Vahit Demir

Atrial Electromechanical Coupling Interval and P-Wave Dispersion in Patients With White Coat Hypertension

Background. The aim of our study was to investigate the effect of white coat hypertension (WCH) to atrial conduction abnormalities by electrocardiographic P-wave analysis and echocardiographic electromechanical coupling (EMC) interval measurement. Methods. The study consisted of sex-, age-, and body mass index-matched 24 patients with WCH, 24 patients with sustained hypertension (SH), and 24 subjects with normotension (NT). The difference between the maximum (Pmax) and minimum P-wave durations on 12-lead electrocardiography was defined as P-wave dispersion (PD). Intra- and inter-atrial EMC were measured by tissue Doppler imaging. Results. Pmax and PD of subjects with WCH were significantly higher than those of normotensives and lower than those of patients with SH. Inter-atrial EMC and left atrial EMC values of WCH group were intermediate between NT and SH groups. There was a significant correlation between left atrial diameter, PD, Pmax, left ventricle mass index, left atrial EMC, and inter-atrial EMC. Conclusion. White coat hypertension is an intermediate group between SH and NT in terms of atrial electromechanical abnormalities which may be associated with the risk of atrial fibrillation.

Electrocardiographic changes in right ventricular metastatic cardiac tumor mimicking acute ST elevation myocardial infarction: A case of misdiagnosis

Introduction In patients with ST elevation myocardial infarction (STEMI), minimizing the reperfusion time is the goal of therapy worldwide. However, the differential diagnosis is critical and when a patient is encountered with chest pain and ST elevation, STEMI should not be the only diagnosis considered. By detailed history and focused physical examination, it is possible to avoid a mistaken diagnosis. Case presentation In this report, we present a case of a male patient with tongue cancer and accompanying myocardial metastasis that causes electrocardiographic changes, who was initially misdiagnosed with ST elevation myocardial infarction. Conclusion Here, we reported a case of metastatic cancer in the heart which was initially diagnosed as acute myocardial infarction. Echocardiography, computed tomography and magnetic resonance imaging of the heart were used accordingly to confirm the myocardial metastasis.

Relationship between neutrophil/lymphocyte ratio and epicardial fat tissue thickness in patients with newly diagnosed hypertension:

Objective Epicardial fat tissue thickness (EFT) and the neutrophil/lymphocyte ratio (NLR) are associated with atherosclerosis. Few studies have focused on the relationship between these parameters in patients with newly diagnosed hypertension. In this study, we examined the relationship between EFT and the NLR in patients with newly diagnosed hypertension detected by 24-hour ambulatory blood pressure monitoring (ABPM). Methods Eighty consecutive patients without chronic illness who were diagnosed with hypertension according to ABPM results and 80 otherwise healthy subjects were enrolled in the study. EFT of each participant was measured echocardiographically. The C-reactive protein (CRP) concentration and NLR were measured from venous blood samples. Results The 24-hour average systolic blood pressure was significantly higher in the hypertension group than in the control group (143±17 vs. 117±7 mmHg, respectively). There were no significant differences in age, sex, or body mass index between the two groups. EFT, the NLR, and the CRP concentration were significantly higher in the hypertension group than control group. Additionally, a significantly positive correlation between EFT and the NLR was found in both the control group and hypertension group. Conclusion A higher EFT and NLR were detected in patients with newly diagnosed hypertension than in healthy subjects.

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

Association of lymphocyte-monocyte ratio and monocyte-to-high-density lipoprotein ratio with the presence and severity of rheumatic mitral valve stenosis

AIM We aimed to evaluate the relationships between monocyte-to-high-density lipoprotein ratio (MHR) and lymphocyte-to-monocyte ratio (LMR) and rheumatic mitral valve stenosis (RMVS). METHODOLOGY A total of 368 patients with mitral stenosis and 80 healthy participants were included. Patients were categorized into two groups in respect to the severity of RMVS as mild-moderate group (mitral valve area ≥1.0 cm2) and severe group (mitral valve area <1.0 cm2). RESULTS The MHR (10.6 ± 2.3, 11.6 ± 2.6, 13.8 ± 3.1; p < 0.001) and C-reactive protein levels (control group, nonsevere RMVS and severe RMVS groups 3.4 ± 0.7, 4.4 ± 1.1, 5.2 ± 1.4, respectively; p < 0.001) were significantly increased whereas LMR (4.51 ± 1.3, 3.57 ± 1.3, 3.14 ± 1.4; p < 0.001) levels were significantly decreased in parallel to the severity of mitral stenosis. DISCUSSION/CONCLUSION MHR and LMR can be used to predict severity of RMVS.