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Angiology 05/2013; · 1.51 Impact Factor
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Chinese medical journal 05/2013; 126(10):2000. · 0.86 Impact Factor
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Angiology 04/2013; · 1.51 Impact Factor
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Cardiology journal 01/2013; 20(2):213. · 1.31 Impact Factor
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ABSTRACT: The fracture of IVUS catheter tip in the coronary artery is a very rare complication. It should be removed as soon as possible. Although it seems to be easy at first glance, percutaneous retrieval of broken IVUS catheter tip has some challenges. We hereby present a case report of successful percutaneous retrieval of broken IVUS catheter, probably caused by calcific left main stenosis, from the left circumflex artery using loop snare technique.
Cardiovascular revascularization medicine: including molecular interventions 03/2012; 13(4):238-40.
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European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 03/2012; 41(3):708. · 2.40 Impact Factor
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International journal of cardiology 02/2012; 156(2):217-8. · 7.08 Impact Factor
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ABSTRACT: Spontaneous coronary artery dissection (SCAD) is known to be a rare but fatal cause of acute coronary syndromes. It is more frequent in young women, particularly in the peripartum period. Intravascular ultrasound (IVUS) has an important role in the diagnosis and management of SCAD. Intramural hematoma that occurs between adventitial and media layer of the vessel wall may occlude the true lumen. IVUS can identify intimal tears, the extension of intramural hematoma and show the adequate compression of intramural hematoma after percutaneous coronary intervention. We present a case of intramural hematoma caused by SCAD in a young woman presenting with acute anterior myocardial infarction, and the role of IVUS in the diagnosis and management of SCAD. (Cardiol J 2012; 19, 5: 532-535).
Cardiology journal 01/2012; 19(5):532-5. · 1.31 Impact Factor
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ABSTRACT: It is yet to be established which factors are responsible for differences among patients with the same degree of coronary artery disease in terms of coronary collateral development (CCD).
Patients who had a greater than or equal to 95% stenosis in at least one epicardial coronary artery were classified into two groups according to their glomerular filtration rate (GFR) level. Afterwards, the degree of CCD was evaluated according to their plasma concentration of asymmetric dimethylarginine (ADMA) and GFR levels.
Rentrop grade 2-3 was found more frequently in patients with GFR > 60 mL/min than in patients with GFR < 60 mL/min (68.6% vs 41.4%, p = 0.032). Then we divided patients into four groups according to their GFR levels and Rentrop grades; whereas we did not find any significant difference for L-arginine or ADMA levels (respectively p = 0.629 and p = 0.076), we did find a statistically significant difference between groups for L-arginine/ /ADMA ratio (p = 0.003) and this statistically significant difference was evident between patients with GFR < 60 mL/min and Rentrop 0-1 and patients with GFR > 60 mL/min and Rentrop 2-3 (1.23 vs 1.69, p < 0.001). Multivariate logistic regression analysis revealed that L-arginine/ADMA ratio was the only variable which had a significant effect on CCD (OR = 1.016; 95% CI 1.001-1.031, Wald = 4.565; p = 0.033).
These results showed that CCD was poor in patients with GFR < 60 mL/min, presumably because of the adverse effect of decreased L-arginine/ADMA ratio on endothelial cells and angiogenesis.
Cardiology journal 01/2012; 19(1):29-35. · 1.31 Impact Factor
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ABSTRACT: This study was designed to evaluate the possible relationship between vascular inflammatory status [namely, high-sensitivity C-reactive protein (hs-CRP) and white blood cell (WBC)] and aortic elasticity parameters in patients with prehypertension.
The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34±6 years) and 25 healthy controls (16 men, mean age=33±6 years) eligible for this study. Aortic elasticity parameters were calculated from aortic diameters measured by echocardiography and blood pressures, simultaneously measured by sphygmomanometry. hs-CRP measurements were taken with latex-enhanced reagent using a Behring BN ProSpec analyzer.
Baseline characteristics of patients with prehypertension and controls were homogeneous. Inflammatory markers were significantly higher in patients with prehypertension compared with those of controls [for WBC (×10(9)/l): 11.46±0.77 (11.50) vs. 8.94±0.91 (9.20), P<0.001; for hs-CRP (μg/dl): 137.84±50.71 (130.00) vs. 78.30±35.20 (65.27), P<0.001]. There was a strong positive correlation between the mean aortic stiffness index and markers of inflammation (for WBC, r=0.857, P<0.001; for hs-CRP, r=0.858, P<0.001), whereas strong negative correlations were observed between aortic elasticity parameters and markers of inflammation (for aortic distensibility of WBC and hs-CRP, r=-0.862, P<0.001; r=-0.869, P<0.001, respectively, and for aortic strain of WBC and hs-CRP, r=-0.890, P<0.001; r=-0.906, P<0.001, respectively).
