A rare congenital anomaly: Pulmonary atresia and abnormal origin of right pulmonary artery

2MAR2041

Yüksek duyarlıklı C-reaktif protein düzeyleri ve safen ven greft hastalığı arasındaki ilişkinin değerlendirilmesi

Amaç: Bu çalışmada safen ven greft hastalığı (SVGH) ile yüksek duyarlıklı C-reaktif protein (hs-CRP) seviyeleri arasındaki ilişki değerlendirildi. Çalışma planı: Çalışmaya koroner arter baypas greft ameliyatı öyküsü olan, önceden belirlenen objektif kriterlere göre koroner anjiyografi yapılan toplam 78 hasta (54 erkek, 24 kadın; ort. yaş 60.4±9.4 yıl; dağılım 37-78 yıl) dahil edildi. Ateroskleroza neden olan risk faktörleri sorgulandı ve tüm hastaların biyokimyasal testleri çalışıldı. Safen ven greftlerden herhangi birinde %50 ve daha fazla darlık olması SVGH olarak tanımlandı. Hastalar SVGH olan (grup 1) ve SVGH olmayanlar (grup 2) olmak üzere iki gruba ayrıldı. Bulgular: Her iki grubun demografik özellikleri ve laboratuvar değerleri karşılaştırıldığında, grup 1’de vücut kütle indeksi (VKİ), total kolesterol/yüksek yoğunluklu lipoprotein (HDL) kolesterol, ürik asit (ÜA) ve hs-CRP düzeyleri anlamlı oranda yüksek olup, HDL kolesterol düzeyi anlamlı oranda düşüktü. Yapılan çok değişkenli lojistik regresyon analizinde VKİ, ÜA ve hs-CRP düzeylerinin SVGH’yi öngörmede bağımsız belirteçler olduğu tespit edildi (hs-CRP OR: 1.522, p<0.01, ÜA OR: 1.48, p=0.01, VKİ OR: 1.31, p=0.04). Yapılan ROC analizinde hs-CRP düzeyi 0.8 mg/dL ‘‘kesim değeri’’ olarak alındığında %80 duyarlılık ve %85 özgüllük oranı ile SVGH’yi belirlediği bulundu. Sonuç: Çalışmamızda SVGH’yi öngördüren en güçlü belirtecin hs-CRP olduğu saptandı. Yüksek duyarlıklı C-reaktif protein, SVGH varlığını öngörme ve izleminde noninvaziv, güvenilir ve yararlı bir belirteçtir.Background: In this study, we aimed to evaluate the relationship between the levels of high-sensitivity C-reactive protein (hs-CRP) and saphenous venous graft disease (SVGD). Methods: A total of 78 patients (54 males, 24 females; mean age 60.4&plusmn;9.4 years; range 37 to 78 years) with previous history of coronary artery bypass graft (CABG) surgery who underwent coronary angiography based on predetermined objective clinical criteria were included. Risk factors leading to atherosclerosis were questioned and biochemical tests were studied in all patients. A 50% or more stenosis in at least one of the saphenous vein grafts was defined as SVGD. The patients were divided in two groups according to the presence of SVGD (group 1), and the absence of SVGD (group 2). Results: When we compared the demographic characteristics and laboratory findings of both groups, body mass index (BMI), total cholesterol/high-density lipoprotein (HDL) cholesterol ratio, uric acid (UA) and hs-CRP levels were significantly higher, while HDL cholesterol level was significantly lower in group 1. Multivariate logistic regression analysis showed that BMI, UA and hs-CRP levels were independent predictors of SVGD (hs-CRP OR: 1.522, p&lt;0.01, UA OR: 1.48, p=0.01, BMI OR: 1.31, p=0.04). The ROC analysis demonstrated that a 0.8 mg/dL hs-CRP cut-off value indicated SVGH with a 80% sensitivity and 85% specificity rate. Conclusion: In our study, hs-CRP was found to be the most powerful predictor of SVGD. High-sensitivity-C-reactive protein is a noninvasive, reliable and useful parameter in the prediction and monitoring of SVGD

Assessment of foetal ventriculomegaly from prenatal to early postnatal period: a single-centre retrospective cohort study

