Cardiogenic Shock Due to Coronary Artery Stent Thrombosis

Stent thrombosis is an uncommon but serious complication that causes sudden death or myocardial infarction (MI). A large MI, especially with ST elevation, can cause cardiogenic shock and pose a significant incidence of morbidity and mortality. Largeness of ischemic territory is the main reason that causes cardiogenic shock. The fundamental treatment strategies are immediate coronary revascularization and perfusion support to avoid end organ damage with medically or mechanical in intensive care units. The prevention, incidences, mechanisms, management, and clinical impacts of cardiogenic shock discussed under this topic

Ranolazine improved left ventricular diastolic functions and ventricular repolarization indexes in patients with coronary slow flow

IntroductionCoronary slow flow (CSF) is a condition commonly encountered during angiography. Recent studies have shown the adverse effects of CSF on left ventricular diastolic functions. CSF reportedly increases the novel ventricular repolarization parameters. Ranolazine is a preparation with a prominent anti-anginal activity that has positive effects on anti-arrhythmic and diastolic parameters. In this context, this study was carried out to investigate the effects of ranolazine on left ventricular diastolic functions and repolarization in patients with CSF.Material and methodsForty-six patients with CSF and 29 control subjects were included in the patient and control groups, respectively. Both groups received ranolazine for one month and were evaluated using 12–lead electrocardiography, conventional echocardiography, and tissue Doppler imaging at the baseline and after one month of ranolazine treatment.ResultsCorrected P, QT dispersion, and Tp-e interval values were significantly higher in the patient group than in the control group. There was a significant decrease in isovolumic relaxation time (IVRT) and deceleration time (DT) values after the ranolazine treatment compared to the baseline values in the patient group but not the control group. A significant increase was observed in the mean E and A velocities and the mean E/A ratio after the ranolazine treatment compared to the baseline values in the patient group. Additionally, there was a significant difference between the Tp-e interval and corrected P dispersion values measured after the ranolazine treatment compared to the baseline values in the patient group but not in the control group.ConclusionThis study's findings demonstrated that ranolazine positively affected impaired diastolic functions and repolarization parameters, particularly in patients with CSF

Effects of Atrial Fibrıllation on Cognitive Functions in Patients Between 65-75 Years of Age

Objective: Atrial fibrillation (AF) is the most common arrhythmia in the elderly population and also the most common cause of ischemic stroke. Ischemic stroke is directly related to cognitive decline. The relationship between atrial fibrillation and cognitive decline has long been associated with stroke. This study aimed to reveal whether the mere presence of atrial fibrillation, independent of stroke, has negative effects on cognitive functions. Material and Method: Male and female patients between the ages of 65 and 75 with no chronic diseases other than known hypertension were included in the study. They were divided into two groups according to electrocardiography findings: the group with newly diagnosed atrial fibrillation and the group with normal sinus rhythm (NSR). To evaluate cognitive functions, the Montreal Cognitive Assessment (MoCA) was applied to both groups and then the groups were compared in terms of scores. Results: No statistically significant difference was observed between the groups in terms of age, patient characteristics, educational status, or laboratory findings. MoCA scores were significantly lower in the AF group than in the NSR group (p=0.001). Multivariable linear regression analysis demonstrated lower age and higher education status were independently associated with high MoCA scores (β: 3.392, 95% CI: 2.375 - 4.410,

Impact of oxidative stress on myocardial performance in patients with diabetes: a focus on subclinical left ventricular dysfunction

Introduction Oxidative stress is known to affect left ventricular functions negatively. There is a strong bidirectional connection between diabetes mellitus (DM) and oxidative stress. In parallel, left ventricular dysfunction is observed more frequently, even in patients with DM without other risk factors. In this context, the objective of this study is to comparatively investigate the potential relationship between oxidative stress and subclinical left ventricular dysfunction (SCLVD) assessed by Myocardial Performance Index (MPI) in patients with and without DM.Research design and methods The sample of this observational cross-sectional single-center study consisted of 151 patients who were evaluated for oxidative stress and SCLVD by tissue Doppler echocardiography. Patients’ total oxidant status (TOS), total antioxidant status (TAS), and Oxidative Stress Index (OSI) values were calculated. The effects of oxidative stress and DM on MPI were analyzed.Results There were 81 patients with DM (mean age: 46.17±10.33 years) and 70 healthy individuals (mean age: 45.72±9.04 years). Mean TOS and OSI values of the DM group were higher than healthy individuals (5.72±0.55 vs 5.31±0.50, p = <0.001; and 4.92±1.93 vs 1.79±0.39, p = <0.001; respectively). The mean TAS value of the DM group was significantly lower than the healthy group (1.21±0.40 vs 3.23±0.51, p = <0.001). There was a significant correlation between OSI and MPI mitral in the DM group (R 0.554, p = <0.001) but not in the healthy group (R −0.069, p=0.249).Conclusions Both oxidative stress and myocardial dysfunction were found to be more common in patients with DM. The study’s findings indicated the negative effect of oxidative stress on myocardial functions. Accordingly, increased oxidative stress caused more significant deterioration in MPI in patients with DM compared with healthy individuals

