Replacement of animal protein in the diet with soy protein is associated with decreased cholesterol levels. However, the effects of soy protein diet on endothelial function are not well known. The aim of the study was to investigate the effects of soy protein diet on plasma lipids and endothelial function parameters assessed by two different methods. Twenty hypercholesterolemic, non-smoker male patients (age 50± I 2) w ith a normal body mass index were inc luded. After calculating their daily requirements, a diet with 25-30% of energy from fats, 1 0-ı 2% from proteins and the rest from carbohydrates was instituted. Sixty percent of the animal source proteins of the diet were substituted by soy. The anthropometric measures, lipid parameters and endothelial functions of the subjects were assessed at baseline and 6 weeks after soy protein diet. Flow mediated endothelium dependent dilatation (EDD) and plasma thrombomodulin (TM) levels were evaluated as endothelial function parameters. Results: After diet plasma total cholesterol, lowdensity lipoprotein cholesterol, apolipoprotein B and triglyceride levels decreased significantly (p

Abstract |Full Text PDF

This study aimed at comparing the observed coronary risk of the original cohort of the Turkish Adult Risk Factor Study with that predicted by the Framingham risk function. For this purpose, after exclusion of cases of coronary heart disease (CHD), 1479 apparently healthy participants of the cohort aged 30-74 years at baseline formed the study population who were followed up prospectively for 10 years. The predicted risk was contrasted with the observed 67 coronary deaths and ı 09 instances of newly developed CHD. Each partic ipant was given points for each risk factor comprised in the Framingham risk score which is devised for predicting fatal and nonfatal heart attacks and angina. Individual risk percentage was computed from the sum of points. According to the risk function, total fatal or nonfatal CHD was predicted in 1 1 O subjects whereas fatal or nonfatal CHD w as considered to have developed in 97 men and 79 women in the course of the ı O years. Thus, compared to that anticipated by the risk model, an excess of coronary events was observed by 60% in the total cohort (by 40% in men, and 93% in women). When 5 categories of almost equa l s izes were formed based on the Framingham ri sk score, the 1 Oyear ineidence of composite coronary events were virtually identical to that expected from the Framingham risk model in the two low-risk categories in both genders. However, in those with moderate and high ri sk, much more events had developed than predicted. The observed excess coronary events in categories with elevated risk was attributed to excess of the absol ute risk among Turks compared to Western populations which is not incorporated in the Framingham model, rather than to limitations related to our diagnostic methods. We hy poth es ized that the low-grade c hron ic inflammation mediated by the metabolic syndrome plays a greater role in the atherothrombotic process in Turkish adults than in many other populations and that this element raises our absolute coronary risk.

It is well known, that deterioration in left ventricular functions and aortic distensibility occur in chron ic aoıti c regurgitation. A decrease in distensibility of the aorta may contribute to deterioration of the left ventricular functions. But in cases with chronic aortic regurgitation, our knowledge is limited on the effect of aortic valve replacement on aortic functions. The aim of this study was to show the effect of the aortic valve replacement on aortic functions in patients with aortic regurgi tation. Method: With thi s aim, 13 cases (2 women, ll men, mean age 36.8±6.2 years) who had chronic aortic regurgitation and needed aortic valve replacement were included in the study. One day prior and 48 hours after, surgery standard transthoracic echocardiography was performed in the patients. During the procedure, intralum inal arteria l pressure was recorded. Aortic strain, distens ibi lity and left ventricular systolic wall stress were measured. Results: When compared before and after aortic valve replacement, significant decrease was found in left ventricular systol ic, diastolic diameters and systolic wall stress, systolic and pulse pressures after the operation (p

Abstract |Full Text PDF

Although a relation between magni tude of ST segment elevation and myocardial damage was shown in the early period of acute myocardial infarction, such a relation among shape of the ST segment elevation, myocardial damage and elinical course remains obscure. With th is purpose 62 acute anterior MI patients who were admitted in the fi rst six hours of their first heart attack were enrolled for the study to demonstrate the relation between shape of the ST elevation prior to thrombolytic treatment and both signal-averaged ECG values detected in the early period (seventh day) of acute myocardial infaretion and el in ical course. Based on the precordial V3 derİ vation prior to thrombo lytic treatment, the shape of the ST elevation was separated into three groups as concave (n=26), straight (n=24) or convex types (n= 1 2). The re w as no statistically significant difference among groups from the points of thrombolytic treatment, endsystolic and end-diastolic volumes. Although both filtered QRS time (FQRS) and low amplitude signals (HFLA) had statistically significant differences in both groups, these were particu larly higher in the convex group. In addition root-mean square voltage of the terminal 40 ms of the f iltered-QRS (RMS40) values were quite lower in the straight and convex groups. Late potential (LP) positiveness and ventricular arrhythmia occurrence was higher in the convex group. Ventricular LP positiveness incidences were ll o/o (3/26) in the concave group, 16% (4/24) in the straight and 58% (7/12) in the convex group (p

