Hakkı Şimşek

Effects of Trimetazidine on T Wave Alternans in Stable Coronary Artery Disease

Background and Objectives Studies reveal that the microvolt T wave alternans (MTWA) test has a high negative predictive value for arrhythmic mortality among patients with ischemic or non-ischemic cardiomyopathy. In this study, we investigate the effects of trimetazidine treatment on MTWA and several echocardiographic parameters in patients with stable coronary artery disease. Subjects and Methods One hundred patients (23 females, mean age 55.6±9.2 years) with stable ischemic heart disease were included in the study group. Twenty-five age- and sex-matched patients with stable coronary artery disease formed the control group. All patients were stable with medical treatment, and had no active complaints. Trimetazidine, 60 mg/day, was added to their current treatment for a minimum three months in the study group and the control group received no additional treatment. Pre- and post-treatment MTWA values were measured by 24 hour Holter testing. Left ventricular systolic and diastolic functions were assessed by echocardiography. Results After trimetazidine treatment, several echocardiographic parameters related with diastolic dysfunction significantly improved. MTWA has been found to be significantly improved after trimethazidine treatment (63±8 μV vs. 53±7 μV, p<0.001). Abnormal MTWA was present in 29 and 11 patients pre- and post-treatment, respectively (p< 0.001). Conclusion Trimetazidine improves MTWA, a non-invasive determinant of electrical instability. Moreover, several echocardiographic parameters related with left ventricular functions also improved. Thus, we can conclude that trimetazidine may be an effective agent to prevent arrhythmic complications and improve myocardial functions in patients with stable coronary artery disease.

Angiographic prevalence of myocardial bridging İn our department

Amaç: Koroner arter anomalisi olan Myokardiyal köprüleşme (MB), epikardiyal koroner arterlerden birinin bir segmentinin miyokardiyum içerisinde seyretmesi ile karakterize bir durumdur. MB tarafından oluşturulan koroner obstrüksiyonun derecesi, MB’nin yerleşimine, kalınlığına, uzunluğuna ve kardiyak kontraktilitenin derecesine bağlıdır. Otopsi çalışmalarında prevalansı %80 kadar yüksek bulunmasına rağmen, koroner anjiografi çalışmalarında prevalansı %0,5 ile %16 arasında değişmektedir.

The Use of Bioresorbable Coronary Scaffold in the Chronic Total Occlusion

PP-379 Because of the length of the lesion in chronic total occlusions (CTO), sometimes more than one stents are used and a metal jacket is prepared. The application of bioresorbable scaffolds in such lesions appears quite attractive. However, the use of these devices may be limited due to former

Heterozigot Ailevi Hiperkolesterolemide aort kapağı tutulumu ve erken koroner arter hastalığı

Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by an elevation of LDL cholesterol concentration in plasma leading to deposition of excess LDL-derived cholesterol in tendons, skin and arteries. We studied a 34 year old woman who applied to dermatology department due to multiple xanthomas. Cardiac consulting was demanded by dermatology department to determine development of atherosclerosis. Patient had no risk factor and symptom related to cardiac problem, except family history included premature coronary artery disease (CAD). On examination systolic murmur was present in aortic area. Echocardiography showed valvular severe aortic stenosis with a good left ventricle systolic function and severe left ventricular hypertrophy. The coronary arteriogram showed widespread CAD involving 3 coronary vessels. We report a case of heterozygous FH type II a with premature CAD and aortic valve involvement. J Clin Exp Invest 2011; 2 (3): 308-311.