Relation between paroxysmal atrial fibrillation and left ventricular diastolic function in patients with acute myocardial infarction

The relation between left ventricular filling pattern and the occurrence of paroxysmal atrial fibrillation was evaluated using Doppler echocardiography in a prospective series of 157 patients with acute myocardial infarction. Paroxysmal atrial fibrillation after acute myocardial infarction was often associated with a higher restrictive filling pattern.

Laser angioplasty in a right coronary artery stent restenosis with the guidance of left internal mammary artery contrast injection: case report

A 43-years-old male who underwent right coronary artery stent implantation 6 months ago presented with total occlusion of right coronary artery at proximal part of the stent without antegrade flow. We successfully used the left internal mammary artery contrast injections for guidance in all stages of the right coronary laser angioplasty intervention.

Marfan's syndrome, dextrocardia and situs inversus associated with discrete subaortic stenosis and aortic insufficiency in an adult female: case report

Marfan's syndrome is an inherited connective tissue defect that affects many organs, especially of the musculoskeletal, ophthalmic and cardiovascular systems, and may be associated with some rare conditions. Here, we report the first known case of Marfan's syndrome, combined with situs inversus totalis with dextrocardia and discrete subaortic stenosis and aortic insufficiency in a 22-year-old woman.

Behçet's disease with a large intracardiac thrombus: a case report

Behçet's disease is recognised as a chronic multisystem disorder with vasculitis as its underlying pathological process. Cardiac involvement is rare and often associated with poor prognosis. A case of a 33 year old man with Behçet's disease, presenting with a large right ventricle and right atrial thrombus, is reported. Two dimensional (cross sectional), colour Doppler, and transoesophageal echocardiography, angiography, computed tomography, and magnetic resonance imaging were used to diagnose the disease. With cyclophosphamide and dexamethasone treatment, the cardiac lesions progressively resolved.

The effects of sertraline and fluoxetine on anxiety in the elevated plus-maze test in mice

The aim of this study was to evaluate the acute and chronic effects of two SSRIs (sertraline and fluoxetine) on anxiety by the elevated plus-maze test. Diazepam increased the time spent in open arms significantly whereas the anxiogenic m-chlorophenylpiperazine (m-CPP) decreased the time significantly. Acute sertraline (10 mg x kg(-1)) and fluoxetine (20 mg x kg(-1)) treatment significantly decreased the time spent in open arms. Acute fluoxetine (20 mg x kg(-1)) treatment also decreased the total number of enclosed arm entries. Seven days sertraline treatment decreased the time spent in open arms, whereas 14 days fluoxetine treatment increased the time spent in open arms. These results show that acute administration of SSRIs may produce anxiogenic effects in the elevated plus-maze test.

Factor V Leiden and its relation to left ventricular thrombus in acute myocardial infarction

OBJECTIVE

The genetic defect of coagulation factor V, known as factor V Leiden, produces a resistance to degradation by activated protein C (APC) and increases the risk of venous thrombosis. However, the role of factor V Leiden in the formation of left ventricular (LV) thrombus has not been studied. We investigated whether factor V Leiden is a risk factor for LV thrombus in patients with acute myocardial infarction (AMI).

