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    Plasma BNP and homocysteine levels in patients with or without congestive heart failure
    (Turkish Society of Cardiovascular Surgery, 2007) Sekban, Ahmet; Benli Aksungar, Fehime; Şahin, Müslüm; Eren Topkaya, Aynur; Akyıldız, Mahmut
    Background: We investigated the relationship between brain natriuretic peptide (BNP), a marker for congestive heart failure, and plasma homocysteine levels. Methods: The study included seven patients (3 females, 4 males) with congestive heart failure and 36 patients (17 females, 19 males) without a history of previous myocardial infarction or congestive heart failure. Plasma BNP and homocysteine levels were measured. All the patients were assessed by transthoracic echocardiography.Results: In 19 patients (44%) plasma BNP and homocysteine levels were lower than 15 pg/ml and 7.91 mol/l, respectively, whereas in 24 patients, the corresponding levels were higher than 68.4 pg/ml and 8.84 mol/l. There was a significant positive correlation between plasma BNP and homocysteine levels (r=0.92, p<0.001, 95% confidence interval 0.86-0.95). No significant differences existed between male and female patients with respect to plasma BNP and homocysteine levels. The mean BNP and homocysteine levels were 369.9±75.4 pg/ml and 13.6±4.6 mol/l in patients with congestive heart failure; and 78.3±24.3 pg/ml and 8.9±2.5 mol/l in patients without a history of previous myocardial infarction or congestive heart failure, respectively. The two groups exhibited significantly different plasma BNP and homocysteine levels. Echocardiographic assessments showed left ventricular diastolic dysfunction in 11 patients without congestive heart failure, having a BNP level above 100 pg/ml. These patients also had higher homocysteine levels.Conclusion: Our results demonstrate that the risk for congestive heart failure may be more reliably assessed if BNP and homocysteine levels are incorporated into diagnostic screening of patients with myocardial infarction and of high-risk patients such as those with diabetes or hypertension.
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    An unusual cause of cardioembolic stroke - Isolated left ventricular noncompaction
    (LIPPINCOTT WILLIAMS & WILKINS, 2008) Sahin, Sevki; Sekban, Ahmet; Ayalp, Sunay; Karsidag, Sibel
    Background: Isolated left ventricular noncompaction (ILVNC) is a rare congenital condition that is the result of an intrauterine developmental arrest, which stops the compaction of the loose myocardial fiber meshwork of the left ventricle. This condition is recognized by an excessively prominent trabecular meshwork and deep intertrabecular recesses of the left ventricle. Although these intertrabecular recesses are prone to thrombus formation, with resulting embolic sequelae, the literature describes only I adult case of a stroke caused by ILVNC. Case Report: We describe a case of cerebral cardioembolism in a 33-year-old man due to ILVNC. Because of echocardiography (ECHO) findings in this case, cardiac magnetic resonance imaging (cMRI) was performed, which allowed a definite diagnosis to be obtained. Conclusion: This case should highlight the importance of performing cMRI especially in younger patients with embolic stroke, if the ECHO suggests a suspected myocardial disorder.