100 research outputs found
Is air travel safe for patients with cardiac implantable electronic devices?
Parallel to the rapid expansion of air travel services and advances in medical technology, more passengers with cardiac implantable electronic devices (CIEDs) fly each year. In general, commercial airline flights are considered safe for patients with CIEDs; nevertheless, some specific precautions should be undertaken in some certain circumstances. Apart from the risk of a minor and overlooked pneumothorax early after implantation of a CIED, which may be aggravated due to sudden pressure changes during flight, electromagnetic interference, cosmic radiation and vibration are the other risks a patient with a CIED may encounter during air travel, nevertheless, these are rare and often do not bring about significant clinical consequences
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
Arterial stiffness and central arterial wave reflection are associated with serum uric acid, total bilirubin, and neutrophil-to-lymphocyte ratio in patients with coronary artery disease
Objective: Total bilirubin (TB) was recently recognized as an endogenous anti-inflammatory and anti-oxidant molecule. Uric acid (UA) takes part
in cardiovascular diseases by inducing oxidative stress, inflammation, and endothelial dysfunction. We assessed the relationship between
serum TB levels, serum UA levels, and inflammatory status assessed by neutrophil-to-lymphocyte ratio (N/L) and arterial stiffness and arterial
wave reflection in patients with a clinical diagnosis of coronary artery disease (CAD).
Methods: We included 145 consecutive patients admitted with stable angina pectoris (SAP) or acute coronary syndrome (ACS). Blood
samples were drawn at admission for complete blood count and biochemistry. Non-invasive pulse waveform analysis for the determination
of augmentation index (AIx) and carotid-femoral pulse wave velocity (PWV) measurements were performed with the commercially available
SphygmoCor system.
Results: When patients were divided into tertiles of PWV and AIx, median N/L and median serum UA levels were the highest and mean TB
levels were the lowest in the third tertile (p<0.001 for all). AIx and PWV were positively associated with serum UA and N/L and negatively associated
with serum TB levels (p<0.001 for all). After adjustments for age, gender, heart rate, systolic blood pressure, and presence of diabetes,
significant correlations persisted for N/L, UA, and TB in ACS patients (p<0.05). In the SAP group, TB was significantly negatively correlated with
AIx and PWV, and UA was significantly positively correlated with PWV (p<0.05).
Conclusion: N/L ratio and serum UA and TB levels might be used to risk-stratify patients with respect to arterial stiffness in CAD patients,
especially in the presence of ACS
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
Coronary artery disease related Mir-19A and Mir-26A are sensitive to simvastatin and ror-alpha ligands in macrophage cells
87th Congress of the European-Atherosclerosis-Society (EAS)European Atherosclerosis So
- …