Background: P53 is a key protein which controls cell cycle arrest and apoptosis in response to DNA damage. Auto-antibodies against p53 have been detected in some cancer patients and also in patients with autoimmune diseases. In these...
moreBackground: P53 is a key protein which controls cell cycle arrest and apoptosis in response to DNA damage. Auto-antibodies against p53 have been detected in some cancer patients and also in patients with autoimmune diseases. In these patients, the main cause of anti-p53 antibody occurrence was considered to be increased intracellular p53 protein in cancer cells and autoreactive lymphocytes, respectively.
Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non-ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony....
moreMitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non-ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony. Ninety-three patients were enrolled consecutively in this cross-sectional study. Patients were evaluated for the presence of intraventricular (DYS Sep-Lat Sys) and papillary muscle (DYS Inter PAP Sys) systolic dyssynchrony using tissue Doppler echocardiographic imaging (TDI). Two-dimensional and Doppler echocardiography were used for quantification of MR. Statistical analyses were performed using unpaired t test, Mann-Whitney U test, correlation and logistic regression analyses. Thirty-seven patients (39%) had significant DYS Sep-Lat Sys and 25 patients (26%) had DYS Inter PAP Sys. Patients with DYS Inter PAP Sys had lower basal septum systolic (p=0.007) and late diastolic velocities (p=0.049), greater MR volume (p=0.01), effective regurgitant orifi...
Cabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in...
moreCabergoline, an ergot-derived dopamine receptor agonist, is used widely in the treatment of Parkinson's disease (PD) and hyperprolactinemia, but may cause heart valve fibrosis, retraction, and clinically significant regurgitation in PD patients. While cabergoline has been used at much lower doses in patients with hyperprolactinemia, controversy persists as to whether it may cause heart valve disease in this situation. Cabergoline is also used in acromegaly at doses similar to those used in hyperprolactinemia. The case is reported of a female patient with acromegaly who had been taking low-dose (0.5 mg/day) cabergoline for one year, and presented with signs and symptoms of right-sided heart failure. Echocardiography revealed a thickened and retracted tricuspid valve associated with severe tricuspid regurgitation and enlargement of the right-heart chambers. The morphology of the tricuspid valve was typical for cabergoline-related valvulopathy. Cabergoline may not be totally safe e...
We present a patient with abnormal origin of the right coronary artery from the left anterior descending artery. The patient had chest pain probably related to myocardial ischemia. This anomaly is very rare and has only been reported in a...
moreWe present a patient with abnormal origin of the right coronary artery from the left anterior descending artery. The patient had chest pain probably related to myocardial ischemia. This anomaly is very rare and has only been reported in a few cases. The abnormal vessel had a rightward course following its take-off from the left anterior descending artery and remained anterior to the main pulmonary artery. There was no significant obstruction. The mechanism of myocardial ischemia remains unexplained.
Prosthetic valve thrombosis (PVT) is a serious complication that may cause significant morbidity and mortality. Despite advances in valve technology, patient education and adequate anticoagulation, the risk of PVT persists indefinitely....
moreProsthetic valve thrombosis (PVT) is a serious complication that may cause significant morbidity and mortality. Despite advances in valve technology, patient education and adequate anticoagulation, the risk of PVT persists indefinitely. Certain clinical and prothrombotic states, including atrial fibrillation, insufficient anticoagulation and pregnancy, predispose these patients to develop PVT. The optimal treatment of the condition is controversial, and to date no randomized clinical trials have been conducted to assist in decision making. Consequently, the guidelines lack definitive Class I recommendations, have significant disparities, and--in most cases--leave the decision to the clinician's experience. A review of the studies, guidelines, and expert opinions on the treatment of PVT was conducted, and treatment recommendations made for obstructive and non-obstructive thrombotic cases, based on the results of the recent reports. Although surgical therapy has been the tradition...
Mitochondrial disorders have been recognized as important secondary causes of cardiomyopathies. Differentiation of these cases from primary cardiomyopathies is important since the pathogenesis, accompanying systemic manifestations, and...
moreMitochondrial disorders have been recognized as important secondary causes of cardiomyopathies. Differentiation of these cases from primary cardiomyopathies is important since the pathogenesis, accompanying systemic manifestations, and prognosis may be different. The typical cardiac manifestation of mitochondrial disorders is hypertrophic cardiomyopathy. We report on an 11-year-old girl with severe obstructive hypertrophic cardiomyopathy and mild myopathy of the lower extremities. Surgical left ventricular septal myectomy was performed and ragged red fibers typical of mitochondrial disorders were detected on histological examination of the resected myocardial sample. Subsequent electron microscopic examination revealed ultrastructurally abnormal mitochondria in the skeletal muscle biopsy, though respiratory chain enzyme analysis was normal. Cardiomyopathy may be the presenting or the sole manifestation of a mitochondrial disorder. Nonobstructive hypertrophic cardiomyopathy has been ...
