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Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: There is substantial evidence that the majority of cases of lower extremity peripheral artery disease are undetected. As a result, there is great interest in the detection of lower extremity peripheral artery disease through routine screening. However, routine screening of lower extremity peripheral artery disease is still debated. Methods: In our cross-sectional study, we included 200 consecutive patients with symptoms suggestive of angina who were undergoing coronary angiography. Irrespective of intermittent claudication, we subsequently performed peripheral angiography to detect lower extremity peripheral artery disease. The predictors of lower extremity peripheral artery disease were analyzed, and the diagnostic utility of these predictors and their combinations were determined. Additionally, the determinants of the amount of radio-opaque material used and peripheral fluoroscopy time were investigated. Results: The overall prevalence of lower extremity peripheral disease was 16%. Being older than 65 years, having coronary artery disease and smoking history remained significant predictors after adjusting for other well-known parameters. Having the combination of age ≥65 and smoking was associated with a positive predictive value of 50% (likelihood ratio 5.06), and having all of the predictors was associated with a positive predictive value of 100% (likelihood ratio >1000). Conclusions: Routine screening for lower extremity peripheral disease patients undergoing coronary angiography may be useful in selected patients. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to estimate the influence of the duration of mobile phone use on heart rate variability (HRV) in healthy individuals. Methods: One hundred forty-eight individuals without any established systemic disease and who had undergone 24-h ambulatory ECG monitoring were included in the case-control study. All the individuals had been using mobile phones for more than 10 years. Three-channel 24-h Holter monitoring was performed to derive the mean heart rate, standard deviation of normal NN intervals (SDNN), standard deviation of 5-min (m) mean NN intervals (SDANN), the proportion of NN50 divided by the total number of NNs (pNN50), the root mean square differences of successive NN intervals (RMSSD), high (HF)-, low (LF)-, very low (VLF)-frequency power, total power components, and the LF/HF ratio. Individuals were divided into four groups according to their duration of mobile phone use [no mobile phone use (Control group), <30 min/day (Group 1), 30-60 min/day (Group 2), and >60 min/day (Group 3)]. Results: All the groups had similar features with regard to demographic and clinical characteristics. No significant arrhythmias were observed in any of the groups. The LF/HF ratio was higher, whereas the SDNN, SDANN, RMSSD, and pNN50 values were lower in the study groups than in the control group (p<0.05). No significant differences were identified among groups with respect to heart rate, VLF, and total power values (p>0.05). Conclusion: In this study, it was shown that the duration of mobile phone use may affect the autonomic balance in healthy subjects. The electromagnetic field created by mobile phone use may induce HRV changes in the long term. [ABSTRACT FROM AUTHOR]

