What is known and objective
Propofol is a most commonly used anaesthetic drug for conscious sedation in outpatient procedures. Previous studies have shown that propofol may affect ventricular ...repolarization based on QT and Tp‐e intervals. Frontal QRS‐T angle is a marker of ventricular depolarization and repolarization difference. However, there is no study investigating the effect of propofol on frontal QRS‐T angle. In this study, we aimed to investigate the effect of propofol on frontal QRS‐T angle in patients undergoing colonoscopy procedure.
Method
A total of 56 patients (53.5% females) who underwent colonoscopy procedure were included in this study. All patients underwent 12‐lead surface electrocardiograms (ECGs) just before colonoscopy and 15 minutes after colonoscopy. QT interval, QTc interval, Tp‐e interval, Tp‐e/QT, Tp‐e/QTc and frontal QRS‐T angle were calculated from 12‐lead ECGs.
Results and discussion
The frontal QRS‐T angle was significantly increased 15 minutes after colonoscopy compared to basal value (36.2 ± 24.3 vs. 29.5 ± 23.6, P = .003). In addition, repolarization parameters including QT, QTc and Tp‐e intervals were significantly prolonged at 15 minutes after colonoscopy compared to basal value, except Tp‐e/QT and Tp‐e/QTc. Significant ventricular or supraventricular arrhythmias were not observed in any patient during the procedure.
What is new and conclusion
In this study, we found that propofol administration increased the frontal QRS‐T angle in patients undergoing colonoscopy procedure. Given that a prolonged frontal QRS‐T angle is associated with ventricular arrhythmias, it may be safer to monitor those patients receiving propofol during colonoscopy procedures.
Propofol is a most commonly used anesthetic drug for conscious sedation in colonoscopy procedures which may affect ventricular repolarization. There is no study investigating the effect of propofol on frontal QRS‐T angle. We have demonstrated that propofol administration increases the frontal QRS‐T angle in patients undergoing colonoscopy procedure. Therefore, we proposed that patients received propofol should be monitored closely in terms of ventricular arrhythmias.
Transradial access has become the most commonly used method for cardiac catheterization. Many medical and technical applications have been proposed to reduce TRA complications. The aim of this study ...is to examine the effect of hand dominance on radial artery spasm and radial artery occlusionin subjects undergoing CC via TRA. Between April 2020 and August 2022, 1713 subjects who underwent CC via TRA were included in the study. Patient data were obtained in terms of hand dominance of the catheterized side and RAS and RAO during a 1-month follow-up period. RAS was seen in 9.6% of the subjects. The RAS in patients catheterized by the dominant hand was significantly higher than that performed by the non-dominant hand (12 vs 7.8%; P = .004). RAO was seen in 1% of the subjects. RAO was significantly higher in the spasm side than in the no-spasm side (3 vs .8%; P = .009). Hand dominance was determined as an independent predictor of radial artery spasm (P = .006). In our study, RAS and RAO were more common on the dominant hand side than on the non-dominant side. Choosing the non-dominant hand for TRA for CC may reduce the incidence of RAS and RAO.
Endothelial dysfunction is considered the first stage in the development of atherosclerosis and assessed by flow-mediated dilatation (FMD) and aortic flow velocity propagation (AVP). Ankle-brachial ...index (ABI) is used to assess peripheral arterial disease and is associated with FMD but the relationship between ABI and AVP is unknown. In this study, we aimed to search the association between AVP, and ABI in patients with newly diagnosed hypertension.
Sixty-eight patients with newly diagnosed hypertension and 34 healthy subjects were enrolled in the cross-sectional observational study. The maximum ankle arterial pressures were divided by the maximum of the brachial arterial pressures to calculate the ABI. AVP was calculated from dividing the distance between points corresponding to the beginning and end of the propagation slope, to the duration between corresponding time points proximally descending aorta. Statistical analysis was performed using Student t-test, Chi-square test, Pearson correlation and linear regression analyses.
Age and gender of both groups were similar. Compared to control group E deceleration time of early diastolic flow velocity (184.0±32.2 vs. 217.1±38.6, p<0.001), isovolumic relaxation time (95.5±19.4 vs. 105.7±18.1, p<0.001) and body mass index (25.6±5.1 vs. 27.5±3.8, p=0.044) values were significantly higher, while ABI (1.08±0.07 vs. 1.14±0.07, p=0.001) and AVP (54.97±9.3 vs. 69.17±10.8 cm/sec, p=0.001) values were significantly lower in hypertensive patients. There was a significant correlation between AVP and ABI (r=0.279, p=0.005). Both ABI and AVP were independent predictors of hypertension (OR - 0.353, 95%CI 0.151-0.826, p=0.02 and OR - 0.133, 95%CI 0.0502-0.35, p=0.001, respectively).
Our data indicate that in patients with isolated hypertension AVP and ABI decrease. We also conclude that AVP is directly associated with ABI.
