Considering the role of autonomic imbalance in the pathogenesis of hypersensitivity reactions, we evaluated the autonomic system through time-domain analysis of heart rate variability (HRV) in patients with allergic rhinitis. Twenty-four patients with allergic rhinitis and 22 healthy subjects (mean age, 41 +/- 8 years and 37 +/- 9 years, respectively) were enrolled in the study. The diagnosis of allergic rhinitis was based on the history, symptoms, and skin prick tests results. Twenty-four-hour ambulatory electrocardiographic recordings were obtained, and the time-domain indices were analyzed. Analysis of HRV revealed that the SD of normal RR intervals, SD of successive differences in normal cycles, and HRV triangular index were not significantly different between the groups, but the root mean square successive difference, number of RR intervals exceeding 50 milliseconds, and percentage difference between adjacent normal RR intervals exceeding >50 milliseconds were significantly greater in the study group, compared with the control group. Our findings showed that HRV indices, which predict parasympathetic predominance, were increased in patients with allergic rhinitis. This finding shows that vagal activation is present not only in the nose but also in other systems, including the cardiovascular system.
Hypertrophic obstructive cardiomyopathy (HOCM), the cause of which is unknown, is a heart disease characterized by obstruction of the left ventricular outflow tract and an increase in interventricular septum thickness. Octreotide, a synthetic analogue of somatostatin, was administered subcutaneously to 15 patients for 6 months in order to determine its efficacy in HOCM. Echocardiographic examination was performed in each patient before we had initiated treatment and after treatment. Interventricular septum thickness, interventricular septum thickness/left ventricular posterior wall thickness, and subaortic gradient decreased significantly at the end of treatment. The ratio of the mitral valve E to A waves increased significantly. We observed that octreotide treatment caused a significant decrease in interventricular septum thickness and subaortic pressure gradient. Before and after therapy left ventricular enddiastolic diameter, left ventricular endsystolic diameter, ejection fraction and fractional shortening were not changed. No adverse effect was observed during the therapy. According to our results, octreotide has some beneficial effects on HOCM and it seems to be a new therapeutic approach for HOCM.
Our method is an easy way for applying angle-corrected PISA method to mitral valve area measurement in patients with mitral stenosis. Absence of the need for estimating the angle is the major advantage.
Situs inversus is a rare condition and there are few reports of myocardial revascularization in such patients. A 56-year-old woman with situs inversus totalis and coronary artery disease underwent successful anastomosis of the right internal mammary artery to the anterior descending coronary artery, and a saphenous vein graft to the right coronary artery.
We aimed to evaluate the correlation between aortic regurgitation severity and brain natriuretic (BNP) levels as a marker for left ventricular dysfunction. Sixty consecutive male patients (mean age 22 ± 3 years) with isolated chronic aortic regurgitation were enrolled in the study together with a control group of 30 agematched healthy volunteers (group A). Patients were classified with regard to aortic regurgitation vena contracta width as follows: group B, < 3 mm, mild (n = 16); group C, ≥ 3 and < 6 mm, moderate (n = 26); group D, ≥ 6 mm, severe (n = 18). BNP measurements were performed with a fluorescence immunoassay kit. BNP levels were increased in patients with aortic regurgitation, and severity of regurgitation had a significant influence on BNP levels. This effect can be explained by the volume loading effect of aortic regurgitation.
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