Young prehypertensives have increased markers of inflammation, namely, hs-CRP and WBC, compared with controls. More importantly, impaired arterial stiffness is significantly associated with the markers of inflammation in patients with prehypertension.
Blood pressure monitoring 04/2011; 16(2):55-61. · 1.62 Impact Factor
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ABSTRACT: To evaluate the relationship between site of infarction (anterior vs. inferior) and circadian variation in patients with ST segment elevation myocardial infarction (STEMI) in a Turkish cohort.
This restrospective study enrolled 465 patients (407 male, mean age 65±7 years) with STEMI. Patients were then categorised into 4 6-hour increments according to the time of day during which the symptoms began (12:00 AM-06:00 AM, 06:00 AM-12:00 PM; 12:00 PM-06:00 PM and 06:00 PM-12:00 AM hours). Characteristics of patients by site of infarction (anterior vs. inferior) were compared.
The frequency of onset of acute anterior MI as determined by onset of pain demonstrated significant circadian variation among the 4 time periods, demonstrating bimodal peaks (afternoon and morning) and a trough between 06:00 PM to 06:00 AM. The incidence of occurrence of MI between 06:00 AM to 06:00 PM was 4.50 times that of the average frequency of the remaining 12 hours of the day. The frequency of onset of acute inferior MI as determined by onset of pain exhibited significant circadian variation among the 4 time periods, demonstrating bimodal peaks (midnight to 06:00 AM and 06:00 AM to noon) and a trough between noon to midnight. The incidence of occurrence of MI between midnight to noon was 4.25 times that of the average frequency of the remaining 12 hours of the day.
Different circadian periodicity in the time of onset of STEMI was found regarding infarction site in a Turkish cohort. This may be related to genetic and⁄or demographic characteristics of the Turkish population.
Medical science monitor: international medical journal of experimental and clinical research 04/2011; 17(4):CR210-5. · 1.70 Impact Factor
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ABSTRACT: This retrospective study aimed to investigate the relationship between admission levels of serum y-glutamyltransferase and poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction.
Reperfusion injury caused by free radical release and increased oxidative stress is responsible for the pathophysiology of the no-reflow phenomenon in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Serum γ-glutamyltransferase is an established marker of increased oxidative stress.
The study population consisted of 80 patients (64 men and 16 women, mean age = 67.5 + 6.6 years) with thrombolysis in myocardial infarction 0/1 flow pre-procedurally. The patients were divided into two groups according to thrombolysis in myocardial perfusion grades that were assessed immediately following primary percutaneous coronary intervention. The two groups (group 1 and group 2) each consisted of 40 patients with thrombolysis in myocardial perfusion grades 0-1 and thrombolysis in myocardial perfusion grades 2-3, respectively.
Admission pain to balloon time, γ-glutamyltransferase and creatine kinase-MB isoenzyme levels of group 1 patients were significantly higher than those of group 2 patients. Pain to balloon time, γ-glutamyltransferase, peak creatine kinase-MB isoenzyme, low left ventricular ejection fraction and poor pre-procedural thrombolysis in myocardial infarction grade were significantly associated with poor myocardial perfusion by univariate analysis. However, only pain to balloon time and γ-glutamyltransferase levels showed a significant independent association with poor myocardial perfusion by backward logistic regression analysis. Adjusted odds ratios were calculated as 4.92 for pain to balloon time and 1.13 for γ-glutamyltransferase.
High admission γ-glutamyltransferase levels are associated with poor myocardial perfusion in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention, particularly in patients with prolonged pain to balloon time.
