Amiloidoz; organ ve yumuşak dokuların hücre dışı boşluğunda amiloid fibril birikiminin neden olduğu bir hastalıktır. Öncü proteinin tipine göre amiloidoz sınıflandırması yapılır. Kalp, böbrek, ...karaciğer, gastrointestinal sistem ve/veya otonom sinir sistemi gibi çeşitli organlarda amiloid birikimi izlenebilmekle birlikte, prognozu en kötü olan organ tutulumu türü kardiyak amiloidozdur. Birçok amiloidoz türleri arasında hemen hemen tüm klinik kardiyak amiloidoz vakalarına, transtiretin amiloidoz (ATTR) veya hafif zincir amiloidoz (AL veya primer sistemik) neden olur. Kardiyak ATTR; kalıtsal (ATTRm) veya doğal tip (ATTRwt) olabilir. Kardiyak tutulum sıklığı ve kardiyomiyopatinin prognozu amiloidoz tipleri arasında değişkenlik gösterir ve klinik belirtiler, organ tutulum paternine bağlı olarak değişir. Değişken klinik fenotip ve genellikle özgül olmayan klinik özellikler, bu hastalıkta tanıda gecikmelere neden olabilir ve tanıda multidisipliner (hematoloji, patoloji, radyoloji, nükleer tıp, nöroloji, nefroloji, kardiyoloji, romatoloji, gastroenteroloji) yaklaşım gerekir. Gelişen tanı yöntemleri klinisyene kardiyak amiloidozda erken tanı olanağını vermektedir. Kardiyak amiloidozdan şüphelenilen hastalarda; görüntüleme yöntemleri ve gerekirse doku biyopsisi ile amiloid birikimi gösterilmelidir. Amiloidoza sebep olan öncü protein saptandıktan sonra, altta yatan hastalığın tedavisi ve semptomatik hastalarda kalp yetmezliğine yönelik tedavi uygulanmaktadır. Erken tanı ve tedavi yaklaşımları ile prognozun düzeltilebildiği gösterilmiştir. Bu derlemede, kardiyak amiloidoz hastalığı hakkında farkındalığın artırılması amaçlanmış olup, günlük pratiğimizde kullanabileceğimiz güncel tanı yöntemleri ve tedavi yaklaşımları ele alınacaktır.
Amyloidosis is a disease caused by the accumulation of amyloid fibril in the extracellular space of organs and soft tissues. Amyloidosis classification is made according to the type of precursor protein. Although amyloid accumulation can be observed in various organs such as heart, kidney, liver, gastrointestinal and/or autonomic nervous system; the worst prognosis type of organ involvement is cardiac amyloidosis. Among many types of amyloidosis, almost all clinical cases of cardiac amyloidosis are caused by transtiretin amyloidosis (ATTR) or light chain amyloidosis (AL or primary systemic). Cardiac ATTR can be hereditary (ATTRm) or wild type (ATTRwt). The frequency of cardiac involvement and prognosis of cardiomyopathy varies between the types of amyloidosis and clinical symptoms vary depending on the organ involvement pattern. Variable clinical phenotype and often non-specific clinical features can cause delays in diagnosis and a multidisciplinary (hematology, pathology, radiology, nuclear medicine, neurology, nephrology, cardiology, rheumatology, gastroenterology) approach is required in diagnosis. The developing diagnostic methods give the clinician early diagnosis of cardiac amyloidosis. Amyloid accumulation should be demonstrated by imaging methods and tissue biopsy is necessary in patients with suspected cardiac amyloidosis. Once the precursor protein that causes amyloidosis has been identified, treatment of the underlying disease and heart failure is performed in symptomatic patients. It has been shown that prognosis can be corrected with early diagnosis and treatment approaches. In this review, it is aimed to raise awareness about cardiac amyloidosis disease, current diagnostic methods and treatment approaches that we can use in our daily practice will be discussed.
