EVALUATION OF RIGHT VENTRICLE SYSTOLIC AND DIASTOLIC FUNCTION IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION

Objective: Atrial fibrillation (AF) is frequently an electrical sign of underlying structural heart disease. Structural remodelling may begin not only in ventricles but also in atrium secondary to AF. In this study, we sought to investigate the effect of paroxysmal atrial fibrillation (PAF) on right ventricle function. Method: We prospectively analyzed 30 patients diagnosed with PAF and 25 control individuals. Cardiac risk factors and medical treatment of patients were obtained and recorded in both groups. Right ventricle tricuspid annular plane systolic excursion (TAPSE) and Tei indexes were measured as an indicator of right ventricular function. Results: There was no statistical difference between groups in terms of demographic and clinical characteristics. Tei index was higher and TAPSE was lower in PAF group compared to control individuals (p>0.05). There was no statistically significant difference between PAF and control groups in terms of right ventricular diastolic functions neither. Although isovolumic relaxation time (IVRT) was higher in PAF group, it did not give statistical significance. Conclusion: In this study, even not being statistically significant Tei index, which assess right ventricular function was over upper limit in PAF patients. This may have been as the result of prolonged IVRT. This result may indicate that right ventricular diastolic functions may be effected in patients with PAF

Isolated coronary artery bypass surgery in patients with mild to moderate ischemic mitral regurgitation: Early results

The optimal management of moderate ischemic mitral regurgitation (MR) remains controversial. Some surgeons advocate coronary artery bypass alone, while others suggest concomitant mitral valve annuloplasty. We aimed to evaluate the early results of isolated coronary artery bypass operation on the cases with mild-to-moderate ischemic MR. Between May 2010 and May 2011, 59 patients (64% male, mean age: 50.5 years) with a preoperative diagnosis of mild-to-moderate ischemic MR underwent a coronary bypass operation. Patients evaluated with preoperative and postoperative (in twelve-month period with an average of five months) transthoracic echocardiogram (TTE). Postoperative mortality was not observed in study group. The preoperative functional capacity of the patients as well as the variables of mild MR and moderate MR showed a statistically significant difference in a positive way when compared with the postoperative functional capacity and MR variables. Postoperative TTE evaluation revealed that only 2 cases have severe MR (3,4%) also 62,7 % of patients have mild and 33.9% of patients have moderate MR. While there was a significant difference in a positive way between the preoperative and postoperative period in terms of left atrial diameter, no significant difference was found for the variables of ejection fraction and pulmonary artery pressure. Among the patients whom undergoing coronary bypass surgery, if there is mild or moderate MR revealed with the TTE prior to the operation, performing only coronary bypass operation will be adequate, and our early results in this matter are satisfactory. But, if severe MR revealed with TTE, performance of mitral valve repair or replacement should be evaluated additional to coronary bypass operation. [Med-Science 2018; 7(1.000): 114-117

Zależność między stężeniem homocysteiny w surowicy a nieprawidłowościami struktury i czynności tętnic szyjnych w nieaktywnej fazie choroby Behçeta

Background: Behçet’s disease (BD) is a chronic autoimmune disorder with symptoms manifesting from an underlying vasculitis. Since the disease activity is correlated with characteristic vascular endothelial dysfunction, BD places individuals at increased risk of cardiovascular diseases, such as atherosclerosis. Hyperhomocysteinaemia is an independent risk factor for arteriosclerotic vascular diseases. Aim: This study was designed to investigate how plasma homocysteine (Hcy) affects the structural and functional properties of the carotid artery in humans. Methods: Sixty-eight BD patients with subclinical atherosclerosis and 40 healthy controls underwent carotid sonography and Doppler ultrasound to measure carotid artery intima–media thickness (C-IMT) and carotid stiffness and distensibility (indicat­ing elasticity). Total Hcy level was determined by enzyme-linked immunosorbent assay. For analysis, the BD patients were sub-grouped according to hyperhomocysteinaemia (> 15 μmol/L). Results: The patients with BD were found to have increased C-IMT and beta stiffness and decreased distensibility. In addition, hyperhomocysteinaemia was significantly correlated with these detrimental changes in the carotid artery, possibly raising the risk of these patients developing atherosclerosis. Conclusions: These findings suggest a potential mechanism of atherosclerosis in BD and highlight the processes that future research should focus on to address identification and prophylactic treatment of BD patients at risk of cardiovascular disease.Wstęp: Choroba Behçeta (BD) to przewlekłe schorzenie autoimmunologiczne z objawami spowodowanymi zapaleniem naczyń. Ze względu na to, że aktywność choroby wiąże się z charakterystyczną dysfunkcją śródbłonka naczyniowego osoby chore na BD są obciążone zwiększonym ryzykiem chorób sercowo-naczyniowych, takich jak miażdżyca. Hiperhomocysteinemia jest niezależnym czynnikiem ryzyka miażdżycowej choroby naczyń. Cel: Badanie przeprowadzono w celu oceny wpływu stężenia homocysteiny (Hcy) w osoczu na strukturalne i czynnościowe właściwości tętnicy szyjnej u ludzi. Metody: U 68 chorych na BD z subkliniczną miażdżycą oraz u 40 zdrowych osób z grupy kontrolnej wykonano badanie ultrasonograficzne (USG) w celu oceny tętnic szyjnych oraz USG doplerowskie w celu pomiaru grubości kompleksu błony środkowej i wewnętrznej tętnic szyjnych (C-IMT) oraz sztywności i rozszerzalności tych tętnic (świadczących o ich elastyczności). Całkowite stężenie Hcy określono metodą immunoenzymatyczną. Na potrzeby analizy chorych na BD podzielono na podgrupy w zależności od obecności hiperhomocysteinemii (Hcy >15 μmol/l). Wyniki: U chorych na BD stwierdzono zwiększone wartości C-IMT i wskaźnika sztywności tętnic beta oraz zmniejszoną rozszerzalność tętnic. Hiperhomocysteinemia była istotnie skorelowana z tymi niekorzystnymi zmianami w tętnicach szyjnych, potencjalnie zwiększającymi ryzyko rozwoju miażdżycy u tych pacjentów. Wnioski: Uzyskane wyniki wskazują na możliwy mechanizm rozwoju miażdżycy u chorych na BD i zwracają uwagę na procesy, na których należy się skupić w przyszłych badaniach dotyczących identyfikacji pacjentów z BD zagrożonych rozwojem chorób sercowo-naczyniowych i odpowiedniego leczenia profilaktycznego w tej grupie osób