Aortic coarctation is a congenital malformation of the aorta that should be diagnosed and corrected early in life. The natural history of unrepaired coarctation of the aorta includes the development of systemic hypertension and subsequent...
moreAortic coarctation is a congenital malformation of the aorta that should be diagnosed and corrected early in life. The natural history of unrepaired coarctation of the aorta includes the development of systemic hypertension and subsequent morbidity and death from cardiovascular disease. Here, we present a case with replacement of the aortic arch and its branches by tortuous multilobulated aneurysms as a result of untreated aortic coarctation.
1. Thromb Haemost. 2005 Nov;94(5):1106-7. Unusual occurrence of left ventricular thrombus with normal left ventricular wall motion in a patient receiving tamoxifen therapy. Cevik C, Izgi C, Ozkan M. Cardiology Clinic, Kosuyolu Heart and...
more1. Thromb Haemost. 2005 Nov;94(5):1106-7. Unusual occurrence of left ventricular thrombus with normal left ventricular wall motion in a patient receiving tamoxifen therapy. Cevik C, Izgi C, Ozkan M. Cardiology Clinic, Kosuyolu Heart and Research Hospital, Istanbul, Turkey. ...
Several studies have shown that psychosocial risk factors such as stress and depression make substantial contribution to the pathogenesis of coronary artery disease. This study aimed to investigate acute stress factors prior to acute...
moreSeveral studies have shown that psychosocial risk factors such as stress and depression make substantial contribution to the pathogenesis of coronary artery disease. This study aimed to investigate acute stress factors prior to acute myocardial infarction (AMI), and stress, depression, and anxiety levels during the subacute period in AMI patients aged ≤ 40 years, in comparison with AMI patients aged >40 years. The study included 200 first-time AMI patients aged ≤ 40 years (n=100; mean age 35 ± 4 years) and >40 years (n=100; mean age 54 ± 9 years). The DASS 21 scale (Depression Anxiety Stress Scales) was administered via face-to-face interviews in the early recovery period of AMI. The patients were also questioned whether they had experienced acute stress factors such as severe emotional or physical stressful events within two hours before the onset of chest pain. In addition, coronary angiography results were assessed based on the two age groups. Comparison of the two age grou...
Matrix metalloproteinases degrade the collagen content of atherosclerotic plaque and reduce plaque stability. In tissue sections of atherosclerotic plaque, the expression of matrix metalloproteinases is increased....
moreMatrix metalloproteinases degrade the collagen content of atherosclerotic plaque and reduce plaque stability. In tissue sections of atherosclerotic plaque, the expression of matrix metalloproteinases is increased. 3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) decrease the tissue expression of matrix metalloproteinases-1, -2, -3, and -9 in atheromatous plaque by attenuating the inflammatory process that leads to increased expression. However, it is not known whether statins decrease levels of matrix metalloproteinase-13--an enzyme crucial to the initiation of collagen degradation-as part of their plaque-stabilizing effect.We prospectively examined the effect of statin therapy on serum levels of matrix metalloproteinase-13, tissue inhibitor of metalloproteinase-1, and low-density-lipoprotein cholesterol in 14 patients with hypercholesterolemia. All were at low risk for adverse cardiovascular events and were given 20 mg/d of rosuvastatin for 4 weeks. Post-therapy...
Atherosclerotic plaques are composed of a lipid rich core, which is covered by a collagen rich fibrous cap. Rupture of the atherosclerotic plaque with superimposed thrombosis is the main cause of acute coronary syndromes, including acute...
moreAtherosclerotic plaques are composed of a lipid rich core, which is covered by a collagen rich fibrous cap. Rupture of the atherosclerotic plaque with superimposed thrombosis is the main cause of acute coronary syndromes, including acute myocardial infarction and unstable angina. The stability of the plaque depends on its collagen content; degradation of the collagen leads to a vulnerable plaque that is prone to rupture. Recent studies have demonstrated a critical role for matrix metalloproteinases (MMPs) in the degradation of the collagen content and the reduction of mechanical stability of the atherosclerotic plaques. Increased expression of various MMPs has been shown in the tissue sections of atherosclerotic plaques. The increased expression of MMPs in the atheroma also leads to increased MMP levels in the circulation. The cholesterol lowering drugs - 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) - decrease the tissue expression of various MMPs in atheroma...
