New prognostic markers in pulmonary arterial hypertension: CRP to albumin ratio and uric acid.

Introduction: Idiopathic pulmonary hypertension(IPAH) is a rare disease that causes severe morbidity and mortality despite advances in treatment management. Evaluating the prognosis of the disease is critical in determining therapeutic approaches. We aimed to evaluate the prognostic significance of C-reactive protein/albumin ratio (CAR) and uric acid, which is an easily applicable and inexpensive parameter in patients with IPAH.

Prediction of fractional flow reserve with angiographic DILEMMA score.

Objective: Angiographic assessment of stenosis has limited predictive value for functionally significant lesions compared with fractional flow reserve (FFR). The recently developed angiographic DILEMMA score, which consists of minimal lumen diameter (MLD), lesion length (LL) and Bypass Angioplasty Revascularization Investigation (BARI) Myocardial Jeopardy Index (MJI) was found to have diagnostic value in predicting FFR ≤0.80.

The value of exercise SPET for the detection of coronary artery steal syndrome secondary to unligated major side branch of left internal mammary artery.

Objective: The clinical significance of unligated major left internal mammary artery (LIMA)-side branches (SB) remains controversial in patients with previous coronary artery bypass graft (CABG) surgery. The aim of this study was to investigate the clinical significance of unligated major LIMA-SB by using exercise myocardial perfusion imaging (MPI) with single-photon emission tomography.

Subjects And Methods: We conducted a retrospective analysis of 2819 consecutive patients who underwent diagnostic angiography.

Bleeding complications during cardiac electronic device implantation in patients receiving antithrombotic therapy: is there any value of local tranexamic acid?

Background: The perioperative use of antithrombotic therapy is associated with increased bleeding risk after cardiac implantable electronic device (CIED) implantation. Topical application of tranexamic acid (TXA) is effective in reducing bleeding complications after various surgical operations. However, there is no information regarding local TXA application during CIED procedures.

Elevated mean pulmonary artery pressure in patients with mild-to-moderate mitral stenosis: a useful predictor of worsening renal functions?

Objective: Renal dysfunction commonly accompanies the course of cardiac disorders and strongly associates with increased morbidity and mortality. Elevated central venous pressure is related to worsening renal function in patients with heart failure. However, predictors of worsening renal function in mitral stenosis-whose pathophysiologic process is similar to heart failure with regard to right heart dysfunction-are unknown.

C-type natriuretic peptide is associated with the severity of Crimean-Congo hemorrhagic fever.

Background: Crimean-Congo hemorrhagic fever (CCHF) is characterized by vascular dysfunction, indicating the involvement of endothelial cells. C-type natriuretic peptide (CNP) plays a critical role in the coordination of vascular tone and is associated with the prognosis in critically ill patients such as those with sepsis and septic shock. We investigated whether CNP is related to the severity of CCHF.

Acute effects of passive smoking on endothelial function.

Impairment of endothelial functions has been shown to occur after acute and chronic exposure to passive smoking (PS), as assessed by flow-mediated dilatation (FMD) of the brachial artery. A total of 61 participants, 30 male and 31 female, mean ages 26 (18-36) were enrolled in the study. All were clinically well and nonsmokers.

Cytokines: potential contributors to arrhythmogenesis in demyelinating syndromes?

Neurological disorders including chronic demyelinating syndromes (CDSs) have been known to elicit propensity to cardiac arrhythmias possibly due to autonomic imbalance, myocardial myocytolysis and some psychological conditions (major depression etc.) associated with these syndromes. CDSs are generally characterized by variable degrees of inflammatory response that may corrrelate with clinical disease activity (relapse, progression etc.

Natriuretic peptides: useful biomarkers in predicting the possibility of restoration and maintenance of sinus rhythm in patients with atrial fibrillation undergoing cardioversion?

Natriuretic peptides (NPs) have been regarded as of diagnostic and prognostic importance in a variety of clinical conditions including congestive heart failure (CHF). Paroxysmal and persistent atrial fibrillations (AFs) have been reported to be associated with high plasma levels of NPs that decline after restoration of sinus rhythm. Rhythm control of AF largely depends on the duration of the arrhythmia and the presence of underlying structural heart disease that may exert negative effects on the restoration and maintenance of sinus rhythm.

Dronedarone: a promising alternative for the management of atrial fibrillation.

Introduction: Atrial fibrillation (AF) is the most frequently encountered chronic arrhythmia associated with significant morbidity. It is generally encountered in the elderly, and will presumably become more prevalent in the future due to the increasing proportion of the elderly in the population. Major studies on AF have demonstrated no significant difference between rhythm and rate control in terms of mortality.

Comparative effects of levosimendan and dobutamine on right ventricular function in patients with biventricular heart failure.

Severe heart failure represents a major source of morbidity and mortality. Poor right ventricular function is an independent prognostic marker for mortality in patients with chronic heart failure. In this study, levosimendan (L) and dobutamine (D) in patients with severe chronic biventricular failure were compared.

