Coronary microvascular dysfunction has been reported to be present in patients with hypertrophic cardiomyopathy (HCM) despite normal epicardial coronary arteries. In this study we aimed to evaluate ...coronary blood flow in patients with HCM by means of Thrombolysis In Myocardial Infarction (TIMI) frame count.
Thirty-two patients with HCM (22 male, 10 female; mean age=48+/-7 years) and 36 healthy control subjects (23 male, 13 female; mean age=49+/-7 years) without any cardiovascular disease were included in the study. All patients and control subjects were selected from individuals who underwent coronary angiography and left heart catheterization in our hospital and were found to have angiographically normal coronary arteries. All patients had an asymmetrically hypertrophic nondilated left ventricle and a basal intraventricular pressure gradient>30 mmHg recorded in the left ventricular outflow tract. A complete transthoracic echocardiographic examination including two-dimensional, M-mode, pulse and continuous Doppler was performed in all patients and control subjects. Coronary flow rates of all subjects were documented by the TIMI frame count method. To obtain corrected TIMI frame count for the left anterior descending (LAD) coronary artery, TIMI frame count for this vessel was divided by 1.7.
Corrected TIMI frame count for the LAD coronary artery was found to be significantly higher in patients with HCM compared to control subjects (35+/-8 vs. 25+/-6, p<0.001). However, we found no significant difference between patients and control subjects regarding TIMI frame counts for the left circumflex (LCx) coronary artery and the right coronary artery (RCA) (LCx: 28+/-6 vs. 26+/-6, p=0.07 and RCA: 26+/-6 vs. 24+/-5, p=0.09). Besides, the corrected TIMI frame count for the LAD coronary artery was found to be significantly correlated with interventricular septal wall thickness (r=0.546, p=0.001) and interventricular septal/posterior wall thickness ratio (r=0.490, p=0.004). However, no significant correlation was detected between the corrected TIMI frame count for the LAD coronary artery and other echocardiographic variables.
We show that patients with HCM had significantly higher corrected TIMI frame counts for the LAD compared to the control subjects. No such difference was detected between the two groups regarding TIMI frame counts for the LCx and RCA, suggesting the presence of regional (interventricular septal) rather than global impairment of coronary blood flow in patients with HCM.
Amaç: Psöriasis Vulgaris (PV), çok sayıda sistemik hastalık insidansının arttığı gösterilen bir kronik yangısal deri hastalığıdır. Ancak PV\'in otonom sinir sistemi üzerine olan etkisi iyi ...tanımlanmamıştır. Artmış sempatik aktivite ile seyreden bozulmuş otonomik işlev bozukluğu, genel populasyonda ani kalp ölümü ve ventriküler aritmilerle ilişkilidir. Kalp Hızı Türbülansı (KHT), anormal barorefleks duyarlılığını ve artmış sempatik tonusu gösteren invaziv olmayan bir testtir. Bu çalışmanın amacı; artmış ventriküler aritmi ve ani kardiyak ölüm riskinin muhtemel göstergeleri olan KHT ve kalp hızı değişkenliği (KHD) parametrelerini kullanarak, PV\'nin kardiyak otonomik fonksiyon üzerine olan etkisini saptamaktır. Gereç ve yöntem: Çalışmaya kardiyovasküler tutulumu olmayan 20 psöriatik hasta ve yaş-cinsiyet yönünden benzer 20 sağlıklı birey dahil edildi. Hastalık ciddiyeti, âPsöriasis Alan Şiddet İndeksiâ kullanılarak değerlendirildi. KHD ve türbülans analizi, 24 saat-Holter kayıtları ile elde edildi. Bulgular: İki grup arasında, klinik, demografik ve biyokimyasal karakteristikler açısından istatistiksel anlamlı farklılık yoktu (p>0.05). KHT parametreleri karşılaştırıldığında, psöriatik hastalarda turbulans onset ve slop değerleri kontrol grubundan farklı değildi (p>0.05). Yüksek frekans gücü haricinde (psöriatik hastalarda daha düşük, p0.05). Sonuç: KHD ve KHT değerleri açısından, PV bozulmuş otonomik fonksiyon ile ilişkili gözükmemektedir. Bu sonuçları doğrulayacak daha ileri araştırmalar gereklidir.