Objective Serum procalcitonin levels are associated with congestive heart failure, but are not established biomarkers of the disease. We evaluated the predictive value of serum procalcitonin levels for diagnosing heart failure and assessing its severity. Methods and results This retrospective, case-control study involved 59 subjects (mean age 59.7 ± 10.1 years; 38 males), including 21 outpatients and 19 inpatients with heart failure and left ventricular ejection fractions < 45%, and 19 healthy controls. Serum procalcitonin levels were measured and compared among the 3 groups. Procalcitonin levels were significantly higher among inpatients (median [interquartile range], 1.45 [0.25-5.80] ng/mL) than among the outpatients (0.35 [0.001-1.70] ng/mL; P < 0.001) or controls (0.05 [0.02-0.08] ng/mL; P < 0.001). Using a procalcitonin cut-off level of 0.09 ng/mL, 35 (87.5%) of the 40 inpatients and outpatients were procalcitonin-positive; all control individuals were procalcitonin-negative. Serum procalcitonin levels differentiated between heart failure patients and healthy controls (sensitivity, 88.9% [95% confidence interval, 75.9-96.2%]; specificity, 100% [82.2-100.0%]; positive predictive value, 100% [91.1-100.0%]; negative predictive value, 79.2% [57.8-92.8%]). Procalcitonin levels were > 0.53 ng/mL in 4/21 (19%) outpatients and in 16/19 (84.2%) inpatients. The sensitivity and specificity of serum procalcitonin levels for differentiating between inpatients and outpatients were 84.2% and 81.0%, respectively (positive predictive value 80% [95% confidence interval, 67.6-92.4%] and 85.0% [73.9-96.1%], respectively). Conclusion Serum procalcitonin levels, showing high sensitivity and specificity for diagnosing and assessing the severity of heart failure in this small study, might be considered potential heart failure biomarkers. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Recent studies have shown that high-sensitivity C-reactive protein (hs-CRP) measured before cardioversion (CV) plays a significant role in predicting atrial fibrillation (AF) relapse. The time course of changes in hs-CRP after successful electrical CV remains controversial. The aim of the present study was to assess the prognostic value of pre- and post-CV hs-CRP levels in predicting the long-term risk of AF. Additionally, we evaluated changes in hs-CRP levels over time following a successful CV. Methods: This prospective study comprised 216 patients with persistent AF who underwent CV (mean age 51.94 ± 8.07 years; 55.6% men). hs-CRP levels were examined in all patients, and blood samples were taken prior to and 1, 2, 7 and 30 days after CV. AF relapse was determined by 24-hour ambulatory electrocardiogram (ECG) monitoring and 12-lead standard ECG during 12 months of follow-up. We further divided the study population into two groups according to their rhythm at the end of the follow-up period (group A: patients with AF at the end of follow-up; group B: patients with sinus rhythm at the end of the follow-up period). Results: The AF recurrence rate was 42.2% throughout the 12-month follow-up period. The basal hs-CRP levels were higher in patients with an AF relapse than in those without (1.68 ± 0.57 vs. 1.12 ± 0.53 mg/dl; p < 0.01). The hs-CRP levels were significantly decreased at 30 days in group B, whereas there was no significant decrease in group A (from 1.12 ± 0.53 to 0.69 ± 0.33 mg/dl, p < 0.01, and from 1.68 ± 0.57 to 1.69 ± 0.76 mg/dl, p > 0.05, respectively). By multivariate Cox analysis, the independent predictors of AF relapse time points were the basal and day-2 hs-CRP levels. Receiver operating characteristic curve analysis showed that the cutoff value of hs-CRP on the 2nd day for predicting AF relapse was 1.85 mg/dl, with a sensitivity of 62%, a specificity of 82%, a positive predictive value of 85.7% and a negative predictive value of 81.6%. Conclusion: The hs-CRP levels both prior to and after CV predict the long-term risk of AF relapse. In the present study, hs-CRP levels were significantly decreased in patients who remained in sinus rhythm at the end of the study. In contrast, hs-CRP levels remained high throughout the follow-up in patients with an AF relapse. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Anatolian Journal of Cardiology / Anadolu Kardiyoloji Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

We investigated the diagnostic value and limitations of 16-slice multidetector computed tomography (MDCT) to detect significant obstructive coronary artery disease in symptomatic patients. A total of 43 symptomatic patients underwent conventional coronary angiography and 16-slice multidetector computed tomography for the detection of significant obstructive coronary artery disease. The diagnostic value and limitations of 16-slice multidetector computed tomography to detect significant coronary stenoses were determined by analyzing all coronary arteries and proximal segments, both including and excluding unevaluable segments. Analysis of all 592 coronary artery segments demonstrated moderate sensitivity (67%) and positive predictive value (69%), with a high specificity (95%) and negative predictive value (94%) for the detection of significant coronary artery stenoses. When the unevaluable segments had been excluded, with the analysis of all evaluable segments, proximal segments, and evaluable proximal segments, sensitivity increased (71%, 77%, and 83%, respectively), and high specificity (95%, 96%, and 96%, respectively) and negative predictive value (95%) were maintained. When we repeated the analysis taking only the patients into account, 16-slice MDCT correctly diagnosed 88% of all patients but a moderate negative predictive value (63%) was obtained. Artifacts caused by cardiac motion were the most frequent reason for unevaluable segments. Calcification was the leading cause of degraded image quality and incorrect diagnosis. Our results demonstrated that 16-slice MDCT has a moderate diagnostic value for the correct diagnosis of symptomatic patients with significant coronary artery disease. This result suggests that 16-slice MDCT may not be able to exclude significant coronary artery disease reliably in patients at high risk. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) with a reported incidence of 7-18%. Recently, P-wave signal-averaged electrocardiogram (P-SAECG) has been used to assess the risk of paroxysmal AF attacks in some diseases. The aim of this study was to determine prospectively whether patients with AMI at risk for paroxysmal AF would be identified by P-SAECG and other clinical variables.Methods: A total of 100 patients (mean age: 59+/-12, 77 male, 23 female) with ST segment elevation AMI were enrolled in this study. Patients with chronic AF were excluded. At entry, all patients underwent standard 12-lead ECG and in the first 24 hours, P-SAECG was taken, and echocardiography and coronary angiography were performed on the patients. Patients are followed for a month in terms of paroxysmal AF attacks and mortality.Results: AF was determined in 19 patients (19%). In patients with AF, abnormal P-SAECG more frequently occurred than in patients without AF (37% vs 15%, P<0.05). Patients with AF were older (70+/-14 vs 56+/-10, P<0.001) and had lower left ventricular ejection fraction (42%+/-8 vs 49%+/-11, P<0.05). AF was less common in thrombolysis-treated patients (47% vs 74%, P<0.05). Thirty-day mortality was higher in patients with AF (16% vs 2%, P=0.05).Conclusions: An abnormal P-SAECG may be a predictor of paroxysmal AF in patients with AMI. Advanced age and systolic heart failure were detected as two important clinical risk factors for the development of AF. [ABSTRACT FROM AUTHOR]

