OBJECTIVES
To identify the causes that affect the time from the onset of symptoms to admission to the hospital, in patients with a diagnosis of acute myocardial infarction (MI).
METHODS
The study was carried out between January 2004 and January 2005 in the Emergency Room of the Uludag University Faculty of Medicine (UUFM) Hospital, Turkey. A total of 180 patients were included. Residents of the UUFM Department of Cardiology distributed a questionnaire to all patients. Socioeconomic level was determined by scoring the socioeconomic factors. For statistical analyses we used the SPSS 13.0 statistical software.
RESULTS
Of the 180 patients, 79.4% (n=143) were admitted to the hospital within 6 hours of onset of symptoms and 20.6% (n=37) the time exceeded 6 hours of which 10% (n=18) admitted in more than 12 hours. Male patients seemed to present earlier than females (p<0.05 and p<0.05). The time to admission decreased as the socioeconomic level improved and the level of education increased. Patients with a history of MI, who had coronary angioplasty and had undergone coronary by-pass surgery admitted to the hospital earlier than those who did not have these factors p=0.042, p=0.005, p=0.026. Subjects who had anginal symptoms prior to acute MI (p<0.001) and patients with diabetes (p<0.001) had a significantly longer admission time.
CONCLUSIONS
It is essential to inform individuals with a low level of education and socioeconomic status; patients with anginal complaints and diabetic persons; particularly females, on the symptoms of MI and the importance of early hospitalization on the outcome.
The aims of the present study were to examine the myocardial performance index and aortic elastic properties of athletes engaged in ball sports and to determine their relationships with aerobic and anaerobic characteristics. Standard M-mode and Doppler echocardiography, maximal oxygen uptake and 30 sec Wingate tests were performed for 32 elite male athletes (12 basketball and 20 soccer players) and 12 healthy sedentary volunteers. Data were analyzed by ANOVA and partial correlation coefficient tests. Absolute values of left ventricular internal diameter, left ventricular posterior wall and interventricular septum thicknesses in diastole were significantly (p < 0.05-0.01) greater in athletes than in controls. The left ventricular internal diameter corrected by body surface area was also greater (p < 0.05-0.01) in the athletes compared with the controls. Absolute and body surface area corrected left ventricular mass were significantly greater (p < 0.05-0.001) in athletes than in controls. Isovolumetric relaxation time was higher (p < 0.01) in soccer players than in controls. There were no significant differences among the groups for myocardial performance index and aortic elastic properties. Left ventricular mass index was poorly correlated (p < 0.01) with VO2max (r = 0.410), peak power (r = 0.439) and average power (r = 0.464) in the athletes. Poor correlations (r = 0.333-0.350, p < 0.05) were also observed between aortic elastic properties and average power in athletes. Myocardial performance index and aortic elastic properties are not different in athletes involved in this study compared with sedentary subjects. Aerobic and anaerobic capacities of the athletes used in this study are poorly explained by these resting echocardiographic findings. Key PointsLeft ventricular internal diameter, left ventricular posterior wall and interventricular septum thicknesses in diastole, and left ventricular mass were significantly greater in athletes than in controls.There were no remarkable differences in Doppler velocities and time intervals between athletes and controls.Myocardial performance index and aortic elastic properties are not different in athletes compared with sedentary subjects.Aerobic and anaerobic parameters of athletes are poorly explained by resting echocardiographic characteristics.VO2max and anaerobic power indices are variables that better determines left ventricular mass developed in ball sport specific training.
Kan basinci (KB) kontrollu olan ve gece olculen kan basincinda yeterli dusme olmayan (non-dipper) hipertansiflerin egzersiz testi sonrasi kalp hizi toparlanmasinda gecikme gosterip gostermedigi incelendi. Tum hastalara Bruce protokolune gore maksimal efor testi uygulandi. Kalp hizi toparlanmasi (KHT), efor testi bittigindeki kalp hizi ile bir dakika sonraki kalp hizi arasindaki fark olarak tanimlandi. Sirkadiyen KB, 24 saatlik ambultuvar KB monitorizasyonu ile tespit edildi. Dipper KB profili olan hastalarin “non-dipper” olanlara gore gece ortalama sistolik ve diyastolik KB daha dusuk, sistolik ve diyastolik KB gece gunduz farki yuzdesi ise daha yuksekti. Dipper olanlarin KHT degerleri “non-dipper” bireylerden daha yuksekti (34.36±14.55/dak-32.48±8.60/dak, p=0.025). Ortalama gece sistolik-diyastolik KB degerleri ve KB gece gunduz farki yuzdesi ile KHT arasinda korelasyon yoktu. Sonuc olarak “Non-dipper” durum ile KHT gecikmesi arasinda istatistiksel olarak anlamli ancak klinik acidan cok da onemli olmayan bir iliski vardir. Bu bulgular “non-dipper” durumun duzeltilmesinden cok KB kontrolunun onemini gosterebilir.
Tissue Doppler imaging (TDI) is a method that determines the tissue motion and velocity within the myocardium.To characterize acute haemodialysis (HD)-induced changes in TDI-derived indices for patients that have end-stage renal disease (ESRD).Cross sectional study.Conventional echocardiography and TDI methods were applied to study ESRD patients (n=58) before and after HD. Pulmonary venous flow, mitral inflow, and TDI signals of the lateral and septal mitral annulus were examined for the determination of altered left-ventricular diastolic filling parameters. Flow velocities from early- (E) and late-atrial (A) peak transmitral; peak pulmonary vein systolic (S) and diastolic (D); and myocardial peak systolic (Sm) and peak early (Em) and late (Am) diastolic mitral annular velocities were also assessed for changes.Transmitral E and A velocities and the E/A ratio decreased significantly after HD (p<0.001). Pulmonary vein S (p<0.001) and D (p<0.001) velocities decreased, and S/D ratios increased significantly (p=0.027). HD led to a reduction in septal Em (p<0.001), lateral Em (p=0.006), and Am (p<0.001) velocities. Contrary to the decreases in Em and Am, the Em/Am ratio remained unchanged.A single HD session was associated with an acute deterioration in the diastolic parameters. Since the Em/Am ratio remained unchanged, we conclude that this index is a relatively load-independent measure of diastolic function in HD patients.
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