Objectives: Psoriasis vulgaris (PV) is a chronic inflammatory skin disorder with increased incidence of many systemic abnormalities. However, the effects of psoriasis on autonomic nervous system have not been previously well-defined. Impaired autonomic function with an increase in sympathetic activity may be associated with ventricular arrhythmias and sudden cardiac death in the general population. Heart rate turbulence (HRT) is a noninvasive test to reflect the increased sympathetic tone and abnormal baroreflex sensitivity. The aim of current study was to investigate the effect of psoriasis on cardiac autonomic function by using HRT and heart rate variability (HRV) parameters as possible indicators of increased risk for ventricular arrhythmias and sudden cardiac death. Materials and methods: The study comprised 20 psoriatic patients without cardiovascular involvement and age and sex matched 20 healthy subjects. The severity of the disease was evaluated by the âPsoriasis Area and Severity Indexâ. The HRV and turbulence analysis were assessed from a 24-hour Holter recording. Results: There were no statistically significant differences between the two groups with respect to clinical, demographic and biochemical characteristics. When HRT parameters were compared; the values of the turbulence onset and slope in psoriatic patients were not significantly different from the control group (p>0.05). HRV parameters except for high frequency power (significantly lower in psoriatic patients, p0.05). Conclusion: Psoriasis appeared not to be associated with impaired autonomic function regarding to HRT and HRV values. Further investigations are needed to confirm these results.
Amaç: Psöriasis Vulgaris (PV), çok sayıda sistemik hastalık insidansının arttığı gösterilen bir kronik yangısal deri hastalığıdır. Ancak PV'in otonom sinir sistemi üzerine olan etkisi iyi ...tanımlanmamıştır. Artmış sempatik aktivite ile seyreden bozulmuş otonomik işlev bozukluğu, genel populasyonda ani kalp ölümü ve ventriküler aritmilerle ilişkilidir. Kalp Hızı Türbülansı (KHT), anormal barorefleks duyarlılığını ve artmış sempatik tonusu gösteren invaziv olmayan bir testtir. Bu çalışmanın amacı; artmış ventriküler aritmi ve ani kardiyak ölüm riskinin muhtemel göstergeleri olan KHT ve kalp hızı değişkenliği (KHD) parametrelerini kullanarak, PV'nin kardiyak otonomik fonksiyon üzerine olan etkisini saptamaktır.
Gereç ve yöntem: Çalışmaya kardiyovasküler tutulumu olmayan 20 psöriatik hasta ve yaş-cinsiyet yönünden benzer 20 sağlıklı birey dahil edildi. Hastalık ciddiyeti, "Psöriasis Alan Şiddet İndeksi" kullanılarak değerlendirildi. KHD ve türbülans analizi, 24 saat-Holter kayıtları ile elde edildi.
Bulgular: İki grup arasında, klinik, demografik ve biyokimyasal karakteristikler açısından istatistiksel anlamlı farklılık yoktu (p>0.05). KHT parametreleri karşılaştırıldığında, psöriatik hastalarda turbulans onset ve slop değerleri kontrol grubundan farklı değildi (p>0.05). Yüksek frekans gücü haricinde (psöriatik hastalarda daha düşük, p<0.05) KHD parametreleri, 2 grup arasında farklılık göstermedi (p>0.05).
Sonuç: KHD ve KHT değerleri açısından, PV bozulmuş otonomik fonksiyon ile ilişkili gözükmemektedir. Bu sonuçları doğrulayacak daha ileri araştırmalar gereklidir.
Objectives: Psoriasis vulgaris (PV) is a chronic inflammatory skin disorder with increased incidence of many systemic abnormalities. However, the effects of psoriasis on autonomic nervous system have not been previously well-defined. Impaired autonomic function with an increase in sympathetic activity may be associated with ventricular arrhythmias and sudden cardiac death in the general population. Heart rate turbulence (HRT) is a noninvasive test to reflect the increased sympathetic tone and abnormal baroreflex sensitivity. The aim of current study was to investigate the effect of psoriasis on cardiac autonomic function by using HRT and heart rate variability (HRV) parameters as possible indicators of increased risk for ventricular arrhythmias and sudden cardiac death.
Materials and methods: The study comprised 20 psoriatic patients without cardiovascular involvement and age and sex matched 20 healthy subjects. The severity of the disease was evaluated by the "Psoriasis Area and Severity Index". The HRV and turbulence analysis were assessed from a 24-hour Holter recording.
Results: There were no statistically significant differences between the two groups with respect to clinical, demographic and biochemical characteristics. When HRT parameters were compared; the values of the turbulence onset and slope in psoriatic patients were not significantly different from the control group (p>0.05). HRV parameters except for high frequency power (significantly lower in psoriatic patients, p<0.05) also did not differ between the both groups (p>0.05).
