No abstract

This study investigated the effects of chronic arsenic exposure on QT- and QTc-interval prolongation, QTc dispersion (QTcd) and transmural dispersion of repolarization (TDR). We compared cardiac parameters from 40 male subjects chronically exposed to arsenic (group A) with those of 40 male subjects not exposed to arsenic (group B). Although subjects in both groups had non-corrected QT intervals within normal limits, subjects in group A had significantly longer QTc and QTcd intervals compared with group B. A total of 70% of group A compared with 10% of group B had QTcd values > 50 ms. The mean TDR value was also significantly higher in group A compared with group B. Although non-corrected QT intervals were within normal limits, those subjects chronically exposed to arsenic had a slight QT prolongation and a higher prevalence of subtle repolarization abnormalities, which might be clinically relevant.

The interatrial conduction time can be estimated with a relatively noninvasive method using P-LAA measurements. This technique can be applied widely in predicting AF recurrence, and appropriate therapy may be applied.

No abstract

Antiphospholipid syndrome is a rare disorder. Acute myocardial infarction is uncommon among these patients. Here we report a case of a 44-year-old man with antiphospholipid syndrome admitted for acute inferior myocardial infarction. Performed coronary angiography revealed that both the right coronary and the left circumflex coronary arteries were occluded by thrombi. We successfully performed primary angioplasty and stent implantation for both of the occluded coronary arteries. In the literature, this is the first case with antiphospholipid syndrome in which primary coronary angioplasty with stent implantation was successfully performed for two coronary arteries with acute thrombotic occlusion.

BackgroundPostoperative atrial fibrillation is common after cardiac surgery. In this study, we aimed to investigate the value of interatrial conduction time for the prediction of early postoperative atrial fibrillation, using intra-operative transoesophageal echocardiography.MethodsA total of 65 patients undergoing cardiac surgery in our hospital between January and March 2007 were prospectively evaluated, and 59 patients with sinus rhythm were included in the study. We performed transoesophageal echocardiography on all patients, and intra-operatively measured the interatrial conduction time, as recently described. The patients with episodes of atrial fibrillation during the post-surgery hospitalisation period were defined as group 1 and those without episodes were defined as group 2.ResultsMean interatrial conduction time was 74 ± 15.9 ms in group 1 and 54 ± 7.9 ms in group 2. The difference in interatrial conduction time between the two groups was statistically significant (p < 0.05). In this study we found a statistically significant interatrial conduction delay between the groups. Postoperative atrial fibrillation was more frequent in patients with a longer interatrial conduction time.ConclusionIncreased interatrial conduction time may cause postoperative atrial fibrillation and it can be measured intraoperatively by transoesophageal echocardiography.

C-reactive protein in unstable angina pectoris and its relation to coronary angiographic severity and diffusion scores of coronary lesions Kararsız anjina pektoris'de C-reaktif protein ve bunun koroner lezyonların koroner anjiyografik şiddeti ve yaygınlık derecesi ile ilişkisi 421ÖZET Amaç: C-reaktif protein (CRP) düzeyleri ile kararsız anjina pektorisli (UAP) hastalarda koroner arter lezyonlarının yaygınlığı ve şiddeti arasında-ki ilişkiyi ve CRP'nin kararsız anjina kliniğine bağımsız etkisini araştırmaktı.Yöntemler: Enine-kesitli, gözlemsel bu çalışmaya yaşları 28-73 arasında 50 hasta alındı. Kararsız anjina sınıflaması Braunwald'a göre yapıldı. Hastaların anjiyografilerinde saptanan lezyonların şiddeti ve yaygınlığı Reardon'un modifiye skorlama yöntemi ile değerlendirildi. Plazma CRP düzeyleri immünotürbidimetrik yöntemle ölçüldü. Nonparametrik testler CRP ve diğer risk faktörlerinin karşılaştırılmasında, lojistik regresyon analizi CRP ve UAP arasındaki bağımsız ilişkinin araştırılmasında kullanıldı. Bulgular: Lezyonların şiddet skoru sınıf IIB1'de 46±18 puan, sınıf IIB2'de 36±20 puan ve sınıf IIIB2'de 53±18 puandı. Sınıf IIB2 ve IIIB2 arasında anlamlı fark vardı (p=0.017). Plazma CRP değerleri ise sırasıyla, 6.6 mg/L, 3.8 mg/L ve 4.8 mg/L bulundu (p=0.371). Difüzyon skoru 4 olan hastaların CRP değerleri difüzyon skoru 1 olan hastalara göre anlamlı olarak yüksek bulundu (11.1 mg/L'ye karşı 3.1mg/L, p=0.048). Tüm çalışma grubu için uygulanan bölümsel korelasyon analizinde, yaş, cinsiyet ve sigaraya göre düzeltme yapıldıktan sonra, CRP değerleri ile koroner lezyonların şiddeti ve yaygınlığı arasında direkt, orta derecede güçlü ve anlamlı bağıntı saptandı, sırasıyla (r=0.30; p=0.034 ve r=0.31; p=0.030). C-reaktif protein ve kararsız anjina pektoris arasında olabilecek bağımsız bir ilişkiyi değerlendirmek için çoklu lojistik regresyon analizi uygulandı, fakat anlamlı bir ilişki saptanmadı (OR: 1.63, %95 GA: 0.90-5.63, p=0.093). Sonuç: Kararsız anjina pektoris kliniğinden bağımsız olarak hastalarımızda CRP düzeyleri ile koroner arter lezyonlarının şiddeti ve yaygınlığı arasında ilişki bulunsa da, CRP ile kararsız anjina klinik şiddeti arasında bağımsız bir ilişki saptanmadı. (Anadolu Kardiyol Derg 2010; 10: 421-8) Anahtar kelimeler: Kararsız anjina, C-reaktif protein, anjiyografi, lojistik regresyon analizi ABSTRACTObjective: We aimed to assess the relationship between C-reactive protein (CRP) and the severity and diffusion of coronary artery lesions in patients with unstable angina pectoris (UAP) and the independent association of CRP with this clinical situation. Methods: This cross-sectional, observational study included 50 patients. Classification by Braunwald was used for UAP. The severity and diffusion of angiographic coronary disease were graded according to Reardon's modified scoring system. Plasma CRP levels were quantified by immunoturbidimetry. Nonparametric tests were used for comparison of CRP and other risk factors, and logistic regression analysis for evaluation of independent association between CR...

Slow flow in angiographically normal coronary arteries is not a rarely seen problem. It is unknown whether it is related with conduction disorders. In this study we investigated the frequency of conduction disorders in patients with normal coronary artery and slow flow. The study included 36 (22 female; mean age 63 +/-11 years) patients who have normal coronary arteries and slow flow in coronary angiography. Patients' 12-lead electrocardiograms were analyzed for the presence of bundle branch block. Twenty-two of 36 patients (61%) demonstrated left bundle branch block. Twelve patients (33%) had normal intraventricular conduction. Only 2 of 36 patients (6%) had right bundle branch block. Microvascular disease has been implicated in coronary slow flow. However, according to the results of this study there is a close association between especially left bundle branch block and coronary slow flow. A causal relation should be sought between them with future studies.