Purpose: Inflammation has a crucial role in the pathogenesis of ST segment elevation myocardial infarction (STEMI). Recently, the C-reactive protein to albumin ratio (CAR) has emerged as a novel ...parameter of systemic inflammation. Although studies have demonstrated the that anterior STEMI location is associated with a higher infarct size and worse prognosis, no study has investigated the CAR in relation to infarct location. We herein aimed to evaluate whether there is a difference regarding the CAR between patients with anterior and non-anterior STEMI location. Materials and Methods: The study population comprised 273 consecutive STEMI patients who were divided into 2 groups based on the STEMI location, as the anterior STEMI group (n=114) and non-anterior STEMI group (n=159). Baseline characteristics were recorded, and the CAR was calculated for all patients. Results: Both groups were similar in terms of the baseline clinical characteristics. However, syntax score (p
Cardiovascular diseases are the most prominent cause of death in patients with schizophrenia. Frontal QRS-T (fQRS-T) angle is a novel marker of myocardial depolarization and repolarization ...heterogeneity. Recent studies have indicated that the fQRS-T angle is associated with some cardiovascular abnormalities. This study aimed to investigate the fQRS-T angle and its relationship with symptoms severity in patients with schizophrenia.
One hundred-six patients with schizophrenia and sixty-four healthy controls were included in this study. fQRS-T angle and QT interval measurements were calculated for each participant from the automatic report of the 12-lead electrocardiography (ECG) device. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I) and The Positive and Negative Syndrome Scale (PANSS) were performed on the patients with schizophrenia.
Corrected QT (QTc) interval and fQRS-T angle were significantly higher in the patients with schizophrenia than healthy controls (p < 0.001 and p < 0.001, respectively). fQRS-T angle was positively correlated with age (r = 0.43), duration of disease (r = 0.37), and negative symptoms scores (r = 0.39). In linear regression analysis, the disease duration and negative symptom severity were the independent predictors of fQRS-T angle in patients with schizophrenia (t = 3.730, p = 0.003 and t = 2.257, p = 0.023, respectively).
The fQRS-T angle may be an important ECG parameter to interpret cardiovascular disease risk in patients with schizophrenia.
The relationship between C-reactive protein (CRP) to albumin ratio (CAR) and contrast-induced nephropathy (CIN) in patients with acute coronary syndrome has been reported. However, the relevance of ...CAR in patients with stable angina pectoris (SAP) has not been clarified. We hypothesized that CAR might predict the development of CIN in patients with SAP undergoing coronary angiography (CAG). Patients (n = 554) with SAP who underwent CAG were included in the study. CIN was defined as a ≥25% increase in serum creatinine compared with baseline value within 72 h of CAG. Participants were divided into two groups: CIN (n = 87) and non-CIN (n = 467). Age, CRP, CAR, mean corpuscular volume (MCV), urea, uric acid, contrast medium volume, the percent of percutaneous coronary intervention were significantly greater, whereas albumin and high-density lipoprotein were significantly lower in the CIN group than non-CIN group (p < .05, for all). Multivariate analysis showed that CAR was the only independent predictor for CIN (odds ratio = 7.065, 95% confidence interval (CI); 3.279–15.221, p < .001). Receiver operating characteristic ROC analysis showed that a CAR ≥ 0.1164 could predict CIN (sensitivity of 71% and specificity of 72%; area under curve = 0.736; 95% CI: 0.677–0.795, p < .001). CAR was significantly greater in patients who developed CIN and this independently predicted CIN.
OBJECTIVEThe long-term durability of transcatheter aortic bioprosthetic valves continues to be a major concern. Standardized criteria of the structural valve deterioration (SVD) and bioprosthetic ...valve failure (BVF) have recently been defined. Limited studies have evaluated the long-term durability of transcatheter aortic valve implantation (TAVI) according to these new definitions. We aim to analyze the durability of TAVI beyond 5 years and to report the frequency of SVD and BVF. METHODSA total of 89 patients who had undergone TAVI and had theoretically completed at least 5 years after the procedure were included. Either a Medtronic CoreValve or an Edwards SAPIEN XT valve were implanted in the patients. New standardized definitions were used to evaluate SVD and BVF. RESULTSThe mean age of the patients was 78.70±6.95 years. SVD occured in 4 (4.5%) patients during 6 years of follow-up. Severe SVD was observed in 2 patients (2.2%), and these patients had the New York Heart Association class II symptoms. Both patients with severe SVD also met the criteria of BVF. Moderate SVD was observed in 2 patients (2.2%), and these patients had no valve-related symptoms. Of the 4 SVD cases, 2 were associated with increased mean transaortic gradients, whereas the remaining 2 cases were associated with intraprosthetic aortic regurgitation. All patients with SVD are still alive, and none of them have required aortic valve reintervention. CONCLUSIONAlthough first-generation TAVI devices were used, we determined the low rate of SVD and BVF at the 6-year follow-up. It may be suggested that there is no major concern associated with TAVI even with first-generation devices regarding long-term durability.
