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Objectives: We hypothesized that long-term morbidity and mortality can be identified by the presence of comorbidities in patients with carotid artery stenosis. In our study we aimed to investigate the relationship between clinical characteristics, laboratory findings and long-term prognosis in carotid artery stenosis patients after stenting Patients and Methods: We retrospectively enrolled 212 patients whom underwent carotid artery stenting (CAS) between January 2010 and December 2012 at Kartal-Kosuyolu Training and Research Hospital. CAS was performed in symptomatic patients with >60% stenosis and in asymptomatic patients with >80% stenosis of extracranial carotid artery. Symptoms were defined by an ipsilateral cerebral or ocular minor or major ischemic event within the past 6 months. Results: Mean age of study population was 67.4 ± 7.9 years and 158 patients (74.5%) were male. In the follow-up period 18 patients had MI, 18 patients had major stroke, 23 patients had transient ischemic attack. Twenty-one patients (9.9%) died from cerebral-cardiovascular causes. All MACCE was found in 64 patients (30.2%). Multivariate analysis revealed that age (OR: 1.09, 95% CI: 1.02-1.17, p = 0.05), heart failure (OR: 3.78, 95% CI: 1.48-9.62, p = 0.005), creatinine (OR: 3.54, 95% CI: 1.16-10.82, p=0.026) and neutrophil-lymphocyte ratio (OR: 2.88, 95% CI: 1.90-4.36, p < 0.0001) were independent predictors of the MACCE. Conclusion: Although, the short-term risk of patients undergoing CAS dominated by lesion-related factors, pre-existing comorbidities may be even more important for the long-term event. Age, heart failure, creatinine and neutrophil-lymphocyte ratio were found as the most important risk factors of MACCE.

Introduction:Thepurpose of this study was to evaluate left ventricular myocardial mechanicsusing 2-dimensional speckle tracking echocardiography (2D-STE) during normal,uncomplicated pregancy and postpartum term.Patientsand Methods: In this prospective, longitudinal study, 86 healthypregnant women who underwent serial 2 dimensional echocardiographic evaluationduring each trimester (trimester one 8-12 weeks; trimester two 20-24 weeks,trimester three 32-36 weeks, and postpartum 10-14 weeks). Two-dimensional STEwas performed to measure global left ventricular longitudinal, circumferential,and radial strain (GLS, GCS, and GRS, respectively).Results: GLS showeda decrease during pregnancy (for first trimester 21.0 ± 2.1%; for secondtrimester 19.9 ± 1.8%; for third trimester 18.2 ± 2.1; for postpartum 19.1 ±1.4, p< 0.001). GCS was significantly reduced during pregnancy (p= 0.033)and peaked as the same value in the first trimester. GRS remained unchangedthroughout the pregnancy and labor (p= 0.033).Conclusion: This study gives normalranges of 2D indices in pregnancy. 2D STE demonstrated that LV longitudinal andcircumferantial strain are significantly reduced, whereas radial strainremained unchanged., Giriş: Bu çalışmanın amacı sağlıklı gebelerde, gebelik süresince ve sonrasında solventrikül fonksiyonlarındaki değişimi “iki boyutlu speckle trackingekokardiyografi (STE)” yöntemi ile araştırmaktır.Hastalar veYöntem: Çalışmaya 86 sağlıklı gebe dahil edilmiş ve gebeliğinbirinci trimester 8-12 hafta, ikinci trimester 20-24 hafta, üçüncü trimester32-36 hafta ve postpartum 10-14. haftada 2 boyutlu ekokardiyografi ilekayıtları alınmıştır. Sol ventrikül global longitüdinal strain (SV-GLS), solventrikül global radiyal strain (SV-GRS), sol ventrikül global sirkumferansiyelstrain (SV-GCS) değerleri not edilmiştir. Bulgular: SV-GLS birinci trimester için -%21.0 ± 2.1; ikinci. trimester için -%19.9 ±1.8; üçüncü trimester için -%18.2 ± 2.1; postpartum -%19.1 ± 1.4, p< 0.001).SV-GCS gebelik boyunca anlamlı olarak azalırken (p= 0.033), post partum dönemde1.ci trimesterde bulunan değerlerine yükseldi. SV-GRS değerlerinde gebelikboyunca değişiklikler istatistiksel olarak anlamlı bulunmadı (p= 0.103).Sonuç: Bu çalışmada STE iledeğerlendirilen, SV-GLS ve SV-GCS ile mekanik fonksiyonlarının anlamlı birşekilde değiştiğini ve SV-GRS’de bir değişim olmadığını saptadık.

