[Show abstract][Hide abstract] ABSTRACT: Objectives: We investigated the effect of frequent ventricular premature beats (VPB) originating from the right ventricular outflow tract (RVOT) on diastolic functions and the relationship between VPBs and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. Study design: The study included 33 symptomatic patients (10 males, 23 females; mean age 40±8 years) with normal left ventricular functions, who had frequent VPBs originating from the RVOT on 24-hour Holter monitoring. All the patients underwent 2D transthoracic echocardiography and Doppler analyses and mitral inflow patterns and serum NT-proBNP levels were evaluated. The results were compared with those of 30 healthy individuals (9 males, 21 females; 37±9 years). Results: Compared to the controls, the patients had a longer isovolumetric relaxation time (IVRT) (p<0.0001) and E-wave deceleration time (EDT) (p<0.0001), a smaller ratio of early diastolic wave to atrial wave (E/A) (p=0.001), and higher NT-proBNP levels (p=0.016). While the mitral inflow pattern was normal in all the controls, it was associated with impaired relaxation in 13 patients. Patients with diastolic dysfunction (n=13) had higher NT-proBNP levels (p=0.03) and greater VPB counts (p=0.001) than those without diastolic dysfunction (n=20). The number of VPBs was inversely correlated with the mitral E/A ratio, and positively correlated with EDT, IVRT, and NT-proBNP levels. Conclusion: Frequent VPBs from the RVOT cause deterioration in diastolic functions in patients without structural heart disease. Considering a parallel rise in NT-proBNP levels with the VPB count, NT-proBNP measurement can be used as a predictor of diastolic dysfunction in symptomatic patients.
[Show abstract][Hide abstract] ABSTRACT: To determine whether pulmonary vascular bed contributes to the development of in situ thrombosis and vascular remodelling in secondary pulmonary hypertension (SPH) via changes in its local secretory activities.
Seventy-one patients with the diagnosis of secondary pulmonary hypertension (38 females, mean age 40.36+/-1.05 years) were included in the study. Selective right and left heart catheterization was performed to each patient for diagnostic purposes. Blood samples obtained from left ventricle (LV) and pulmonary artery (PA) of each patient were analyzed for levels of plasminogen activator inhibitor-1 (PAI-1), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF), D-dimer, von Willebrand factor (vWF), protein-C, antithrombin-III, fibrinogen, and plasminogen. Results were compared between LV and PA. Correlation analysis between each parameter and mean pulmonary artery pressure (MPAP) was performed.
Although mean level of VEGF in LV and PA were found to be in normal range, it was significantly higher in LV than in PA (p<0.001). Mean PDGF and D-dimer levels, which remained in normal range were also higher in LV (p<0.001 and p<0.001, respectively) than in PA;.vWF showed similar degree of elevation in both LV and PA. Only one parameter, PAI-1, was found to be significantly higher in PA than in LV (p=0.012). Antithrombin-III, protein C, plasminogen, and fibrinogen levels showed no significant differences between two chambers. They also remained in normal range, except for fibrinogen, which was slightly elevated in both LV and PA. Correlation analysis revealed strong positive correlation between D-dimer level in both LV and PA and MPAP (r=0.775, p<0.001 and r=0.649, p<0.001, respectively).
In SPH, pulmonary vascular bed shows increased thrombotic, hypofibrinolytic, and proliferative activities, which are partially related to the severity of illness.
No preview · Article · Jul 2005 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology
[Show abstract][Hide abstract] ABSTRACT: Although patent ductus arteriosus (PDA) is the most common type of extracardiac shunt, aberrant PDA associated with other cardiac malformations as double brachiocephalic trunk and interrupted left subclavian artery is extremely rare. To the best of our knowledge, the literature contains no other report of a patient who has PDA originated from left subclavian artery associated with ventricular septal defect (VSD), double brachiocephalic trunk and interrupted left subclavian artery. © 2004 Elsevier Ireland Ltd. All rights reserved.
No preview · Article · Jul 2005 · International Journal of Cardiology
[Show abstract][Hide abstract] ABSTRACT: A Am ma aç ç:: Bu çal›flma, sekonder pulmoner hipertansiyonda (SPH) s›kl›kla izlenen in situ tromboz geliflimine ve vasküler yeniden biçimlenmeye pul- moner vasküler yata¤›n lokal katk›s›n› araflt›rmak için planlanm›flt›r. Y Yö ön nt te em mlle er r:: Kliniimizde kalp kateterizasyonu yap›lan 71 SPH hastas› (38 kad›n, 33 erkek; yafl ortalamas› 40.36± 1.05 y›l) çal›flmaya dahil edilmifl- tir. Her hastan›n pulmoner arter (PA) ve sol ventrikülünden (LV) al›nan kan örneklerinde plazminojen aktivator inhibitör-1 (PAI-1), trombosit kö- kenli büyüme faktörü (PDGF), damar endoteli büyüme faktörü (VEGF), D-Dimer, von-Willebrand faktörü (vWF), protein-C, antitrombin-III, fibrino- jen ve plazminojen düzeyleri bak›larak karfl›laflt›r›lm›flt›r. Ayr›ca her parametrenin ortalama PA bas›nc› (MPAP) ile korelasyonu araflt›r›lm›flt›r. B Bu ullg gu ulla ar r:: Ortalama VEGF düzeyi LV'de PA'e göre daha yüksektir (p