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  • ISSN: 2333-6676
    Volume 2, Issue 2
    January-March 2014
    Case Report
    Nicola Alessandri*, Claudia Iannone, Angela Dei Giudici, Emiliano Coletta, Antonella Maddaluno, Flavia Tersigni, Michela D'Ascanio, Flavio Moscariello, Fabrizio Tufano, and Bich Lien Nguyen
    Abstract: In this article are reported hypokinetic arrhytmias (asystole or AVB 3°) arising after several months from ablation procedure that needed definitive pacemaker implantation. This event, coming in patients submitted to ablation of left atrial roof and cavotricuspid isthmus area, could be considered, primarily, complications of ablation. However, their appearance long time after the RF-TCA let us to consider them autonomic and independent events.
    The observation of these events opens a patho-physiological discussion in relation to current knowledge and we suggest these three hypothesis: a)"Electric remodelling as a result of ablation procedure"; b)"Development of the natural history of AF"; c)"Random observation".
    Olivier Huttin1*, Zied Frikha1, Pierre-Yves Marie2, Yves Juillière1 and Christine Selton-Suty1
    Abstract: A 55-year-old man with acute congestive heart failure was referred to the echocardiography laboratory for evaluation of a dilated cardiomyopathy with severe left ventricular systolic dysfunction and criteria for non-compaction. Cardiac magnetic resonance imaging confirmed a non-compacted apical LV with segmental dysfunction and an inferior myocardial infarction. Coronary angiogram showed a chronic right coronary occlusion. Speckle tracking imaging with analysis of peak systolic strain and post systolic strain index helped to differentiate ischemia and non-compaction as mechanisms of wall motion abnormalities. These findings support the concept that non-compaction is a phenotypic marker of an underlying diffuse cardiomyopathy involving both morphologically normal and non-compacted myocardium and the association with micro and macro vascular coronary arteries disease is discussed.
    Review Article
    Banovic M1,2*
    Abstract: Aortic valve replacement (AVR) therapy is clear in symptomatic AS patients, because it improves symptoms, LV function and survival. However, the indications for AVR in asymptomatic patients with severe AS are vague and the subject of ongoing debate. There are observational data that early AVR leads to favorable outcome compared to late (after symptom onset) surgery. Having in mind that operative risk for isolated AVR is low in experienced centers, there is growing and reasonable interest in identifying the subsets of asymptomatic patients which may benefit from early AVR.
    Deepark Sharma1, Xianghong MA2, Fawang DU2 and Yanmin XU2*
    Abstract: Hypertension is a powerful risk factor for cardiovascular disease and frequently occurs in conjunction with obesity and the metabolic syndrome. Recent research into the underlying pathophysiologic processes common to these entities has uncovered the role of a heightened inflammatory state signified by a host of circulating biocytokines. Recent data however, have suggested that components of the innate and adaptive immune system also contribute to hypertension. Traditionally, atherosclerosis has been considered an inflammatory disease, however increasing evidence suggests that inflammation also contributes to hypertension, and if efforts are taken to block inflammation, the end-organ damage and severity of blood pressure elevation can be reduced. Surprisingly, thymus-derived lymphocytes (T cells) seem to be involved in hypertension, indicating that the adaptive immune system might contribute to this disease.
    Edam Ziadinov1*, Nasser Al-Kemyani2 and Hilal Al-Sabti1
    Abstract: The article is dedicated to the management of internal mammary artery spasm intra- and postoperatively based on the accumulated evidence in the literature. It provides stepwise decision algorithms for safely resolving the spasm and prevention of relapse.
    Research Article
    Murat Celik*, Uygar Cagdas Yuksel, Emre Yalcinkaya,Yalcin Gokoglan, Hasan Kutsi Kabul, Baris Bugan, Cem Barcin, Turgay Celik and Atila Iyisoy
    Abstract:
    Objective: The accurate underlying pathogenic mechanism behind spontaneous echo contrast (SEC) is complex and poorly understood. The aim of this study is to characterize the relationship between mean platelet volume (MPV) and left atrium SEC.
    Material and methods: We screened retrospectively the records of 172 patients with AF in whom transesophageal echocardiography was performed. Patients were categorized according to the presence of the left atrial SEC. Group 1 was consisted of patients with AF and left atrial SEC (-), and group 2 was consisted of patients with AF and left atrial SEC (+). Basal demographic, laboratory and echocardiographic features of the patients were compared between two groups. Multivariate regression analysis was established to identify the independent association between MPV levels and other potential variables.
    Results: The study group included 105 men (61%) and 67 women (39%), and the mean age of the patients was 64.48 ± 13.90 years. Group 1 was consisted of 97 patients (70 (72.2%) men and mean age 61.90 ± 15.75 years) and Group 2 was consisted of 75 patients (35 (46.7%) men and mean age 67.82 ± 10.23 years). We observed that SEC (+) patients had higher MPV values (8.94 ± 0.98 fL vs. 8.52 ± 1.15 fL, p value 0.012). The mean MPV values for 8.65 fL for patients with SEC (+), 8.93 fL for patients with SEC (++) and 9.15 fL for SEC patients with (+++). (p value between groups was 0.038). In multivariate regression analysis, only the association between MPV level and the degree of SEC remained statistically significant (β= 0.165, p = 0.042).
    Conclusion: We conclude that AF patients with SEC have significantly higher MPV levels compared with AF patients without SEC.
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