Late pacemaker twiddler syndrome.
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Electric Power Supplies↗
Biomedical subjects
Erdogan Yasar
Publications and source records attributed to Erdogan Yasar.
Effect of glucose-insulin-potassium infusion on myocardial damage due to percutaneous coronary revascularization.
Percutaneous coronary intervention has been known to cause myocardial damage as a result of microvascular dysfunction due to microembolization and microinfarction. Previous studies have shown that glucose-insulin-potassium (GIK) infusion decreases mortality in patients with acute myocardial infarction. Therefore, in this study, we aimed to investigate the effect of GIK infusion on myocardial damage due to percutaneous coronary revascularization. A total of 52 consecutive nondiabetic patients diagnosed with non-ST-elevation acute coronary syndrome and designated for elective percutaneous coronary intervention were randomized in a double-blind fashion into GIK and normal saline groups. GIK infusion (30% dextrose, 300 U insulin, and 60 mEq potassium chloride) at a dose of 1.5 ml/kg/hour was initiated 24 hours before the intervention and continuing during and until 1 hour after the intervention. Troponin I levels were recorded in venous blood samples before and 12 and 24 hours after the intervention. The increase in troponin I was significantly lower at 12 and 24 hours in the GIK group compared with those of the saline controls (p=0.022 and p=0.005, respectively). GIK infusion initiated 24 hours before coronary stenting for non-ST-elevation acute coronary syndrome resulted in less myocardial damage as determined by postprocedure troponin I levels.
Acute Disease↗
Relationship between myocardial injury and soluble P-selectin in non-ST elevation acute coronary syndromes.
BACKGROUND: The relationships among troponin concentration, early phase coagulation activation and soluble P-selectin concentration was evaluated in this study. METHODS AND RESULTS: Troponin-l, soluble P-selectin, von Willebrand factor (vWF), fibrinogen, plasminogen, plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) concentrations of 202 consecutive patients with non-ST elevation acute coronary syndrome (NSTE-ACS) were measured at the time of admission. Patients were classified into 2 groups as troponin-negative (<0.2 ng/ml, n=129) or positive (>or=0.2 ng/ml, n=73). Soluble P-selectin concentrations were found to be higher (p<0.001) and correlated with troponin concentrations (r=0.313, p<0.005) in troponin-positive patients with NSTE-ACS. In these patients fibrinogen (p<0.001), plasminogen (p<0.001) and PAI-1 (p<0.026) concentrations were higher and t-PA concentrations were lower (p<0.013) and all these parameters correlated with P-selectin concentrations (p<0.001). There was no difference between the groups according to vWF concentrations (p=0.379). Soluble P-selectin concentrations were found to be an independent predictor of troponin positivity (beta=0.295, odds ratio =1.05, p<0.001). Analysis of regression revealed a significant effect of troponin on soluble P-selectin concentrations (r=0.52, r2=0.27, p<0.001). CONCLUSIONS: The results suggest that higher soluble P-selectin concentrations might be involved in increased coagulation activation and myocardial injury development in patients with NSTE-ACS.
Acute Disease↗
Left ventricular diverticulum in two adult patients.
Left ventricular diverticulum is a rare congenital anomaly. In the adult population, the incidence was reported to be 0.26% in nonselected patients who underwent cardiac catheterization. Diverticula are usually localized near the apex and most often involve the inferior or anterior parietal walls of the left ventricle. In this report, two cases with congenital left ventricular diverticulum are presented, and the pathophysiologic, diagnostic, and therapeutic approaches of this cardiac malformation are discussed.
Chest Pain↗
Treatment strategies in myocardial bridging: a case report.
Myocardial bridging is one of the nonatherosclerotic causes of coronary artery disease and is characterized by muscles overlying the intramyocardial course of a major epicardial coronary artery segment, leading to systolic compression. Myocardial bridging is considered a benign condition in most cases, but has been associated with serious cardiac events such as myocardial infarction and sudden death. We discuss the case of a 63-year-old man who was admitted to our hospital with effort-induced angina, bradycardia, and left ventricular hypertrophy on electrocardiogram. On coronary angiography, we found significant myocardial bridging with total occlusion in the left anterior descending artery during systole. In patients with myocardial bridging, symptoms often manifest during exercise and with tachycardia. But it is interesting to note that our patient was bradycardic and became symptomatic with minimal effort. Thus, we thought that these emphasized its significance and affected treatment strategy.
Angina Pectoris↗