Effect of noise on the electrocardiographic parameters Tascanov, Mustafa Begenc; Havlioglu, Suzan; Tanriverdi, Zulkif ...
International archives of occupational and environmental health,
08/2021, Letnik:
94, Številka:
6
Journal Article
Recenzirano
Purpose
Noise, defined as any sound that is unpleasant, is one of the most important environmental problems. Prolonged exposure to noise has been shown to be associated with the development of ...cardiovascular diseases. No study investigated the effect of noise on surface electrocardiography (ECG).
Aims
The aim of our study is to investigate the effect of noise on surface ECG parameters including P-wave dispersion (PWD), QT intervals, corrected QT interval (QTc), T-wave peak to end (Tp-e) interval, and Tp-e/QT and Tp-e/QTc ratios.
Methods
A total of 51 people working in the textile factory affected by the noise and 43 volunteers without any disease and who were not exposed to noise were included in this study. The average noise level in the textile factory was 112 dB. A 12-lead ECG was obtained from all individuals. PR interval, PWD, QRS duration, QT interval, QTc interval, Tp-e interval, and Tp-e/QT and Tp-e/QTc ratios were calculated for all individuals.
Results
The noise group had significantly increased PWD 35 (28–40) vs. 28 (22–36)
p
= 0.029, QT interval ( 373.5 ± 27.3 vs. 359.3 ± 2.74,
p
= 0.001), QTc interval (409 ± 21 vs. 403 ± 13
p
= 0.045), Tp-e interval (90.6 ± 6.0 vs. 83.5 ± 7.3
p
< 0.001), Tp-e/QT (0.24 ± 0.03 vs. 0.23 ± 0.02,
p
= 0.015) and Tp-e/QTc (0.22 ± 0.02 vs. 0.21 ± 0.02
p
< 0.001) compared to control group. Also, duration of working was positively correlated with PWD (
r
= 0.468,
p
= 0.001) and Tp-e/QTc ratio (r = 0.328,
p
= 0.019). In multiple linear regression linear regression analysis, noise was the independent predictor of both PWD (β = 0.244,
p
= 0.032) and Tp-e/QTc (β = 0.319,
p
= 0.003)
Conclusion
We showed that noise significantly increased PWD, QT and Tp-e interval measurements. Also, noise was the independent predictor for both PWD and Tp-e/QTc.
Frontal QRS-T angle is a novel marker of myocardial repolarization, and an increased frontal QRS-T angle associated with adverse cardiac outcomes. Non-dipper hypertension is also associated with ...adverse cardiac outcomes. This study aimed to investigate the relationship between frontal QRS-T angle and non-dipper status in hypertensive patients without left ventricular hypertrophy (LVH).
This study included 122 hypertensive patients without LVH. Patients were divided into two groups: dipper hypertension and non-dipper hypertension. The frontal QRS-T angle was calculated from 12-lead electrocardiography.
Frontal QRS-T angle (47.9° ± 29.7° vs. 26.7° ± 19.6°, P < 0.001) was significantly higher in patients with non-dipper hypertension than in patients with dipper hypertension. In addition, frontal QRS-T angle was positively correlated with sleeping systolic (r = 0.211, P = 0.020), and diastolic (r = 0.199, P = 0.028) blood pressures (BP), even if they were weak. Multivariate analysis showed that the frontal QRS-T angle was independent predictor of non-dipper status (QR: 1.037, 95% CI: 1.019-1.056, P < 0.001).
Frontal QRS-T angle is independent predictor of non-dipper status in hypertensive patients without LVH.
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