Tunzale Seydaliyeva

Increased QT dispersion in sickle cell disease: Effect of pulmonary hypertension

Background: QT dispersion has been proposed to be a predictor of adverse outcomes in a variety of cardiac disease states. The objective of this study was to examine QT dispersion in patients with sickle cell disease (SCD) and to assess the effect of pulmonary hypertension (PHT) on QT dispersion. Methods: We performed Doppler echocardiographic assessments of pulmonary artery systolic pressure in 73 (mean age 18.5 ± 8.0 years) steady-state SCD patients and 25 (mean age 19.6 ± 7.2 years) healthy subjects. Resting 12-lead electrocardiogram was recorded and QT dispersion was calculated as the difference between maximum and minimum QT intervals. Bazett’s formula was used to obtain a rate-corrected value of the QT interval (QTc). Results: Maximum QTc, minimum QTc and QTc dispersion were significantly increased in SCD patients compared to the control subjects (p < 0.0001, p < 0.05, p < 0.0001, respectively). Among SCD patients, patients with PHT had higher maximum QTc and QTc dispersion than patients without PHT (p < 0.0001). However, minimum QTc showed no significant differences between the two patient groups. Conclusion: QTc dispersion is significantly increased in SCD patients, especially those with PHT indicating regional inhomogeneity of ventricular repolarization.

Right ventricular and pulmonary function in sickle cell disease patients with pulmonary hypertension

The effects of sickle cell disease (SCD) on right ventricular (RV) and pulmonary function in SCD patients with pulmonary hypertension is not well-known. The aim of this study was to investigate RV and pulmonary functions in patients suffering from SCD with or without pulmonary hypertension using color tissue Doppler imaging and spirometry. We evaluated 48 asymptomatic patients with SCD. All patients underwent echocardiography with tissue Doppler imaging and pulmonary function test. Patients were divided into two groups: Group 1 consisted of 27 patients (age, 18.1 ± 7.1 years) with normal pulmonary artery pressure, and group 2 consisted of 21 patients (age, 21.4 ± 7.4 years) with pulmonary hypertension. Both groups were compared with a sex- and age-matched control group including 24 normal healthy subjects (age, 19.8 ± 9.2 years). Tricuspid lateral annular systolic (Sm) and early diastolic velocity (Em) were higher in group 1 than group 2 and the control group (p < 0.05). Tricuspid lateral annular late diastolic velocities (Am), isovolumetric contraction time, and myocardial performance index (MPI) were higher and the Em/Am ratio was lower in group 2 than group 1 and the control group (p < 0.05). However, no differences were found in the tricuspid lateral annular Em deceleration time, ejection time, and isovolumetric relaxation time between group 1, group 2, and the control group. Tricuspid lateral annular Sm and Em were similar in group 2 and the control group. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the diffusion capacity of the lung for carbon monoxide were decreased in both groups of patients compared to the control group (p < 0.05). However, there was no difference in respiratory rate, FEV1/FVC ratio, peak expiratory flow, and total lung capacity between group 1, group 2, and the control group. There were no differences in any indices of lung function between the two groups of patients. MPI is useful index to evaluate RV function in patients with SCD. RV diastolic function was disturbed in only SCD patients with pulmonary hypertension. On the other hand, the restrictive pattern of pulmonary function abnormalities had developed in both groups of patients.

Subclinical left ventricular dysfunction in multiple sclerosis

Objectives –  To investigate the left (LV) and right ventricular (RV) function in multiple sclerosis (MS) using standard echocardiography and Doppler tissue imaging (DTI).

GIANT LEFT ATRIUM MIMICKING A RIGHT THORACIC MASS: CASE REPORT

Financial Disclosure: The authors have no financial disclosures to report in relation to this manuscript. Author Contributions: Dr. Oba was involved in the study concept, design, analysis and interpretation of data, and the writing of the manuscript. Dr. Kazunari Suzuki and Dr. Ouchi contributed to the design of the study and the acquisition of the subject and helped prepare the manuscript. Dr. Matsumura, Dr. Tatsuya Suzuki, and Dr. Nakano took part in the analysis and the interpretation of the data. Sponsor’s Role: None.

