Evaluation of the anatomical and electrical axis of the heart after pneumonectomy

Aim: To investigate the position of the heart after pneumonectomy and, also to find out how the changes in the electrical axis of the heart contribute for the possible electrocardiographic and echocardiographic changes. Methods: Ninety-eight patients with pneumonectomy were included to this observational study. To calculate the rotation of the heart and angle measurement two perpendicular lines, one septal and another atrioventricular, were drawn on the images acquired from thoracic computed tomography. Thoracic CT were taken at every 3 months for the first two years. On electrocardiograms net QRS vectors, amplitudes of p waves, findings of right and left ventricular hypertrophy, and other possible changes were recorded. Results: The mean age of all patients was 55.51 ± 8.9. Right pneumectomy was performed in 40 (57%) and left pneumonectomy in 30 cases (43%) cases. There was no significant change regarding both the angle of rotation and the amount of pleural effusion between the findings of the second and first year after the operation. The QRS shift was significantly more pronounced in patients with left pneumonectomies than right pneumonectomies. On echocardiography these cases showed right ventricular hypertrophy and increased pulmonary artery pressures in the second year when compared to the preoperative period. Conclusions: The current study showed that many significant changes occurred in the electrocardiographic and echocardiographic parameters of the heart after pneumonectomy

Venous leg symptoms in migraineurs: a potential clue on the pathophysiology of migraine

BACKGROUND: Migraine is a neurovascular disorder which cerebral venous congestion might have role in pathogenesis. The objective was to assess the association between venous disease and migraine by using the Venous Insufficiency Epidemiological and Economic Study-Quality of Life/Symptoms (VEINES-QoL/Sym) questionnaire in migraineurs and non-migraineurs. METHODS: The study was designed as a non-randomized, prospective cohort study and consisted of patients diagnosed with migraine and age-, sex- matched healthy subjects without migraine. All participants were examined for the presence of chronic venous disease (CVD). VEINES-Sym questionnaire was applied to assess venous symptoms. The Migraine Disability Assessment (MIDAS) questionnaire was used to assess the severity of disease in migraineurs. RESULTS: Participants were classified into two groups as migraine-positive group (N.=130) and migraine-negative group (N.=130). Migraine patients and control group were comparable in terms of clinical status and demographic parameters. Total VEINES-Sym score was lower in patients with migraine compared to control group (34.4 +/- 8.7, 37.6 +/- 8.12, P=0.003, respectively). Additionally, there was a significant negative correlation between VEINES-Sym score and total MIDAS disability score (r=-0.33, P<0.001) and MIDAS severity levels (little or no, mild, moderate, severe) (r=-0.266, P=0.003) of the migraineurs. Logistic regression analysis revealed that VEINES-Sym score is an independent and statistically significant associate of migraine (OR=0.95, 95% CI:0.92-0.98, P=0.001). CONCLUSIONS: We have documented an independent association between migraine and VEINES-Sym score indicating possible pathophysiological link between migraine and CVD. Further studies are warranted to figure out the pathophysiological associations between migraine and venous vascular pathology and peripheral varicose vein

Evaluation of Arterial Stiffness Using Pulse Wave Velocity and Augmentation Index in Patients with Chronic Venous Insufficiency

