ABSTRACT
Patients with angiographically normal coronary arteries sometimes exhibit delayed clearance of contrast medium. This contrast layering (CL) was tested with intravascular ultrasound (IVUS) and markers of endothelial dysfunction and oxidative stress. The study group (n = 26) consisted of patients with CL and the control group (n = 32) comprised patients with normal coronary arteries despite angina symptoms. The CL was observed in 36 coronary arteries of 26 patients in the study group. Total antioxidant status and nitric oxide levels were significantly lower; total oxidant status, malondialdehyde plasma levels, and oxidative stress index were significantly higher in patients with CL than in controls. The IVUS studies revealed that atherosclerotic plaque burden, fibrous tissue, dense calcific tissue, and necrotic core ratios were significantly higher in the coronary segments with CL compared with adjacent normal segments. These results support the concept of CL as a new angiographic appearance of early atherosclerosis.
Subject(s)
Contrast Media/pharmacokinetics , Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Coronary Vessels/diagnostic imaging , Iohexol/analogs & derivatives , Adult , Aged , Biomarkers/blood , Case-Control Studies , Coronary Artery Disease/blood , Coronary Vessels/metabolism , Early Diagnosis , Female , Fibrosis , Humans , Iohexol/pharmacokinetics , Male , Malondialdehyde/blood , Middle Aged , Necrosis , Nitric Oxide/blood , Oxidative Stress , Plaque, Atherosclerotic , Predictive Value of Tests , Turkey , Ultrasonography, Interventional , Vascular Calcification/diagnostic imagingABSTRACT
Serum uric acid (SUA) level is a marker of endothelial dysfunction and oxidative stress. Consecutive patients (n = 64) with normal coronary angiography who demonstrated calcific aortic stenosis (AS) by transthoracic echocardiography were included in the study. The patients were categorized into 3 groups: 23 mild AS (12 males), 21 moderate AS (10 males), and 20 severe AS cases (10 males). Fasting SUA level was significantly higher in the severe AS group than in the moderate and mild AS groups (severe AS, 6.3 ± 1.6; moderate AS, 4.9 ± 1.3; mild AS; 4.6 ± 1.4 mg/dL; P < .001, respectively). There was a positive correlation between SUA level and maximum as well as mean aortic gradient (r = .521, P < .001 and r = .526, P < .001, respectively). There was a negative correlation between SUA level and aortic valve area (r = -.447, P < .001). Levels of SUA were increased in calcific AS cases. In addition, there was a positive correlation between severity of calcific AS and SUA levels.
Subject(s)
Aortic Valve Stenosis/blood , Aortic Valve/pathology , Calcinosis/blood , Uric Acid/blood , Aged , Aortic Valve/diagnostic imaging , Aortic Valve/physiopathology , Aortic Valve Stenosis/classification , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/physiopathology , Biomarkers/blood , Blood Pressure , Calcinosis/classification , Calcinosis/diagnostic imaging , Calcinosis/physiopathology , Coronary Angiography , Echocardiography, Doppler , Female , Humans , Male , Middle Aged , Severity of Illness IndexABSTRACT
Kounis syndrome, also named as "allergic angina syndrome," is a diagnosis in which exposure to an allergen causes mostly coronary spasm and rarely plaque rupture, resulting in ischemic myocardial events. Myocardial bridging is defined as an intramural segment of a coronary artery and its systolic compression by overlying fibers. Myocardial bridging generally has a benign prognosis and mostly affects the mid portion of left anterior descending coronary artery. However, some cases with myocardial ischemia, infarction, and sudden death have also been reported. A 17-year-old boy presented to the clinic with acute anterolateral myocardial infarction after having first dose of clindamycin and diagnosed as Kounis syndrome. Further diagnostic workup of the patient showed myocardial bridging at the mid left anterior descending artery. In this report, we present the combination of Kounis syndrome and myocardial bridging leading to myocardial infarction at young age.