The aim of this study was to evaluate the early neonatal outcomes of cases with foetal ventriculomegaly (VM) and to investigate the aetiological and prognostic factors according to the degree of VM in a single tertiary referring centre. The medical records of 87 foetuses diagnosed with VM (≥10 mm) within 6 years were evaluated. Postnatal evaluation and early neonatal prognosis were determined in 39 cases divided into two groups as mild (10–15 mm, 30 cases) and severe (>15 mm, 9 cases) according to the ventricular size. The mean gestational age at which foetal VM was detected was 22 + 3 weeks. In terms of severity, severe cases of VM were more frequent in terminated pregnancies. There was no difference in gestational age, birth weight, fifth minute Apgar scores, or cord blood gases between mild and severe cases at delivery. Isolated VM was detected in 63% of mild and 22% of severe cases. In severe cases, the need for intensive care and surgery was higher than in mild cases. Antenatal VM regressed in 50% of mild cases and 22% of severe cases. Increasing knowledge about neonatal prognosis, the factors involved in aetiology, and the degree of VM will guide the management of foetal VM.IMPACT STATEMENT What is already known in this subject? Some cases of foetal VM resolve spontaneously, and postnatal ultrasonography can detect normal ventricle sizes. While 74.6% of isolated VM cases show spontaneous regression, this rate is 52.1% in nonisolated cases. The gestational week at the time of diagnosis, the degree and cause of VM, intrauterine progression and the presence of any genetic, infectious, cerebral, or extracerebral disorders all influence the prognosis. What do the results of this study add? Antenatal VM regressed in 50% of mild cases and 22% of severe cases. In severe cases, the need for intensive care and surgery was higher than in mild cases. The higher frequency of accompanying cerebral findings in severe cases was striking. What are the implications of these findings for clinical practice and/or further research? The current study revealed that isolated VM with ventricular diameter less than 15 mm, after excluding out chromosomal abnormalities and prenatal infections, and no prior history of VM, has a favourable neonatal prognosis in terms of mortality and morbidity. In cases of foetal VM, increased knowledge of neonatal prognosis will guide pregnancy care and postnatal follow-up planning. Prospective multicentre studies on the neonatal period are required to bridge the gap between foetal VM and long-term consequence

Cardiac Diastolic Function Is Impaired at Rest and Worsens With Exercise in Otherwise Healthy Individuals With Insulin Resistance

WOS: 000358558400018PubMed ID: 25902882Insulin resistance (IR) is a pathophysiological condition and is associated with cardiovascular risk factors including heart failure. However, studies demonstrating myocardial abnormalities in the early phases of IR are limited. The aim of this study was to investigate myocardial function in otherwise healthy individuals with IR. Individuals with IR who were free of cardiovascular risk factors and healthy controls were included. Stress echocardiography with tissue Doppler imaging (TDI) was performed. Systolic and diastolic TDI waves were compared in both groups. A total of 77 individuals (51 with IR and 26 controls) were included in our study. The tissue early flow (e')/atrial contraction (a') ratio at rest was significantly lower in the IR group (P = 0.003). The annular early flow (E)/e' ratio, a predictor of left ventricular filling pressure, was similar in both groups at rest (P = 0.522). After exercise, e'/a' impairment became more prominent in the IR group (P < 0.001); whereas the E/e' ratio was also significantly lower (7.6 +/- 1.8 versus 6.7 +/- 0.9; P = 0.007) in the IR group. Myocardial involvement seems to occur in patients with IR, before the appearance of other cardiovascular risk factors. Exercise induced diastolic worsening may be a predictor of reduced compliance and increased ventricular stiffness. More detailed prospective studies are required for more precise results

Patients who have 4G Alleles in Plasminogen Activator Inhibitor1 Gene Have Higher Mean Platelet Volume Values at the Time of ST-Elevation Myocardial Infarction

29th Turkish Cardiology Congress of the Turkish-Society-of-Cardiology (TSC) with International Participation -- OCT 26-29, 2013 -- Antalya, TURKEYWOS: 000329858400523…Turkish Soc Cardio