Background: Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) with a reported incidence of 7-18%. Recently, P-wave signal-averaged electrocardiogram (P-SAECG) has been used to assess the risk of paroxysmal AF attacks in some diseases. The aim of this study was to determine prospectively whether patients with AMI at risk for paroxysmal AF would be identified by P-SAECG and other clinical variables. Methods: A total of 100 patients (mean age: 59 ± 12, 77 male, 23 female) with ST segment elevation AMI were enrolled in this study. Patients with chronic AF were excluded. At entry, all patients underwent standard 12-lead ECG and in the first 24 hours, P-SAECG was taken, and echocardiography and coronary angiography were performed on the patients. Patients are followed for a month in terms of paroxysmal AF attacks and mortality. Results: AF was determined in 19 patients (19%). In patients with AF, abnormal P-SAECG more frequently occurred than in patients without AF (37% vs 15%, P < 0.05). Patients with AF were older (70 ± 14 vs 56 ± 10, P < 0.001) and had lower left ventricular ejection fraction (42%± 8 vs 49%± 11, P < 0.05). AF was less common in thrombolysis-treated patients (47% vs 74%, P <0.05). Thirty-day mortality was higher in patients with AF (16% vs 2%, P = 0.05). Conclusions: An abnormal P-SAECG may be a predictor of paroxysmal AF in patients with AMI. Advanced age and systolic heart failure were detected as two important clinical risk factors for the development of AF. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

It has previously been shown that leukocyte elastase is involved in the pathogenesis of atherosclerosis. Few studies have addressed the relation between leukocyte elastase concentrations and coronary artery disease (CAD). The authors investigated (1) the clinical significance of leukocyte elastase determination in the diagnosis of CAD and (2) the relation between plasma leukocyte elastase concentration and lesion morphology. The study included 185 subjects (140 men, 45 women) who underwent coronary angiography during investigation of chest pain; 135 had coronary stenosis (Group I) and 50 had nonstenotic coronaries (Group II). Among Group I patients, those with simple atheromatous plaques were distinguished from those with complex plaques. Elastase concentrations in Group I were greater than in Group II (57.1 ± 1.16 μg I-1 vs 27.6 ± 1.0 μg I-1, P<0.001), and greater in complex plaque patients than in those with simple plaques (64.5 ± 1.24 μg I-1 vs 45.9 ± 1.01 μg I-1, P<0.001). Logistic regression analysis showed (1) that elastase concentration, age, and sex had independent value for prediction of CAD and (2) that among Group I patients, the risk of complex plaques was greatest for those with high elastase concentration. These results suggest that plasma leukocyte elastase concentration is a sensitive diagnostic marker of CAD and that high values of elastase may indicate the presence of complex atheromatous plaques. [ABSTRACT FROM AUTHOR]

Nifedipine, a calcium-channel-blocking agent, was administered orally to 44 untreated patients (Group A) and sublingually to 51 untreated patients (Group B) who had a diastolic blood pressure more than 90 mm Hg and systolic blood pressure more than 140 mm Hg. The mean pretreatment systolic and diastolic blood pressure values were 185.3 ± 26.0 and 115.1 ± 13.4 mm Hg in Group A patients and 193.6 ± 23.1 and 118.1 ± 14.1 mm Hg in Group B patients respectively (p >0.05). The hypotensive activity of nifedipine was observed at the tenth minute in both groups. Mean systolic and diastolic pressures were 168.9 ± 23.7 and 101.9 ± 14.2 mm Hg in Group A and 170.6 ± 26.2 and 103.0 ± 15.8 mm Hg in Group B, (p < 0.001) Diastolic blood pressures dropped under 100 mm Hg at the twentieth minute in both groups. Maximal reduction of blood pressure was observed at the fortieth minute in both groups and the degree of reduction in blood pressure was also the same (mean systolic and diastolic blood pressures: 143.7 ± 22.1 and 86.9 ± 11.7 in Group A and 148.7 ± 21.4 and 91.7 ± 17.0 in Group B (p>0.05) The authors conclude that sublingual nifedipine administration is not superior to oral nifedipine administration (in capsular form) in the acute treatment of hypertension. [ABSTRACT FROM AUTHOR]

