ST yükselmeli miyokart enfarktüsü hastalarında çekilen pıhtının histopatolojik özelliklerinin uzun dönem sol ventrikül fonksiyonuyla ilişkisi

Objective: This study was an investigation of the severity ofinflammation (SOI) in aspirated material and thrombus age toexamine any association with pre-discharge and long-term leftventricular (LV) function after ST-elevation myocardial infarction (STEMI).Methods: The study group comprised 25 patients with STEMIfrom whom an occlusive thrombus was aspirated from the infarct-related artery with a 7-F catheter. The SOI in the aspirate was determined according to the mean leukocyte countin 5 high-power magnification fields and graded as mild in thepresence of ≤100 leukocytes per field or significant if therewere >100 leukocytes per field. The thrombi were categorizedas fresh or lytic/organized (L/O) using predefined criteria.Echocardiographic assessment was performed prior to discharge and at 1 year. Adverse left ventricular remodeling (LVR)was defined as a 20% increase in LV end-diastolic volume incomparison with baseline values.Results: LVR was observed in 8 patients. The mean leukocytecount of the aspirate (127.5±86.0 vs 227.2±120.7; p=0.026)and frequency of significant inflammation (35% vs 75%;p=0.046) were significantly higher in the group with LVR. Theserum high-sensitivity C-reactive protein (hsCRP) level wassignificantly correlated with the leukocyte count of the aspirate (r=0.532; p=0.006). An L/O thrombus was related to betterpre-discharge and long-term LV volumes and ejection fractionvalues compared with a fresh thrombus.Conclusion: A significant increase in the leukocyte count inthe aspirate and a fresh thrombus might predict long-term LVfunctional deterioration irrespective of the clinical and procedure-related characteristics. In addition, serum markers of inflammation, like hsCRP, might also reflect the intensity of thelocal inflammatory response at the site of occlusion.Amaç: Bu çalışmada, ST yükselmeli miyokart enfarktüsü(STYME) sonrası emme yöntemiyle alınan pıhtının yaşı veyangı düzeyinin (YD), taburculuk öncesi ve uzun dönem solventrikül (SV) fonksiyonlarıyla olası ilişkisi araştırıldı.Yöntemler: Çalışmaya enfarktüsle ilişkili arterden tıkayıcı pıhtının 7-F kateter yardımıyla alındığı 25 STYME hastası dahiledildi. Pıhtının YD, beş yüksek düzeyde büyütme alanındagörülen ortalama lökosit sayısına göre derecelendirildi: alanbaşına hafif ≤100 lökosit ve belirgin >100 lökosit. Ayrıca, örnek daha önceden tanımlanmış kriterlere göre taze veya litik/organize (L/O) olarak da sınıflandırıldı. Ekokardiyografik değerlendirme taburculuk öncesi ve birinci yılda yapıldı. Olumsuzsol ventrikül yeniden biçimlenmesi (SVYB), SV diyastol sonuhacminde başlangıç değerine göre %20 artış olması şeklindetanımlandı.Bulgular: SVYB sekiz hastada gözlendi. Alınan örneğin ortalama lökosit sayımı (127.5±86.0 ve 227.2±120.7; p=0.026) vebelirgin yangısı olan hastaların sıklığı (%35 ve %75; p=0.046)SVYB gözlenen grupta anlamlı olarak daha yüksekti. Serumyüksek duyarlıklı keratin C-reaktif protein (hsCRP) düzeyi, örneğin lökosit sayımıyla anlamlı biçimde orantılıydı (r=0.532,p=0.006). Örneğin L/O yapısı, taze pıhtı varlığına kıyasla dahaiyi taburculuk öncesi ve uzun dönem SV hacimleri ve ejeksiyonfraksiyonu değerleriyle ilişkiliydi.Sonuç: Örnekte artmış lökosit sayısı ve taze pıhtı varlığı, klinikve işlemle ilişkili özelliklerden bağımsız olarak SV fonksiyonlarında uzun dönemde bozulma ile ilişkili olabilir. Bunun yanında, hsCRP gibi serum yangı belirteçleri tıkanıklık bölgesindekiyangısal cevabın şiddetini yansıtabilir

Assessment of repolarization abnormalities in baseline electrocardiograms of patients with myocarditis

WOS: 000414976900005PubMed ID: 29151301Background/aim: Myocarditis in the acute phase usually presents with sinus tachycardia but many other arrhythmias might be seen as well. In this study we aimed to investigate repolarization abnormalities in baseline ECG of patients with myocarditis for the first time. Materials and methods: Thirty patients diagnosed with myocarditis and 25 healthy age-matched controls were included. Two different cardiologists measured corrected QT (QTc), QT dispersion (QTd), QT peak (QTp), T wave peak to T wave end (TpTe), TpTe/QT ratio, and TpTe/QTc ratio in 12-lead ECG. Results: When compared with the control group, QTp (P:0.021), QT (P:0.003), TpTe (P < 0.001), TpTe/QTc ratio (P < 0.001), and TpTe/QT ratio (P:0.005) were significantly higher in patients with myocarditis. A comparison of receiver operating characteristic (ROC) curves was conducted using the Hanley and McNeil method. The area under the curve (AUC) of the electrocardiographic characteristics QT (AUC: 0.736; 95% CI [0.600-0.846]), QTP (AUC:0.680; 95% CI [0.540-0.799]), and TpTe (AUC:0.771; 95% CI [0.638-873]) and TpTe/QTc (AUC:0.774; 95% CI [0.641-0.876]) and TpTe/QT (AUC:0.726; 95% CI [0.589-0.838]) in myocarditis were not significantly different from each other but all of them were different from 0.5. Conclusion: Baseline ECGs of patients with myocarditis were associated with repolarization abnormalities. These novel findings may be one of the reasons underlying arrhythmic events in patients with myocarditis

Evaluation of atrial conduction features with tissue doppler imaging in patients with chronic obstructive pulmonary disease

The electrical activity of atria can be demonstrated by P waves on surface electrocardiogram (ECG). Atrial electromechanical delay (AEMD) measured with tissue Doppler imaging (TDI) echocardiography can be a useful non-invasive method for evaluating atrial conduction features. We investigated whether AEMD is prolonged in patients with chronic obstructive pulmonary disease (COPD)

Evaluation of atrial conduction features with tissue doppler imaging in patients with chronic obstructive pulmonary disease

The electrical activity of atria can be demonstrated by P waves on surface electrocardiogram (ECG). Atrial electromechanical delay (AEMD) measured with tissue Doppler imaging (TDI) echocardiography can be a useful non-invasive method for evaluating atrial conduction features. We investigated whether AEMD is prolonged in patients with chronic obstructive pulmonary disease (COPD)