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BACKGROUND: Left ventricular false tendon (LVFT) is a fibromuscular band crossing the left ventricular cavity. And Chiari's network (CN) is a highly mobile, mesh-like, echogenic structure in right atrium. In this study, we aimed to evaluate the coexistence of LVFT in patients with CN. CN patients were examined with live/real-time three-dimensional transthoracic echocardiography (TTE) for visualization of LVFT. RESULTS: This is a single-center prospective study of 49 patients with CN. In literature studies, the average ratios of LVFT were 22% in the normal population. In our study, an increased ratio of LVFT (n = 31, 63.3%) was found in CN patients evaluated with a three-dimensional TTE (63.3% versus 22%) (p = 0.01). The interatrial septal aneurysm was found in 31 (63.3%) patients with CN. And, the positive contrast echocardiography examination was determined in 22 (61.1%) patients with CN. CONCLUSIONS: Our study reveals that CN is associated with LVFT and is also associated with cardiac anomalies like an interatrial septal aneurysm, and atrial septal defect. And LVFT can be evaluated better with three-dimensional TTE than with traditional two-dimensional TTE. Patients with CN should be evaluated more carefully by three-dimensional echocardiography as they can be in synergy in terms of the cardiac pathologies they accompany.
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OBJECTIVES: In this study, we aimed to evaluate in-patients with iron deficiency anemia concerning etiology. METHODS: In our study, we retrospectively evaluated 150 in-patients (60 male and 90 female) with iron deficiency anemia in Sisli Etfal Hospital, Department of Internal Diseases between 2005 and 2010. Anemia was defined as Hb <12 g/dl for women and <13 g/dl for men and transferrin saturation ≤15%. RESULTS: In our study, 60 male and 90 female patients were included. Analyzing the etiology of iron deficiency anemia in 150 patients, we identified erosive gastritis in 35 (23.3%) patients, gastric cancer in 15 (10%) patients, colon polyps in 14 (9.3%) patients, erosive gastritis in 14 (9.3%) patients, myoma in 14 (9.3%) patients, diverticulosis in 13 (8.6%) patients, colon cancer in seven (4.6%) patients, menometrorrhagia in seven (4.6%) patients, malabsorption in six (4%) patients, hemorrhoids in six (4%) patients, celiac disease in four (2.6%) patients, bladder cancer in three (2%) patients, hematologic malignancy in three (2%) and other diseases (unexplained etiology) in 23 (15.3%) patients. CONCLUSION: When iron deficiency anemia is detected, it may be a warning of an underlying severe illness. Reasons for many cases arise from upper and lower gastrointestinal tract diseases. Endoscopic examinations are important for diagnosis. We suggest performing gastroscopy and colonoscopy together in patients with iron deficiency anemia.
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Introduction: Microalbuminuria (MAU), a complication of diabetes, is closely related to cardiovascular events. A fragmented QRS (fQRS) in the electrocardiogram (ECG) was found to be strongly associated to cardiovascular morbidity and mortality. Objective: The aim of this study was to assess the association between a fQRS and MAU in patients with type 2 diabetes mellitus (T2DM). Patients and methods: One hundred and twenty-seven patients (mean age, 50.49 years; 44.01% male) with T2DM of at least six months duration and at least two urine albumin/creatinine ratios (ACRs) available were enrolled into the study between December 2015 and May 2016. All patients underwent ECG and echocardiography, and were taken blood and urine samples. Patients were divided into two groups according to presence of fQRS (group 1) or absence of fQRS (group 2). Results: Both groups had similar baseline characteristics. MAU and glycosylated hemoglobin (HbA1c) levels and left ventricular end-diastolic diameter (LVEDd) were increased in patients with a fQRS in the ECG (p=0.002, p=0.02, and p=0.007, respectively). Univariate and multivariate logistic regression analysis showed MAU and an increased LVEDd to be independent risk factors for the presence of a fQRS in the ECG of T2DM patients. Discussion and conclusions: In this study, a fQRS was associated to MAU. In T2DM, MAU may be related to subclinical diastolic and systolic dysfunction (AU)
Introducción: La microalbuminuria (MAU), una complicación de la diabetes, está relacionada estrechamente con episodios cardiovasculares. Se ha hallado una asociación clara entre un QRS fragmentado (QRSf) y morbilidad y mortalidad de causa cardiovascular. Objetivo: El objetivo de este estudio era evaluar la asociación entre un QRSf y la MAU en pacientes con diabetes mellitus tipo 2 (DM2). Pacientes y métodos: Se incluyó en el estudio a 127 pacientes (edad media 50,49 años; 44,01% varones) con DM2 de al menos seis meses de duración y de quienes se disponía de al menos dos cocientes albúmina/creatinina en orina entre diciembre de 2015 y mayo de 2016. Se realizaron ECG y ecocardiografía a todos los pacientes y se les recogieron muestras de sangre y orina. Se dividió a los pacientes en dos grupos en función de la presencia de QRSf (grupo 1) o su ausencia (grupo 2). Resultados: Los dos grupos tenían características basales similares. La MAU, la hemoglobina glucosilada (HbA1c) y el diámetro telediastólico del ventrículo izquierdo (DTDVI) estaban aumentados en los pacientes con QRSf en el ECG (p=0,002, p=0,02 y p=0,007, respectivamente). Los análisis de regresión logística uni- y multivariable mostraron que la MAU y el aumento del DTDVI eran factores independientes de riesgo de la presencia de QRSf en el ECG de los pacientes con DM2. Comentario y conclusiones: En este estudio, el QRSf se asoció con MAU. En la DM2, la MAU puede estar relacionada con disfunción diastólica y sistólica subclínica (AU)
Subject(s)
Humans , Male , Female , Middle Aged , Diabetes Mellitus, Type 2/complications , Diabetes Mellitus, Type 2/diagnostic imaging , Albuminuria/diagnosis , Cardiovascular Diseases/complications , Cardiovascular Diseases/mortality , Electrocardiography/methods , Prospective Studies , Cross-Sectional Studies/methods , Multivariate AnalysisABSTRACT
INTRODUCTION: Microalbuminuria (MAU), a complication of diabetes, is closely related to cardiovascular events. A fragmented QRS (fQRS) in the electrocardiogram (ECG) was found to be strongly associated to cardiovascular morbidity and mortality. OBJECTIVE: The aim of this study was to assess the association between a fQRS and MAU in patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: One hundred and twenty-seven patients (mean age, 50.49 years; 44.01% male) with T2DM of at least six months duration and at least two urine albumin/creatinine ratios (ACRs) available were enrolled into the study between December 2015 and May 2016. All patients underwent ECG and echocardiography, and were taken blood and urine samples. Patients were divided into two groups according to presence of fQRS (group 1) or absence of fQRS (group 2). RESULTS: Both groups had similar baseline characteristics. MAU and glycosylated hemoglobin (HbA1c) levels and left ventricular end-diastolic diameter (LVEDd) were increased in patients with a fQRS in the ECG (p=0.002, p=0.02, and p=0.007, respectively). Univariate and multivariate logistic regression analysis showed MAU and an increased LVEDd to be independent risk factors for the presence of a fQRS in the ECG of T2DM patients. DISCUSSION AND CONCLUSIONS: In this study, a fQRS was associated to MAU. In T2DM, MAU may be related to subclinical diastolic and systolic dysfunction.
