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NLR was correlated with important prognostic markers in PAH such as NYHA FC, BNP and TAPSE. This simple marker may be useful in the assessment of disease severity in patients with PAH.

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We found characteristic patterns of plaque distribution at coronary bifurcations. Proximal segments demonstrated larger plaque volume than distal segments, despite similar percentages of plaque burden. Plaque volume accumulated opposite to the flow divider, especially in distal segments. The side-branch take-off angle in the cross-sectional plane influenced the plaque distribution in bifurcation lesions.

The results of the study show that in patients with PAH, the presence of severe TR is associated with an overestimated PASP measurement on echocardiography.

SUMMARYThe aim of this study was investigate the effects of carvedilol therapy on ventricular repolarization characteristics as assessed by QT dispersion (QTd) and heart rate variability (HRV) in patients with heart failure.Thirty-one patients with heart failure (mean age, 63.9 years) were included in the study. Carvedilol was administered in addition to standard therapy for CHF at a dose of 6.25 mg/day and uptitrated to the maximum tolerated dose. Control group consisted of 14 patients with heart failure (mean age, 69.4 years) who could not take carvedilol due to several reasons. All patients were followed-up 6 months. QT dispersion (QTd), and corrected QTd (QTcd) values were calculated at baseline and at the end of follow-up. Time domain and frequency domain heart rate variability analysis were performed with ambulatory Holter ECG.Mean carvedilol dose was 23.9 ± 13.9 mg. Significant reductions were observed in the QTd (P = 0.016) and QTcd (P = 0.001) with carvedilol therapy, whereas QTd (P = 0.47) and QTcd (P = 0.43) did not change significantly in the control group. The QT maximum value did not change significantly but the QT minimum value (P = 0.03) was significantly increased after carvedilol therapy. Although the mean SDANN value was improved (P = 0.039), other HRV parameters such as mean SDNN (P = 0.32), rMSSD (P = 0.74), and the LF/HF ratio (P = 0.35) did not change significantly after carvedilol therapy.This prospective controlled study shows that carvedilol therapy decreased QT dispersion and improved ventricular repolarization characteristics but did not change autonomic dysfunction in patients with heart failure. (Int Heart J 2006; 47: 565-573)

Amaç: Atriyal fibrilasyonda sol atriyal trombüs oluşması açısından koagülasyon parametrelerinin rolü yeterince araştırılmamıştır. Atriyal fibrilasyonlu hastalarda sol atriyal trombüs ile veya onun öncüsü olduğu düşünülen spontan eko-kontrast varlığı (SEK) ile beta fibrinojen gen polimorfizmi ile trombosit glikoprotein IIIa gen polimorfizmi arasındaki ilişkiyi araştırmayı amaçladık. Yöntemler: Transözofageal ekokardiyografi yapılan atriyal fibrilasyonlu 47 hasta enine kesitsel gözlemsel çalışmamıza dahil edildi. Hastalar 2 gruba ayrıldı. Sol atriyal trombüsü olanlar Grup 1'i (n=24) ve trombüsü olmayanlar grup 2'yi (n=23) oluşturdu. Beta fibrinojen gene polimorfizm veya glikoprotein IIIa gen polimorfizmlerini saptamak için genetik analizler yapıldı. İstatistiksel analizde Mann Whitney U ve Ki-kare testleri kullanıldı. Bulgular: Demografik ve klinik özellikler bakımından gruplar arasında fark saptanmadı. Beta fibrinojen 455 G/A gen polimorfizm sıklığı grup 1'de (%37.5) grup 2'ye göre (%15) istatistiksel anlamlılığa ulaşmayacak şekilde (p=0.23) daha yüksek saptandı. Çalışma grubuna ciddi SEK'i olan hastalar da eklendiğinde (trombüs ve ciddi SEK n=27) 2 grup arasındaki fark (%44.4-%10) istatistiksel anlamlılığa ulaşmaktaydı (p=0.01). Glikoprotein IIIa Pl A1/A2 polimorfizmi ise gruplar arasında (p=0.73) SEK eklense de (p=0.82) farklı bulunmadı. Grup I'de grup II'ye göre mitral yetmezliği skoru daha düşük olma eğiliminde (p=0.08), SEK skoru ise anlamı olarak daha yüksek idi (p=0.03). ÖZETOb jec ti ve: The role of coagulation parameters left atrial thrombus formation in atrial fibrillation has not been investigated before. We aimed to investigate the association between the beta-fibrinogen gene polymorphism or glycoprotein IIIa gene polymorphism and presence of left atrial (LA) thrombus or spontaneous echo contrast (SEC) in patients with atrial fibrillation (AF). Methods: Forty-seven patients with AF, in whom transesophageal echocardiography was performed, were included to this cross-sectional observational study. Patients were divided in two groups; those with LA thrombus (n=24) were assigned to group 1 and those without thrombusin group 2 (n=23). DNA analysis was conducted to determine gene polymorphism in all patients. Mann-Whitney U test or Chi-square tests were used for statistical analysis Results: There were no significant differences between groups regarding to demographic and clinical characteristics. The frequency of betafibrinogen 455 G/A polymorphism was higher (37.5%) in group 1 as compared to group 2 (15.1%) but it did not reach statistical difference (p=0.23). When we added patients with severe SEC in the study group (patients with severe SEC and/or thrombus n=27) the difference (44.40%-10%) reached the statistical difference (p=0.01). Glycoprotein IIIa Pl A1/A2 polymorphism was not different between groups with (p=0.82) or without SEC (p=0.73). Conclusion: In patients with atrial fibrillation, beta-fibrinogen 455 G/A gene polymorphism is associated with the presence of left atrial thrombus and severe SEC...

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