Effect of insomnia and excessive daytime sleepiness on cardiac functions in older adults.

Background: We investigated the potential harmful effect in older adults of insomnia and excessive daytime sleepiness (EDS) on myocardial functions and electrophysiologic changes of the heart in terms of heart rate and QT intervals corrected for heart rate (QTc).

Methods: The study included 32 insomnia patients and 30 control subjects. An Insomnia Severity Index score of ≥15 indicated insomnia, while a score of <8 was accepted as the control group.

Multiple Anterior Mitral Valve Perforation After Deep Transfemoral Aortic Valve Implantation.

Transcatheter aortic valve implantation (TAVI) is an alternative for high-risk aortic valve replacement. There are limited data related to the late complications of TAVI. Deep aortic prosthetic valve implantation can cause direct erosive perforation of anterior mitral leaflet or erosive endothelial lesion which predisposes the tissue to infective endocarditis.

Nonalcoholic fatty liver disease as a multi-systemic disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. NAFLD includes a wide spectrum of liver conditions ranging from simple steatosis to nonalcoholic steatohepatitis and advanced hepatic fibrosis. NAFLD has been recognized as a hepatic manifestation of metabolic syndrome linked with insulin resistance.

False Lumen Catheterization in a Patient Who Has Type A Aortic Dissection That Mimics Acute Inferior Myocardial Infarction: A Case Report.

We report a 61-year-old patient who suffered from a type A aortic dissection that mimicked an acute inferior myocardial infarction. During a routine cardiac catheterization procedure, diagnostic catheters can be inserted accidentally into the false lumen. Invasive cardiologists should keep this complication in mind.

The effect of myocardial fibrosis on left ventricular torsion and twist in patients with non-ischemic dilated cardiomyopathy.

Background: Left ventricular (LV) rotation, twist, and torsion are important aspects of the cardiac performance. Myocardial fibrosis can be identified as the late gadolinium enhancement (LGE) in cardiac magnetic resonance (CMR). In this study, we investigated the association between myocardial fibrosis and LV rotational parameters in patients with nonischemic dilated cardiomyopathy (NDC).

Relation of the severity of contrast induced nephropathy to SYNTAX score and long term prognosis in patients treated with primary percutaneous coronary intervention.

Background: SYNTAX score (SXscore) has been developed to assess the severity and complexity of coronary artery disease. The aim of this study was to evaluate whether baseline SXscore was associated with contrast induced nephropathy (CIN) after primary percutaneous coronary intervention (p-PCI) in patients with ST-elevation myocardial infarction (STEMI). Secondarily we aimed to investigate the relation of the severity of CIN to long term prognosis.

[A late coronary aneurysm after sirolimus stent implantation which was treated with coronary graft stent].

Drug eluting stents are being used frequently because of their less restenotic properties. However, their effect on preventing neo-intimal hyperplasia may cause many adverse effects such as coronary artery aneurysm (CAA). We report a case that presented with a CAA which was the latest developed CAA after the implantation of drug eluting stents in literature so far.

No harmful effect of dialysis-induced hypotension on the myocardium in patients who have normal ejection fraction and a negative exercise test.

Background: We investigated the effects of dialysis-induced hypotension (DIH) on the myocardium of patients who have a normal ejection fraction and normal treadmill stress tests.

Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (non-DIH), and 30 control subjects. Mitral-myocardial systolic velocity (MSV), the mitral E'/A' ratio, the left ventricle filling pressure index (E/E' ratio), tricuspid-MSV, and the tricuspid E'/A' ratio were calculated.

Coronary calcium score, albuminuria and inflammatory markers in type 2 diabetic patients: associations and prognostic implications.

Aims: To investigate the relationship of coronary artery calcium (CAC) scores with common carotid artery intima media thickness (CCA-IMT), albuminuria and inflammatory factors in type 2 diabetes.

Methods And Results: 128 asymptomatic type 2 diabetic patients, with at least one cardiovascular risk factor in addition to diabetes, were included in the study. CAC scores, carotid arteries plaque formation and CCA-IMT were assessed.

Myxoma developing after open heart surgery: is radiofrequency ablation responsible for the formation of the tumor?

34-year-old male with history of recurrent atrial fibrillation (AF) and mitral stenosis, status post radiofrequency ablation (RFA) and prosthetic mitral valve replacement two years earlier was admitted with prosthetic valve thrombosis for redo mitral valve surgery. During the surgery, a 2 x 1.5 x 1 cm mass was identified on the interatrial septum, attached to the edge of tricuspid valve's septal leaflet by a stalk.

Multiple coronary cameral fistulae: a rare anomaly and cause of ischaemia.

An 82-year-old hypertensive, diabetic woman was admitted to our department for pre-operative cardiac evaluation. A myocardial perfusion scan revealed apicoseptal and inferior segment hypoperfusion. Coronary angiography exhibited extensive multiple coronary cameral fistulae draining into the left ventricle in a homogeneous and circular way.

The prognostic value of very low admission LDL-cholesterol levels in ST-segment elevation myocardial infarction compared in statin-pretreated and statin-naive patients undergoing primary percutaneous coronary intervention.

Background: Some recent trials reported that, low admission low-density lipoprotein-cholesterol (LDL-C) levels were associated with increased mortality in patients with acute coronary syndromes. We aimed to compare the effect of very low admission LDL-C levels on prognosis in statin-pretreated and statin-naive patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary angioplasty.

Methods: The study population consisted of 1808 patients with acute STEMIs who underwent primary angioplasty.

Reversible myocardial stunning due to carbon monoxide exposure.

