Relationship of left atrial global peak systolic strain with left ventricular diastolic dysfunction and brain natriuretic peptide level in patients presenting with non-st elevation myocardial infarction

PubMed: 25338184Background: In patients presenting with non-ST elevation myocardial infarction, we investigated the relationship of left atrial deformational parameters evaluated by 2-dimensional speckle tracking imaging (2D-STI) with conventional echocardiographic diastolic dysfunction parameters and brain natriuretic peptide level.Material/Methods: We enrolled 74 non-ST segment elevation myocardial infarction patients who were treated with percutaneous coronary intervention and 58 healthy control subjects. Non-ST segment elevation myocardial infarction patients had echocardiographic examination 48 h after the percutaneous coronary intervention procedure and venous blood samples were drawn simultaneously. In addition to conventional echocardiographic parameters, left atrial strain curves were obtained for each patient. Average peak left atrial strain values during left ventricular systole were measured.Results: BNP values were higher in non-ST segment elevation myocardial infarction patients compared to controls. Mean left atrium peak systolic global longitudinal strain in Group 2 (the control group) was higher than in the nonST segment elevation myocardial infarction group. Left atrium peak systolic global longitudinal strain was significantly correlated with left ventricular ejection fraction. There was a significant inverse correlation between left atrium peak systolic global longitudinal strain and brain natriuretic peptide level, left atrium volume maximum, and left atrium volume minimum.Conclusions: Our study shows that Left atrium peak systolic global longitudinal strain values decreased consistently with deteriorating systolic and diastolic function in non-ST segment elevation myocardial infarction patients treated with percutaneous coronary intervention. Left atrium peak systolic global longitudinal strain measurements may be helpful as a complimentary method to evaluate diastolic function in this patient population. © Med Sci Monit, 2014

Aortic propagation velocity in the prediction of coronary artery disease severity

Aims. To investigate the association of the aortic propagation velocity (APV) with coronary artery disease (CAD) in patients with stable angina pectoris (SAP) through SYNTAX scores (SS). ethods. The study population comprised 214 SAP subjects who received a coronary angiography. The APV and ca-rotid intima-media thickness (CIMT) were examined and SS was calculated. Subjects were grouped following specific SS criteria: SS less than 22 (low) and SS greater than or equal to 22 (high). Results. High SS subjects had lower APV compared to low SS [39.0 (32.0-51.7) vs. 55.0 (45.0-62.0) cm/s, respectively; P<0.001] and higher CIMT (0.86 +/- 0.24 vs. 0.74 +/- 0.21 mm, respectively; P<0.001). APV demonstrated a negative cor-relation with the CIMT (r=-0.239, P<0.001), age (r=-0.188, P=0.006) , and SS (r=-0.561, P <0.001) and showed a positive association with LV ejection fraction (r=0.163, P=0.017). APV, CIMT, diabetes, low-density lipoprotein cholesterol (LDL-C), and age were determined to be markers independently of a high SS. Conclusion. APV, CIMT, diabetes, LDL-C and age are independently linked to the CAD severity of SAP subjects. Decreased APV, an indicator of subclinical atherosclerosis, may independently help determine the severity of atherosclerotic CAD in SAP patients

Current approach to contrast nephropathy

Contrast nephropathy is the third most common cause of hospital acquired acute renal failure. With the increasing use of contrast media in radiological procedures it has become one of the major challenges encountered during routine cardiology practice. Contrast nephropathy leads to undesirable clinical circumstances which may result in dead as well as increasing length of hospitalisation and high costs. For these reasons, we present contrast nephropathy in this mini review.</p

Effect of human gestational diabetes mellitus on arterial stiffness

Background. The present study aims to evaluate the parameters for aortic stiffness by comparing gestational diabetes mellitus (GDM) with a healthy control group via transthoracic echocardiography. Methods. This was a cross-sectional study involving monitoring of 62 pregnant women (33 with GDM and 29 with uncomplicated pregnancy as controls) during the third trimester. The aortic strain, aortic distensibility, and aortic stiffness values were measured via transthoracic echocardiography. Measurements of GDM group were repeated after 6 months. Results. Blood pressure levels, heart rate, and basic echocardiography were similar in both groups, but BMI was significantly higher in the GDM group (p &lt;0.001). Whereas, aortic strain and distensibility were significantly lower in the GDM group (p &lt;0.001). Aortic stiffness index was significantly higher in the GDM group (p &lt;0.001). Aortic stiffness parameters did not exhibit any significant difference between the insulin-receiving GDM group and the diet-controlled GDM group. Postprandial glucose levels were correlated positively with the aortic stiffness index (p=0.04) and negatively with the level of aortic strain (p&lt;0.01) and distensibility (p=0.03). The aortic stiffness in normoglycemic postpartum group at 6th month showed a significant improvement (p&lt;0.001); but not in hyperglycemic postpartum group. Conclusion. Arterial stiffness was increased in women with GDM compared to the control group. A correlation between postprandial glucose and arterial stiffness was found. The aortic stiffness can be affected irreversibly from increased clinical and subclinical levels of glucose in postpartum period

Giant myocardial bridge

Koroner arterin bir bölümünün miyokard içinde seyretmesi miyokardiyal köprü (MK) olarak adlandırılmaktadır. Diğer arterlerde de görülebilmesine rağmen MK en sık sol ön inen koroner arterde görülmektedir. MK 10-30mm uzunluğundaki kas lifleridir. Kalp kası bandı nedeniyle oluşan asıl hemodinamik bozukluk sistol sırasında oluşan darlığın, erken ve middiyastolik faza kadar devam etmesidir. Kalp kası bandı olup, hasta üçüncü grupta semptomatikse ve bu semptomlar etkin tıbbi tedaviye rağmen devam ediyor ve efor testi veya eforlu talyum sintigrafisinde iskemi tespit edilmişse suprakoroner miyotomi tercih edilmesi gereken bir yöntemdir.When a portion of the coronary arteries in the myocardium it is called myocardial bridge (MB). Although MB occurs in other arteries; it most frequently occurs over anterior descending coronary artery. MB is muscle fibers 10-30mm long. Actual hemodynamic disorder caused by myocardial band is the continuation of the narrowing that occurs during systole phase until early and middiastolic phase. If patients have myocardial band and are in the third group and symptomatic and if these symptoms continue in spite of effective medical treatment and there is ischemia in the exercise test or thallium scintigraphy with exercise test; supracoronary myotomy is a preferable method