ABS TRACT Objective: Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non- ischemic DCM patients with narrow QRS intervals and its association with papillary...
moreABS TRACT Objective: Mitral regurgitation (MR) increases mortality in dilated cardiomyopathy (DCM). We investigated the prevalence of functional MR in non- ischemic DCM patients with narrow QRS intervals and its association with papillary muscle dyssynchrony. Methods: Ninety-three patients were enrolled consecutively in this cross-sectional study. Patients were evaluated for the presence of intraventricular (DYS Sep-Lat Sys) and papillary muscle (DYS
... Successful Endovascular Stenting of Total Juxtarenal Aortic Occlusion Performed through Brachial and Femoral Access. Mohammad Otahbachi MD,; Ashwani Kumar MD,; Cihan Cevik MD,; Alex Suarez MD. Article first published online: 22 APR...
more... Successful Endovascular Stenting of Total Juxtarenal Aortic Occlusion Performed through Brachial and Femoral Access. Mohammad Otahbachi MD,; Ashwani Kumar MD,; Cihan Cevik MD,; Alex Suarez MD. Article first published online: 22 APR 2009. ...
Obscure gastrointestinal (GI) bleeding can be a perplexing and difficult problem in elderly patients, especially if they are hemodynamically unstable. If aortic stenosis is also present, the cause of the GI bleeding may be explained. We...
moreObscure gastrointestinal (GI) bleeding can be a perplexing and difficult problem in elderly patients, especially if they are hemodynamically unstable. If aortic stenosis is also present, the cause of the GI bleeding may be explained. We present a 66-year-old man with a medical history of coronary artery disease who presented with acute GI bleeding. During his hospital course, the patient had a colonoscopy showing diffuse angiodysplasia and an echocardiogram showing severe aortic stenosis. This combination of angiodysplasia and aortic stenosis is known as Heyde's syndrome. It has been hypothesized that the aortic stenosis causes an acquired von Willebrand factor deficiency that leads to GI bleeding. Aortic valve replacement, when possible, can prevent recurrent GI bleeding in these cases, but medical decisions in these cases are complex and difficult.
P53 is a key protein which controls cell cycle arrest and apoptosis in response to DNA damage. Auto-antibodies against p53 have been detected in some cancer patients and also in patients with autoimmune diseases. In these patients, the...
moreP53 is a key protein which controls cell cycle arrest and apoptosis in response to DNA damage. Auto-antibodies against p53 have been detected in some cancer patients and also in patients with autoimmune diseases. In these patients, the main cause of anti-p53 antibody occurrence was considered to be increased intracellular p53 protein in cancer cells and autoreactive lymphocytes, respectively. Intracellular p53 also increases with cardiomyocyte apoptosis during heart failure and autoreactive lymphocytes play a role in the course of idiopathic dilated cardiomyopathy (IDC) and ischemic cardiomyopathy (ICM). Based on these observations, we hypothesized that anti-p53 antibody response may also occur in patients with heart failure due to ICM and IDC. The aim of this study was to evaluate anti-p53 antibodies in the serum of patients with heart failure due to IDC and ICM. 70 eligible patients with heart failure and severe left ventricular systolic dysfunction (mean fractional shortening 12.03 +/- 3.93%) were included in the study. The aetiology of heart failure was IDC in 26 patients and ICM in 44 patients, according to the angiographic and echocardiographic findings. Anti-p53 antibodies were not detected in any of the patients. Anti-p53 antibodies do not occur in patients with heart failure due to IDC and ICM, possible explanations are discussed in the text.
Behçet's...
moreBehçet's disease is a rare chronic autoimmune vasculitis with characteristic skin findings. Vascular involvement generally affects veins more than arteries, and coronary arterial involvement is extremely uncommon. Here we report the significant coronary artery aneurysms detected in a 41-year-old man with Behçet's disease who had been in remission for 13 years. Our case illustrates the necessity of initial non-invasive cardiac assessment of patients with Behçet's disease.
