Evaluating the effects of cardiac resynchronization therapy on pathophysiological pathways of heart failure using surrogate biomarkers.

Background: Several studies have investigated the effects of cardiac resynchronization therapy (CRT) on heart failure (HF), but none have evaluated the pathophysiological pathways involved in a single group of patients. Therefore, this study aims to assess the long-term effects of CRT on six different patho-physiological pathways involved in the process of HF by the use of surrogate biomarkers.

Methods: In a group 44 patients with HF, six groups of biomarkers were measured, both at baseline and 1 year after CRT implantation: inflammation (interleukin [IL]-4, IL-6, tumor necrosis fac-tor [TNF]-a, high sensitive C-reactive protein [hsCRP]); oxidative stress (myeloperoxidase [MPO], oxidized low-density lipoprotein [oxLDL], uric acid); extracellular matrix (ECM) remodeling (matrix metalloproteinase [MMP]-2 and -9, galectin-3, procollagen III N-terminal propeptide [prokol-3NT]); neurohormonal pathways (endothelin-1, chromogranin-A); myocyte injury (troponin T, creatine kinase MB fraction [CK-MB]), myocyte stress (B-type natriuretic peptide [BNP]).

Evaluation of heart rate recovery index in heavy smokers.

Objective: Cigarette smoking increases the risk of cardiovascular events. The heart rate recovery index (HRRI) is an indicator of autonomous nervous system function and is an independent prognostic risk factor for cardiovascular diseases. In this study, we aimed to evaluate HRRI in heavy smokers.

Diastolic dysfunction and contrast-induced nephropathy in patients undergoing coronary angiography.

Objectives: It has been demonstrated that decreased left ventricular ejection fraction (LVEF) is associated with an increased risk of contrast-induced nephropathy (CIN). In this study, we aimed to assess whether there is a relationship between left ventricular (LV) diastolic dysfunction and renal function decline after coronary angiography (CAG).

Patients And Methods: The study consisted of two groups: group I, patients with normal diastolic function; group II, patients with cardiac symptoms and abnormal diastolic function.

Increased epicardial adipose tissue thickness is linked to aortic stiffness in patients with primary hypertension.

Aims: In patients with hypertension (HT), increased aortic stiffness is related to higher cardiovascular morbidity and mortality. Recent investigations have shown that epicardial adipose tissue (EAT) is a new potential cardiometabolic risk factor. The aim of our study was to examine the relation between echocardiographically measured EAT thickness and aortic stiffness in patients with primary HT.

Intracavitary cardiac hydatid cysts with a high risk of thromboemboli. Invasive nature of cardiac echinococcosis.

Hydatid cysts are a serious health problem in many countries that raise farm animals, and they usually involve the liver and lungs. Although cardiac involvement is a rare manifestation of hydatid cyst disease, its early diagnosis and surgical management are crucial. Patients with cardiac hydatidosis may develop acute life-threatening complications secondary to their invasion of surrounding cardiac structures, such as cyst rupture together with systemic and pulmonary dissemination.

Effects of α-MSH on ischemia/reperfusion injury in the rat sciatic nerve.

Background: Ischemia/reperfusion (I/R) causes the production of toxic free radicals and leads to pathological changes in nerve tissue. We investigated the effect of alpha-melanocyte stimulating hormone (α-MSH) in a rat model for sciatic nerve I/R and discuss the possible cytoprotective and antioxidant mechanism of α-MSH against ischemic fiber degeneration.

Methods: Experiments were performed using 42 adult male Wistar rats.

Double-edged sword in the heart: trapped deep venous thrombus in a patent foramen ovale.

Trapped thrombus in a patent foramen ovale is a rare condition. Echocardiography is the main tool for diagnosis and for determination of the treatment to choose. There are a number of treatment options for trapped deep venous thrombus in a patent foramen ovale, including surgical thrombectomy, thrombolytics, and anticoagulant therapy.

The diagnosis and clinical importance of tumour neovascularisation from coronary artery to right atrial myxoma.

Myxomas are the commonest cardiac tumours and are usually localised in the atria. Neovascularisation in cardiac myxomas has been shown in previous case reports. However, the clinical importance of neovascularisation in cardiac myxomas is not well understood.

Single left coronary artery and coronary sinus opening anomaly in a patient presenting with cardiac symptoms.

A single left coronary artery is an extremely rare congenital anomaly that is commonly associated with other congenital cardiac malformations. We present a case involving a single left coronary artery and coronary sinus anomaly demonstrated on coronary angiography and multidetector computed-tomography angiography. To the best of our knowledge, this rare combination has not been reported previously.

