Koroner yavaş akımın miyokard perfomans indeks üzerine etkisi

Objective: This study was aimed to investigate the left ventriculer myocardial performance index (Tei index) in patients with coronary slow flow phenomenon Material and Methods: 25 patients with slow coronary flow (15 men; 10 women; mean age 51 ± 12 years) and 20 subjects with angiographically normal coronary arteries (12 men; 8 women; mean age 52 ± 12 years) were included in the study. All the subjects underwent echocardiography and tissue Doppler imaging to determine left ventriculer (LV) diastolic functions and left ventriculer myocardial performance index (LV MPI). Results: Conventional echocardiography parameters, maximal velocity of early diastolic filling (p=0,02), ratio of maximal early to late diastolic filling (p=0,037) were significantly lower, deceleration time of early diastolic filling was significantly higher (p=0,043) in the patient group. Among tissue Doppler parameters the mitral annulus peak early diastolic velocity and ratio of early to late diastolic velocity were lower in patients group than in controls (p <0,001) but isovolumetric relaxation time were significantly increased in patients group than controls (p<0,001). LV MPI was significantly prolonged in coronary slow flow group ( p < 0,001). TIMI frame count was negatively correlated with the mitral lateral annulus early diastolic velocity and the ratio of mitral lateral annulus early to late diastolic velocity whereas it was positively correlated with mitral isovolumetric relaxation time and LV MPI. Conclusion: Our findings demonstrate that patients with coronary slow flow phenomenon affects diastolic functions and LV MPI. Therefore, patients with coronary slow flow phenomenon should be carefully followed-up.Amaç: Bu çalışmada koroner yavaş akımı olan hastalarda sol ventrikül miyokard performans indeksinin (Tei indeksi) incelenmesi amaçlanmıştır. Gereç ve Yöntem: Koroner yavaş akımı olan 25 hasta (15 erkek; 10 kadın; ort yaş 51 ± 12 yıl) ve koroner arterleri normal olan 20 olgu (12 erkek; 8 kadın; ort yaş 52 ± 12 yıl) çalışmaya alınmıştır. Tüm hastaların ekokardiyografi ve doku doppler görüntüleme ile sol ventrikül diyastolik fonksiyonları ve miyokard performans indeksi saptandı. Bulgular: Koroner yavaş akımı olan grupta maksimal erken diyastolik dolum hızı, maksimal erken diyastolik dolum hızının geç diyastolik akım hızına oranı (p=0,037) anlamlı derecede düşük saptanırken; erken diyastolik dolum hızı deselerasyon zamanı anlamlı derecede yüksekdi (p=0,043). Hasta grubunda, kontrol grubuna göre doku doppler parametreleri arasında mitral anulus erken pik diyastolik hız ve erken diyastolik akım oranı anlamlı derecede düşük saptandı (p<0.001) ancak izovolümetrik relaksasyon zamanı anlamlı derecede artmış olarak bulundu (p<0.001). Sol ventrikül miyokard performans indeksi koroner yavaş akımı olan grupta anlamlı derecede uzamıştır( p < 0.001). TIMI kare sayısı ile mitral lateral anulus erken diyastolik hız ve mitral lateral anulus erken diyastolik hızın geç diyastolik hıza oranı arasında negatif korelasyon saptanırken, izovolümetrik relaksasyon zamanı ve sol ventrikül miyokard performans indeksi ile pozitif korelasyon saptanmıştır. Sonuç: Çalışmamızda koroner yavaş akımlı hastalarda diyastolik fonksiyonların ve miyokard performans indeksinin etkilendiğini gösterdik. Bu nedenle koroner yavaş akımı olan hastalar dikkatli bir şekilde takip edilmelidir

The time interval from the initiation of the P-wave to the start of left atrial appendage ejection flow: Does it reflect interatrial conduction time ?

Recurrence of atrial fibrillation is more common in patients with atrial conduction delay. In the present study, we evaluated whether findings obtained from transesophageal echocardiography (TEE), a semi-invasive method, correlate with those from an invasive method, electrophysiologic study (EPS), in measuring interatrial conduction time. Methods and Results: We compared two methods of calculating interatrial conduction time in a group of 33 patients. The origin of the P-wave on the surface electrocardiogram (ECG) was taken as the onset of atrial activation. The time interval from this point to the commencement of the left atrial appendage ejection flow (P-LAA) was measured by TEE. Meanwhile, simultaneous recordings of the left atrial appendage were obtained with a catheter positioned in the LAA, and an invasive interatrial conduction time was measured from the origin of the surface's earliest P-wave (I-IACT). The mean I-IACT (46.27 +/- 13.25 ms) correlated strongly with the mean P-LAA (49.91 +/- 12.72 ms; r = 0.839, P < 0.0001). Conclusion: The interatrial conduction time can be estimated with a relatively noninvasive method using P-LAA measurements. This technique can be applied widely in predicting AF recurrence, and appropriate therapy may be applied

Successful coil embolization of LIMA side branch that is suspected to cause recurrent angina

