P Wave Dispersion is Increased in Pulmonary Stenosis

Aim: The right atrium pressure load is increased in pulmonary stenosis (PS) that is a congenital anomaly and this changes the electrophysiological characteristics of the atria. However, there is not enough data on the issue of P wave dispersion (PWD) in PS. Methods: Forty- two patients diagnosed as having valvular PS with echocardiography and 33 completely healthy individuals as the control group were included in the study. P wave duration, p wave maximum (p max) and p minimum (p min) were calculated from resting electrocariography (ECG) obtained at the rate of 50 mm/sec. P wave dispersion was derived by subtracting p min from p max. The mean pressure gradient (MPG) at the pulmonary valve, structure of the valve and diameters of the right and left atria were measured with echocardiography. The data from two groups were compared with the Mann-Whitney U test and correlation analysis was performed with the Pearson correlation technique. Results: There wasn’t any statistically significance in the comparison of age, left atrial diameter and p min between two groups. While the MPG at the pulmonary valve was 43.11 ± 18.8 mmHg in PS patients, it was 8.4 ± 4.5 mmHg in the control group. While p max was 107.1 ± 11.5 in PS group, it was 98.2 ± 5.1 in control group (p=0.01), PWD was 40.4 ± 1.2 in PS group, and 27.2 ± 9.3 in the control group (p=0.01)Moreover, while the diameter of the right atrium in PS group was greater than that of the control group, (38.7 ± 3.9 vs 30.2 ± 2.5, p=0.02). We detected a correlation between PWD and pressure gradient in regression analysis. Conclusion: P wave dispersion and p max are increased in PS. While PWD was correlated with the pressure gradient that is the degree of narrowing, it was not correlated with the diameters of the right and left atria

High Altitude and Heart

Nowadays, situations associated with high altitude such as mountaineering, aviation increasingly draw the attention of people. Gas pressure decreases and hypoxia is encountered when climbing higher. Physiological and pathological responses of human body to different heights are different. Therefore, physiological and pathological changes that may occur together with height and to know the clinical outcomes of these are important . Acute mountain sickness caused by high altitude and high altitude cerebral edema are preventable diseases with appropriate precautions. Atmospheric oxygen decreasing with height, initiates many adaptive mechanisms. These adaptation mechanisms and acclimatization vary widely among individuals because of reasons such as environmental factors, exercise and cold. High altitude causes different changes in the cardiovascular system with various mechanisms. Although normal individuals easily adapt to these changes, this situation can lead to undesirable results in people with heart disease. For this reason, it should be known the effective evaluation of the people with known heart disease before traveling to high altitude and the complications due to the changes with height and the recommendations can be made to these patients. [TAF Prev Med Bull 2011; 10(2.000): 211-222

N-terminal pro-B-type natriuretic peptide levels increases after hyperbaric oxygen therapy in diabetic patients

Purpose: Diabetic patients receive hyperbaric oxygen therapy for non-healing lower extremity ulcers. Exposure to hyperbaric hyperoxia during hyperbaric oxygen therapy may affect cardiovascular functions by different mechanisms. Patients may experience serious problems such as pulmonary edema and death during hyperbaric oxygen therapy. The effect of hyperbaric oxygen therapy on cardiovascular functions in diabetic patients is not well documented. N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been suggested as powerful biochemical marker of cardiac function. The aim of this study was to investigate the effect of hyperbaric oxygen therapy on NT-proBNP levels in diabetic patients. Methods: Twenty-five diabetic patients (19 male and 6 female, 64.7 ± 10.2 yr), who were planning to undergo hyperbaric oxygen therapy for non-healing lower extremity ulcers, were prospectively enrolled into the study. All patients were evaluated with echocardiography before the study. Heart rate and arterial blood pressure of patients were measured, and venous blood samples were drawn from each patient for NT-proBNP analysis before and immediately after the hyperbaric oxygen therapy. Results: NT-proBNP levels increased from 815 ± 1096 pg/ml to 915 ± 1191 pg/ml after HBO2 therapy (P 0.05). Conclusion: Hyperbaric oxygen therapy induces considerable ventricular wall stress in diabetic patients. Care should be taken when a diabetic patient with cardiovascular disease is treated with hyperbaric oxygen therapy