Evin Bozcali

Oxidative DNA Damage and Antioxidant Defense After Reperfusion in Acute Myocardial Infarction

Purpose Myocardial damage mediated by oxidative stress during acute myocardial infarction (MI) has been suggested as an obstructive factor on recovery after an MI. 8-Hydroxydeoxyguanosine (8-OHdG) is a marker for oxidative DNA damage; superoxide dismutase (SOD) and glutathione peroxidase (G-Px) are major antioxidant enzymes. We determined changes in the plasma level of 8-OHdG and activities of SOD and G-Px in patients with MI and examined the relations between those changes and other cardiac markers. Methods Blood samples were taken at the beginning of the therapy, on the third day of hospitalization, and on the day patients were discharged home. Plasma level of 8-OHdG and SOD and G-Px activities were measured by enzyme-linked immunosorbent assay and spectrophotometric kits, respectively. Results 8-Hydroxydeoxyguanosine level at the beginning of the therapy was found to be decreased on the third day of therapy and on the day patients were discharged home. With respect to the treatment way, 8-OHdG level was found to be slightly decreased on the third day of therapy and then remained stable in the group treated with thrombolytic agents. However, 8-OHdG level was found to be sharply decreased on the third day of therapy in the group that underwent primary percutaneous transluminal coronary angioplasty. No significant relations were determined between those measured parameters and serum levels of cardiac markers. Conclusion Although not correlated with other cardiac markers, plasma level of 8-OHdG shows a decrease after reperfusion therapy in patients with MI, and primary percutaneous transluminal coronary angioplasty seems much more effective than thrombolytic therapy for providing a low level of 8-OHdG.

Unusual case of aortic valve involvement in patient with Löffler's endomyocarditis: management, follow-up and short review of the literature.

Idiopathic hypereosinophilic syndrome (IHES) is an uncommon systemic disease which is characterised by blood eosinophilia and multiple clinical presentations. Cardiac involvement is the major cause of mortality and morbidity. Here we describe a 59-year-old man with symptoms of progressive dyspnea on exertion, and productive cough as an unusual case of Löffler endomyocarditis with a mass on the aortic valve which showed regression with treatment.

Diagnostic significance of serum galectin-3 levels in heart failure with preserved ejection fraction.

Objective Galectin-3, reflecting cardiac fibrosis, is a promising biomarker in early detection of heart failure with preserved ejection fraction (HFpEF). We aimed to clarify the clinical utility of galectin-3 levels in the diagnosis of HFpEF and to compare galectin-3 with N-terminal pro-brain-type natriuretic peptide (NT-proBNP) levels. Methods and results The study included 44 HFpEF patients (mean age 60 ± 6.78 years, 24 men) and 38 control subjects (mean age 57 ± 8.98 years, 20 men). Galectin-3 and NT-proBNP levels were assessed by the ELISA kits. The receiver operating characteristics (ROC) curve was used to examine the diagnostic performance of galectin-3 and NT-proBNP in HFpEF. Galectin-3 and NT-proBNP levels were significantly increased in patients with HFpEF compared to controls [5.35 ng/ml (0.86 – 14.90) vs 0.51 ng/ml (0.15 – 1.71) P< 0.0001, 617.75 ± 271.30 pg/ml vs 66.35 ± 54.01 pg/ml P< 0.0001, respectively]. Galectin-3 correlated with NT-proBNP, left atrial volume index, left ventricular mass index, and E/E’ (r = 0.90, P< 0.0001; r = 0.75, P= 0.0001; r = 0.86, P= 0.0001; r = 0.80, P= 0.0001; respectively). The area under the ROC curve was 0.98 for galectin-3 and 1.0 for NT-proBNP. Conclusions Our results support that, in addition to NT-proBNP, galectin-3 is also a valuable biomarker for the diagnosis of patients with HFpEF.

ω-3 fatty acid treatment in cardiac syndrome X: a double-blind, randomized, placebo-controlled clinical study.

