Left Main Coronary Artery Thrombus Resulting from Combined Protein C and S Deficiency

Inherited hypercoagulopathies such as protein C and S deficiency usually lead to the formation of venous thrombi in clinical practice; however, they rarely lead to arterial thrombosis. It has been demonstrated that both protein C and S deficiency may lead to myocardial infarctions. However, our literature review revealed no reports of left main coronary artery thrombi caused by protein C and S deficiency. This paper presents a case of a left main coronary artery thrombus resulting from protein C and S deficiency in a young patient with normal coronary arteries

Investigation of the atrial electromechanical delay duration in Behcet patients by tissue Doppler echocardiography

Aims To investigate the atrial electromechanical delay (EMD) duration that is a non-invasive predictor of atrial fibrillation (AF) in patients with Behcet's disease (BD)

Assessment of left atrial mechanical functions in thyroid dysfunction

INTRODUCTION Thyroid hormone deficiency can lead to the impairment of cardiac function

Evaluation of atrial electromechanical delay and left atrial mechanical function in patients with obstructive sleep apnea Cardiac involvement in patients with OSA

The aim of this study was to evaluate atrial electromechanical delay measured by tissue Doppler imaging and left atrial mechanical function in patients with obstructive sleep apnea (OSA)

Can Aortic Elastic Parameters be Used for the Diagnosis of Volume Overload in Patients with End Stage Renal Disease

Background: We aimed here to investigate hydration status by echocardiography in end stage renal disease (ESRD) patients. Methods: 25 ESRD patients [15 males; mean age: 54.0 +/- 16.6 years; 13 hemodialysis; 12 peritoneal dialysis] were considered eligible for this study. We also examined 29 healthy volunteers as a control group (17 males; mean age: 46.5 +/- 12.8 years). Body composition analysis using the bioimpedance spectroscopy technique was performed for volume overload diagnosis. The ratio of extracellular water (ECW) to height was used as volume indices. The aortic elastic parameters were calculated by echocardiography. A correlation analyses was performed between the ratio of ECW to height indicating the volume overload and the aortic elastic parameters e.g. Aortic strain (AS), Aortic distensibility (AD) and Aortic stiffness index (ASI). Results: The ratio of ECW to height that indicates volume overload in ESRD patients was considerably higher than that in the control group (10.25 +/- 1.98 L/m vs 8.66 +/- 1.22 L/m, p=0.001). There was a negative correlation between the ratio of ECW to height and AS and AD and a positive correlation between the ratio of ECW to height and ASI. Conclusion: Given the importance of the diagnosis and follow up of volume overload, the results show that aortic elasticity measurements, being easy to perform and replicate, can be used for this purpose. Copyright (c) 2012 S. Karger AG, Base

The Value of P wave dispersion in predicting reperfusion and infarct related artery patency in acute anterior myocardial infarction

Purpose: The aim of this study is to investigate whether P wave dispersion (PWD), measured before, during and after fibrinolytic therapy (FT,) is able to predict successful reperfusion and infarct related artery (IRA) patency in patients with acute anterior MI who received FT

The Value of P wave dispersion in predicting reperfusion and infarct related artery patency in acute anterior myocardial infarction

Purpose: The aim of this study is to investigate whether P wave dispersion (PWD), measured before, during and after fibrinolytic therapy (FT,) is able to predict successful reperfusion and infarct related artery (IRA) patency in patients with acute anterior MI who received FT. Methods: Sixty-eight patients who presented with acute anterior MI were enrolled in the study. An electrocardiogram was performed before and at 30, 60, 90 and 120 minutes after the start of FT. PWD was defined as the difference between maximum and minimum P wave duration on standard 12-lead surface electrocardiogram. A multivariate logistic regression model was used to assess whether PWD was predictor of IRA patency and ST-segment resolution (STR) on electrocardiogram. Results: PWD120 was significantly lower in patients with STR on electrocardiogram (38 patients) compared with those without STR (30 patients) (44.8±11.5 vs. 52.9±10.3 ms; p < 0.001). PWD120 was found to be significantly lower in patients with patent IRA (31 patients) compared to those with occluded IRA (37 patients) (42.3±9.7 vs. 53.5±10.6 ms; p < 0.001). Logistic regression analysis revealed that PWD120 significantly predicted STR and IRA patency. A ≥51.6 ms PWD120 can predict an occluded IRA with a 87% sensitivity, ≥51 ms PWD120 can predict no reperfusion with a 74% sensitivity. Conclusion: PWD values, which were higher than 51 ms and 51.6 ms in patients who received fibrinolytic therapy, can serve as a marker of failed reperfusion and occluded IRA. PWD values, in combination with other reperfusion parameters, can contribute to the identification of rescue PCI candidates

