Can Syntax Score Play A Role In The Evaluation Of Viability?

WoSScopusPubMe

Noninvasive Cardiac Imaging For The Diagnosis Of Coronary Artery Disease In Women

Cardiovascular diseases are the foremost cause of morbidity and mortality for both genders worldwide. Appropriate diagnostic tests with increased accuracy and safety provide the decisive relationship between diagnosis and treatment of coronary artery disease ( CAD). However, it has been known that women at risk for occurrence of CAD are less often conducted for the proper diagnostic tests compared to men. Many noninvasive diagnostic modalities (exercise/stress electrocardiogram, echocardiography, nuclear imaging, magnetic resonance imaging and coronary computerized tomography) are available for this purpose in the women. In this review, we present the current data on the role of both conventional and modern noninvasive diagnostic tests in the assessment of women with CAD suspicion.WoSScopu

Evaluation Of The Valvular And Biventricular Functions In Parkinson Patients Using Ergotamine-Derived Dopamine Agonist: An Observational Study

Objective: In this study, we aimed to evaluate the impact of cabergoline use in patients with Parkinson's disease on valvular and biventricular functions. Methods: In this observational cohort study, patients with Parkinson disease were divided into 2 groups as 34 patients (41.2% female, age; 57.4 +/- 15.3 years) using cabergoline (Group 1) and 42 patients (61.9% female, age; 53.7 +/- 7.1 years) not using cabergoline (Group 2). In addition to conventional echocardiography and diastolic functions, tissue Doppler imaging was used to evaluate both global and regional systolic -diastolic functions. Correlations were assessed using Pearson correlation coefficient for normally distributed variables. Results: In group 1 patients cabergoline was used for 7.7 +/- 5.1 years and mean and cumulative cabergoline dose were 3.3 +/- 1.1 mg and 9.8 +/- 7.0 g respectively. Left ventricular systolic functions and tissue Doppler measurements of septal and lateral mitral annulus and right ventricular systolic and diastolic velocities were similar between groups. Mitral valve tenting area was significantly higher in patients using cabergoline (p=0.007). The association between cumulative cabergoline dose and diastolic functions was also evaluated which revealed that among diastolic function parameters, Epeak (r=0.253, p=0.042), E/A (r=0.256, p=0.026) and DT (r=-0.382, p=0.001) were correlated with cumulative cabergoline dose. There was a positive correlation between cumulative cabergoline dose and duration of cabergoline therapy with composite regurgitation score (r=0.435, p<0.001; r=0.485, p<0.001, respectively). Conclusion: Our findings indicated that despite the well known effects of cabergoline on valvular functions, we did not observe any alteration in systolic functions, but diastolic functions which was associated with cumulative cabergoline dose in patients with Parkinson's disease.WoSScopu

Relationship Between Vitamin D Level and Left Atrial Fibrosis in Patients with Lone Paroxysmal Atrial Fibrillation Undergoing Cryoballoon-Based Catheter Ablation

Background: Left atrial (LA) fibrosis is known as the hallmark for arrhythmogenic substrate in atrial fibrillation (AF). Quantification of LA fibrosis by using delayed-enhanced magnetic resonance imaging (DE-MRI) in AF patients is a pioneering noninvasive technique. Vitamin D (vitD) negatively regulates the renin-angiotensin system, binds to vitD receptors on cardiac myocytes, and has antioxidant properties that may ameliorate the inflammation and proarrhythmic substrate formation. However, its role in LA fibrosis is unclear. We aimed to investigate the association of serum 25(OH)D level with the extent of LA fibrosis by using DE-MRI and also predictors for AF recurrence after cryoablation was assessed in patients with paroxysmal AF. Methods: A total of 48 patients with lone paroxysmal AF (41.7% female; age: 48.5 +/- 8.4 years) who underwent DE-MRI at 1.5 T and initial cryoballoon-based catheter ablation along with 48 healthy control subjects were enrolled. Fibrosis degree was categorized according to Utah class defined in the DECAAF study. Results: Serum 25(OH)D levels were significantly lower in AF group compared to control group (25.8 +/- 7.6 ng/ml vs. 31.0 +/- 9.5 ng/ml, p = 0.004). Serum 25(OH)D levels were associated with moderate severe LA fibrosis independent of other measures (OR: 0.72, 95% CI: 0.54-0.97, p = 0.028). At a mean 16.5 +/- 2.6 months follow-up, late recurrence was observed in 10 (20.8%) patients. In multivariable Cox regression analysis, LA volume index (HR: 1.42, 95% CI: 1.01-2.01, p = 0.045) and the extent of LA fibrosis (HR: 1.14, 95% CI: 1.01-1.28, p = 0.034) were found as independently associated with late AF recurrence during follow-up. Conclusion: Lower levels of serum 25(OH)D are significantly associated with more extensive LA fibrosis in patients with lone paroxysmal AF and may be implicated in the pathophysiology of AF recurrence after cryoablation. Further large-scale studies are needed to elucidate the exact role of vitD deficiency and replacement on LA fibrosis. (C) 2016 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.WoSScopu

