Aim. Donor organ injury during cold preservation before transplantation negatively impacts graft survival. The current study was to examine available evidences for the efficacy of different cold storage solutions that are used to preserve donor hearts in vitro prior to orthotopic transplantation.

Material and methods. A systematic search of full-length articles published from 1980 to August 2012 was performed in PubMed and Google Scholar. Detailed searches were also made for availability of any sourceware for histopathology images of endomyocardial biopsies of stored hearts.

Results. Not even a single controlled trial has been published relating to this topic. However, we assessed all available literature pertaining to this topic, and performed original, simple yet innovative analyses using ImageJ, a Java based image analyses program, to show the tremendous power to objectively examine the efficacy of the storage solution. Our analysis suggest that ImageJ may be conveniently used to obtain evidences (or lack of it) of ischemic injury of donor hearts during cold storage.

Conclusions. Even the UNOS database does not provide histopathological evidences of cardiac biopsies of orthotopically transplanted hearts. We, however, make the case of the need for image analyses and making availability of images to allow establishing evidence of the usefulness of these storage solutions. We recommend obtaining endomyocardial biopsy prior to orthotopic transplantation and create a registry of H&E stained slides. This is the only step that will direct us towards evidence based care of such highly critical patients who need the equally challenging surgical intervention of cardiac transplantation.

In our work we describe the case of a patient with a Brugada syndrome. It is a rare syndrome which carries a potential risk of sudden cardiac death which occurs usually at an early age. Unfortunately it is most frequently the first clinical manifestation of this genetic disease. Sometimes, as in our patient it could co-exist with other cardiovascular abnormalities which give us an opportunity to establish the right diagnosis and apply adequate preventive measures. It is of paramount importance to explore the possibility of the existence of this syndrome in the patient’s family members. The first diagnostic procedure is an ECG which is an inexpensive and readily available diagnostic tool.

An obese patient with comorbities was admitted to the emergency department with shock, widespread hematoma due to a previous above-knee amputation, and had emergency conventional peripheral angiography in a hybrid operating room after an initial diagnosis of femoral artery fistulisation. Due to the graft infection, the femoropopliteal graft was removed a month previous. However, bleeding occurred in the native common femoral artery, which had been previously removed and repaired. According to this symptom, coil embolization and gelfoam process were performed as life-saving procedures.

Anomalous origin of the right coronary artery (RCA) from the left coronary sinus is a rare congenital anomaly. Here, we report a case of a 54-year-old symptomatic woman who was admitted with a history of unstable angina pectoris, hypertension, coronary arteriosclerosis, diabetes mellitus, hypercholesterolemia and previous coronary bypass operation (CABG). Coronary angiography was performed and a right coronary artery was discovered, which was seen to arise from the left 
coronary sinus.

This paper presents a novel method for the detection of Arrhythmia diseases using both heart sounds and ECG signals. This automated classification and analysis system is aimed to assist the cardiologist to make the diagnosis faster and more efficient. Most of the heart valve disorders are reflected to heart sounds and can be detected through Phono Cardio Gram (PCG) signal analysis. Heart sounds carry information about the mechanical activity of the cardiovascular system. The heart sound segmentation process segments the Phono Cardio Gram (PCG) signal into four parts: S1 (first heart sound),systole, S2 (second heart sound) and diastole. It can be considered as one of the most important phases in the autoanalysis of PCG signals. Systolic and Diastolic time periods of heart sound signals are used to detect the abnormality of heart functions. The Systolic and diastolic time periods are matched with the ECG signals. The interval between two consecutive R peak values in ECG signal is considered as one cardiac cycle. A single cardiac cycle consists of S1, Systole, S2 and Diastole. Both Echocardiogram and Electrocardiogram signals are analyzed for the accurate diagnosing of cardiac vascular diseases.

Aim. The diagnosis of previous myocardial infarction (MI) is difficult in patients with pacemaker and usually further tests must be done to confirm the diagnosis. To overcome this difficulty five major ECG criteria have been proposed by authors: 1. Notching 0.04 second in the ascending limb of the S wave of leads V3,4 or 5 (Cabrera’s sign), 2. Notching of the upstroke of the R wave in leads I, aVL or V6 (Chapman’s sign), 3. Q wave >0.03 second in leads I, aVL or V6, 4. Notching of the first 0.04 second of the QRS complex in leads II, III, aVF, 5. Q wave >0.03 second in leads II, III, aVF. The aim of this study is to find the predictive value of the five major proposed criteria for MI in pacing ECG of patients with previous MI.