Koroner arter baypas cerrahisinde greft amacıyla sık kullanı- lan sol internal mamaryan arterde (LIMA) yan dalların anastomoz öncesi kapatılması, cerrahi sonrası çalmaya bağlı miyokard iskemisini engellemek için son derece önemlidir. Bu vakada koroner arter baypas cerrahisinden 2 yıl sonra özellikle kol egzersizi sırasında belirginleşen göğüs ağrısı yakınması bulunan bir hastada koroner çalma sendromuna neden olduğunu düşündüğümüz LIMA yan dalı başarılı koil embolizasyon ile kapatılmasını gösterdik.The left internal mammarian artery (LIMA) is the most commonly used arterial graft for coronary artery bypass grafting (CABG). Selective occlusion of LIMA side branches during surgery is important for avoiding myocardial ischemia. We report on a case with limp claudication on exertion due to patent LIMA side branch following CABG operation two years prior to hospital admission. The patent side branch was successfully occluded with coil embolization

Koroner yavaş akımın miyokard perfomans indeks üzerine etkisi

Objective: This study was aimed to investigate the left ventriculer myocardial performance index (Tei index) in patients with coronary slow flow phenomenon Material and Methods: 25 patients with slow coronary flow (15 men; 10 women; mean age 51 ± 12 years) and 20 subjects with angiographically normal coronary arteries (12 men; 8 women; mean age 52 ± 12 years) were included in the study. All the subjects underwent echocardiography and tissue Doppler imaging to determine left ventriculer (LV) diastolic functions and left ventriculer myocardial performance index (LV MPI). Results: Conventional echocardiography parameters, maximal velocity of early diastolic filling (p=0,02), ratio of maximal early to late diastolic filling (p=0,037) were significantly lower, deceleration time of early diastolic filling was significantly higher (p=0,043) in the patient group. Among tissue Doppler parameters the mitral annulus peak early diastolic velocity and ratio of early to late diastolic velocity were lower in patients group than in controls (p <0,001) but isovolumetric relaxation time were significantly increased in patients group than controls (p<0,001). LV MPI was significantly prolonged in coronary slow flow group ( p < 0,001). TIMI frame count was negatively correlated with the mitral lateral annulus early diastolic velocity and the ratio of mitral lateral annulus early to late diastolic velocity whereas it was positively correlated with mitral isovolumetric relaxation time and LV MPI. Conclusion: Our findings demonstrate that patients with coronary slow flow phenomenon affects diastolic functions and LV MPI. Therefore, patients with coronary slow flow phenomenon should be carefully followed-up.Amaç: Bu çalışmada koroner yavaş akımı olan hastalarda sol ventrikül miyokard performans indeksinin (Tei indeksi) incelenmesi amaçlanmıştır. Gereç ve Yöntem: Koroner yavaş akımı olan 25 hasta (15 erkek; 10 kadın; ort yaş 51 ± 12 yıl) ve koroner arterleri normal olan 20 olgu (12 erkek; 8 kadın; ort yaş 52 ± 12 yıl) çalışmaya alınmıştır. Tüm hastaların ekokardiyografi ve doku doppler görüntüleme ile sol ventrikül diyastolik fonksiyonları ve miyokard performans indeksi saptandı. Bulgular: Koroner yavaş akımı olan grupta maksimal erken diyastolik dolum hızı, maksimal erken diyastolik dolum hızının geç diyastolik akım hızına oranı (p=0,037) anlamlı derecede düşük saptanırken; erken diyastolik dolum hızı deselerasyon zamanı anlamlı derecede yüksekdi (p=0,043). Hasta grubunda, kontrol grubuna göre doku doppler parametreleri arasında mitral anulus erken pik diyastolik hız ve erken diyastolik akım oranı anlamlı derecede düşük saptandı (p<0.001) ancak izovolümetrik relaksasyon zamanı anlamlı derecede artmış olarak bulundu (p<0.001). Sol ventrikül miyokard performans indeksi koroner yavaş akımı olan grupta anlamlı derecede uzamıştır( p < 0.001). TIMI kare sayısı ile mitral lateral anulus erken diyastolik hız ve mitral lateral anulus erken diyastolik hızın geç diyastolik hıza oranı arasında negatif korelasyon saptanırken, izovolümetrik relaksasyon zamanı ve sol ventrikül miyokard performans indeksi ile pozitif korelasyon saptanmıştır. Sonuç: Çalışmamızda koroner yavaş akımlı hastalarda diyastolik fonksiyonların ve miyokard performans indeksinin etkilendiğini gösterdik. Bu nedenle koroner yavaş akımı olan hastalar dikkatli bir şekilde takip edilmelidir

Comparison of DDD versus VVIR pacing modes in elderly patients with atrioventricular block

Objectives: Dual-chamber pacing is believed to have an advantage over single-chamber ventricular pacing. The aim of this study was to determine whether elderly patients who have implanted pacemakers for complete atrioventricular block gain significant benefits from dual-chamber (DOD) pacemakers compared with single chamber ventricular (VVIR) pacemakers

Neutrophil to lymphocyte ratio is associated with proximal/middle segment of the LAD lesions in patients with ST segment elevation infarction

Introduction: Neutrophil to lymphocyte ratio (NLR) was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied. Aim of the study : To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD) in anterior miyocardial infarction patients. Material and methods : Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters. Results : Between group I (n = 41, mean age 52.5 ±12.7) and group II (n = 17, mean ages 52.0 ±10.8); NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01). In group I, left ventricular ejection fraction (LVEF) was significantly lower (p = 0.02). In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01) and negatively correlated with LVEF (r = –0.28, p = 0.03). Conclusions : The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients