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Extracorporeal life support (ECLS) is instituted for the management of life threatening pulmonary or cardiac failure (or both), when no other form of treatment has been or is likely to be successful. It has being used in developed countries for many years. ECLS has come into practice for a while in Turkey, in order to ECLS recommendations. However, most of them are postcardiotomy cases. However, this therapeutic option has more indications including its reason that brought it into practice. All equipment of the system has being changed with the developing technology. The aim of this paper is to point out this modality, to introduce equipment, and to give information about organization and management to bring this therapeutic option in Turkey in order. [ABSTRACT FROM AUTHOR]

Extracorporeal life support (ECLS) is instituted for the management of life threatening pulmonary or cardiac failure (or both), when no other form of treatment has been or is likely to be successful. It has being used in developed countries for many years. ECLS has come into practice for a while in Turkey, in order to ECLS recommendations. However, most of them are postcardiotomy cases. However, this therapeutic option has more indications including its reason that brought it into practice. All equipment of the system has being changed with the developing technology. The aim of this paper is to point out this modality, to introduce equipment, and to give information about organization and management to bring this therapeutic option in Turkey in order. [ABSTRACT FROM AUTHOR]

With the recent technological developments, computed tomography is becoming more important in the diagnosis of cardiovascular diseases. However, potential complications of the radiation dose used during the test have led debates. In the current situation, the data about undesirable effects of radiation dose used in cardiac computed tomography is not clear. In this paper, we reviewed the data about computed tomography and the risk of radiation. In order to reduce the risk of radiation due to computed tomography, the test should be performed with proper indication and in suitable patients. Besides, recently developed radiation dose reduction technologies and patient specific protocols have significantly reduced the radiation exposure. The clinicians should be well informed about the radiation reduction techniques and aware of the technical capabilities in their hospital. [ABSTRACT FROM AUTHOR]

Pulmonary arterial hypertension (PAH) is a clinical syndrome that is often diagnosed late and is associated with a progressive clinical deterioration and death. However, over the past ten years there has been a dramatic increase in the number of effective therapies. Identification of dysfunctional pathways in the pulmonary circulation provided novel therapeutic targets with the goal of reducing pulmonary vascular resistance and death from right ventricular failure. Treatment strategies are determined according to current guidelines. Pulmonary artery vasoreactivity, functional class and response to treatment are important concepts for initiation of medical therapy. With the availability of medications that target different pathologic processes, combination therapy has become a frequently used therapeutic option in PAH. In this paper, we aimed to review the therapeutic algorithms in pulmonary hypertension based on current guidelines. [ABSTRACT FROM AUTHOR]

Pulmonary arterial hypertension (PAH) is an uncommon disorder that may be hereditable, idiopathic or associated with conditions like drug exposure, connective tissue disease, HIV infection or congenital heart disease. Familial disease are usually due to mutations in the bone morphogenic protein receptor type 2 (BMPR2), activin-like kinase-type 1 (ALK1) and endoglin (ENG). Functional and structural changes in the pulmonary vasculature lead to increased pulmonary vascular resistance. Vascular remodeling involves endothelial dysfunction, activation of fibroblasts and smooth muscle cells and recruitment of circulating progenitor cells. Vasoconstriction has also been shown to affect the remodeling process. Genetics, cellular and molecular basis of PAH are discussed in the paper. [ABSTRACT FROM AUTHOR]

Acute heart failure syndrome is a heterogeneous group, which requires distinct therapeutic approaches. Diuretics and/or vasodilators for patients with high blood pressure and inotropic agents for patients with low left ventricular ejection fraction and evidence of hypoperfusion are kept in the forefront. Early initiation of therapy along with accurate and early diagnosis in acute heart failure reduces mortality and morbidity significantly. Therefore, it is critically important to develop algorithms, which could easily be followed by all physicians. In this paper, in parallelism with heart failure guidelines and utilizing data of the clinical studies, performed by colleagues of our country in this area, therapeutic algorithms compatible with the conditions of our country are suggested for distinct clinical presentations of acute heart failure. [ABSTRACT FROM AUTHOR]

Left ventricular functions are among the most important predictors of prognosis in cases with coronary artery disease. Cases with moderate or high degree of left ventricular function are at high risk of death and correct evaluation of myocardial viability is clinically important while they are under medical therapy. In a considerably high percent of these patients, significant improvements occur in left ventricular functions after successful revascularization. In both left ventricular function and viability assessment there are many invasive and non-invasive (echocardiography, nuclear imaging, computerized tomography, magnetic resonance imaging, etc.) diagnostic methods. Here in this paper we will discuss solely role of echocardiography in the assessment of viability in patients with left ventricular dysfunction. [ABSTRACT FROM AUTHOR]

Major cardiovascular events cause about 80% of the total mortality in diabetic patients. It has been shown that diabetic patients have hyperactive platelets. It may be expected that aspirin, through its antiplatelet action, could change the risk for vascular events in people with diabetes. However, some data suggest that aspirin may be less effective than expected in preventing cardiovascular events in patients with diabetes. In this paper, we review the aspirin use in diabetics with respect to cardiovascular endpoints. [ABSTRACT FROM AUTHOR]

Major cardiovascular events cause about 80% of the total mortality in diabetic patients. It has been shown that diabetic patients have hyperactive platelets. It may be expected that aspirin, through its antiplatelet action, could change the risk for vascular events in people with diabetes. However, some data suggest that aspirin may be less effective than expected in preventing cardiovascular events in patients with diabetes. In this paper, we review the aspirin use in diabetics with respect to cardiovascular endpoints. [ABSTRACT FROM AUTHOR]

Reperfusion therapy with intravenous thrombolytic agents in acute ST-segment elevation myocardial infarction reduces the infarct size, preserves ventricular function, and therefore reduces mortality. Experimental and clinical studies also showed that time to successful reperfusion is a critical determinant of survival. In this paper the importance of very early (pre-hospital) thrombolysis, its comparison with percutaneous interventional therapy and the feasibility in Turkey are discussed. Although primary coronary interventions are preferred in patients with ST-segment elevation myocardial infarction intravenous, early bolus thrombolysis in the pre-hospital stage provides a therapeutic option as good as primary angioplasty. Until necessary policy and technical substructure are completed cardiology centers should apply the most suitable reperfusion strategy according with the guidelines, feasibilities and their experience. [ABSTRACT FROM AUTHOR]

Reperfusion therapy with intravenous thrombolytic agents in acute ST-segment elevation myocardial infarction reduces the infarct size, preserves ventricular function, and therefore reduces mortality. Experimental and clinical studies also showed that time to successful reperfusion is a critical determinant of survival. In this paper the importance of very early (pre-hospital) thrombolysis, its comparison with percutaneous interventional therapy and the feasibility in Turkey are discussed. Although primary coronary interventions are preferred in patients with ST-segment elevation myocardial infarction intravenous, early bolus thrombolysis in the pre-hospital stage provides a therapeutic option as good as primary angioplasty. Until necessary policy and technical substructure are completed cardiology centers should apply the most suitable reperfusion strategy according with the guidelines, feasibilities and their experience. [ABSTRACT FROM AUTHOR]