METHODS AND RESULTS

We have analyzed clinical, echocardiographic and biochemical data in 135 consecutive patients (aged 58 +/- 13 years; 31 women) with first anterior AMI. Two-dimensional echocardiographic examination was performed on days 1, 3, 7, 15 and 30; LV thrombus was detected in 33 (24.4%) of 135 patients with AMI. The study also included 95 control subjects. Healthy age and sex-matched subjects without a personal or family history of ischaemic heart disease, stroke or thromboembolic disease served as a control group. Blood samples from the patients and controls were analyzed for the factor V Leiden mutation by DNA analysis, using the polymerase chain reaction. In addition, concentrations of fibrinogen, von Willebrand factor (vWF), tissue plasminogen activator (t-PA), plasminogen activator inhibitor-1 (PAI-1) and D-dimer were measured in 135 patients. There was no significant difference in the prevalence of factor V Leiden between patients and control subjects. The prevalence of the factor V mutation was 9% (3/33) in patients with thrombus, and 7.7% (8/103) in patients without thrombus. The prevalence of factor V Leiden was 7.3% (7/95) in control subjects. No significant differences in plasma fibrinogen (480 +/- 195 vs. 444 +/- 179 mg/dl, p = 0.6), D-dimer (471 +/- 256 vs. 497 +/- 293 ng/dl, p = 0.7), vWF (112 +/- 18 vs. 103 +/- 15%, p=0.5), PAI-1 (26.7+/- 9.8 vs. 28.1 +/- 10.2 ng/dl, p = 0.6), and t-PA (19.8 +/- 8.7 vs. 17.2 +/- 9.1 ng/dl, p = 0.7), levels are found in patients with LV thrombus when compared with those without LV thrombus. Multivariate analyses showed that peak creatine kinase level (p = 0.002) and LV wall motion score index (p = 0.003) were independent predictors of LV thrombus formation.

CONCLUSION

Factor V Leiden mutation is not a risk factor for LV thrombus formation in patients with AMI.

A coronary aneurysm complicated by acute myocardial infarction. A case report

Coronary artery aneurysm (CAA) is a relatively rare disease that may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. This report describes the case of a man aged 65 years old who had an anterior myocardial infarction due to left anterior descending artery (LAD) aneurysm. We attempted early percutaneous transluminal coronary angioplasty (PTCA) for treatment of acute myocardial infarction, but were not successful. He was then treated with intracoronary streptokinase. Serial coronary angiographies showed recanalisation and aneurysm on the LAD. The patient was operated on with coronary bypass surgery, and treated with an oral anticoagulant, nitrate, and blocker. He was well after one year of follow-up.

The role of nitrergic system in lidocaine-induced convulsion in the mouse

The effects of N-nitro-L-arginine-methyl ester (L-NAME) a nitric oxide (NO) synthase inhibitor and L-arginine, a NO precursor, were investigated on lidocaine-induced convulsions. In the first experiment, four groups of mice received physiological saline (0.9%), L-arginine (300 mg/kg, i.p.), L-NAME (100 mg/kg, i.p.) and diazepam (2 mg/kg), respectively. Thirty minutes after these injections, all mice received lidocaine (50 mg/kg, i.p.). In the second experiment, four groups of mice received similar treatment in the first experiment, and 30 min after these injections, all mice received a higher dose of lidocaine (80 mg/kg). L-NAME (100 mg/kg, i.p.) and diazepam (2 mg/kg) significantly decreased the incidence of lidocaine (50 mg/kg)-induced convulsions. In contrast, the L-arginine treatment increased the incidence of lidocaine (80 mg/kg, i.p.)-induced convulsions significantly. These results may suggest that NO is a proconvulsant mediator in lidocaine-induced convulsions.

Serum lipoprotein(a) and its relation to left ventricular thrombus in patients with acute myocardial infarction