Thrombus aspiration for treating distal coronary macroemboli during primary percutaneous coronary intervention.

Percutaneous coronary interventions (PCI) of thrombus-containing lesions are associated with increased risk of complications such as distal coronary embolisation and impaired coronary circulation. Although the use of thrombectomy devices to aspirate thrombus during primary PCI is currently not routinely recommended, there is growing evidence suggesting the use of thrombus aspiration catheters during PCI. Here, we report the case of a 70 year-old patient undergoing thrombus aspiration therapy because of the development of coronary bifurcation macroemboli during initial phase of primary PCI.

Cystic and hemorrhagic giant left atrial myxoma in a patient presenting with exertional angina and dyspnea.

Myxomas are the most common type of primary cardiac tumors and are usually localized in the atrium. The clinical features of the disease depend on the size, location, mobility, and fragility of the mass. In our case report, we present a 38-year-old female patient admitted to our hospital with typical exertional angina and dyspnea.

The relationship between inflammation, platelet activation and antiplatelet resistance.

Even though there is a strong evidence suggestive of benefits and safety of dual (aspirin plus clopidogrel) antiplatelet therapy, decreased responsiveness or "resistance" to mono- and/or dual antiplatelet therapy has been described in association with an increased thrombotic risk. Various mechanisms contribute to antiplatelet resistance, with abundant production of inflammatory markers being of particular importance. The current review overviews implications of inflammation in antiplatelet resistance.

Prevention of contrast-induced impairment of renal function by short-term or long-term statin therapy in patients undergoing elective coronary angiography.

A decline in kidney function after contrast exposure is associated with a high risk of morbidity and mortality during hospitalization and over long-term periods. Several retrospective and recent prospective clinical trials have shown that statin therapy might prevent contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. In this study, we aimed to assess the effects of statin therapies on renal function parameters in patients undergoing elective coronary angiography.

The relationship between acute coronary syndrome and inflammation: a case of acute myocardial infarction associated with coronary involvement of Sweet's syndrome.

Sweet's syndrome is characterized by skin lesions and fever. One of the rare extracutaneous manifestations of Sweet's syndrome is cardiovascular involvement including coronary artery occlusion. In this article, we present a case of acute myocardial infarction associated with exacerbation of Sweet's syndrome.

The relationship between intermittent left bundle-branch block and slow coronary flow in a patient presenting with acute coronary syndrome.

Coronary slow flow phenomenon (CSFP) is characterized by delayed opacification of coronary vessels in a normal coronary angiogram. The incidence of CSFP is reportedly 1% among patients undergoing coronary angiography, and is more prevalent in patients presenting with acute coronary syndromes (ACS). Over 80% of patients with CSFP experience recurrent chest pain.

Prinzmetal-variant angina in a patient using zolmitriptan and citalopram.

Prinzmetal-variant angina is a syndrome of chest pain caused by myocardial ischemia secondary to reversible coronary artery vasospasm, which may occur in angiographically normal and diseased coronary arteries. It typically occurs at rest and is accompanied by transient ST-segment elevation. Although the underlying pathophysiology is not well established, coronary spasm secondary to increased serotonergic activity as well as increased sympathetic activity may prevail.

Antiphospholipid antibody syndrome: coexistence of left ventricular apical thrombus and deep vein thrombosis causing pulmonary thromboembolism in a patient with systemic lupus erythematosus.

We report a 36-year-old woman with a 1-year history of systemic lupus erythematosus who was admitted with acute onset of dyspnea and chest pain. She presented with a classic medical history of antiphospholipid antibody syndrome, including spontaneous abortion, deep venous thrombosis, and clinical manifestations of lupus activation. The differential diagnosis was made after a detailed history and examinations with transthoracic/transesophageal echocardiography, deep venous ultrasonography, chest computed tomography, and coronary angiography.

Impaired aortic elasticity in patients with psoriasis.

Background: Psoriasis vulgaris is a chronic inflammatory disease involving 1-3% of the human population worldwide. Many systemic diseases including cardiovascular disturbances have been described in psoriatic patients. The effect of psoriasis on aortic elasticity parameters has not been well-defined previously.

Association between plasma asymmetrical dimethylarginine activity and saphenous vein graft disease in patients with coronary bypass.

Background: Coronary vein graft disease is an important contributor to the morbidity after coronary artery bypass graft surgery. Graft occlusion is a serious complication, which limits the use of the saphenous vein as a coronary bypass conduit. Asymmetrical dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxide synthase and it reduces the bioavailability of nitric oxide and begets endothelial dysfunction.