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  • ISSN: 2378-9344
    Volume 3, Issue 2
    Case Report
    Alassane Mbaye*, Aliou Alassane Ngaide, Malick Ndiaye, Isabelle Kouame, and Momar Dioum
    Infective tricuspid endocarditis on a healthy heart is rare. It remains extremely serious because of cardiovascular complications. We report on a case that occurred in a black child aged of 14 years old with no particular history. He was admitted for septicemia starting at joint and muscle level. He had syncope a few days later in a context of a bradycardia. The electrocardiogram gave evidence of a complete atrioventricular block, and the echocardiography showed tricuspid vegetation with significant regurgitation. Despite controlling the infection with antibiotics, evolution was marked by right ventricular failure and persistence of the complete atrioventricular block, which was well tolerated without cardiac pacing.
    Research Article
    Arushi Asthana*, Bernard Ashby, Stephen Balter, Ajay J. Kirtane, Emmanuel Ekanem, and William A. Gray
    Aim: To identify predictors of patient-radiation-exposure measured as reference-point air-kerma (Kar) and kerma-area product (PKA), in peripheral endovascular procedures and to compare these measures in the percutaneous coronary and peripheral procedure groups.
    Methods and results: Data included 164 peripheral angiographies with endovascular intervention (PA + EI), and 1200 percutaneous coronary procedures comprising 400 each of coronary angiographies (CA), percutaneous coronary interventions (PCI), and same-sitting angiography and intervention (CA+PCI), performed in the year 2008, at Columbia University Medical Center. Multiple linear-regression analysis was done to identify predictors of radiation in the peripheral procedure group. The ANOVA test with Tukey's correction was employed to compare log-doses in all the four procedure groups.
    Median (mean) Ka,r in milligray, was 1034 (1216) for CA, 2916 (3455) for PCI, 2806 (3246) for CA+PCI and 661 (1012) for PA+EI. Median (mean) PKA in Gy.cm2 was 67 (81) for CA, 174 (213) for PCI, 165 (207) for CA+PCI and 80 (138) for PA+EI. CA+PCI compared to PCI, did not employ significantly different doses of radiation. Within the PA+EI group, even with controls, each kilogram increase in weight was associated with a 1.26 % increase in Ka,r (CI: 0.54%, 1.99%; p-value = 0.0007) and a 1.75% increase in PKA (CI: 1.06%, 2.45%; p-value: < .0001), and women were exposed to 32.6% less Ka,r(CI: - 48.23%, -12.22%; p-value = 0.0037) and 34.33 % less PKA (CI: -48.90%, -15.61%; p-value = 0.0012).
    Conclusions: Endovascular intervention associated patient-radiation-exposure is roughly comparable to that in a diagnostic coronary angiogram and is significantly less compared to coronary intervention. Within PA+EI, exposure differs by patient and procedural characteristics.
    Murat Baykara, Mehmet Akif Sarica*, Ozlem Gundogdu Secen, Betul Kizildag, and Nursel Yurttutan
    Objective: To determine the effect of cilostazol on carotico-vertebral system compliance, distensibilty, stiffness, flows and other vascular events through non-invasive methods in patients with stable IC/PAD.
    Method: Our study was performed in Elazig training and research hospital between January 2012 and December 2012. Twenty-nine patients (22 male, 7 female) who had been treated with cilostazol 100 mg twice daily during six month were included in the study. Ultrasound measurements of carotid and vertebral arteries were performed at baseline, at 3 and 6 months after starting of treatment and the evaluation of the arterial stiffness measurements were performed by the pre-defined method.
    Results: The mean age of the participants was 64.64 years. Pulsatility index, resistive index, sistolic/diastolic velocity ratio and intima-media thickness values were decreased in carotid and vertebral arteries, elastic modulus were decreased in carotid arteries while cross-sectional compliance, cross-sectional distensibility and diastolic wall stress values were increased in carotid and vertebral arteries with treatment. Also arterial flow and cross-sectional area were increased in vertebral arteries with treatment.
    Conclusion: Cilostazol treatment increased vertebral artery flows and reduced the progression of carotid atherosclerosis without increasing the risk of bleeding in patients with peripheral arterial disease during a long-term follow-up.
    Review Article
    Rong Huang*, Ehab M. Khalil, Brianna D. Mackie, and Yunfei Mao
    Methylation has emerged as an increasingly important chemical modification that is involved in the regulation of many biological processes. Consistent with the extensive and diverse set of biological functions regulated by methylation, transmethylation reactions are catalyzed by a large family of methyltransferases with a broad range of substrate specificity, including histone proteins involved in transcriptional regulation, tumor suppressor proteins such as p53 and Rb, DNA and RNA substrates, and small molecule substrates such as catecholamines, nicotinamide, and various xenobiotics. This review focuses on a small subset of this large family of methyltransferases and the role they play in cardiovascular development, function, and disease. Specifically, we highlight two protein methyltransferase (PMT) subfamilies that modify histone and non-histone protein substrates: protein arginine methyltransferases (PRMT) that methylate the side chain of arginines, and the SmyD protein family that N-methylate the side chain of lysines. We also discuss a potential role that nicotinamide N-methyltransferase (NNMT) plays in cardiovascular disease by creating a metabolic sink for homocysteine, an amino acid known for its adverse effects on the cardiovascular endothelium and smooth muscle cells.
    Elisabetta Moscarella*, Alfonso Ielasi, Bernardo Cortese, and Attilio Varricchio
    Drug eluting stents (DES) have dramatically reduced the rate of in-stent restenosis (ISR) compared to bare metal stents (BMS). However ISR still occurs due to the widespread use of DES in complex lesions and high-risk patients, and it is not a benign phenomenon. Treatment of patients with ISR is still a challenge for interventional cardiologists. DES and BMS-ISR present different characteristics in terms of morphological pattern, time of presentation after stent implantation, underlying substrate and response to treatment. Treating DES-ISR is even more challenging than treating BMS-ISR. Several therapeutic options have been proposed, but a definite answer to this problem still has to be defined. In this paper we reviewed the data with currently available therapeutic modalities, in patients presenting with both BMS- and DES-ISR.
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