Factors affecting sleep quality in patients with systemic lupus erythematosus

Objective This study aimed to assess the sleep quality and the factors affecting the sleep quality in patients with SLE. Methods This was a descriptive and cross-sectional study conducted in 105 patients with SLE who were admitted to the rheumatology polyclinic of a university hospital between May and July 2017. The data were collected using a Patient Description Form and the Pittsburgh Sleep Quality Index (PSQI). Results The total mean (standard deviation) PSQI score of the patients was 7.81 (3.11). Duration of disease, presence of comorbid diseases, side effects of drugs, and sleep disruption and related problems were identified as factors affecting sleep quality. The model of the regression showed that side effects of drugs, sleep disruption, and trouble falling asleep suffered higher PSQI score (bad sleep quality). Conclusions Results of this study showed that the sleep quality was generally poor in patients with SLE. Sleep quality was affected by some disease and sleep variables. Therefore, comprehensive sleep evaluation is necessary in the planning of treatment and care of SLE patients and to implement initiatives to improve sleep patterns in these patients

Effects Of Pacemaker And Implantable Cardioverter Defibrillator Electrodes On Tricuspid Regurgitation And Right Sided Heart Functions

Background: The aim of this study was to assess the effect of trans-tricuspid placement of permanent pacemaker (PPM), implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) leads prospectively on tricuspid valve and right-sided heart functions using two-dimensional echocardiography. Methods: A total of 41 patients (31 male, mean age: 63.6 +/- 12.2 years) were included in this prospective study. Initial echocardiographic evaluation was performed before cardiac device implantation and re-evaluation by echocardiography was performed immediately after the procedure and at 1st, 6th and 12th months. In addition to standard echocardiographic examinations, vena contracta (VC), proximal isovelocity surface area (PISA), and tissue Doppler evaluations were also performed in the study population. Results: Tricuspid regurgitation (TR) is worsened by 1 grade in 70.8% of the patients and 2 grades in 17.1% of the patients in the follow-up. Eight patients without baseline TR developed new-onset TR (9.8% mild, 9.8% moderate) after lead implantation. In the follow-up period, 41.5% of the patients who had mild TR before lead implantation developed moderate TR and 7.3% developed severe TR, whereas 19.5% of the patients with moderate TR developed severe TR during the follow-up. In the follow-up period, VC of TR was increased [median: 0.32 (0.16-0.60) cm in pre-implantation period, and 0.41 (0.18-0.80) cm at 12th month, p = 0.001]. Similarly PISA value of TR was also increased [median: 0.46 (0.15-1.10) cm in pre-implantation period and 0.52 (0.28-1.20) cm at 12th month, p = 0.001]. However, there is not a significant difference between PPMs/ICDs and CRTs regarding the effects on TR (p < 0.05). In addition, right ventricular dimensions and right atrial volumes were increased during the follow-up. Conclusions: Implantation of permanent transvenous right ventricular electrode is associated with worsening of TR, right atrial and right ventricular dimensions. Further studies are needed in order to both outline the effect of those findings on outcomes and clarify the time dependent changes in those functions