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    Myocardial blush grade: T evaluate myocardial viability in patients with cute myocardial lnfarction
    (Sage Publications Inc, 2007) Seyfeli, Ergun; Abaci, Adrian; Kula, Mustafa; Topsakal, Ramazan; Eryol, Namik K.; Arinc, Huseyin; Ozdogru, Ibrahim
    Myocardial blush grade (MBG) is used to assess myocardial perfusion in the infarcted myocardium. The purpose of this study was to determine whether the analysis of myocardial blush grade after resolution of the acute phase of myocardial infarction is useful for assessing myocardial viability. The present study is consisted of 64 patients (55 men, mean age 55 11 years) who had acute myocardial infarction and nonoccluded stenosis (>50%) in an infarct-related artery. All the patients had thrombolysis in myocardial infarction (TIMI)-3 flow in the infarct-related artery on coronary angiograms. Myocardial viability was determined by single-photon emission computed tomography (SPECT) within the same week after coronary angiograms. MBG 0 in 5 (8%) patients, grade 1 in 10 (16%) patients, grade 2 in 23 (36%) patients, and grade 3 in 26 (40%) patients were present. Fifty-four (84%) of 64 patients showed myocardial viability by SPECT. Myocardial viability was demonstrated in 1 1 of 15 patients (74%) with MBG 011 and 43 of 49 patients (88%) with MBG 2/3. There was a weak relation between MBG and myocardial viability by correlation analysis (r = 0.28, p = 0.025). If MBG 0 and 1 are regarded as a sign of nonviable myocardium, and if MBG 2 and 3 are regarded as a sign of viable myocardium, the sensitivity of MBG for the prediction of myocardial viability was 79%, specificity was 40%, positive predictive value was 88%, and negative predictive value was 27%. MBG has a weak correlation with myocardial viability. Although sensitivity is fairly good, specificity is very low. We concluded that the diagnostic value of MBG is limited to detect myocardial viability in the infarcted region.
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    Relationship between elastic properties of the aorta and uric acid levels in newly diagnosed hypertensive patients
    (Turkish Soc Cardiology, 2006) Gur, Mustafa; Yilmaz, Remzi; Demirbag, Recep; Seyfeli, Ergun; Ozdogru, Ibrahim; Altiparmak, Ibrahim Halil; Dogan, Ali
    Objectives: The association between elastic properties of the aorta and uric acid levels was investigated in patients with newly diagnosed hypertension. Study design: The study included 109 patients (68 females, 41 males; mean age 51.6+/-6.9 years) with newly diagnosed hypertension. Echocardiographic examination was performed. Systolic and diastolic diameters were measured by M-mode echocardiography, and elastic indices (aortic strain and distensibility) were calculated. Pulse pressure was obtained by a sphygmomanometer. Blood samples were obtained to determine serum uric acid levels and other biochemical parameters. The results were compared with those of a control group consisting of 21 age-and sex-matched healthy volunteers. Results: Compared to the control group, aortic strain and distensibility were significantly lower (p<0.001) and uric acid levels were significantly higher (p=0.044) in hypertensive patients. In multivariate regression analysis, aortic strain and distensibility showed independent relationships with uric acid levels (p=0.010 and p=0.009, respectively), age (p=0.001 and p<0.001), and left ventricular mass index (p=0.002 and p<0.001) in the patient group. Multivariate analysis according to gender showed that aortic strain and distensibility were in independent relationship with uric acid levels, age, and left ventricular mass index only in female patients. Conclusion: These data support the view that increased uric acid levels may have a role in the pathogenesis of impaired elastic properties of the aorta especially in hypertensive women.