It is well known that the incidence of left ventricular (LV) thrombosis is high in patients with acute myocardial infarction (AMI). Due to the high degree of structural homology with plasminogen, lipoprotein(a) may produce thrombogenic effects by modulating the fibrinolytic system. However, the role of Lp(a) level in the formation of LV thrombus has not been studied. This study sought to determine whether Lp(a) is a risk factor for LV thrombus in patients with AMI. We have analyzed clinical, echocardiographic and biochemical data in 102 consecutive patients (aged 58+/-12 years, 92 men / 10 women) with first anterior AMI. Two-dimensional examination was performed on days 1, 3, 7, 15, and 30. Blood samples were obtained within 12 h after the onset of symptoms and before beginning the therapy. Plasma levels of fibrinogen and Lp(a) were measured using enzyme-linked immunosorbent assay and immunonephelometric methods, respectively. LV thrombus was detected in 20 (20.3%) patients. No significant difference was found for admission Lp(a) levels between patients with or without thrombus (30.5+/-17.2 vs 32.3+/-22.4 mg/dl, p = 0.7). Univariate analysis showed that patients with LV thrombus had a higher wall motion score index (1.8+/-0.3 vs 1.4+/-0.3, p = 0.002), a higher peak creatine kinase level (2945+/-898 vs 1805+/-1336, I / U p = 0.004), a larger end-diastolic volume (139.7+/-38.6 vs 114.1+/-41.8 ml, p = 0.04), a larger end-systolic volume (83.1+/-34.3 vs 59.2+/-30.6 ml, p = 0.02 ), and a lower ejection fraction (38+/-12 vs 47+/-11, p = 0.04). In multivariate analyses, only peak creatine kinase level (p = 0.04) and LV wall motion score index (p = 0.002) were independent predictors of left ventricular thrombus formation. These results suggest that Lp (a) is not a risk factor for LV thrombus in patients with AMI. Our data demonstrate that the best predictors of LV thrombus formation after AMI are a high peak creatine kinase level and a high LV wall motion score index.

Doppler-derived mitral deceleration time as an early predictor of left ventricular thrombus after first anterior acute myocardial infarction

BACKGROUND

The relation between left ventricular (LV) diastolic function and LV thrombus has not yet been fully investigated. The aim of this study was to determine whether early assessment of Doppler-derived mitral deceleration time (DT), a measure of LV compliance and filling, may predict LV thrombus formation after acute myocardial infarction.

METHODS AND RESULTS

Two-dimensional and Doppler echocardiographic examinations were performed in 98 consecutive patients (aged 57 +/- 12 years; 8 women) with first acute myocardial infarction. The patients were studied within 24 hours and at days 3, 7, 15, and 30 after arrival to the coronary care unit. Mitral flow velocities were obtained from the apical 4-chamber view with pulsed Doppler. LV thrombus was detected in 20 of 98 patients. Patients were divided into 2 groups according to LV thrombus formation: group 1 (n = 20) with thrombus and group 2 (n = 78) without thrombus. Mitral E-wave DT was significantly shorter in group 1 than group 2 (134 ms vs 175 ms; P <.001). Patients in group 1 had significantly larger LV end-diastolic and end-systolic volumes and a higher wall motion score index than patients in group 2 (133 +/- 39 mL vs 112 +/- 41 mL, P =.03; 83 +/- 34 mL vs 59 +/- 30 mL, P =.003; and 1.8 +/- 0.3 mL vs 1.5 +/- 0.3 mL, P =.007, respectively). The LV ejection fraction was significantly lower in group 1 than in group 2 (39% +/- 13% vs 48% +/- 12%; P =.004). In a multivariate regression analysis, mitral E-wave DT was identified as an independent variable related to development of LV thrombus (P =.04).

CONCLUSIONS

Doppler-derived mitral DT is superior to conventional clinical and 2-dimensional echocardiographic assessment in estimating the risk of left ventricular thrombosis after myocardial infarction.

Rupture of the right sinus of valsalva into the right ventricle: echocardiographic and angiographic imaging

We report a 16-year-old girl with acute rupture of the sinus of Valsalva. This case is unique in that the right coronary sinus of Valsalva ruptured into both the right and left ventricles, producing severe aortic insufficiency. The diagnosis was made with two-dimensional and color Doppler echocardiography which showed an abnormal jet flow from the aortic root into both ventricles. The diagnosis was confirmed by magnetic resonance imaging and aortic root angiography. Early diagnosis is important so that urgent surgical treatment can be taken.

Two-dimensional color doppler echocardiographic imaging of a Gerbode defect: a case report

A Gerbode defect is a ventricular septal defect that communicates directly between the left ventricle and the right atrium. The pathology may be due to a congenital defect, can result from trauma, or can occur after endocarditis or aortic valve replacement. We report the case of a 20-year-old man who has a defect between the left ventricle and the right atrium (Gerbode defect) that was diagnosed with two-dimensional color Doppler echocardiography.

