Right ventricular myocardial performance index and exercise capacity in athletes

Right ventricular function is important for exercise capacity in athletes. The aim of this study was to investigate the effects of habitual exercise training on right ventricular global function. Fifty-two male athletes (25 runners, 27 wrestlers) and 43 age-matched sedentary male subjects were studied. All subjects in the study underwent an echocardiography examination and cardiopulmonary exercise test. Maximal oxygen consumption, right ventricular cavity diameters, and diastolic parameters were higher in the athletes than in controls. However, the right ventricular myocardial performance index was lower in athletes compared with controls. Therefore, the right ventricular myocardial performance index showed a negative correlation with maximal oxygen consumption (r = −0.61; P < 0.001). The right ventricular myocardial performance index may reflect changes in right ventricular function and exercise capacity in athletes.     

Tissue Doppler properties of the left atrial appendage in patients with mitral valve disease

OBJECTIVE: The purpose of this study was to compare the left atrial appendage (LAA) tissue Doppler imaging (TDI) with the classical LAA function parameters in patients with mitral valve disease. METHODS: Twenty patients who had pure mitral regurgitation (group 1), 20 patients who had pure rheumatic mitral stenosis (group 2), and 20 healthy patients (group 3) were included in this study. All the cases were sinus rhythm. In order to determine the LAA functions, LAA late filling (LAALF), and late emptying (LAALE) flow velocities and LAA fractional area change (LAAFAC) were measured. LAA tissue Doppler evaluations were obtained from the PW Doppler, which was placed on the LAA lateral wall in a transverse basal short-axis approach. LAA late systolic (LAALSW) and late diastolic (LAALDW) wave velocities were obtained from TDI records transesophageal echocardiography (TEE). RESULTS: There were no significant differences among groups 1, 2, and 3 in terms of age, left ventricular (LV) ejection fraction, gender, and heart rate. No differences were observed between group 1 and the control group with respect to LAALE, LAALF, and LAAFAC. LAALE velocity and LAAFAC were significantly decreased in group 2 than group 1. LV diastolic diameter was significantly greater, whereas LAALSW and LAALDW velocities were significantly decreased in group 1 compared with group 3. There were no differences between groups 1 and 2 regarding to LAALSW and LAALDW velocities. LAALE, LAALF, LAALSW, LAALDW velocities, and LAAFAC were significantly decreased in group 2 than group 3. CONCLUSION: The TDI method may detect the LAA systolic dysfunctions, which cannot be detected using classical methods, on tissue level in patients with mitral regurgitation. In addition, the deterioration of the LAA functions at tissue level in patients with rheumatic mitral stenosis was also detected.     

The effect of fluoxetine on ischemia–reperfusion after aortic surgery in a rat model

Background

Aortic ischemia–reperfusion (IR) is an important factor in the development of postoperative acute lung injury after abdominal aortic surgery. The aim of the present study was to examine the effect of fluoxetine (Flx), a selective serotonin reuptake inhibitor widely used as a preoperative anxiolytic, on lung injury induced by abdominal aortic IR in rats.

Methods

Wistar rats were randomized into three groups (n = 7 per group): (1) control (sham laparotomy); (2) IR without Flx (60-min ischemia and 120-min reperfusion); (3) IR with Flx (Flx + IR) (Flx 20 mg/kg/d, intraperitoneally for 3 d before surgery). Lung tissue samples and bronchoalveolar lavage (BAL) were obtained for biochemical analysis of oxidative status. Ischemia-modified albumin (IMA) level and protein concentrations in BAL and lung wet to dry weight ratios were determined. Histologic evaluation of the lung tissues was also performed.

Results

IR without Flx led to significant increase in lipid hydroperoxide, malondialdehyde, and pro-oxidant–antioxidant balance and decrease in superoxide dismutase, glutathione, and ferric reducing antioxidant power activities (P < 0.05 versus control), whereas Flx was able to restore these parameters (P > 0.05 versus control) and decrease IMA level (P < 0.01 versus control) and protein concentration (P < 0.05 versus control) in BAL and wet to dry lung weight ratio. Histologic evaluation showed that Flx attenuated the morphologic changes associated with lung injury.

Conclusions

The results indicate that Flx confers protection against aortic IR-induced lung oxidative stress and cellular integrity. IMA levels in BAL may be used as a follow-up marker for the efficacy of treatment in lung injury.     

Left Main Coronary Artery Obstruction by Dislodged Native-Valve Calculus after Transcatheter Aortic Valve Replacement

Transcatheter aortic valve replacement can be an effective, reliable treatment for severe aortic stenosis in surgically high-risk or ineligible patients. However, various sequelae like coronary artery obstruction can occur, not only in the long term, but also immediately after the procedure. We present the case of a 78-year-old woman whose left main coronary artery became obstructed with calculus 2 hours after the transfemoral implantation of an Edwards Sapien XT aortic valve. Despite percutaneous coronary intervention in that artery, the patient died. This case reminds us that early recognition of acute coronary obstruction and prompt intervention are crucial in patients with aortic stenosis who have undergone transcatheter aortic valve replacement.     

Serum adipokine levels in patients with sarcoidosis

Clinical Rheumatology - Sarcoidosis is a chronic inflammatory disease characterized by non-caseating granuloma which etiology is unknown yet. Adipokines are different proteins synthesized by...