Differences in sex, angiographic frequency, and parameters in patients with coronary artery anomalies: single-center screening of 25 368 patients by coronary angiography

Background: Although the prevalence of coronary artery anomalies varies in different series, the precise population frequency is unknown. Materials and methods: The medical records of all patients who underwent coronary angiography between January 2002 and August 2012 were retrieved, and 238 cases with coronary anomalies were evaluated. Unlike other studies, we compared several angiographic parameters (fluoroscopy time, number of images, and catheters used) in addition to frequency and sex data. Results: The angiographic frequency of coronary artery anomalies was 0.94%. The most common coronary anomaly was a left anterior descending-circumflex artery originating from separate ostia (0.29%). The second most common anomaly was a right coronary artery (RCA) originating from the left sinus of Valsalva (sV) (0.23%). Overall, coronary artery anomalies (1.28 vs. 0.80%; P&lt;0.001) and a left anterior descending-circumflex artery originating from separate ostia (41.3 vs. 25.3%, P=0.010) were more frequent in women than in men. The percentage of patients requiring more than two catheters during the procedure was significantly higher for an RCA originating from the left sV (45.7 vs. 16.7%, P&lt;0.001) and in hypertensive patients (85.7 vs. 70.8%, P=0.015). On comparing the three most common coronary anomalies, an anomalous RCA originating from the left sV had a significantly higher value for at least one angiographic parameter. Conclusion: An anomalous RCA originating from the left sV is the most difficult type of anomaly to perform the ostial coronary cannulation during procedure. The results of this study may lead to the development of more suitable diagnostic catheters for an anomalous RCA originating from the left sV

Assessment of QRS duration and presence of fragmented QRS in patients with Behcet's disease

WOS: 000323225700010PubMed: 23612364Background QRS prolongation and the presence of QRS fragmentation in 12-lead ECG are associated with increased mortality and sudden cardiac death in the long term. In this study we aimed to assess QRS duration and fragmentation in patients with Behcet's disease (BD).Methods A total of 50 patients (mean age 42.7 +/- 12.0 years) previously diagnosed with BD were recruited. In addition, a control group consisting of 50 healthy people (mean age 39.4 +/- 12.5 years) was formed. The longest QRS duration was measured in surface 12-lead ECG and QRS complexes were evaluated in terms of fragmentation. Serum C-reactive protein levels were also obtained.Results QRS duration and corrected QT duration were significantly longer in patients with BD compared with controls (102.75 +/- 11.91 vs. 96.99 +/- 10.91 ms, P=0.007; 438.55 +/- 30.80 vs. 420.23 +/- 28.06 ms, P=0.003, respectively). Fragmented QRS (fQRS) pattern was more common in patients with BD than controls [n=27 (54%) vs. n=16 (32%), P=0.026]. Disease duration was longer in patients with BD with fQRS compared with those without (12.67 +/- 8.68 vs. 7.09 +/- 7.06 years, P=0.010). Furthermore, C-reactive protein level was higher in patients with BD with fQRS compared with those without (6.53 +/- 4.11 vs. 4.97 +/- 6.32 mg/dl, P=0.043). Correlation analysis revealed no association between disease duration and QRS duration (r=0.219, P=0.126).Conclusion QRS duration is greater and fQRS complexes are more frequent in patients with BD. These findings may indicate subclinical cardiac involvement in BD. Given the prognostic significance of ECG parameters, it is reasonable to evaluate patients with BD with prolonged and fQRS complexes more in detail such as late potentials in signal averaged ECG in terms of cardiac involvement