Primary neuroendocrine small cell carcinoma of the breast

A 60-year-old Turkish woman presented with a left breast mass, which was considered for neoadjuvant chemotherapy. By the end of the treatment cycles, the tumor had decreased in size, and the patient underwent modified radical mastectomy with axillary lymph node dissection. Pathologic examination of the tumor revealed a small cell carcinoma with neuroendocrine features confirmed by immunohistochemical stains. Multiple axillary lymph nodes were involved by metastatic small cell carcinoma carrying the same morphologic characteristics noted in the primary breast tumor. We hereby present this case as a primary neuroendocrine small cell carcinoma of the breast. This entity occurs very rarely in the breast, and fewer than a dozen cases have been reported in the literature. Extrapulmonary small cell carcinoma of the breast is reportedly a very aggressive tumor for which no consensus for treatment has yet been drawn.

Mitral valve prolapse and mitral insufficiency in two siblings with Gaucher's disease

Gaucher's disease is an autosomal recessive storage disorder. We report two siblings with Gaucher's disease, both of which had mitral valve prolapse and mitral insufficiency. One of the siblings died of bacterial endocarditis and pneumonia, while the other continues under followup.

Influence of caffeine on metabolic and cardiovascular functions during sustained light intensity cycling and at rest

This study assessed the influence of caffeine on metabolic and cardiovascular functions during sustained, light intensity cycling and at rest. Eight healthy, recreationally active adults participated in four randomly assigned, double-blind experimental trials of 60 min upright seated cycle exercise (30% VO2 max) or equivalent rest with caffeine (5 mg.kg-1) or placebo consumed 60 min prior to data collection. Gas exchange was measured by open-circuit spirometry indirect calorimetry. Global blood flow was evaluated by thoracic impedance cardiography and arterial blood pressure by auscultation. A repeated measures ANOVA indicated that pretrial caffeine increased oxygen uptake and energy expenditure rate (p < 0.05) but did not change respiratory exchange ratio. Systolic, diastolic, and mean arterial blood pressure were elevated following caffeine intake (p < 0.05). Cardiac output, heart rate, stroke volume, and systemic vascular resistance were not significantly different between caffeine and placebo sessions. For each of the metabolic and hemodynamic variables examined, the effects of caffeine were similar during constant-load, light intensity cycling and at rest. These data illustrate that caffeine's mild thermogenic influence can be mediated without a major shift in substrate oxidation mixture. Caffeine at this dosage level alters cardiovascular dynamics by augmenting arterial blood pressure.

Influence of dietary selenium and vitamin E on the levels of fatty acids in brain and liver tissues of lambs

In this study, the effects of dietary vitamin E, selenium, and their combination on the levels of fatty acid composition of the brain and liver tissues were examined. In brain tissue, the amounts of most fatty acids increased in vitamin E, combination and selenium groups compared with control group values. While the proportions of myristic, pentadecanoic, palmitic, linoleic, and total saturated fatty acids were decreased in vitamin E, Se and combination groups, eicosapentaenoic, total unsaturated and MUFA were increased in the same groups. In addition, the proportions arachidonic, eicosapentaenoic, total unsaturated, omega 6 and MUFA in the combination group were higher than in the control group. In liver tissue, the amounts of myristic, pentadecanoic, palmitic, eicosedienoic, eicosapentaenoic, docosahexaenoic, omega 3 and PUFA were higher in the combination group than in the control group. Also the proportions of eicosapentaenoic, docosahexaenoic acids in supplemented groups were higher than those in the control group. We conclude that dietary vitamin E and selenium have an influence on the levels of fatty acids in the brain and liver.

