Racial Differences Affecting Night Time Blood Pressure Dipping Groups in Hypertensive Patients

Blood Pressure (BP) dipping is defined as the difference in BP from average waking to sleeping measurement. BP follows normal circadian rhythm of dipping at night at about 10-15% as compared to the day. Night time dipping is further divided into 4 types, reverse dipper (<0%), non-dipper (0-10%), dipper (10-20%) and extreme dipper (>20%). 

The dip is thought to be affected by an inability to excrete sodium during the daytime. It has also been found to be greatly reduced in populations who are regularly exposed to seasonal changes. Studies have shown how different dipping status of blood pressure during the night time affects the prognosis of diseases. This is especially so in the case of reverse dippers, which are frequently linked to higher mortality in Cardiovascular Diseases (CVD), perhaps related to nocturnal hypoperfusion and/or an exaggerated morning BP surge. Read More>>>>>>

Prevalence, Diagnostic and Therapeutic Characteristics - Right Ventricular Infarction

The current issue of the article published an article that was meant to provide a wholesome idea of the diagnosis, prognosis, treatment as well as sociodemographic correlations of right ventricular infarction. 

It was concluded that though right ventricular infarction are usually considered as rare occurrences, they are most often found to be associated with extension of persisting inferior myocardial infarction. Furthermore, the prognosis of the disease is even worse in patients with hemodynamic instability. Read More>>>>>>>>

Possible Benefits of Direct Oral Anticoagulants for the Electrophysiological Substrate Properties of Atrial Fibrillation

Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia, and is associated with thromboembolic events. Previous studies also have shown a close relationship between AF and heart failure, and heart failure can be one of the most important risk factors for AF. 

Atrial Fibrillation

Therefore, heart failure animal models have been established to investigate the structural and electrical remodeling for AF substrates and suggested that the structural and/or electrical remodeling caused by heart failure may play an important role in AF genesis. Several recent studies have demonstrated that Direct Oral Anticoagulants (DOACs) can directly modulate the mechanical and electrophysiological properties of the Left Atrium (LA) and Pulmonary Veins (PVs) and suggest that DOACs may have a beneficial effect of anti-AF actions via preventing AF progression in addition to their anti-thrombotic action. Read More>>>>>>>>

Ankle and Toe-Brachial Pressure Index after Exercise in Patients on Maintenance Hemodialysis

The incidence of symptomatic peripheral arterial disease (PAD) in patients undergoing hemodialysis (HD) ranges from 19 to 23%, being higher than in the general population. In some HD patients, PAD is asymptomatic, and rapidly progresses; critical limb ischemia (CLI) is detected without intermittent claudication. 

Ankle and Toe-Brachial Pressure Index

Refractory CLI requires lower-limb amputation, markedly reducing activities of daily life or leading to death from sepsis. Therefore, it is important to detect latent PAD in the early stage and perform treatment. For PAD screening, the ABI is routinely used. However, in HD patients, the sensitivity of this index is low due to marked arterial calcification, delaying the detection of PAD. As a means to overcome this limitation, there is a method to measure lower limb blood flow after exercise. In this article, we review the usefulness of these examinations. Read More>>>>>>>>

Use of Anti TNF-α Therapy in Systemic Vasculitis

There are several vascultic disorders still labeled as difficult-to-treat conditions due to its rarity and complexity at the time of presentation. The need for effective treatment for vasculitis is demanding since it carries a high incidence of morbidity and mortality either as a long term consequence of the disease itself or from the therapeutic interventions. 

Anti TNF-α Therapy

However, the available studies to provide evidence of therapies to practicing clinicians are mostly based on non-randomized controlled trials. Conducting a well-controlled randomized clinical trial is difficult due to multiple limitations; for example, failure to establish a measurable endpoint in vascultic disorders leads to different endpoints, making it difficult to obtain evidence from these trials. Read More>>>>>>>>>>

Trans Ulnar Approach for Unprotected Left Main Coronary Artery Disease

A 65 year old male presented with chest pain, sweating and uneasiness for four hours and diagnosed as unstable angina. There was no history of hypertension diabetes mellitus or dyslipidemia.

TIMI III flow achieved Dіer stent deployment

On general physical examination, pulse rate was 102 per minute, BP 140/86 mm of Hg, respiratory rate 18 per minute jugular venous pulse was normal. Auscultation of the heart and lung was unremarkable. Electrocardiogram showed ST segment depression of 2 mm in leads I, II, aVL, aVF and V3 to V6 with ST segment elevation in lead aVR. 

Two dimensional echocardiography revealed concentric left ventricular hypertrophy, normal left ventricular function, no regional wall motion abnormality, mild mitral and tricuspid regurgitation and normal chamber dimension. Hematological investigation and routine bio-chemistry were also normal. Read More>>>>>>

Why Treat Chronic Total Occlusion without Stents? - A Short Comment

Chronic total occlusions (CTO) of coronary arteries have been a focus point of research in interventional cardiology for several years. Recanalization, balloon dilatation and implantation of drug eluting stents (DES) are recognized treatment options for patients with symptomatic CTO. 

 

Chronic total occlusions

Recanalization of CTO ranks among the most complicated percutaneous coronary interventions (PCI) and the procedures are to be performed by well-equipped and experienced centers. During the last decades the procedural success rates increased due to improved technical equipment and increasing operator experience. It is still uncertain whether PCI is the optimal treatment method for CTO and it competes with coronary artery bypass grafts (CABG) and medical treatment. Large retrospective registries have shown a reduction of adverse events and a clinical improvement after successful CTO PCI. Read More>>>>>>>