The Effect of Selective Endothelin Receptor a Antagonism by Bq-123 on Myocardial Ischemia-Reperfusion Induced Apoptotic Cell Death

The objective of the present study was to investigate the possible impact of specific endothelin-A (ETA) receptor blockage by BQ-123 on myocardial ischemia-reperfusion (MI/R) induced apoptosis in rats. To produce MI/R, a branch of the descending left coronary artery was occluded for 30 min followed by 2 h reperfusion. Thirty-two rats were randomly assigned to four groups equally: (1) sham-operated group, (2) MI/R group, (3) MI/R+BQ-123-treated group, and (4) MI/R+ET-1+BQ-123-treated group. TUNEL staining, caspase-3 and caspase-9 activities were determined immunohistologically. MI/R group revealed extensive TUNEL positive cardiomyocytes especially in the free wall of the left ventricule, interventicular septum, and apex zone. Intensity of TUNEL-positive cardiomyocytes reduced as a result of BQ-123 treatment compared to the sham group in the same sections. Result of the caspase activity was found to correlate with TUNEL evaluation. BQ-123 administrations to MI/R group with or without ET-1 caused significant decrease both in lipid peroxidation and nitric oxide (NO) generation. Also, BQ-123 leads to augmentation of superoxide dismutase, catalase and glutathione contents. We propose that selective ETA antagonism by BQ-123 has a worthwhile effect on apoptotic cell death following MI/R, and that scavenging of free radicals by selective ETA antagonist is part of this beneficial effect. [Med-Science 2012; 1(4.000): 254-70

Cardiovascular effects of JWH-018 from synthetic cannabinoids [Sentetik kannabinoidlerden JWH-018in kardiyovaskuler etkileri]

The content of synthetic cannabinoids (SC) which are known in Europe as Spice, in the U.S.A. as K2, and in Turkey as Bonsai or Jamaica is not standard. Also SC are known to contain approximately 400 chemical compounds which vary from country to country. SC mimics the effect of Δ9-tetrahydrocannabinol (THC) which is the major effective content of Cannabis or Marijuana by cannabinoid-1 (CB1) and cannabinoid-2 (CB2) receptors in the body cell. Although the new SC are synthesized and the number of new variants is increased in every day; JWH-018 among these variants exerts full agonist effect on both CB1 and CB2 receptors also it has a short-term effect as 2 hours. For this reason, JWH-018 is the most commonly used as SC. There are a few data in the literature regarding to the pharmacokinetic and pharmacodynamic effects of SC. Furthermore, most of the existing data are based on in vitro experiments. In the JWH-018 report, at Critical Review Report Agenda item 4.5 Expert Committee on Drug Dependence of World Health Organization (WHO), Thirty‐sixth Meeting Geneva, 16‐20 June 2014, is declared that despite a marked elevation of the heart rate is one of the clinical signs very often seen after intoxication with SC, there is no available study data regarding effects of SC on cardiovascular, respiratory, gastrointestinal, liver, kidneys and genitourinary systems. The aim of this review is to highlight cardiovascular effects of JW-018 which is considered to be the prototype for synthetic cannabinoids to prepare the ground for new work to be done. [Med-Science 2016; 5(4.000): 1049-54