Effects of vitamin E and selenium on some rumen parameters in lambs

The effects of supplemented selenium and vitamin E on a number of rumen parameters such as the population of rumen protozoa, pH, concentration of volatile fatty acids and ammonia nitrogen in the rumen content were studied. Eight lambs were randomly allocated into two groups: a control group and an experimental group receiving vitamin E (DL-alpha-tocopheryl acetate, 250 mg/kg of feed) and selenium (sodium selenite, 0.3 mg/kg of feed) supplementation. Samples of rumen content were taken from all lambs three times daily once a week (before feeding as well as 3 and 6 h after feeding) over a period of 10 consecutive weeks. In addition, the lambs were weighed at the end of experiment. The total counts and percentage proportions of rumen protozoa, the pH value, and the levels of ammonia nitrogen and volatile fatty acids were determined in the samples of rumen content. The levels of acetic acid, propionic acid, butyric acid and total volatile fatty acids, the total counts of protozoa, and the percentage proportion of Diplodinium were found to be significantly higher in the supplemented than in the control group (P < 0.05, P < 0.01), whereas the pH values and the percentage proportion of Dasytricha ruminantium were significantly lower in the supplemented group than in the control (P < 0.05). However, there was no statistically significant difference between the two groups in ammonia nitrogen levels. The body mass gain of lambs in the supplemented group was significantly higher than that of the control animals (P < 0.01). Combined selenium and vitamin E supplementation of the lambs' ration caused an increase in the levels of volatile fatty acids, total counts of protozoa, and body mass gain while decreasing the pH value of the rumen content.

The effects of selenium, vitamin E and their combination on the composition of fatty acids and proteins in Saccharomyces cerevisiae

The aim of our studies was to test the effect and role of vitamin E and selenium supplements on yeast cell. In this study, the effects of selenium (Se), vitamin E (Vit. E), and their combination (Se plus Vit. E) on the composition of fatty acids and proteins were examined in Saccharomyces cerevisiae strains WET136 and 522. S. cerevisiae cells were grown up in YEPD medium supplemented with Se, Vit. E or their combination. It was found that the level of stearic acid was increased in all supplemented groups (p < 0.05; p < 0.001). The content of saturated and unsaturated fatty acids was decreased (p < 0.05; p < 0.01; p < 0.001) in Vit. E and Vit. E plus Se supplemented S. cerevisiae. On the other hand, Se alone caused an increase (p < 0.001) in the saturated fatty acids but a decrease (p < 0.05; p < 0.001) in the unsaturated fatty acids. Total proteins in S. cerevisiae were significantly increased (p < 0.001) by Vit. E supplement. There was no significant change observed in S. cerevisiae supplemented with Se. These findings indicate that membrane composition of S. cerevisiae is affected by both Vit. E and Se supplements.

Influences of intraperitoneally and dietary administered vitamin E and selenium on the lipid composition in reproductive organs of male animals

The aim of this work was to determine the protective effect of intraperitoneally and dietary administered vitamin E and selenium (Se) on the total lipid, cholesterol, and fatty acid composition in rat and lamb testes. The level of total lipid in rat testes was significantly decreased (p < 0.001) in the combination group as compared to the control group but slightly decreased in lamb testes (p < 0.05). In addition, the level of total lipid in lamb testes was significantly decreased (p < 0.001) by the Se alone. The content of total cholesterol in rats was higher in the Se group and its level in lamb testes was higher in the vitamin E groups than in the control group (p < 0.001). In rats testes, the amounts of palmitic, oleic, arachidonic acids, the total fatty acid, total unsaturated and total omega 6 acids were higher (p < 0.001) in the Se group. The proportions of palmitic and arachidonic acids were reduced in the vitamin E group and linoleic acid, total unsaturated, and total omega 6 fatty acids were high (p < 0.05) in the vitamin E and combination groups. In lamb testis tissues, the amounts of palmitic, arachidonic, total unsaturated and total omega 6 fatty acids were decreased in the vitamin E group in comparison to the control (p < 0.05). However, the amounts of arachidonic and total omega 6 fatty acids increased (p < 0.05) in the Se group. The proportions of arachidonic acid, total unsaturated fatty acid and total omega 6 fatty acids were high (p < 0.05) in the Se and combination groups. We concluded that the level of total lipid in testis tissues was reduced by dietary and intraperitoneally administered vitamin E and Se together. In contrast, it seems that the proportions of unsaturated and essential fatty acids in examined tissues are increased by vitamin E and Se.

