Şıho Hidayet

Left atrial volume and function in patients with white-coat hypertension assessed by real-time three-dimensional echocardiography.

BackgroundWhite-coat hypertension (WCH) is a disease based on the disparity of a patient’s blood pressure measurements between the physician’s office and the patient’s home environment. The aim of the present study is to evaluate the left atrial (LA) volume and functions in WCH. MethodsIn total, this study included 37 WCH (17 women, 20 men, mean age 48.4±5.7 years) and 30 healthy individuals (18 women, 20 men, mean age 47.9±7.5 years). All patients underwent real-time three-dimensional and comprehensive two-dimensional echocardiography (2DE) with tissue Doppler evaluation to estimate left atrial volumes and mechanical functions. ResultsLA diameters were significantly higher in the patients compared with the controls (37±2.8 vs. 35±3.1 mm, P=0.017). LA total systolic volume and LA maximal volume were significantly higher in the patients. (41.1±6.9 vs. 35.5±3.7 ml, P<0.001; 25.8±5.4 vs. 21.3±3.3 ml, P<0.001, respectively). LA volume before LA contraction and LA active stroke volume were significantly higher in the patients with WCH than in the normotensives (24.4±6.3 vs. 20.9±2 ml, P=0.002; 9.1±4.8 vs. 6.7±2.5 ml, P=0.007, respectively). Moreover, the LA expansion index was significantly higher in the patients with WCH than in the normotensives (178.7±53.6 vs. 155.3±36.3, P=0.037). However, the total emptying volume fraction of the LA was similar between the two groups. ConclusionWe showed that LA structural functions and volumes were increased in the WCH group. Although increased LA volume has been observed in many diseases, structural changes in LA may be accepted as an early sign for clinical cardiac remodeling in patients with WCH, suggesting the necessity of early intervention for preventing clinical cardiovascular disease.

Coexistence of Unstable Angina Pectoris and Wolff-Parkinson-White Syndrome Developed After Consumption of Energy Drink

Consumption of energy drinks (ED) in the world and in our country is increasing every year. The companies rely on allegations that consumption of ED is enhancing physical and emotional stability and concentration and increase their market shares. However relation of ED with cardiovascular diseases has been started to be discussed almost on the day it was started to be consumed. It is used especially by young and adolescent people as a support to boost their physical and mental performance. Although ED contains many ingredients, the substance that was heavily accused of causing an increase in the sympathomimetic activity in cardiac events was caffeine (1,2). In spite of the fact that; exact mechanism operating in the diseases developing from cardiovascular problems related to consumption of ED cannot be explained fully, various cases had been reported, including Acute Coronary syndrome, cardiovascular arrest, supra-ventricular and ventricular arrhythmia (3-6). WolffParkinson-White (WPW) syndrome is identified by short PR interval and delta wave in electrocardiography (ECG) and may cause paroxysmal tachycardia including death in rare cases. In this study, we aimed to present a case of 34-year-old male patient, admitted to the emergency department because of Enerji içeceklerine ilgi her geçen gün artmakta ve enerji içeceği tüketimi de buna paralel olarak artmaktadır. Kullanıcılar çoğunlukla keyif almak, performans ve dikkati artırmak amacıyla enerji içeceklerini kullanmaktadır. Ancak enerji içecekleri istenmeyen kardiyolojik olaylara neden olabilirler. Literatürde enerji içeceklerinin yol açtığı kardiyolojik sorunlar az da olsa yayınlanmaktadır. Wolff-Parkinson-White sendromu taşikardilere neden olan, seyrek olarakta ani ölümün görülebilebileceği doğumsal bir kalp hastalığıdır. Bu olguda enerji içeceği tüketilmesi sonrası unstabil anjina pektoris ve intermitant Wolf-Parkinson-White sendromu saptanan genç bir olguyu sunduk. Anahtar Kelimeler: Anjina, Enerji İçeceği, Kafein, Wolf-Parkinson-White Sendromu Öz Abstract

Prediction of postoperative atrial fibrillation with left atrial mechanical functions and NT-pro ANP levels after coronary artery bypass surgery: A three-dimensional echocardiography study

Postoperative AF (POAF) is the most common cause of morbidity after coronary artery bypass surgery. In this study, we aimed to show the relationship between POAF and N‐terminal pro‐atrial natriuretic peptide (NT‐pro ANP) levels and the relationship between mechanical functions and left atrial volume measured using preoperative three‐dimensional echocardiography (3D ECHO) among patients that will undergo isolated coronary artery bypass grafting (CABG) in elective conditions.

Coexistence of Single Coronary Artery Anomaly and Aortic Arch Anomaly

A 74-year-old male patient was admitted to our hospital for evaluation of recent onset atypical chest pain. His medical history included hypertension, dislipidemia and smoking. Physical examination was unremarkable. The resting electrocardiogram was demonstrated biphasic T waves on lateral derivations. Transthoracic echocardiography showed normal left and right ventricular dimensions and functions. Coronary angiography was planned for the patient. First, right transradial approach tried; but guidewire could not be advanced to ascendig aorta. Coronary angiography was performed through the right femoral artery. Multiple attempts to cannulate the left coronary ostium were unsuccessful. The right coronary artery cannulated from its normal ostium in the right sinus of Valsalva. After a very short common main stem, the artery divided into a right coronary artery, and separate left anterior descending artery and circumflex artery (Figure A). The coronary arteries were normal without any significant stenosis and any extrinsic compression. An aortic root injection confirmed the absence of left coronary ostium. Also, a retroesophageal right subclavian artery originating from the left aortic arch (arteria lusoria) was detected as the last branch of aortic arch on contrast enhanced computerized tomography (Figure B-C). The patient discharged with medical teraphy.