The aim of this study was to compare left ventricular (LV) functions by speckle tracking echocardiography (STE) in chronic kidney disease (CKD) patients in various stages and under different renal replacement treatments in order to evaluate possible differences between them. This prospective study included 150 patients with CKD. Renal transplantation patients with glomerular filtration rate greater than 60 ml/min/1.73 m, patients receiving hemodialysis three times a week, and patients in the predialysis stage with glomerular filtration rate less than 30 ml/dk/1.73 m were assigned into Group 1 (n = 50), Group 2 (n = 50), and Group 3 (n = 50), respectively. LV longitudinal, circumferential, and radial myocardial deformation parameters (strain, strain rate [SR], rotation, twist) were evaluated by STE. Peak systolic longitudinal strain was higher in the transplantation group than the hemodialysis group (- 19.93 ± 3.50 vs - 17.47 ± 3.28%, p < 0.017). Peak systolic circumferential strain was lower in the hemodialysis group (- 20.97 ± 4.90%) than Groups 1 and 3 (- 25.87 ± 4.20 and - 24.74 ± 4.55%, respectively, p < 0.001). Peak systolic radial SR was higher in the transplantation group than the hemodialysis group (1.84 ± 0.52 vs 1.55 ± 0.52 s, respectively, p < 0.017). Other longitudinal and circumferential deformation parameters together with peak early diastolic radial SR and twist were also significantly different between the groups. Strain, SR, and twist values were mostly lower in the hemodialysis patients, but generally higher in the transplantation patients. LV functions evaluated by STE are better in the renal transplantation patients than the hemodialysis patients and than those in the predialysis stage. This may indicate beneficial effects of renal transplantation on cardiac functions.

Background Chronic kidney disease (CKD) patients are at higher risk for cardiac arrhythmias. The risk of arrhythmia may change with different treatment modalities. We proposed to compare the effects of varied therapy methods on myocardial repolarization parameters (Tp‐e, QT, QTc intervals, Tp‐e/QT, Tp‐e/QTc ratios) and P‐wave dispersion (PWD) in patients with CKD. Methods Three groups were formed from the patients aged between 18 and 65 years, as Group 1 consisting of CKD patients receiving hemodialysis (HD) three times a week, Group 2 consisting of predialysis CKD patients and Group 3 consisting of CKD patients who underwent successful transplantation. All patients’ basic demographic data, risk factors, and echocardiographic parameters were recorded, and electrocardiographic repolarization parameters and PWD were analyzed. Results The PR, QT, and QTc intervals were significantly shorter in the transplantation group compared to the other groups (P = .020, P < .001, P = .035; respectively). Tp‐e interval, Tp‐e/QT, and Tp‐e/QTc ratios were significantly higher in the predialysis group compared to the other groups (P < .001, P < .001, P = .001; respectively), while there was no significant variation between the HD and transplantation groups (P > .05). PWD was significantly increased in the predialysis group compared to other two groups (P < .001), while no significant variation between the HD and transplantation groups was observed. Conclusion We found that the Tp‐e interval, Tp‐e/QT, Tp‐e/QTc, and PWD were significantly higher in the predialysis CKD group, but the PR, QT, and QTc intervals were significantly shorter in the transplantation group compared to the other groups. The prognostic significance and prediction of these parameters in arrhythmic events in CKD patients requires further evaluation with long‐time follow‐up.

Background Renal transplantation (RT) has been demonstrated to improve left ventricular systolic function. However, only few studies have attempted to reveal the effects of transplantation on left atrial (LA) function. In our study, we aimed to compare LA function between RT and hemodialysis patients. Methods This cross-sectional study included 75 consecutive patients with RT, and 75 age- and gender-matched patients on maintenance hemodialysis. LA strain and strain rate (SR) analyzed by two-dimensional (2D) speckle tracking echocardiography (STE) were compared between the groups in addition to standard echocardiographic parameters. Results LA strain during reservoir phase (29.88 ± 5.76% vs 26.11 ± 5.74%, P < .001), LA strain during conduit phase (− 15.28 ± 5.00% vs − 12.92 ± 4.38%, P = .003), and LA strain during contraction phase (− 14.60 ± 3.32% vs − 13.19 ± 3.95%, P = .020) were higher in the transplantation group. Similarly, LA peak SR during reservoir phase (1.54 ± 0.33 s− 1 vs 1.32 ± 0.33 s− 1, P < .001), LA peak SR during conduit phase (− 1.47 ± 0.49 s− 1 vs − 1.12 ± 0.42 s− 1, P < .001), and LA peak SR during contraction phase (− 2.13 ± 0.46 s− 1 vs − 1.83 ± 0.58 s− 1, P = .001) were higher in the transplantation group as well. Conclusions LA function assessed by 2D STE was better in RT patients than hemodialysis patients. This may suggest favorable effects of RT on LA function.

We report the case of a female patient under oral prednisolone therapy due to a diagnosis of idiopathic intracranial hypertension with papilledema. Unfortunately, short-term treatment with prednisolone caused an unusual complication in the patient, i.e., recurrent myocardial ischemia. Possible mechanisms leading to this complication were evaluated in the light of current knowledge.

Thrombotic coronary artery occlusions usually manifest as acute coronary syndrome with cardiogenic shock, acute pulmonary edema, cardiac arrest, fatal arrhythmias, or sudden cardiac death. Although it usually occurs based on atherosclerosis, it can also occur without atherosclerosis. There is no predictor of coronary artery thrombosis clinically and no consensus regarding the optimal treatment. In the current literature, treatment options include emergency coronary artery bypass grafting, entrapment of thrombus in vessel wall with stent implantation, intracoronary thrombolysis, glycoprotein IIb/IIIa inhibitors, anticoagulation with heparin, and thrombus aspiration as reperfusion strategies. Here, we reviewed a new treatment strategy based on the literature, and a case series with successful results in hemodynamically stable patients with low-dose slow infusion tissue plasminogen activator (tPA) for thrombotic coronary artery occlusions that allow coronary flow was reported. Prospective randomized studies and common consensus are needed on low-dose, slow-infusion tissue plasminogen activator treatment regimen and optimal treatment management for thrombotic coronary artery occlusions.