All prosthetic valves are at least mildly stenotic and have relatively high transvalvular pressure gradients that can be observed despite normal prosthesis function. Such gradients may be due to a ...mismatch between prosthesis effective orifice area (EOA) and patient's body size. Valve prosthesis-patient mismatch (VP-PM) may occur due to mismatches of both parameters, the expected hemodynamic performance of the prosthesis and the cardiac output requirements of the patient, which are largely related to the body size at rest. In other words, a prosthesis may be adequate for patients with a small body surface area (BSA) but might become obstructive for patients with a large BSA. The only parameter that has proven to be consistently and realistically useful to predict and describe VP-PM is the effective orifice area index (EOAI). The projected EOAI was identified as the best parameter to predict the VP-PM occurrence after surgery. VP-PM has been known to be independently and significantly associated with clinical outcomes. Severe VP-PM has a significant impact on early and late mortality, whereas moderate VP-PM may have a significant effect on mortality only in vulnerable subsets of patients, and particularly in those with depressed LV systolic function. The surgeon's anticipation of VP-PM prior to surgery, and successfully implented preventive strategies can reduce the incidence of VP-PM. Preventive strategies to avoid VP-PM should be individualized according to the anticipated severity of VP-PM and of the patient's baseline risk profile.
To investigate mean platelet volume (MPV) levels in patients with coronary slow flow (CSF).
465 stable angina pectoris cases with angiographically normal coronary arteries were recruited coronary ...slow flow group (n=76), control group (n=389) in the observational retrospective cohort study. Clinical, biochemical and demographic variables including MPV were noted and coronary blood flow was assessed with TIMI frame count (TFC).
Gender, smoking, height, serum creatinine, uric acid levels, hemoglobin, waist/hip ratio, systolic blood pressure but not MPV were significantly different among groups. Independent predictors of CSF were height (p=.029) and serum uric acid level (p=.045). Gender, height, weight, hip circumference, systolic blood pressure, fasting blood glucose, serum urea, creatinine, uric acid levels, hemoglobin and platelet count were associated with mean TFC whereas independent predictors of mean TIMI frame count were height (p=.010) and serum uric acid level (p=.041).
Height and serum uric acid level but not MPV were independent predictors of both CSF and mean TFC.
Hemangiomas are rare benign tumors of the heart. Clinical presentation is highly variable according to the location, size, and extension of the tumor. Hemangiomas have been described in all cardiac ...chambers, but most occur on the right side of the heart and in the left atrium. Although diagnosis is typically made by echocardiography, the definite diagnosis can be made with certainty only from a very careful histopathologic examination. The authors report a case of atypically located hemangiomas originating from the left atrial appendage and right atrium in a 71-year-old woman who presented with ischemic stroke. Transthoracic and transesophageal echocardiography demonstrated an elongated left atrial mass originating in the atrial appendage and extending well into the left atrium to the mitral orifice, as well as a right atrial mass and intense biatrial spontaneous echo contrast. It was unclear whether the masses represented thrombus or an unusually located atrial tumor. Immunohistologic examinations revealed a biatrial cavernous hemangioma with no signs of malignancy.
Blood samples from patients of the study group were obtained before and 6 months after the surgery, and from the control group immediately after coronary angiography to measure serum PON and ...arylesterase activities.
The present trial was designed to investigate the effects of iron deficiency anemia (IDA) on plasma oxidant/antioxidant balance and to determine the relation between the PTX3 levels and the oxidative ...stress parameters in patients with IDA.
The serum paraoxonase and arylesterase activities are related to coronary artery diseases. However, there are a few data about the association of paraoxonase and arylesterase activities with in-stent ...restenosis (ISR). The aim of this study was to evaluate the relationship between paraoxonase and arylesterase activities and ISR in patients with bare metal stent (BMS).
Thirty-one patients with normal coronary artery (group 1) and 60 with BMS were enrolled in this observational study. According to the ISR, the patients were classified as group 2, without the ISR (n=29) and group 3, with the ISR (n=31). Serum paraoxonase and arylesterase activities were measured spectrophotometrically.
The paraoxonase and arylesterase activities were lower in patients with BMS than in the individuals with normal coronary artery (P < 0.001 and P = 0.001, respectively). The enzyme activities were also higher in patients without ISR than with ISR (both of P < 0.001). In bivariate correlation analyses in patients with BMS, ISR shows significant positive correlations with the presence of hypertension and hyperlipidemia, type C lesion, and stent length, but shows negative correlations with type A lesion stent diameter, high-density lipoprotein cholesterol, and paraoxonase and arylesterase activities. In regression analysis, ISR is independently associated with paraoxonase and arylesterase activities (β = -0.216, P = 0.038 and β = -0.452, P < 0.001, respectively), type A lesion (β = -0.251, P = 0.013), and stent diameter (β = -0.192, P = 0.024) in patients with BMS.
Our study shows that decreased paraoxonase and arylesterase activities play a significant role in ethiopathogenesis ISR in patients with BMS.
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