Conclusion: Psoriasis appeared not to be associated with impaired autonomic function regarding to HRT and HRV values. Further investigations are needed to confirm these results.
Amaç: Psöriazis, genellikle diz, dirsek, saçlı deri, umblikus ve lomber alanda ortaya çıkan gümüsi beyaz renkli
kepeklenmelerle kaplı eritemli plaklarla karakterize, kronik infl amatuar bir deri ...hastalığıdır. Psöriaziste kardiyovasküler bozukluklar dahil çok sayıda sistemik hastalık
tanımlanmıstır. Biz bu çalısmada psöriazis hastalarında,
ventriküler aritmilerin artısı ve ani kardiyak ölüm riskinin
muhtemel bir göstergesi olan QT dispersiyonunu (QTD)
ve düzeltilmis QT dispersiyonunu (QTcD) değerlendirmeyi planladık.
Gereç ve Yöntemler: Çalısmaya psöriazisli 23 hasta ve
yas ve cinsiyet açısından hasta grubu ile benzerlik gösteren sağlıklı 20 kontrol bireyi alındı. Hastalığın ciddiyetinin değerlendirilmesinde, "Psoriazis Alan Siddet İndeksi"
(PASİ) kullanıldı. Tüm bireylere 25 mm/sn hızında 12 derivasyonlu elektrokardiyografi çekildi ve 24 saatlik holter
monitorizasyonu yapıldı. QTD ve QTcD ölçümleri yapıldı.
QTD, en büyük ve en küçük QT değerleri arası fark olarak
tanımlandı ve düzeltilmis QT (QTc) Bazett formülüne göre
hesaplandı. QTD ve QTcD ile PASİ ve hastalık süresi arasında korelasyon analizi yapıldı.
Bulgular: QTD ve QTcD hasta grubunda kontrol grubundan istatistiksel olarak anlamlı düzeyde yüksek tespit edildi (QTD; sırasıyla, 67.5±17.4 ve 44.0±11.9 ms, p<0.001,
QTcD; sırasıyla, 72.4±17.6 ve 47.8±12.8 ms, p<0.001).
QTD ve QTcD ile PASİ ve hastalık süresi arasında pozitif
korelasyon saptandı.
Sonuç: Bu çalısmada psöriazisli hastalar sağlıklı bireylerle karsılastırıldığında, QTD ve QTcD'u artmıs ve bu artıs
hastalık süresi ve ciddiyetiyle korele izlendi.
Objectives: Psoriasis is a chronic infl ammatory skin disorder characterized by erythematous plaques, generally
at the elbows, knees, scalp, umbilicus and lumber area.
Many systemic diseases including cardiovascular disturbances have been described in psoriatic patients. In
the present study, we aimed to investigate QT dispersion
(QTD) and corrected QT dispersion (QTcD) as a possible
indicator of increased risk for ventricular arrhythmias and
sudden cardiac death in patients with psoriasis.
Materials and methods: Twenty-three patients with psoriasis and age and gender matched 20 control subjects
were enrolled in the study. The severity of the disease
was evaluated by the "Psoriasis Area and Severity Index (PASI)". Standard 12-lead electrocardiographs at 25
mm/s paper speed and 24-hour holter examination were
performed in all subjects. QTD and QTcD were measured. QTD was defi ned as the difference between the
maximum and minimum QT interval measurements and
QTc was calculated according to Bazett's formula. Correlation analysis was performed between QTD and QTcD
and PASI and duration of the disease.
Results: QTD and QTcD were signifi cantly greater in psoriatic patients than controls (QTD, 67.5±17.4 vs 44.0±11.9
ms, p<0.001, respectively; QTcD, 72.4±17.6 vs 47.8±12.8
ms, p<0.001, respectively). There were a positive correlation between QTD and QTcD and PASI and longevity of
psoriasis disease.
Conclusion: In the present study, the patients with psoriasis have an increased QTD and QTcD when compared
with healthy subjects and this increase was found to be
correlated with the duration and severity of the disease.
Continuous Murmur Due to a Mediastinal Tumor Tufekcioglu, Omac; Yildirim, Nesligul; Karabal, Orhan ...
Echocardiography (Mount Kisco, N.Y.),
February 2006, 2006-Feb, 2006-02-00, 20060201, Letnik:
23, Številka:
2
Journal Article
Recenzirano
Despite the lengthy differential diagnosis of causes of cardiac murmurs, the association of a mediastinal mass and a continuous murmur is very rare. We report herein a case of a mediastinal tumor and ...continuous murmur where transthoracic echocardiography provided clear differential diagnosis and demonstrated the cause of murmur.
