A Young Aged Myocardial Infarction with Factor V Leiden Mutation and High Lipoprotein A Level

Summary Factor V Leiden (FVL) mutation has been shown tendency to thrombosis. Lipoprotein a (Lpa) is thought to be proatherogenic and prothrombotic. There are several publications that were reported that FVL mutation might be responsible for myocardial infarction especially in a young age group. 33 year old male patient was admitted to the emergency room with chest pain. Acute anterior myocardial infarction was diagnosed with electrocardiography. Coronary Angiography was performed. Coronary Angiography showed that there was a total occlusion in the proximal part of the left anterior descending artery (LAD). Other coronary arteries were normal. Complete patency was achieved with direct stent procedures in the completely occluded part of the left anterior descending coronary artery. FVL heterozygous mutation was found with polymerase chain reaction method. Elevated Lpa was found in the same period. A control angiography was done 2 months after the stent application because of recurrent anginal attacks. In the control angiography, it was observed that stent was open. [Cukurova Med J 2013; 38(3.000): 525-527

Nitric oxide functions in the heart

Nitric oxide (NO) is an important organizer of the cardiovascular function and is an important mechanism in hampering the pathogenesis of the diseased heart. The scenario of bioavailable NO in the myocardium is complicated: 1) NO obtain from both endogenous and exogenous NO synthases (NOSs) and the number of NO from exogenous sources varies considerably. 2) NOSs are located at separated regions of cardiac cells and are organized by varied ways under stress.3) NO arranges various target proteins via different ways of post-transcriptional modification which are soluble guanylate cyclase [sGC]/cyclic guanosine monophosphate [cGMP]/protein kinase G [PKG]-dependent phosphorylation, S-nitrosylation, and trans-nitrosylation. 4) the downgradient stabilizers of NO differ from proteins and enzymes in the mitochondria and membrane.5) NOS generates several radicals in addition to that NO (varied NO-associated yields) and stimulates redox responses. But, NOS inhibits cardiac oxidases to diminish the sources of oxidative stress in diseased hearts. Recent consensus indicates the importance of nNOS protein in cardiac protection under pathological stress and NO-dependent mechanisms are better understood in healthy and diseased hearts. </p

The diagnostic value of QT dispersion for acute coronary syndrome in patients presenting with chest pain and nondiagnostic initial electrocardiograms

BACKGROUND: Patients presenting with chest pain and nondiagnostic electrocardiograms (ECG) in the emergency department (ED) often pose a challenge to physicians. QT dispersion (QTD) is an electrocardiographic marker of myocardial ischemia due to nonhomogeneous ventricular repolarization. We hypothesized that QTD could accurately identify patients with acute coronary syndrome (ACS) who presented with chest pain and nondiagnostic initial ECGs

The effect of rapid blood pressure control on P-wave dispersion in hypertensive urgency

A sharp increase in blood pressure, increase in atrial pressure and atrial strain, left ventricular diastolic dysfunction, and left ventricular hypertrophy (LVH) lead to heterogeneity and instability in atrial conduction. The resulting physiopathological situation may elevate maximum Pwave duration (P-max) and P-wave dispersion (PWD) in electrocardiography. The objective of our study was to explore the effect of the sudden change in atrial hemodynamics on P-max and PWD, which may indicate the risk of atrial fibrillation (AF) development in hypertensive urgency

Is there a correlation between systolic heart failure and levels of toll-like receptor-5 and N-terminal pro-B-type natriuretic peptide?

Objective: Specific biomarkers are essential in the diagnosis of heart failure. Our trial aim is determined that relationship between toll-like receptor-5 (TLR-5) and N-terminal pro-B-type natriuretic peptide (NT-ProBNP) in patients with reduced ejection fraction. Methods: Two groups were formed in our study (normal and patient group). Among the two groups were investigated that relationship between TLR-5 and NT-ProBNP. Results: The plasma levels of both NT-ProBNP and TLR-5 are significantly higher in patients with congestive heart failure than healthy individuals. However, there is no definite correlation between plasma levels of NT-ProBNP and TLR-5 in patients with congestive heart failure. The high-level plasma TLR-5 is of prognostic value independent from the plasma NT-ProBNP levels, in these patients. Conclusion: As a conclusion, according to recent studies, the high plasma levels of NT-ProBNP and TLR-5 are mainly associated with high mortality and longer hospitalization rate in individuals with heart failure. Therefore, the higher is plasma levels of markers such as TLR-5 and NT-ProBNP, the worse is the overall prognosis in these patients. NT- ProBNP and TLR-5 are thought to be the cheapest and the most appropriate marker to be determined

The Effect of Acute Allergic Reactions on Diastolic Heart Function

Purpose: Diastolic heart failure is characterized by the presence of heart failure symptoms despite preserved systolic function. Cytokines released during allergic reactions may impair diastolic heart function, either through their direct toxic effects or by inducing coronary artery spasm. The purpose of this study was to examine the effects of acute allergic reactions on diastolic heart function. Methods: Fifty patients, randomly selected from those who were admitted to the emergency room between May 2010 and December 2010 with the complaints of rash and itching, and who were subsequently diagnosed with allergic reactions based on the clinical and laboratory findings, were included in the study as the allergy group. Thirty healthy volunteers, in whom the diagnosis of allergy was ruled out based on the clinical and laboratory data, were use as the control group. Diastolic heart functions were evaluated in patients presenting with allergic reaction as well as in control subjects. Results: There was no significant difference between the two groups in terms of basal systolic functions, diameters of the cavities and wall thicknesses, and biochemical parameters. Color M mode flow progression velocities, E ratios, E/A ratios and mitral lateral annulus tissue Doppler velocities measured by echocardiography at Day 0 and Day 5 were significantly altered in the allergy group (p < 0.05). Conclusion: Impairment in diastolic functions was observed following acute allergic reactions. Acute allergic reactions could be a cause of mortality and morbidity if they lead to the development of diastolic heart failure