We report on a 37-year-old patient who suffered from myocardial stunning after exposure to carbon monoxide, despite having normal coronary arteries. As myocardial ischaemia may be asymptomatic in these patients, close monitoring with serial electrocardiography and of serum cardiac enzymes and troponins is recommended.

Attenuated cardiovascular response to sympathetic system activation during exercise in patients with dialysis-induced hypotension.

Background: We wished to investigate potential causes of dialysis-induced hypotension (DIH), including the attenuated cardiovascular response to sympathetic system activation during exercise and myocardial dysfunction.

Methods: This study included 26 end-stage renal disease (ESRD) patients with DIH, 30 ESRD patients without DIH (Non-DIH), and 30 control subjects. Each patient was evaluated with echocardiography and a symptom-limited treadmill stress test.

Impairment of the left ventricular systolic and diastolic function in patients with non-alcoholic fatty liver disease.

Background: Non-alcoholic fatty liver disease (NAFLD) is considered the liver component of the metabolic syndrome. We investigated the diastolic and systolic functional parameters of patients with NAFLD and the impact of metabolic syndrome on these parameters.

Methods: Thirty-five non-diabetic, normotensive NAFLD patients, and 30 controls, were included in this study.

A halo in the heart during coronary angiography: calcified left ventricular aneurysm with thrombus formation.

A 74-year-old man presented with chest pain and dyspnoea at the cardiology outpatient clinic. His past medical history included an anterior myocardial infarction in 2008. In the coronary angiogram, a 'halo image' was seen right after the injection of the contrast agent, and it corresponded with the location of the left ventricular aneurysm.

Grading functional mitral regurgitation by tissue Doppler-derived isovolumic acceleration parameters in patients with nonischemic dilated cardiomyopathy.

Functional mitral regurgitation (FMR) is relatively common in heart failure and it is associated with adverse prognosis. The severity of FMR is usually assessed by echocardiography. Tissue Doppler echocardiography is used to acquire signals to determine the myocardial systolic functional parameters, including systolic ejection velocity and the systolic isovolumic acceleration (IVAs) rate.

Aortic elastic properties in nonalcoholic fatty liver disease.

Background: Recent studies have shown that patients with nonalcoholic fatty liver disease (NAFLD) have an increased risk of developing cardiovascular disease. Aortic stiffness, an early marker of arteriosclerosis, is associated with cardiovascular mortality. In this study, the aortic elastic properties of nondiabetic, normotensive NAFLD patients were evaluated.

A promising new inotrope: levosimendan.

Intravenous positive inotropic agents are commonly used to treat the patients with acute decompensated heart failure due to left ventricular systolic dysfunction. Although these agents seem to be beneficial for improving symptoms of heart failure in the short-term; it has been reported that they are associated with increased mortality and morbidity. Levosimendan is a new calcium sensitizer and K-ATP channel opener, has emerged as an alternative option of pharmacologic inotropic support in patients with decompensated heart failure.

[Usefulness of isovolumic acceleration and tissue Doppler echocardiographic parameters for predicting postoperative functional recovery after heart valve surgery].

Introduction And Objectives: Postoperative right ventricular (RV) systolic dysfunction is associated with perioperative myocardial ischemia, hypothermic cardiac arrest, cardiopulmonary bypass and pericardial injury. As myocardial acceleration during isovolumic contraction (IVA) and myocardial velocity during isovolumic contraction (IVV) are little affected by loading conditions, they can predict myocardial function better than conventional parameters. We investigated the usefulness of these parameters for predicting postoperative RV systolic function after isolated heart valve surgery.

The influence of dipper and nondipper blood pressure patterns on left ventricular functions in hypertensive patients: a tissue Doppler study.

Objectives: We investigated the effect of dipper and non-dipper blood pressure patterns on left ventricular diastolic filling parameters in hypertensive patients.

Study Design: Fifty-five hypertensive patients (37 women, 18 men; mean age 55+/-10 years) were evaluated with echocardiography and ambulatory 24-hour blood pressure monitoring. All the patients received antihypertensive drug therapy for at least three months prior to the evaluations.

N-terminal pro brain natriuretic peptide to predict prognosis in dilated cardiomyopathy with sinus rhythm.

Aims: To assess the value of plasma NT proBNP levels for predicting adverse outcomes in patients with dilated cardiomyopathy (DCM).

Methods: Seventy-eight patients with DCM (EF <40%) with sinus rhythm were enrolled. All patients had undergone echocardiographic examination, coronary angiography, and cardiac catheterisation.

Influence of diurnal blood pressure rhythm on aortic elastic properties in hypertensive subjects.

Objective: The aim of this study was to evaluate whether there is a relationship between aortic elastic properties and diurnal blood pressure rhythm in hypertensive subjects.

Methods And Results: This study included 41 hypertensive patients who were taking medical treatment and had undergone ambulatory blood pressure monitoring (ABPM). The patients were classified according to their night mean systolic blood pressure (Nm-SBP) fall.

Fibrillatory wave amplitude as a marker of left atrial and left atrial appendage function, and a predictor of thromboembolic risk in patients with rheumatic mitral stenosis.

Background: Patients with mitral stenosis, especially those with atrial fibrillation, are at increased risk for thromboembolic complications. Size of the left atrium, left atrial appendage dysfunction and severity of mitral stenosis are known risk factors for thromboembolism in patients with mitral stenosis. It has been postulated that F-wave amplitude on surface ECG is correlated with left atrial size, left atrial appendage function, and risk of thromboembolism in patients with nonrheumatic atrial fibrillation.