Contribution and Value of Biomarkers in Acute Aortic Syndromes

Background: Acute aortic syndromes, being mostly underdiagnosed due to unspecific symptoms, are associated with high morbidity and mortality. Diagnosis carried out by transesophageal echocardiography, computed tomography and magnetic resonance imaging. However, there are lots of biochemical assays being investigated, but none of them used reliably to identify acute aortic syndromes. Biomarkers could accelerate the diagnostic time with cost effective way and could get place in definitive diagnostic algorithm of acute aortic syndrome. This review aims to identify contribution and value of biomarkers in acute aortic syndromes

Anesthetic management in electrophysiology laboratory : A multidisciplinary review

© 2018 CardioFront LLC. All rights reserved.Many clinical challenges have been encountered in electrophysiology laboratories (EP) while implanting intracardiac defibrillators for lethal arrhythmias, using pacemakers for bradyarrhythmias, placing pacemakers with multiple leads in patients with heart failure and cardiac ablation procedures. In this environment, anesthesiology plays a very critical role to ensure patients comfort, as well as maintains operator's convenience and facilitate management of undesired situations. EP laboratories are mostly used for diagnosis of certain heart diseases. Mean while, with the exponential increase in interventional procedures in our decade, electrophysiologists' need to cooperate with the anesthesiologists more frequently. The literature is still unclear about the effects of anesthetic agents on cardiac conduction pathways, but as we know with our previous data, the most agents we are using currently have more or less effect on the cardiac conduction systems. In this review, we aimed to describe the safe anesthesia methods in cardiac diagnostic procedures and have a closer look up the anesthetic outcomes of these procedures. This article comprehensively reviews the anesthesia practice encountered in electrophysiology laboratories

Comparison of transradial versus transfemoral diagnostic coronary angiography in terms of oxidative stress: Which option is more physiological?

In this randomized, single-center, clinical study we aimed to compare the oxidative stress response in patients undergoing diagnostic transradial or transfemoral elective coronary angiography. Sixty patients with stable angina pectoris undergoing elective coronary angiography to either transradial (n = 30) or transfemoral (n = 30) approach were included. The levels of plasma total oxidative status (TOS) were measured and compared just before and immediately after the procedure in both groups. The clinical and laboratory findings were compatible between the two groups. Although the levels of plasma total oxidative status after coronary angiography were increased in both groups (TF pTOS 20. +/- :3; 34 +/- 3 vs TR pTOS 18 +/- 2; 23 +/- 4), this was more pronounced in the transfemoral group as compared with the transradial group (Delta pTOS: 11 +/- 4 vs 4 +/- 3, p < 0.001) In correlation analysis, TOS levels and white blood cell counts (r = 0.25, p = 0.042), total cholesterol levels (r = 0.267, p = 0.041), triglyceride levels (r = 0.253, p = 0.049), serum creatinine levels (r = 0.260, p = 0.043) were found to be moderately positively correlated. This study showed that oxidative stress response associated with heart catheterization is more evident in patients undergoing transfemoral coronary angiography versus transradial coronary angiography

Comparison of Demographic Profile, Laboratory, Epidemiology and Clinical Outcomes in Patients with Native Valve and Prosthetic Valve Endocarditis

Background: Infective endocarditis (IE) is a heterogenous infection that affects the endothelial surface of the intracardiac structures and other implanted intracardiac devices. We aimed to compare demographical characteristics, causative microorganisms, treatment, and prognosis of prosthetic and native valve endocarditis diagnosed in two separate hospitals

Comparison of Demographic Profile, Laboratory, Epidemiology and Clinical Outcomes in Patients with Native Valve and Prosthetic Valve Endocarditis

Background: Infective endocarditis (IE) is a heterogenous infection that affects the endothelial surface of the intracardiac structures and other implanted intracardiac devices. We aimed to compare demographical characteristics, causative microorganisms, treatment, and prognosis of prosthetic and native valve endocarditis diagnosed in two separate hospitals