Ulein’in Total Sentezine Giriş

In this part of the study of total synthesis ulein, 3-ethyl-1,2,3,4-tetrahydrocarbazole (1) has been obtained from phenylhydrazinium hycrochloride with 4-ethylcyclohexanon in the atmosphere of nitrogen. 3-Ethyl-1-oxo-1,2,3,4-tetrahydrocarbazole (2) has been synthesized from the reaction of oxidation of 3-ethyl-1,2,3,4-tetrahydrocarbazole (1). The structures of these compounds were determined by IR-, 1H-NMR spectroscopic data and elemental analysis

Effects of diabetes mellitus on left atrial volume and functions in normotensive patients without symptomatic cardiovascular disease

Purpose: Left atrial (LA) size has been shown to be a predictor of adverse cardiovascular outcomes. The aim of the study was to evaluate the direct effect of diabetes mellitus (DM) on left atrial volume and phasic functions by using real-time three-dimensional echocardiography (RT3DE) in a population of patients free of symptomatic cardiovascular disease and hypertension. Methods: Comprehensive transthoracic echocardiographic examination was performed on 40 consecutive patients with DM (20 male, age: 50.5 +/- 7.3 years) and 40 healthy controls (20 male, age: 48.4 +/- 6.7 years). In addition to conventional 2D echocardiographic measurements RT3DE was performed to assess LA volumes and phasic functions. Results: There were no significant difference between groups regarding parameters reflecting LV systolic function as LV diameters and ejection fraction. However, regarding parameters reflecting LV diastolic function; transmitral deceleration time and E/E' ratio values were significantly higher and majority of early diastolic tissue Doppler velocity values were significantly lower in diabetic patients compared with controls. RT3DE demonstrated significantly higher LA maximum and minimum volumes for diabetic patients compared with controls (40.9 +/- 11.9 vs 34.6 +/- 9.3 mL, p: 0.009 and 15.6 +/- 5.9 vs 11.9 +/- 4.6 mL, p: 0.002, consecutively). LA total emptying fraction (TEF), expansion index (El) and active emptying fraction (AEF) were found to be significantly lower in diabetics reflecting depressed LA reservoir and pump functions. There was no significant difference between groups regarding passive emptying fraction (PEF) which is assumed to be a marker of left atrial conduit function. Conclusion: Patients with type 2 diabetes mellitus were found to have increased LA volume and impaired atrial compliance and contractility. Evaluation of asymptomatic diabetic patients by using RT3DE atrial volume analysis may facilitate recognition of subtle myocardial alterations related with type 2 diabetes. (C) 2014 Elsevier Inc. All rights reserved

Evaluation of right ventricular dyssynchrony in patients with acute inferior myocardial infarction and its relation with mortality

Purpose The aim of this study was to evaluate right ventricle (RV) dyssynchrony and its relation with mortality using speckle-tracking echocardiography (STE) in patients with acute inferior myocardial infarction (IMI). Methods One hundred and fifty-eight consecutive patients with acute IMI treated with primary percutaneous coronary intervention, and 44 healthy subjects were included. RV myocardial involvement (RVMI) was defined as an elevation >1 mm in V1 or V4R and/or the presence of a culprit lesion at the proximal portion of the first RV marginal branch after reviewing coronary angiography. Patients were followed for 3 years to determine the cardiovascular mortality. Results Overall, 70 patients with IMI had RVMI. IMI patients had significantly higher RV peak systolic longitudinal strain dyssynchrony (PLSSD) index, lower peak longitudinal systolic strain (PLSS), longer time to PLSS, and time to PLSS differences compared to healthy controls while the patients with RVMI had significantly worse values compared to patients without RVMI and healthy controls. Twenty-seven patients (17.1%) died within 2 years. RVMI was more prevalent in mortality group, and they had significantly higher RV PSSD index, whereas they had lower RV free wall PLSS and longer time to PLSS differences. Receiver operating characteristics (ROC) analysis revealed that a RV PLSSD index > 65 ms predicted mortality with a sensitivity of 88.9% and specificity of 71.8% in IMI patients. Conclusions Intra- and inter-ventricular dyssynhcrony may develop in patients with acute IMI, especially in those with RV involvement, which might have a negative effect on the prognosis of these patients

The impact of right ventricular function assessed by 2-dimensional speckle tracking echocardiography on early mortality in patients with inferior myocardial infarction

BackgroundRight ventricular (RV) involvement in inferior myocardial infarction (MI) increases in-hospital morbidity and mortality. HypothesisRV systolic dysfunction assessed by 2-dimensional speckle tracking echocardiography (STE) might be a predictor of early mortality in patients with acute inferior MI. MethodsEighty-one consecutive patients with acute inferior MI (mean age, 60.812.7years; 18 females) were included. RV myocardial involvement was defined as an elevation >1mm in V-1 or V4R within 12hours of symptom onset. RV function was assessed by STE. Patients were followed for 30days for all-cause mortality. ResultsThirty-eight patients had RV myocardial involvement, and they had significantly lower tricuspid annular plane systolic excursion (TAPSE), tricuspid annular systolic velocity (RVS), and left ventricular (LV) and RV global longitudinal strain (GLS). Nine patients (11%) died within 30days. The mean age of mortality group was higher with more female frequency. They had significantly higher pro-BNP, hs-troponin T, and creatinine levels, but lower hemoglobin levels. TIMI 3 flow was significantly less achieved in mortality group. RV myocardial involvement was more frequent in the mortality group, and they had significantly lower TAPSE, RVS, and LV and RV GLS. Multivariate analysis revealed that age and RV GLS were independent predictors of early mortality. RV GLS -14% predicted early mortality in patients with acute inferior MI with a sensitivity of 88.9% and a specificity of 62.5% (AUC: 0.817, P =0.002). ConclusionsRV GLS may be useful in predicting early mortality in patients with acute inferior MI

Evaluation of arterial stiffness and hemodynamics by oscillometric method in patients with systemic sclerosis

Arterial stiffness and its hemodynamic consequences are associated with adverse cardiovascular events. Pulse wave velocity (PWV) and augmentation index (AIx) are noninvasive markers of arterial stiffness. Systemic sclerosis (SSc) is a systemic, autoimmune disease affecting mainly the small vessels. The aim of this study was to evaluate the arterial stiffness parameters and hemodynamics by oscillometric method in patients with SSc. Thirty-five consecutive patients with diagnosed SSc and 35 age- and sex-matched healthy controls were included in the study. Measurements of arterial stiffness were carried out by using a Mobil-O-Graph arteriograph system that detected signals from the brachial artery. While hemodynamic parameters were not statistically significant between SSc and control groups, heart rate was significantly higher in SSc group (84 +/- 12 and 72 +/- 7 bpm, p = 0.001). SSc patients had significantly higher AIx and PWV values compared with controls (27.9 +/- 12.4 versus 21.0 +/- 11.4 %, p = 0.019 and 6.56 +/- 1.5 versus 5.04 +/- 0.17 m/s, p < 0.001, respectively). PWV was significantly associated with SSc when adjusted by heart rate (p = 0.001, Odds ratio (OR): 17.304, 95 % confidence interval (CI): 3.225-92.832). PWV and AIx were significantly higher in patients with SSc. Measurement of arterial stiffness parameters using oscillometric method was reliable, reproducible and easy in patients with SSc