Introduction: The aim of this study was to use speckle-tracking echocardiography (STE) for identifying subclinical global systolic function abnormalities in chronic asymptomatic alcoholic patients with a normal ejection fraction. Patients and Methods: We included 30 healthy subjects (age 34.8 ± 5.8 years) and 75 asymptomatic alcoholic patients (age 39.8 ± 6.5 years) and divided them into two groups according to their total lifetime dose of ethanol (TLDE): group I (TLDE < 15 kg ethanol/kg body weight) and group II (TLDE ≥ 15 kg ethanol/kg body weight). In the two-dimensional (2D)-STE analysis, the left ventricular (LV) global longitudinal strain (G-LS), longitudinal global strain rate in systole (G-SRsys), longitudinal global strain rate in early diastole (G-SRearly) and longitudinal global strain rate in late diastole (G-SRlate) values were obtained. Results: Alcoholic patients had larger end-systolic and end-diastolic dimensions, thicker interventricular septal and posterior wall and higher LV mass index. However, there were no differences in the end-systolic and end-diastolic dimensions and LV mass index among them. The ejection fraction did not differ between the groups. The G-LS values were lower in alcoholic patients (p< 0.001). G-LS was found to be significantly lower among alcoholic patients, although the LV mass index and LV dimensions remained unchanged. Although G-SRsys was lower in alcoholic patients compared with that in controls (p= 0.03), there were no differences in the G-SRearly and G-SRlate values. There was a significant correlation between G-LS values and TLDE (r= 0.49, p< 0.001). Conclusion: To the best of our knowledge, this is the first study demonstrating the presence of early functional abnormalities of longitudinal systolic function by 2D-STE in chronic alcoholic patients. These functional mechanics have a parallel impairment with the increase in alcohol consumption.

Hepatit Cvirüsü (HCV) tedavisinde peginterferon (Peg-IFN)2b ve ribavirin tedavisi konvansiyonel interferon veribavirin tedavisinden daha etkilidir. Peg-IFN ve ribavirin tedavisinin önemlietkilerinin yanında ateş, halsizlik, heyecan, huzursuzluk, nötropeni ve trombositopenigibi bir çok yan etki görülebilir. Ayrıca kardiyak aritmiler ve senkop gibinadir olaylar da Peg-IFNtedavisine bağlı gelişebilir. Bizler bu çalışmada Peg-IFN ve ribavirin tedavisi sırasında presenkop atağı vereenteran taşikardilerin en sık formu olan atriyoventriküler nodal reenterantaşikardi gelişen bir yoğun bakım hastasını sunuyoruz., Thetreatment of hepatitis C virus (HCV) with peginterferon (Peg-IFN) α2b andribavirin is more effective than with conventional interferon and ribavirin.Despite the important effects of Peg-IFN and ribavirin therapy, many sideeffects, such as fever, fatigue, anxiety, irritability, neutropenia andthrombocytopenia, may be observed. In addition, cardiac arrhythmias and syncopeare rare consequences of Peg-IFN therapy. In this study, we report an intensivecare unit patient who developed atrioventricular nodal reentrant tachycardia(AVNRT), which is the most common type of reentrant supraventriculartachycardia, and presyncopal attack during Peg-IFN and ribavirin therapy.