Abstract |Full Text PDF

It is known that platelets play an important role in the patogenesis and natural history of acute myocardial infaretion (AMI). In this study, we investigated the relationship between mean platelet volume (MPV) and early phase complications in AMI. The MPV were measured in 213 patients with AMI (163 males, 50 females, mean age: 56.7±1 1.2 years) being admitted within 24 hours after onset of chest pain on admission, on the second and fifth days of infarction. Age- and sex-matched 70 healthy volunteers were taken as controls. The patients were divided into two groups as uncomplicated (group I, n= 131) and complicated ca ses (group II, n=82). Additionally, group II was subdivided into 4 subgroups: group Ila (recurrent angina-reinfarction, n=24) , group Ilb (severe heart fai lure-cardiogenic shock, n=41), group Ilc (severe arrhythmias, n=34) and group Ild (deceased, n=9). Both in group I and Il, the MPV was significantly higher than in the control group (p0.05). In conclusion, MPV increases in early phase of AMI. The high MPV measured on admission is related to increased frequency of recurrent angina-reinfarction and severe arrhythmia. We conclude that high MPV in AMI on admission may be a marker for recurrent ischaemic heart events and severe arrhythmia developing in the early phase of AMI.

Due to some of the unfavorable results of hormone replacement therapy, plant source estrogens, in other words, phytoestrogens have recently received great attention. The nıaj or classes of phytoestrogens include isoflavones, lignans and coumestans. Among these the most comınon and widely investigated is the class of isoflavones. The active components of isoflavones, genistein and daidzein, are similar in structure to estrogen and have selective estrogenic actions. Soy is the main source of isoflavones. The favorable effects of soy consumption on lipid profile has been known for many years. The theories put fo rward to explain such an effect are the facilitation of fecal bile acid excreation, the changes in hormone concentrations and the direct effects on hepatic ınetabolisın. The non-lipid effects of phytoestrogens are currently under investigation. Reduction in platelet aggregation, increased vascular reactivity, antioxidant and antiproliferative effects are the main non-lipid cardiovascular system effects of phytoestrogens. With the addition of recently discovered bone protective role against osteoporosis and antineoplastic effects, phytoestrogens have the potential of being a good alternative to hormone replacement therapy. The aiın of the present review was to evaluate the effects of phytoestrogens on cardiovascular and non-cardiovascular systems.

Heart Rate Variability (HRV) which can be defined as the cyclic variations in sinus ry th ın, gives information about the sympathetic and parasympathetic balance thus it is regarded as an indicator of ca rdiac otonomic tane and cardiorespiratuar system. In selected patient populations, analys is of Heart Rate Variability (HRV) yields important information about sinoatrial responsiveness to autonomic input and mortality risk stratification. Clinical use of depressed HR V has been proved as a predictor of risk after acute myocardial infaretion and as an early warning sign of diabetic neuropathy. However, routine application of HRV analysis to cardiovascular medicine awaits further investigation. The purpose of this article is to provide a brief overview of techniques used in analyzing HRV, to review of heart rate s ignal processing as it relates to autonomic input to the heart and to various elinical cardiovascular conditions, and to summarize the effects of some drugs and interventions on HRV.

Internet has much to offe r to health care professionals . Medline and re lated literature databases, are now available on-line. Similarly, electronic versions of journals are also available online. Many s ites dealing with various aspects of pediatric cardiology are also available. Most are aimed at the lay public, but some sites dedicated exclusively to medical professionals can alsa be found. The Internet also allows cheap and instantaneous connectivity between health care professionals through e-mail. Moreover, digital copies of images can be exchanged as e-mail attachments. Should an international pediatric cardiology database format be agreed upon, access to patient records, including imaging information, could be further s implified. Such records could potentially be entered into a single central database, in which global results for epidemiology, diagnostics, surgery, and outcome could be readily studied.

The effective drainage, applied at the true time, is very important to prevent constructive pericarditis which is high fibrin density in intraperi card ial cavity, in purulent pericarditis. When pericardial drainage is inadequate in cases with pur ul ent pericarditis, fibrinolytic therapy may be an option. In this case we elected this choice.

Left ventricular myxomas are rarely occur. They can cause systemic emboli, obstruction of flow, valvular regurgitation, arrhythmia and sudden death. Diagnosis can be made by two- dimensio nal echocardiography. Tum or neovascularization from branches of the left circumflex or right coronary artery was observed in patients with myxoma. This report firstly presents a large left ventricular myxoma presenting left anterior descending coronary artery neovascularization in a case underwent cerebrovascular accident due to cerebral emboli .