Short QT syndrome: a very rare arrhythmogenic entity.

Short QT syndrome (SQTS) is a gene-related arrhythmogenic syndrome harbouring a large spectrum of symptoms ranging from mild palpitations to sudden cardiac death.The mutation of genes (KCNH2, KCNQ1, and KCNJ2) encoding for cardiac potassium channels plays a central role in SQTS. Electrocardiography is the primary important step in the diagnosis (short QT interval along with T wave changes), but ECG findings may be easily ignored.

Impact of beta-blockers on sleep in patients with mild hypertension: a randomized trial between nebivolol and metoprolol.

Introduction: Sleep is an innate and essential part of human life. Various aspects of sleep are negatively affected by beta-blockers. We compared the impact of two beta-blockers, metoprolol succinate (extended release) and nebivolol, on sleep quality in patients with stage 1 hypertension.

The effect of smoking on cardiac diastolic parameters including Vp, a more reliable and newer parameter.

Background: Previous studies have focused mainly on the acute effects of smoking on the diastolic function of the heart. The present study was conducted to demonstrate the chronic effects of smoking on the diastolic functional parameters of the heart, including transmitral M- mode coloured flow propagation velocity (Vp), among relatively younger asymptomatic adults.

Method: Hundred smokers with histories of incessant smoking for at least one year prior to the time of the investigation were included in the prospectively designed study as group I.

Initial syncope associated with alternating attacks of supraventricular tachycardia and atrioventricular block long after surgical correction of tricuspid atresia.

The Fontan procedure has become a generic term to define a surgical procedure that orients the systemic venous return directly to the pulmonary arteries, and has been used as a palliative operation for pulmonary atresia, tricuspid atresia, double inlet ventricle and complex single ventricle. The earliest type of Fontan procedure was a simple atriopulmonary anastomosis between the right atrium and the pulmonary artery. Atrial arrhythmias, particularly atrial flutter and sinus node dysfunction may occur in the early and late postoperative period after simple atriopulmonary anastomosis.

Comparison of myocardial performance index versus ratio of isovolumic contraction time/ejection time in left ventricular systolic dysfunction.

Myocardial performance index (MPI) has been regarded as an important parameter in the evaluation of ventricular systolic function in congestive heart failure. This study was designed to investigate the relationship between the ratio of isovolumic contraction time/left ventricular ejection time (IVCT/LVET), MPI, and LV systolic function. A total of 43 patients (patient group) with LV ejection fractions (LVEFs) <55% were compared with 43 patients (control group) with LVEF values >or=55%.

Levosimendan improves renal function in patients with acute decompensated heart failure: comparison with dobutamine.

Background: Levosimendan is a relatively new cardiac inotropic agent with calcium sensitizing activity. This study was conducted to investigate the effects of levosimendan (L) and dobutamine (D) on renal function in patients hospitalized with decompensated heart failure (HF).

Method: The present study included 88 consecutive patients hospitalized with acutely decompensated HF (New York Heart Association (NYHA) Class 3-4) requiring inotropic therapy.

The severity of ST segment elevation in acute inferior myocardial infarction: does it predict the presence of a proximal culprit lesion along the right coronary artery course?

Objective: Acute inferior myocardial infarction (AIMI) is generally characterized by ST segment elevation in the limb leads (D2, D3, aVF). Many trials have reported the close relation between the severity of this ST segment elevation and the extent of infarction, and also the prognosis. Based on the clinical studies, several electrocardiographic (ECG) criteria have also been propounded to identify the infarct-related artery.

Sleep quality among relatively younger patients with initial diagnosis of hypertension: dippers versus non-dippers.

Background: Sleep is a basic physiological process. Normal sleep yields decrease in sympathetic activity, blood pressure (BP) and heart rate. Those, who do not have expected decrease in their BP are considered "non-dippers".

Asymptomatic total anomalous pulmonary venous connection with double drainage in a young adult: a case report.

Total anomalous pulmonary venous connection is an uncommon congenital anomaly in which all pulmonary venous return drains to the right atrium or one of its tributaries. Survival beyond infancy without surgical palliation is unlikely, so this anomaly is not encountered in the adult population with congenital heart disease. The patient presented here was 22 years old on admission and had no total anomalous pulmonary venous connection-associated symptoms.

Heart rate turbulence: an additional parameter in determining the need for mechanical relief of mitral stenosis?

Background And Aim Of The Study: Heart rate turbulence (HRT) is a relatively newer parameter which has predictive value for mortality and severity in a variety of cardiovascular diseases. The study aim was to investigate the relationship between HRT and isolated acquired mitral stenosis (MS) on the basis of symptoms considered important in prognosis and for determining mechanical relief of the stenotic valve.

Methods: Among 46 patients with MS undergoing transthoracic echocardiography (TTE), 22 with moderately severe or severe symptoms of MS (NYHA class 3-4) (group 1) were compared with 24 with mild to moderate or no symptoms of MS (NYHA class 1- 2) (group 2).