Successful recanalization of previously subintimal stenting of the right coronary artery

Stent placement in the subintimal or false lumen is a rare complication of coronary interventions. Subintimal stenting can cause chronic total occlusion. Angiography images of previously treated CTO cases should be carefully monitored. To avoid placing a stent in the false lumen, it must be absolutely sure that it is inside the lumen. In this case, we presented a successful case of chronic total occlusion in the right coronary artery with a subintimal stent. [Med-Science 2020; 9(3.000): 796-8

Evaluation of Left Ventricular Function of Patients with Irritable Bowel Syndrome with Tissue Doppler and 2D Speckle Tracking Echocardiography

We aimed to evaluate the systolic and diastolic functions of left ventricule in irritable bowel syndrome (IBS) by conventional echocardiography and two-dimensional (2D) speckle tracking echocardiography (STE) method. Thirty patients with IBS diagnosed with Rome III criteria were referred to our clinic. Standart echocardiographic and 2D-STE evaluation were obtained from all participants. C-reactive protein and erythrocyte sedimentation rate showing inflammation were significantly higher in patients with IBS compared to control group. Comparision of echocardiographic and tissue doppler imaging parameters measured from the septal mitral annulus demonstrated similar values between both groups. There were not any differences between the groups in terms of SRS-3C, SRE-4C, SRE-3C, SRE-2C, GLSRE, SRA-4C, SLA-3C, SLA-2C and GLSRA (p>0.05, for all). GLS (p=0.002), GLSRS (p=0.021), SRS-2C (p=0.030), S-4C (p=0.001), S-3C (p=0.025) and S-2C (p=0.012) values were significantly lower in IBS patients than in the control group. Our results suggest that IBS of which pathogenesis cannot be clearly elucidated is an inflammatory process and the heart may also be affected from this process. 2D-STE can also be useful in determination of subclinical left ventricular dysfunction in IBS patients. [Med-Science 2015; 4(3.000): 2507-15

Is Nebivolol Really Effective in Preventing Contrast Induced Nephropathy?

Background/Aims: Contrast induced nephropathy (CIN) has multifactorial etiopatogenesis including oxidative stress and vasoconstriction. Nebivolol is an antioxidant and has vasodilatatory effect via NO release and may prevent CIN development. We have noticed that a few number of studies that have evaluated the effectiveness of nebivolol for the prevention of CIN used serum creatinine (sCr) levels for CIN detection. However, sCr is an insensitive marker for renal damage. Therefore in this study we used serum neutrophil-gelatinase associated lipocalin (NGAL), a more sensitive marker of renal damage, to evaluate preventive role of nebivolol in CIN. Methods: 159 patients undergoing coronary angiography (CAG) who had at least one risk factor for CIN were divided into nebivolol (+) and (-) groups. CIN was defined as a rise in sCr of 0.5mg/dl or a 25% increase from the baseline value. Serum Cr, glomerular filtration rate (eGFR) and NGAL levels were assessed before and 48 h after CAG. Mehran risk scores were calculated for both groups. Results: Both groups were similar in terms of baseline characteristics, Mehran risk scores, and current medications. Clinically, CIN developed at similar rates in both groups. Serum Cr, eGFR and NGAL values were similar in both groups before and after CAG. Serum Cr and NGAL levels increased and eGFR decreased significantly compared to the levels before CAG. Patients who developed CIN were significantly older (p=0.003), and were more likely to have DM (p=0.012), a higher mean contrast agent volume (pConclusion: According to the results of our study Nebivolol does not seem to prevent CIN in patients undergoing CAG. However, further randomised controlled trials with more sensitive renal damage markers are obviously needed to understand the actual effect of nebivolol on CIN especially through oxidative pathways and in high risk patients