Erratum: Giant left atrium mimicking a right thoracic mass: Case report (Journal of the American Geriatrics Society (2006) 54, (183-184))

Dear Readers: Please note that, in the article, ‘‘Effect of a Dementia Care Management Intervention on Primary Care Provider Knowledge, Attitudes, and Perceptions of Care Quality,’’ published in J Am Geriatr Soc 2006;54:311–317, on p 311, column 1, in the Abstract, under the subheading ‘‘Setting,’’ it begins, ‘‘Sixteen clinics (eight intervention, eight usual care).’’ Instead, it should begin, ‘‘Eighteen clinics (nine intervention, nine usual care).’’ In the next section of the abstract, under the subheading ‘‘Participants,’’ it reads, ‘‘Two hundred thirty-two medical providers; 129 from eight intervention clinics; 103 from eight usual-care clinics.’’ Instead, it should read, ‘‘Two hundred thirty-two medical providers; 129 from nine intervention clinics; 103 from nine usual-care clinics.’’ On page 312, column 1, second paragraph, line 4, it reads, ‘‘Alzheimer’s Disease Coordinated Care for San Diego Seniors (ACCESS) was tested by randomizing 16 clinics (8 to intervention, 8 to usual care).’’ Instead it should read, ‘‘Alzheimer’s Disease Coordinated Care for San Diego Seniors (ACCESS) was tested by randomizing 18 clinics (9 to intervention, 9 to usual care).’’ On the same page (312), column 2, under the subheading ‘‘Provider Sample,’’ the paragraph begins, ‘‘Surveys were sent to all eligible primary care providers at the 16 study clinics.’’ It should read, ‘‘Surveys were sent to all eligible primary care providers at the 18 study clinics.’’ Finally, on page 314, column 1, under the subheading ‘‘Results,’’ the first line reads, ‘‘Of the 232 providers identified at 16 clinics.’’ It should begin, ‘‘Of the 232 providers identified at 18 clinics.’’ Dear Readers: Please note that, in the Drugs and Pharmacology article, ‘‘A Systematic Review of the Efficacy and Safety of Atypical Antipsychotics in Patients with Psychological and Behavioral Symptoms of Dementia,’’ published in J Am Geriatr Soc 2006;54:354–361, on p 359, column 2, under the subheading ‘‘Long-Term Safety,’’ in the first paragraph, in the middle of line 4, it begins, ‘‘In risperidone trials,’’ Instead, it should read, ‘‘In olanzapine trials,’’ Also, in line 6, it reads, ‘‘In olanzapine trials.’’ Instead, it should read, ‘‘In risperidone trials.’’

453 P Wave duration and dispersion in mitral valve prolapse

1 ; T. Seydaliyeva 1 1 Mustafa Kemal University, Cardiology Dept., Antakya/Hatay, Turkey Aims: P wave dispersion (PWD) is an electrocardiographic measurement, which reflects a disparity in atrial conduction and vulnerability to atrial fibril- lation. In this study, we compared P wave duration and PWD of mitral valve prolapse (MVP) patients with healthy control subjects. We also investigate the echocardiographic determinants of PWD in MVP patients. Methods and results: Sixty-nine MVP patients (mean age 36.1±12.4 years) and 32 healthy control subjects (mean age 35.2±10.9 years) were included in the study. Twelve-lead surface electrocardiography recording was ob- tained from all participants. The change in maximum and minimum P wave duration was measured manually and the difference between the two val- ues was defined as PWD. There was no difference between the two groups in terms of baseline demographic characteristics. Maximum P wave dura- tion was higher in MVP patients than controls (123.8±7.2 vs 115.3±6.1 ms, p=0.007). Minimum P wave duration was found to be similar in MVP pa- tients and healthy controls. Mean PWD value of MVP patients was found to be higher than those of controls (52.6±12.7 vs 46.2±9.1 ms, p=0.01). In patients with MVP, multiple regression analysis revealed that among the echocardiographic parameters that were tested, the echocardiographic degree of the prolapse, anterior mitral leaflet thickness, left atrial diameter and detection of mitral regurgitation were independently associated with PWD. Conclusion: P wave duration and PWD are increased in patients with MVP. PWD is related to the echocardiographic degree of the prolapse, anterior mitral leaflet thickness, left atrial diameter and detection of mitral regurgita- tion. The echocardiographic assessment may help to identify a subgroup of patients at increased risk of atrial arrhythmias.