Background: In this study, we sought to investigate the relation of gamma-glutamyltransferase (GGT) levels with the significance of coronary artery disease (CAD), clinical presentation, left ventricular (LV) function, and inflammatory activity. Methods: A total of 235 patients (mean age: 60.1 ± 10.5 years, 166 [70%] males) who had coronary angiography were included in the study. Patients who had CAD constituted the study group (Group 1, n = 189) and patients who had insignificant coronary disease or normal coronary activity constituted the control group (Group 2, n = 46). Results: GGT levels were higher in Group 1 than Group 2 (38.7 ± 30.9 U/L versus 27.5 ± 17.5 U/L, p = 0.025). Left ventricular ejection fraction (LVEF) was lower in Group 1 than Group 2 (52.6%±11.7% versus 58.8%±11.3%, p<0.002). GGT activity (40.2 ± 32.5 U/L versus 29.1 ± 18.3 U/L, p<0.002) and c-reactive protein (CRP) levels (33.9 ± 43.6 mg/dl versus 17.8 ± 29.8 mg/dl, p<0.002) were higher, LVEF (52.6%±12.1% versus 56.5%±11.0%, p = 0.021) was lower in patients with acute coronary syndrome compared with stable CAD group. In regression analysis, CRP levels (p<0.0001, odds ratio [OR] = 3.77, 95% confidence interval [CI] 0.10
Chronic smoking in young, healthy people causes significant alterations in the longitudinal diastolic myocardial function parameters as assessed by color tissue Doppler imaging.
SUMMARYLeft ventricular diverticulum is a rare congenital anomaly. In the adult population, the incidence was reported to be 0.26% in nonselected patients who underwent cardiac catheterization. Diverticula are usually localized near the apex and most often involve the inferior or anterior parietal walls of the left ventricle. In this report, two cases with congenital left ventricular diverticulum are presented, and the pathophysiologic, diagnostic, and therapeutic approaches of this cardiac malformation are discussed. ( LEFT ventricular diverticulum is a rare congenital anomaly. In the adult population, the incidence was reported to be about 0.4% in an autopsy series of patients with cardiac death, and about 0.26% in nonselected patients who underwent cardiac catheterization.1,2) Diverticula are usually localized near the apex and most often involve the inferior or anterior parietal walls of the left ventricle.3) They can be associated with midline defects concerning the pericardium, and malformations such as septal defects, 4) pulmonary stenosis or dextrocardia. 5) We report two cases of isolated congenital left ventricular diverticulum with complaints of concomitant chest pain. CASE 1A 55-year-old male patient was referred to our clinic because of complaints of chest pain during effort. There were no coronary risk factors except smoking (20 years) and age. His blood pressure was 135/80 mmHg and he had a regular pulse of 84 beats/min. No heart murmur was detected and his lungs were clear. An abdominal examination was unremarkable and edema was absent. No abnormal neurological findings were noted, and the results of laboratory tests and chest X-rays were unremarkable. An electrocardiogram (ECG) showed a sinus rate of From the
The aim of this study was to investigate the role of adrenergic activity in patients with slow coronary flow (SCF) and its relationship to TIMI frame count on the pathogenesis of SCF. Plasma noradrenalin and adrenalin concentrations at rest were compared in 51 patients diagnosed with SCF through coronary angiography and TIMI frame count; and 44 healthy controls with normal coronary flow (NCF). Furthermore, the relationship between TIMI frame count and noradrenalin and adrenalin levels was investigated. Plasma noradrenalin (127.9 +/-9.2 and 79.3 +/- 7.3 ng/mL, p < 0.0001) and adrenalin levels (63.9 +/- 2.6 and 44.7 +/- 2.8 ng/mL, p < 0.0001) were higher in patients with SCF when compared to patients with NCF. Noradrenalin and adrenalin levels were effected with SCF-dominant vessels with respect to TIMI frame count (p = 0.012 and p < 0.0001). Patients with SCF in 1, 2, or 3 vessels had different noradrenalin and adrenalin levels (p <0.003 and p < 0.0001). Patients with TIMI frame count above the 75th percentile had significantly higher noradrenalin and adrenalin levels when compared with those between the 25th-50th percentiles and below (p < 0.001 and p = 0.011, respectively). Correlation analysis established that both adrenalin and noradrenalin levels were correlated with TIMI frame counts of left anterior descending (LAD) and circumflex (Cx) arteries. Exercise testing revealed ischemia in 6 patients. Their TIMI frame counts were above the 75th percentile, and they had higher noradrenalin and adrenalin levels when compared with those without ischemia (p = 0.029, p = 0.045). Higher noradrenalin and adrenalin levels and correlation between TIMI frame count and ischemia in patients with SCF suggest that increased adrenergic activity may be the manifestation of slow coronary flow.
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