ObjectiveWe conducted a clinical trial to examine the effect of &ohgr;-3 fatty acids in patients with cardiac syndrome X (CSX). We aimed to evaluate the potential impact of &ohgr;-3 fatty acids on endothelial function, oxidative stress, and symptom relief in the CSX. Methods and resultsEighteen patients with CSX were enrolled according to a double-blind, randomized, placebo-controlled design. Patients were randomized to &ohgr;-3 fatty acids (1440 mg/day, n=8) or placebo (n=10) for 4 months. We assessed plasma levels of malondialdehyde (MDA), endothelium-dependent vasodilatation [flow-mediated dilatation (FMD)], endothelium-independent vasodilatation [nitroglycerin-mediated dilatation (NMD)], and status of symptom [score with Seattle Angina Questionnaire (SAQ)] before and after the treatment. After 4 months, patients who were treated with &ohgr;-3 fatty acids showed significant increases in the FMD (from 47±48 to 104±23%, P<0.05) and NMD (from 51±53 to 93±35%, P<0.05) values, and significant decreases in the plasma MDA levels (4.4±0.86 to 3.35±0.33 µmol/l, P=0.012). SAQ scores were increased significantly in both groups (from 60±14 to 73±15%, P<0.05 placebo, from 67±10 to 81±9%, P<0.05 treatment group). NMD was correlated negatively with the plasma MDA levels. ConclusionFour months of therapy with a moderate dose of &ohgr;-3 fatty acids improved the endothelial function and reduced oxidative stress in patients with CSX.

Vascularization Pattern of C6 Glioma is Modified with Medroxyprogesterone Acetate and Ibuprofen in Wistar Rat Brain

Beneficial effects of medroxyprogesterone acetate (MPA) in cancer therapy is partly mediated via its antiangiogenic activity. The same is true for the antitumoral action of non-steroidal antiinflammatory drugs. We have studied two liposoluble drugs, MPA and the analgesic ibuprofen, on glioma vascularizationin vivo. In this study we have shown that, until the sacrifice at 27. day after tumor inoculation in the right hemisphere, MPA had a slight though insignificant activity to reduce the fatality of C6 glioma, growing in right cerebral hemisphere of male Wistar rats. But ibuprofen both alone or with MPA had no effect on survival with gavage application of a 30 mg/kg/day dosing regime. On histological analysis, intra-and peritumoral vessels were counted. Progesterone seemed to lower intratumoral, but to increase peritumoral vessels, especially glomeruloids, around the tumor mass. Coadministration of ibuprofen acted to suppress the peritumoral vessel increase, and to enhance lymphomonocytic infiltration around tumor vessels.

Circulating p53 and cytochrome c levels in acute myocardial infarction patients

Background Apoptosis causes myocardiocyte loss during and after myocardial infarction. Therapeutic approaches designed to arrest apoptosis would be a significant new development in the recovery of acute myocardial infarction (AMI). In order to examine apoptotic markers in the circulation, serum levels of p53 and cytochrome c were assessed in patients with AMI. Methods Blood samples were taken on admission (before initiation of therapy) and on the 3rd and 7th days of hospitalization. Serum levels of p53 and cytochrome c were measured by enzyme-linked immunassay. Results The serum level of p53 was higher in AMI patients on admission compared to the control group. A time-dependent decrease was observed in the serum level of p53, but there was no significant change in the serum level of cytochrome c during therapy. Conclusions p53, but not cytochrome c, appears to have potential as a biomarker for reporting on apoptosis following myocardial infarction.

Regression of Thrombus and Electrocardiographic Changes With Thrombolytic Therapy in Acute Massive Pulmonary Embolism

A 57-year-old man who had undergone successful right coronary artery stenting 2 weeks previously was admitted to the emergency department with sudden onset of syncope, palpitation, hypotension (80/60 mm Hg), mild chest pain, and dyspnea. Coronary angiography, which was performed immediately with the suspicion of stent thrombosis, showed a patent stent in the right coronary artery without stenosis or thrombosis. Laboratory tests showed normal levels of creatine kinase and troponin I. Transthoracic echocardiography revealed right ventricular global hypokinesia with dilatation and impaired right …