Material and methods. Twenty- three pacemaker patients with known MI (anterior 15, inferior 8) and 24 healthy pacemaker control patients; 17 female, 30 males, aged between 17-92 years with mean age of 59,5 ± 20 years, total 47 patients were studied. Documentation and localization of MI was based on history and confirmed by angiography and or scintigraphy.

Results. Sensitivity was lower in all parameters for prediction of any MI whereas specificity was higher and ODA was moderate. Cabrera’s and Chapman’s sign had moderate sensitivity (60%-60%) whereas high specificity (90%-90%) and ODA (81%-81%) for anterior MI. Sensitivity of Q wave in I, aVL or V6 was lower (47%) for anterior MI but specificity and ODA was higher 84% and 92% respectively.

Conclusion. In conclusion Cabrera’s and Chapman’s sign have a moderate sensitivity and higher specificity for recognising previous anterior MI in pacing patients.

Aim. Takayasu’s arteritis (TA) is a chronic inflammatory disease that affects predominantly the aorta. Percutaneous intervention (PI) may be use the TA. In this manuscript, we studied the outcomes (in-hospital and 6 months later) and effectiveness of PI in patients with TA.

Material and methods. The study was performed on 24 consecutive patients (39.3±11.8 (20–61) years; 4 men and 20 women) with TA who were treated with PI, surgical or medical therapy. Nine patients (7 females, 2 male) underwent PI. PI was performed after the erythrocyte sedimentation rate had been normalized in patients with TA.

Results. Although 9 patients received PI with stent for subclavian, carotid, renal and coronary artery, 1 patient received PI with only balloon for brachial artery. One percutaneous transluminal angioplasty and 10 stentings were performed. There was not any complication during interventional procedure. The patients were followed for 6 months. After 6 month, the arteries treated were patent and showed no proliferative lesions in Doppler ultrasound at 8 patients. At a woman patient, left subclavian artery restenosis was determined in Doppler ultrasound and confirmed by angiography. During angiography the stenotic lesion has been successfully treated with balloon angioplasty.

Conclusions. Takayasu’s patients with active systemic disease must receive immunosuppressive therapy before PI. PI was performed after the active period such as during normal erythrocyte sedimentation rate. In these circumstances, PI in patient with TA may be safely and much less traumatic. Also, recurrence of stenosis in patient with TA has been treated successfully by reintervention without significant complications.

Aim. This study aimed to study the effect of patients’ and physician’s characteristics as a predictor of length of stay (LOS) in patients undergoing coronary bypass surgery.

Material and methods. This was a retrospective study conducted at Tabriz Shaheed Madanee Cardiac Teaching Hospital in Iran in 2010. The 349 patients who did undergo a bypass surgery during 2008–2010 were studied. Patients and physicians characteristic were collected from patients medical records using a researcher developed checklist. Independent Samples Test of ANOVA was conducted to compare LOS between categorical variables. Data was analyzed using the SPSS17 statistical package.

Results. The mean age of the patients was 59.7 years. Overall average LOS was 15.58 (10.02) days. The findings of this study indicate that older patients stayed in the hospital for a significantly longer period than did younger patients. Patients’ stay at the hospital was statistically significant and longer than assessed expected length of stay estimated by physicians (P< 0.05). Patient admitted to the hospital through emergency department and patients with no hospitalization history stayed longer in the hospital (P≤0.01).).Early discharged patients and death cases also had a longer LOS (P ≤ 0.01).Patient whose attending physicians were working in private sector, in addition to Shaheed Madanee Hospital and had higher level of education stayed longer than those whose physicians worked only at Shaheed Madanee Hospital (P≤ 0.01).

Conclusion. Institutional characteristics –physicians practice both in private sector and public teaching hospital, physicians’ level of education, discharge process guidelines, and admission protocols were most important factor in predicting LOS. The patient’s hospitalization history whether patient was hospitalized before or not, was also a predictor.

Aim. The transcatheter aortic valve implantation (TAVI) which developed in the recent years has become an alternative for surgery. However, in spite of new developments the process based vascular and neurological complications still remain to be a problem with elderly patients who also tend to have many co-morbid conditions. With this study we aimed to evaluate the TAVI efficacy and reliability on patients with scarcely relative contraindication and with intracardiac thrombus who are mostly left out of the study.

Methods and Results. There has been a successful TAVI process conducted in our clinic for antiplatelet and anticoagulation for 6 cases in which thrombus was seen in left atrial appendix (LAA) via transesophageal echocardiography (TEE) and which are not suitable for surgical valve replacement due to atrial fibrillation (AF) and severe AS comorbid reasons. Edwards SAPIEN XT valve was implanted to all patients transfemorally with general anaesthesia. The process was facilitated successfully and no major/minor stroke was observed in post-process early period, and 9 month controls, in average.