The effects of dietary selenium and vitamin E and their combination on the fatty acids of erythrocytes, bone marrow and spleen tissue lipids of lambs

The object was to determine the influence of dietary vitamin E, selenium and their combination on the fatty acid content of erythrocytes, bone marrow and spleen lipids of Akkaraman lambs. After supplementation for 15 days, the amount of all fatty acids was slightly higher (p < 0.05) in the vitamin E as compared to the control group, whereas the amount of longer fatty acids was significantly higher (p < 0.01, p < 0.001) in the selenium and combination groups. On the thirtieth day, the amount of all fatty acids was slightly high (p < 0.5) in all the supplemented groups in comparison with the control group. In the bone marrow lipids, the amount of longer fatty acids was decreased (p < 0.05, p < 0.01, p < 0.001) in the vitamin E and combination groups as compared to the control. Although the amount of some fatty acids was high (p < 0.05, p < 0.01) in the selenium group compared to the control, linoleic (18:2), linolenic (18:3) and the polyunsaturated fatty acids (PUFA) were lower (p < 0.05, p < 0.001). In the spleen lipids, the amount of longer fatty acids was slightly decreased (p < 0.05) in the vitamin E group as compared with the control; however the amount of longer fatty acids was significantly higher (p < 0.05, p < 0.01) in the selenium and combination groups in comparison to the control group. Thus dietary supplementation with selenium was more effective than dietary vitamin E supplementation in altering the fatty acid content of the erythrocyte, bone marrow and spleen lipids.

Protective role of intraperitoneally administrated vitamin E and selenium on the levels of total lipid, total cholesterol, and fatty acid composition of muscle and liver tissues in rats

The aim of this work was to determine the protective effects of intraperitoneally administrated vitamin E and Se on total lipid, total cholesterol, and fatty acid composition of rat liver and muscle tissues. Total lipid content of muscle tissue in Se and combination groups decreased as compared to the control group. However, the level of total lipid in the liver tissues was seen to decrease only in the combination group (P < 0.05). While the amount of total cholesterol in liver tissue was lower (P < 0.05) in the vitamin E and combination groups, the amount of total cholesterol in muscle tissue decreased (P < 0.05) in the combination group. The amount of linoleic acid in muscle tissue slightly decreased (P < 0.05), whereas the eicosenoic and eicosatrienoic acid amounts significantly increased (P < 0.01, P < 0.001) in the vitamin E group as compared to the control group. The amounts of most fatty acid decreased (P < 0.05) in the combination group. The proportions of eicosenoic, eicosatrienoic, and total polyunsaturated fatty acid (PUFA) within the total fatty acid were higher (P < 0.05) in vitamin E group, whereas these fatty acids proportions were lower (P < 0.05) in the Se group. Although the proportions of palmitic, linolenic, and total saturated fatty acids were low (P < 0.05), oleic and total unsaturated fatty acid proportions were higher (P < 0.05) in the combination group than in the control group. The amount of palmitic acid and total saturated fatty acid in liver tissue decreased (P < 0.01 and P < 0.05, respectively) in the vitamin E and combination groups. However, the amount of linoleic acid only decreased (P < 0.05) in the combination group. The amount of PUFA was slightly higher (P < 0.05) in vitamin E. The proportions of stearic acid and linoleic acid decreased (P < 0.05) both in the Se and combination groups. However, the proportions of eicosatrienoic, omega 6, and PUFA were slightly higher (P < 0.05) in the vitamin E group, but total saturated fatty acid proportion significantly decreased (P < 0.01) in both the vitamin E and combination groups. In conclusion, the level of total lipid and cholesterol in muscle and liver tissues were reduced by administrating vitamin E and Se together. Additionally, the fatty acid synthesis in the muscle and liver tissues was decreased by this process. However, it was observed that the protective effect of intraperitoneally administrated vitamin E was higher than Se on fatty acid composition in muscle and liver tissues.