity of CHD was statistically evaluated using IBM SPSS Statistics 21 for Windows. Results: The mean age of the study population was 60.2 +/- 11.0 years. 252 were female (35.7%) and 453 were male (64.3%). Of the patients, 59.0% had significant CHD, 34.6% had diabetes mellitus, 67.7% had hypertension, 55.3% had hyperlipidaemia, and 45.4% were current smokers. The mean SYNTAX score was 10.6 +/- 12.9. According to the SYNTAX score, 289 of the patients (41%) had normal coronary arteries and non-significant CHD (controls, SYNTAX score: 0), 236 of the patients (33.5%) had mild CHD (SYNTAX score: 1-22), 97 (13.8%) had moderate CHD (SYNTAX score: 23-32), and 83 (11.8%) had severe CHD (SYNTAX score: >= 33). The mean SUA values were 5.3 +/- 1.5 mg/dL in the control group, 5.6 +/- 1.4 mg/dL in the mild CHD group, 6.2 +/- 1.6 mg/dL in the moderate CHD group, and 6.5 +/- 1.7 mg/dL in the severe CHD group. According to Spearman's rho analysis, a positive correlation between the SUA levels and the SYNTAX score was determined to be statistically significant (p < 0.001, r = 0.239; p = 0.002, r = 0.148 in men; p = 0.001, r = 0.204 in women). Conclusions: In this study, we found a positive correlation between the SUA level and the SYNTAX score. Therefore, this routine biochemical test can be used for the evaluation of the severity of CHD besides other risk factors in clinical practice. However, larger scale randomised studies are needed to show the effects of SUA on the severity of CHD

Hsa-miR-584-5p as a novel candidate biomarker in Turkish men with severe coronary artery disease

Coronary artery disease (CAD) is still the preliminary cause of mortality and morbidity in the developed world. Identification of novel predictive and therapeutic biomarkers is crucial for accurate diagnosis, prognosis and treatment of the CAD. The aim of this study was to detect novel candidate miRNA biomarker that may be used in the management of CAD. We performed miRNA profiling in whole blood samples of angiographically confirmed Turkish men with CAD and non-CAD controls with insignificant coronary stenosis. Validation of microarray results was performed by qRT-PCR in a larger cohort of 62 samples. We subsequently assessed the diagnostic value of the miRNA and correlations of miRNA with clinical parameters. miRNA-target identification and network analyses were conducted by Ingenuity Pathway Analysis (IPA) software. Hsa-miR-584-5p was one of the top significantly dysregulated miRNA observed in miRNA microarray. Men-specific down-regulation (p = 0.040) of hsa-miR-584-5p was confirmed by qRT-PCR. ROC curve analysis highlighted the potential diagnostic value of hsa-miR-584-5p with a power area under the curve (AUC) of 0.714 and 0.643 in men and in total sample, respectively. The expression levels of hsa-miR-584-5p showed inverse correlation with stenosis and Gensini scores. IPA revealed CDH13 as the only CAD related predicted target for the miRNA with biological evidence of its involvement in CAD. This study suggests that hsa-miR-584-5p, known to be tumor suppressor miRNA, as a candidate biomarker for CAD and highlighted its putative role in the CAD pathogenesis. The validation of results in larger samples incorporating functional studies warrant further research

Discordance of low density lipoprotein cholesterol and non-high density lipoprotein cholesterol and coronary artery disease severity

87th Congress of the European-Atherosclerosis-Society (EAS)European Atherosclerosis So

Nötrofil lenfosit oranı daha yaygın, ciddi, kompleks koroner arter hastalığı ve miyokart perfüzyonunda bozulma ile ilişkilidir

We investigated the relation between neutrophil to lymphocyte ratio (N/L) and the extent, severity, and complexity of coronary artery disease (CAD) and myocardial perfusion. Study design: One hundred and fifty-one patients who underwent coronary angiography with stable angina pectoris (SAP) (n=93) or acute coronary syndrome (ACS) (n=58) were included in the study. Blood samples were drawn before coronary angiography. Gensini and SYNTAX scores and myocardial blush grade (MBG) were assessed. Results: Neutrophil counts were 4.4±1.4 and 5.0±1.6 in the SAP and ACS groups (p=0.018), whereas lymphocyte counts were 2.2±0.7 and 2.1±0.7, respectively (p=0.104). N/L was 2.2±1.2 in the SAP and 2.6±1.0 in the ACS (p=0.002) groups. In patients with SAP, N/L was significantly correlated with Gensini and SYNTAX scores (Gensini score r=0.32, p=0.002; SYNTAX score r=0.36, p=0.000), but there was no significant correlation between N/L and MBG. In the ACS group, N/L had a more powerful association with both Gensini and SYNTAX scores (Gensini r=0.42, p=0.001; SYNTAX r=0.51, p=0.000). N/L was negatively correlated with MBG in ACS patients (r= -0.48, p=0.000). Significant correlations persisted both in the SAP and ACS groups after correcting for age, diabetes, hyperlipidemia, and statin use; however, the associations were weaker. Cut-off N/L to predict moderate to severe CAD according to SYNTAX score was 2.26, with 72% sensitivity and 71% specificity (area under the curve [AUC]: 0.772, 95% confidence interval [CI] 0.679-0.865, p<0.001). Conclusion: N/L is associated with severe, extensive and complex CAD and may be used to predict moderate to severe involvement in patients with CAD