Conclusion. Other than AS, also AF, whose frequency increases with age, is an important risk factor for neurological complications. In patients who has AF and AS the source of the cardioembolic focus is mainly LAA. The post-TAVI antiplatelet and anticoagulation treatment is not clear for these patients. We tried to show that TAVI process is reliable in terms of the risk of stroke, in careful processing and suitable anticoagulation treatment for the patients with AF, AS and LAA in this first case study in literature, as far as we know.

Aim. We planned a cinefluoroscopy (CF) study to mark the ideal opening and closing tube angles for mitral and aortic positioned mechanical valves. Our hypothesis was that if we find an intensity zone where the valves were optimally seen, then starting the CF examination from that tube position would shorten the examination duration

Material and methods. Between January 2010 and August 2011, 192 consecutive patients (mean age 51,86±12,80 years; 101 women and 91 male) with mitral (n=135; monoleaflet: 37; bileaflet: 98) and aortic (n=87; monoleaflet:19; bileaflet: 68) and tricuspid (n=3; all bileaflet) prostheses were enrolled into the study. Cinefluoroscopy was performed with Philips Radiologic System. For each type and location of mechanical prostheses optimal opening-closing angles obtained and marked on x-y axis graphic. Furthermore, we investigated whether there is an intensity zone quadrant.

Results. Among patients with prosthetic bileaflet mitral valve in supine position optimal images were obtained: 34 (58,6%) patients were in RAO-Cranial, 12 (20,7%) were in left anterior oblique (LAO) cranial, 7 (12,1%) were in RAO caudal and 5 (8,6%) were in LAO caudal angles. Among patients with prosthetic bileaflet aortic valves in supine position shown: 27 (50%) patients were in LAO-cranial, 10 (18,5%) were in RAO- cranial, 9 (16,7%) were in LAO-caudal and 8 (14,8%) patients were in RAO-caudal angles.

Conclusion. According to our results it seems logical to start mitral position CF assessment by RAO-Cranial angles quadrant and for aortic position by LAO-Cranial angles quadrant to decrease time and lower radiation exposure.

Aim. The purpose of this study was to compare three prophylactic regimens, sodium-bicarbonate based hydration, sodium-bicarbonate + N-acetylcysteine (NAC), and sodium-bicarbonate + NAC + theophylline, for the prevention of contrast induced nephropathy.

Material and methods. We prospectively randomized 151 patients with baseline eGFR values between 30–59 ml/min/1.73m² who were also undergoing coronary angiography with three prophylactic treatments: intravenous hydration with sodiumbicarbonate (3 ml/kg/h for 1 hours before and 1 ml/kg/h for 6 hours after contrast exposure, group 1; n=50), hydration + NAC (600 mg p. o. twice daily the preceding day and the day of angiography, group 2; n=50), and hydration + NAC + theophylline (600 mg p. o. NAC and 200 mg theophylline p. o. twice daily for the preceding day and the day of angiography, group 3; n=51). The incidence of contrast induced nephropathy (0,5 mg/dl increase in serum creatinine from the baseline value 48 hours after intravascular injection of contrast) from the three groups was compared.

Results. Of the 151 patients, 4 patients (7.8%) in group 3 experienced CIN (p=0.01). CIN did not develop in group 1 and 2.

Conclusion. Among patients with eGFR values between 30–59 ml/min/1.73m² undergoing coronary angiography, use of sodium-bicarbonate based hydration alone and sodium-bicarbonate with NAC was associated with a reduction in the rate of contrast induced nephropathy. Sodium-bicarbonate with theophylline therapy was found to have no effect for the prevention of contrast-induced nephropathy.

European Society of Cardiology (ESC) National Society Cardiovascular Journals (NSCJs) are high-quality biomedical journals focused on cardiovascular diseases. The Editors´ Network of the ESC devises editorial initiatives aimed at improving the scientific quality and diffusion of NSCJ. In this article we will discuss on the importance of the Internet, electronic editions and open access strategies on scientific publishing. Finally, we will propose a new editorial initiative based on a 
novel electronic tool on the ESC web-page that may further help to increase the dissemination of contents and visibility of NSCJs.

The study is to investigate the potential protective effect of sevoflurane on adriamycin induced myocyte injury. We prepared primary myocyte culture from neonatal rats and subjected the cells to adriamycin treatment. We found that adriamycin treatment induced cell apoptosis, decreased cell vitality, which could be reversed with sevoflurane exposure after the drug treatment, potentially through the regulation of Bcl-2 anti-apoptotic pathway. The study suggested the potential roles of sevoflurane in clinical management of patients after adriamycin chemotherapy.