Suleyman M. Aslan

Statin Use before By-Pass Surgery Decreases the Incidence and Shortens the Duration of Postoperative Atrial Fibrillation

Backround: The aim of the present observational study is to search the incidence of postoperative atrial fibrillation (AF) in patients with or without preoperative statin treatment. Methods andResults: The population consisted of 362 consecutive patients (267 on and 95 not on statin). Diabetes mellitus was more frequent in statin group (p = 0.03). Other demographic and procedural variables were similar in the both groups (All p > 0.05). Postoperative AF was less frequent and its duration was shorter in statin group compared to non-statin group (p = 0.03 and 0.0001, respectively). The Kaplan-Meier analysis showed the protective effect of statins against the risk of developing AF (p = 0.01). Conclusion: Statin treatment before the by-pass surgery decreases the incidence and shortens the duration of postoperative AF.

Elevated carbohydrate antigen 125 levels in hypertrophic cardiomyopathy patients with heart failure

Carbohydrate antigen 125 (CA 125), known as a tumor marker for ovarian cancer, has been reported to increase and relate to severity in heart failure patients with systolic dysfunction. Hypertrophic cardiomyopathy (HCM) has a wide clinical spectrum that often includes heart failure symptoms. The aim of this study was to evaluate the role of CA 125 in HCM patients, its relation to severity of symptoms, and degree of diastolic dysfunction. CA 125 blood levels were determined in 32 HCM patients (21 male; age 51.3 ± 18.4 years) and in 30 healthy volunteers (19 male; age 49.6 ± 16.1 years). Echocardiographic examinations were performed in all patients. The results were grouped according to clinical status (New York Heart Association class) of the patients. The mean serum level of CA 125 was 14.6 ± 23.8 U/ml in the study group and 7.6 ± 4.8 U/ml in the control group. There was no significant difference between the groups (P = 0.12). CA 125 levels increased as the New York Heart Association functional class increased (class I/II: 6.2 ± 2.4 U/ml; class III: 30.6 ± 36.4 U/ml; P < 0.001). The mean CA 125 level in functional class III patients (30.6 ± 36.4 U/ml) was significantly higher than that of the control group (7.6 ± 4.8 U/ml) (P < 0.001) and the functional class I/II group (6.2 ± 2.4 U/ml) (P < 0.001). There was a significant difference over all three diastolic dysfunction groups with respect to CA 125 levels (4.9 ± 1.3 U/ml in impaired relaxation group, 11.8 ± 6.9 U/ml in pseudonormal group, and 52.6 ± 45.6 U/ml in restrictive filling group; P < 0.0001). Serum CA 125 is related to the clinical severity of HCM. Whether CA 125 has a specific biological role in HCM requires further investigation.

Elastic properties of the ascending aorta in patients with beta-thalassemia major.

Background: β‐thalassemia major (β‐TM) is a congenital hemolytic disorder characterized by impaired left ventricular and endothelial function. However, elastic properties of the aorta have not been sufficiently investigated in patients with β‐TM. We investigated whether β‐TM is related to impaired ascending aortic elastic properties. Methods: We studied 36 patients with β‐TM (age: 15.8 ± 2.6 years) and 30 age‐ and sex‐matched control subjects by echocardiography. Aortic elastic indexes, aortic strain (%), distensibility (cm2 dyn−1 10−3), and stiffness index were calculated from the echocardiographically derived thoracic aortic diameters (mm/m2), and the measurement of pulse pressure obtained by cuff sphygmomanometry. Results: Patients versus control subjects had increased aortic diameters (P < 0.001), lower mean aortic strain (9 ± 3.6 vs. 14.9 ± 3.2, P < 0.001) and distensibility (0.6 ± 0.36 vs. 0.8 ± 0.2, P < 0.012), and higher mean stiffness index (5.3 ± 2.4 vs. 2.8 ± 0.6, P < 0.001). Aortic elastic indexes were significantly associated with ferritin level, while stiffness index was significantly related to platelet count. Conclusion: Elastic properties of ascending aorta are impaired in patients with β‐TM. Impaired functions of aorta may lead to deterioration of left ventricular function.

Elastic Properties of the Ascending Aorta in Patients with ?-Thalassemia Major

Background: β‐thalassemia major (β‐TM) is a congenital hemolytic disorder characterized by impaired left ventricular and endothelial function. However, elastic properties of the aorta have not been sufficiently investigated in patients with β‐TM. We investigated whether β‐TM is related to impaired ascending aortic elastic properties. Methods: We studied 36 patients with β‐TM (age: 15.8 ± 2.6 years) and 30 age‐ and sex‐matched control subjects by echocardiography. Aortic elastic indexes, aortic strain (%), distensibility (cm2 dyn−1 10−3), and stiffness index were calculated from the echocardiographically derived thoracic aortic diameters (mm/m2), and the measurement of pulse pressure obtained by cuff sphygmomanometry. Results: Patients versus control subjects had increased aortic diameters (P < 0.001), lower mean aortic strain (9 ± 3.6 vs. 14.9 ± 3.2, P < 0.001) and distensibility (0.6 ± 0.36 vs. 0.8 ± 0.2, P < 0.012), and higher mean stiffness index (5.3 ± 2.4 vs. 2.8 ± 0.6, P < 0.001). Aortic elastic indexes were significantly associated with ferritin level, while stiffness index was significantly related to platelet count. Conclusion: Elastic properties of ascending aorta are impaired in patients with β‐TM. Impaired functions of aorta may lead to deterioration of left ventricular function.

A Rare Cause of Myocardial Infarction: Acute Inferoposterior Myocardial Infarction After Successful Intravenous Thrombolytic Treatment of Mechanical Mitral Prosthetic Valve Thrombosis

Prosthetic valve thrombosis is a rare and dreaded complication of patients with mechanical valves, particularly those in the mitral position. A 45-year-old female with status post prosthetic mitral valve replacement was admitted to the hospital with acute pulmonary edema. Echocardiography showed mitral valve thrombosis which was treated with tissue plasminogen activator (t-PA). During t-PA infusion she developed acute inferoposterior myocardial infarction. Coronary angiography showed normal coronary arteries. Presented case had acute inferoposterior myocardial infarction secondary to coronary emboli after the successful thrombolytic treatment of prosthetic mitral valve thrombosis.