A patient with resting heart rate over 100 beats per minute (bpm) displayed 1.5–2 mm ST segment depression in her ECG during daily activities. She had unprovoked further increase in her heart rate up to 145 bpm, and during these episodes, her ECG displayed further ST segment depression up to 3 mm and of 0.12 second duration. An organic cause could not be found to explain her sinus tachycardia. Results of all laboratory investigations, including coronary angiography, were normal. It was observed that during an episode of reflex vagotonia, when her heart rate was below 95 bpm, her previously depressed ST segments became isoelectric. With the thought that this patient's ST segment depression was rate dependent, carotid sinus massage was performed, and when the heart rate slowed to 95 bpm her depressed ST segments became isoelectric. The same response was accomplished with beta blockers. Sympathetic hyperactivity was thought to be the most likely mechanism of ST segment depression in this patient. A critical increase in heart rate caused these ECG abnormalities. [ABSTRACT FROM AUTHOR]

The precise pathogenetic mechanism(s) of rheumatic fever and rheumatic heart disease have never been defined. C-reactive protein (CRP) is increased in patients with acute rheumatic fever, but it is not known whether plasma levels increase in patients with chronic rheumatic valve disease. The aim of this study was to determine the role of inflammation detected by high sensitivity CRP (hs-CRP) levels in the progression of chronic rheumatic valve disease. A total of 113 patients with chronic rheumatic valve disease (81 women, 32 men; mean age 40±14 years, range 13–70), 51 patients with prosthetic valve(s) (31 women, 20 men; mean age 48±13 years, range 21–71) and 102 healthy subjects (68 women, 34 men, mean age 41±12 years, range 25–73), as a control group, were assessed. Patients with acute rheumatic fever, acute infection, inflammatory disease, malignancy, acute myocardial infarction and trauma were excluded. hs-CRP was determined using latex-enhanced immunonephelometric assays on a BN II analyzer (Behring). Transthoracic echocardiography was performed in all patients in order to evaluate valvular disease. Levels of hs-CRP were significantly higher in patients with chronic rheumatic heart disease than in patients with prosthetic valve(s) and healthy subjects (0.62±0.64 vs. 0.35±0.41 vs. 0.24±0.18 mg/l, P<0.01 and P<0.001 respectively). No correlation was observed between CRP and age, sex or functional capacity. We found that hs-CRP is increased in chronic rheumatic heart disease; this may indicate that inflammatory response still persists in the chronic phase. [Copyright &y& Elsevier]

Presented here is a 39-year-old male patient with no structural heart disease but a ventricular tachycardia with right bundle branch block morphology and right axis deviation, which is responsive to adenosine. The ventricular tachycardia was initiated by ventricular pacing, shown to originate from the mid-anterior free wall region of the left ventricle and terminated by adenosine. Radiofrequency current application at a site where presumed P potentials were recorded eliminated the tachycardia, a finding that suggests that the origin of the tachycardia may be closely related to the anterior fascicle. [ABSTRACT FROM AUTHOR]

Copyright of Archives of the Turkish Society of Cardiology / Türk Kardiyoloji Derneği Arşivi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses a study to determine the risk factors associated with diabetes mellitus (DM) including coronary atherosclerosis. Topics discussed include a diagnostic test for DM, symptoms of acute coronary syndrome, prediabetic status on coronary atherosclerosis with the first-time acute coronary syndrome, and plaque phenotypes.

Single coronary artery anomaly associated with coronary fistula is a rare entity. Transcatheter coil embolization is the treatment of choice for coronary artery fistulas. In this case report, we describe a patient with both single coronary artery anomaly and coronary fistula who was successfully treated with coil embolization. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 63-year-old woman who had congestive heart failure and complained about dyspnea at rest, abdominal distention and swelling in the legs. Considering clinical, electrocardiographic and echocardiographic findings, it was decided to implant a biventricular pacemaker. It was concluded that Eustachian valve (EV) can hinder access to coronary sinus (CS) during biventricular pacemaker implantation.

The article presents a case study of a 57-year-old man admitted to the hospital with atypical chest pain and dyspnea. He has history of dyslipidemia, smoking and hypertension. Atypical left coronary artery (LCA) ostia from the right sinus of Valsalva was identified behind the right coronary ostia and to the aorta. Lesions in the right and left coronary systems are also discovered.