[Association between oxidative stress parameters and inflammations markers according to the gravityt of the acute coronary syndrome]

Cardiovascular disease is the consequence of appearance and development of atherosclerosis lesions of associated with a inflammatory complication. To elucidate a possible association between several inflammation and oxidative stress markers according to the severity of coronary artery disease. This study was carried on 93 coronary subjects with: unstable angina [UA; n=42]; stable angina [SA; n=15] and acute myocardial infarction [AMI; n=36] and 140 control subjects to whom lipidic, oxidative and inflammatory parameters were determined. In addition to a moderate hyperhomocysteinemia observed in the coronary artery disease, a significant higher levels of the oxidized LDL [ox-LDL] were found among these patients [p< 0.001]. A positive correlation was found between the markers of the inflammation and the gravity of the acute coronary syndrome. One note a significant increase of the rate of ox-LDL and high sensitive CRP to AMI by reports in UA and SA [p=0.00, and p=0.001 respectively] which is linked to an elevation of the plasmatic concentration of the total homocysteine. This study suggests an association between the markers of the inflammation and oxidative parameters in the acute coronary syndrome

[Abnormalities of the interatrial septum associated with cerebral ischemia in young adults: Contribution of trans-oesophageal echocardiography]

About 40% of the mechanism of ischaemic stroke in young adults remains unclear. A paradoxical embolism associated with persistence of a patent foramen ovale and/or the presence of an atrial septal aneurysm are significantly more frequent in patients examined for ischaemic stroke of unknown cause than in control subjects. Was to evaluate the contribution of trans-oesophageal echocardiography to the diagnosis of abnormalities of the interatrial septum and to identify the role played by this condition in unexplained ischemic stroke. In 30 consecutive patients, trans-oesophageal echocardiography recording were made during a saline contrast study. Abnormalities of the interatrial septum was diagnosed in 23.3% cases. The proportion of patent foramen ovale was 10% [3 patients]; atrial septal aneurysm was detected in 6.6%[2 patients]. The prevalence of patent foramen ovale associated with atrial septal aneurysm was 6.6% [2 patients]. Transesophageal echocardiography with contrast appears to be an effective exam in diagnosis of abnormalities of the interatrial septum and our study was suggestive of their embolic nature

[Abnormalities of haemostasis in myocardial infarction with normal coronary artery]

Myocardial infarction with normal coronary artery is usually inaugural, with electric and clinical characteristics similar to those with atheroma. The role of constitutional or acquired abnormalities of haemostasis has been more incriminated in the pathogenesis of myocardial infarction with normal coronary. The aim of our study was to research abnormalities of haemostasis in patients with myocardial infarction and angiographically absolutely normal coronary arteries. Thirty nine, patients with myocarcdial infarction and normal coronary arteries were included in our study. They were 33 males and 6 females aged between 22 and 75 years [44 +13 years], in whom the deficiency in protein C and S. antithrombin, activated protein C resistance and antiphospholipid antibodies were assessed Concurrent abnormalities of haemostasis were found in 10 patients: Antiphospholipid antibodies, found in 5 patients constitute the most frequent abnormality. The other abnormalities were deficiency in protein C in two cases, deficiency in protein S 2 cases, deficiency in antithrombin in 2 cases and activated protein C resistance in 3 cases In our study, in face of the high prevalence of these abnormalities, it seems reasonable to research them, especially in young patients with myocardial infarction with normal coronary artery. This should have an impact on the management of these patients

[Cardiac amyloidosis revealing multiple myeloma]

Amyloidosis is a rare disease characterized by an extracellular accumulation of a protein polysaccharide complex [Amyloid]. Cardiac involvement is considered as a major prognostic factor. We report the case of two women, hospitalized for heart failure. The diagnosis of cardiac amyloidosis was suggested by echocardiography left ventricular concentric hypertrophy and typical amyeloid infiltration with hyperechoic. shiny and granite-like aspect of the interventricular septum. The histological confirmation was obtained by gastric biopsy in the first case and biopsy of the salivary glands in the second revealing an amyloidosis AL. This cardiac amyloidosis was secondary to multiple myeloma: monoclonal Gammopathy with immunoglobulin Lambda in the first and Kappa in the second, and the presence of a plasmocyte infiltration in the sternal puncture. Amyloidosis is a rare pathology, the cardiac involvement is frequent in the type AL and can occur with or without clinical manifestations. Echocardiography should be systematic in patients with confirmed amyloidosis