Background: A noninvasive marker of disease severity and presence of symptoms is required in patients with chronic rheumatic valve disease (RVD). Aims: We sought to test the utility of measuring of N-terminal pro-B type natriuretic peptide (NT-proBNP) in chronic phase RVD. We also evaluated whether echocardiographic measures are interrelated with NT-proBNP levels. Methods: The study comprised 92 patients with RVD (mean age of 40F14 years) and 50 age/gender-matched control subjects. Functional status was assessed. Detailed echocardiographic examination was performed and mitral valve score was estimated. Venous blood samples were taken for measuring the level of NT-proBNP. Results: The plasma levels of NT-proBNP rose with increasing severity of mitral valve stenosis ( pb0.001), increasing severity of mitral valve score ( pb0.001), increasing severity of clinical symptom ( pb0.001), increasing severity of mitral regurgitation ( pb0.013), presence of mitral valve calcification ( pb0.001), presence of tricuspid valve stenosis ( pb0.001), increasing severity of tricuspid regurgitation ( pb0.011), presence of aortic stenosis ( p=0.043), decreasing left ventricular ejection fraction ( pb0.001), presence of left atrial thrombus ( p=0.0019), and with increasing left atrium dimensions ( p=0.002). Conclusion: NT-proBNP levels in patients with chronic RVD are a potential marker of disease severity and correlates with symptoms.
Carbon monoxide is a nonirritant, odorless, colorless gas, and is lighter than air. It is an end product of the incomplete combustion of hydrocarbons. Its effects are most prominent in organs sensitive to oxygen deprivation, such as the heart, brain, and kidney. Carbon monoxide poisoning becomes more abundant in winter and at cold places. In Turkey, every year we see several deaths due to poisonous gas leaks from coal or wood stoves. Deaths particularly due to hypoxia-related central nervous system damage and ventricular dysrhythmias are observed. On the other hand, an association between thromboembolic accidents and carbon monoxide poisoning has been shown in literature. Thromboembolic accidents in the mesenteric, central nervous system, and extremities are reported. However, no atrial thrombus has been mentioned. In this study, a case of an atrial thrombus associated with carbon monoxide poisoning following a diagnosis of carbon monoxide poisoning and treatment in the emergency room is reported and the literature is revisited.
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