Clinics (São Paulo, Brazil) 01/2011; 66(10):1729-34. · 1.59 Impact Factor
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Arquivos brasileiros de cardiologia 06/2010; 94(6):181. · 1.32 Impact Factor
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International journal of cardiology 02/2009; 141(1):105-7. · 7.08 Impact Factor
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ABSTRACT: The release of brain natriuretic peptide (BNP) is increased in heart failure (HF). The plasma concentrations of BNP and N terminal pro-BNP (NT-proBNP) fall after effective pharmacologic treatment of HF, which suggests that measurements of plasma BNP may be helpful in evaluating therapy. Despite the initial reports that suggested a positive effect of levosimendan on short- and long-term survival in patients with severe HF, the results of the recently presented large-scale clinical trials provided rather controversial results. Further clinical studies are needed to end the confusion regarding the effects of levosimendan on prognosis in patients with decompansated HF.
International journal of cardiology 09/2008; 128(1):97-9; authr reply 100-2. · 7.08 Impact Factor
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ABSTRACT: Variant angina is generally a benign disease with self limiting symptoms. But in some cases serious ventricular arrhythmias which can lead to death can be seen. In this paper we present a case of variant angina who subsequently developed polymorphic ventricular tachycardia and was treated successfully with long acting nitrate and calcium channel blockade therapy.
International journal of cardiology 11/2007; 121(2):210-2. · 7.08 Impact Factor
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European Heart Journal 05/2007; 28(7):787. · 10.48 Impact Factor
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Arquivos brasileiros de cardiologia 03/2007; 88(2):e47. · 1.32 Impact Factor
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ABSTRACT: Although hypertension has been shown to be one of the most important predictors of reduced arterial elasticity, there is not enough data about aortic elastic properties in patients with prehypertension. Accordingly, the current study was designated to evaluate aortic elastic features in young patients with prehypertension.
The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34+/-6 years) and 25 healthy controls (16 men, mean age=33+/-6 years) eligible for the current study. Aortic strain, distensibility index and stiffness index beta were calculated from aortic diameters measured by echocardiography and blood pressures simultaneously measured by sphygmomanometry.
Prehypertensive patients were detected to have significantly lower aortic distensibility and strain indexes than the controls: (5.77+/-1.91 vs. 8.63+/-2.67 cm dynx10, respectively, P<0.001; strain index: 13.81+/-4.50 vs. 17.47+/-4.25%, respectively, P=0.005). Aortic stiffness index beta of the prehypertensive group, however, was significantly higher than that of the control group (3.73+/-1.41 vs. 2.97+/-0.82, P=0.02).
Whatever the mechanism, young patients with prehypertension have impaired aortic elasticity compared with healthy controls. This finding has suggested that the development of overt hypertension may be prevented or delayed by using the agents that have the ability to reduce arterial stiffness by regressing and/or preventing functional and structural changes on the arterial wall.
Blood Pressure Monitoring 11/2006; 11(5):251-5. · 1.52 Impact Factor
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ABSTRACT: Metabolic syndrome with its associated cardiovascular risk factors and prothrombotic, procoagulant and proinflammatory properties and its detrimental effects on coronary microcirculation may play a role in the occurrence of poor myocardial perfusion after primary percutaneous coronary intervention in patients with acute myocardial infarction. Accordingly, this study was designed to evaluate the association between metabolic syndrome and myocardial perfusion grade in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
The study population included 283 consecutive patients (229 men, mean age=62+/-8 years) admitted to our hospital with ST-elevation myocardial infarction and who underwent primary percutaneous coronary intervention. Thrombolysis in myocardial infarction (TIMI) myocardial perfusion grade (TMPG) was graded densitometrically on the basis of visual assessment of relative contrast opacification of the myocardial territory subtended by the infarct vessel in relation to epicardial density. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Patients were divided into two groups on the basis of the myocardial perfusion grade determined after percutaneous coronary intervention. Group I consisted of 223 patients with good myocardial perfusion (TMPG 2-3) after successful percutaneous coronary intervention and group II of 60 patients with poor myocardial perfusion (TMPG 0-1).
The prevalence of metabolic syndrome was found to be significantly higher in patients with poor myocardial perfusion than in those with good myocardial perfusion (40 vs. 20%, respectively, P=0.002). Moreover, we detected an independent association between metabolic syndrome and the occurrence of poor myocardial perfusion grade (adjusted OR=2.54, 95% CI=1.35-4.75, P=0.003).
We have shown, for the first time, a significant association between metabolic syndrome and impaired myocardial perfusion after percutaneous coronary intervention in patients with acute myocardial infarction. This data may partially explain the poor short and long-term outcomes of acute myocardial infarction in patients with metabolic syndrome.
Coronary Artery Disease 06/2006; 17(4):339-43. · 1.24 Impact Factor