Background and Objectives. Chronic venous insufficiency (CVI) is a common pathology of the circulatory system and is associated with a high morbidity for the patients and causes high costs for the healthcare systems. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality. The relationship between CVI and arterial stiffness using pulse wave velocity (PWV) and augmentation index (Aix) was evaluated in this study. Methods. Sixty-two patients with the stage of C3-C5 chronic venous disease (CVD) and 48 healthy subjects were enrolled in the study. To assess arterial stiffness, all cases were evaluated with I.E.M. Mobil-O-Graph brand ambulatory blood pressure monitor device. PWV and Aix were used to assess arterial stiffness in this study. Results. The mean age was 61.9±11.05 years and 54 % of the patient population was females. PWV and Aix were significantly higher in CVI patients than controls (8.92±1.65 vs. 8.03±1.43, p=0.001; 25.51±8.14 vs. 20.15±9.49, p=0.003, respectively) and also positive linear correlation was observed between CVI and all measured arterial stiffness parameters (r=0.675 for CVI and PWV, r=0.659 for CVI and Aix, respectively). A PWV value of > 9.2 has 88.9 % sensitivity and 71.4 % specificity to predict the presence of CVI. Conclusions. PWV and Aix are the most commonly used, easy, reproducible, reliable methods in the clinic to assess arterial stiffness. Logistic regression analysis showed that PWV and Aix were the independent predictors of CVI. PWV has the sensitivity of 88.9 % and specificity of 71.4 % to detect the presence of CVI

Evaluation of repolarization dispersion in patients with idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) is a serious lung disease of unknown etiology and characterized by interstitial fibrosis. The patients usually present with potentially fatal cardiac arrhythmias. This study aimed to investigate indicators of arrhythmia based on electrocardiography (ECG) in patients with IPF. ECG indicators of ventricular depolarization (VD) and repolarization (VR) (QT, QTc, QTd, QTdc, Tp-e, JT and JTc intervals, Tp-e / QT ratio, Tp-e / QTc ratio, Tp-e / JT ratio, and Tp-e / JTc ratio) were analyzed retrospectively in patients with IPF (n:52) and compared with the healthy control group (n:52). The mean QRS interval was lower in patients with IPF compared to the control group, indicators of VD and VR were higher in patients with IPF compared to the control group (p &lt; 0.05). A positive correlation was found between indicators of VD and VR and inflammation markers (CRP and cTn-I) (p &lt; 0.05). We found that indicators of VD and VR were higher in patients with IPF and that is positively correlated with inflammatory markers. Inflammation in cases of IPF may be associated with the development of malignant or chronic cardiac arrhythmias. [Med-Science 2022; 11(2.000): 677-81

Evaluation of left atrial volume and functions by 3D echocardiography in patients with prediabetes and investigation of its correlation with NT-pro ANP levels

Background: An increased burden of cardiovascular disease is observed in prediabetes compared to normoglycemic. In this study, we aimed to evaluate left atrium (LA) volume indices and mechanical functions in prediabetes patients by real-time three- dimensional echocardiography (3DE) and examine the relationship of these parameters with N-terminal pro-atrial natriuretic peptide (NT-pro-ANP) levels. Methods: 41 patients diagnosed with prediabetes by the oral glucose tolerance test in the endocrinology outpatient clinic and 43 healthy controls were included in this study. We evaluated the volume indices and mechanical functions of the LA using 3DE. Plasma NT-proANP was evaluated by the enzyme-linked immunosorbent assay method. Results: Median NT-pro-ANP level was higher in the prediabetes group than the control group (1.5 vs 0.7 nmol/L, p<0.001). Levels of LA volume index (LAVI), minimum and maximum of LA volume (Vmin, Vmax; respectively), pre- atrial contraction volume (VpreA), active emptying fraction, and total and active emptying volume, each reflects reservoir and pump functions of LA, were higher in the prediabetes group. In contrast, the LA passive emptying fraction (PEF) level was lower (p<0.05). There was a positive correlation between levels of NT-pro-ANP and Vmax (r= 0.352, p=0.024), Vmin (r= 0.563, p<0.001), VpreA (r= 0.504, p<0.001), and LAVI (r= 0.338, p=0.031), while negative correlation existed between levels of NT-pro-ANP and total emptying fraction (r = -0.522, p<0.001) and PEF (r= -0.349, p=0.025) was found. Conclusion: LA volume and mechanical functions are impaired in prediabetes patients, and this deterioration was positively correlated with NT pro-ANP levels. The current findings demonstrate that cardiac structural deterioration in prediabetes patients is just initiated before overt diabetes onset