S52 Cardiology Posters / International Journal of Cardiology 140, Supplement 1 (2010) S1–S93 PP-035 EFFECT OF BLOOD SELENIUM LEVEL AND GLUTATHION PEROXIDASE ACTIVITY ON DEVELOPMENT OF ACUTE MYOCARDIAL INFARCTION Meral Gunaldi , Aysen Helvaci, Nergis Ekmen, Gulay Yilmaz, Mehmet Zorlu Department of 2nd Internal Medicine, Okmeydani Research and Training Hospital, Istanbul, Turkey Objective: Atherosclerosis is a vascular disease that is occured especially in aorta, coronary arteries and cerebral arteries with thickening of arteries and loss of elasticity. Clinical studies shows decreases in antioxidant activity in atherosclerosis patients. However, the relationship between atherosclerosis and levels of antioxidants are unknown.The purpose of this study, by comparing patients who were diagnosed blood Se and GPx level acute myocardial infarction (AMI) with the party in control group to investigate whether there are differences between these two groups. Data to be obtained from this study was thought to be effective in prevent or delay the development of AMI. Methods: In this study, blood selenium and glutahtione peroxidase levels compared with statically between the patients with miyocardial infarction diagnose and healthy control group. In myocardial infarction with ST ele- vation group there were 7 women, 13 men; in healthy control group there were 14 women and 10 men. In both groups, selenium and glutathione peroxidase levels were measured in blood. Results: As a result, in our study, patients with the diagnosis of AMI with the control group were compared between the Se and GPx levels. AMI patients detected statistically significant lower levels of Se. GPx levels in the AMI groups, although have lower average rate, statistically significant has not been determined. Conclusions: Our findings, as noted in many literature study has shown, especially the addition of Se to the diet in elderly patients may increase antioxidant protection. Also in the body via increased Se level, ischemic hearth disease antioxidant mechanism can be strengthened against oxida- tive stress. PP-036 DIFFERENT CLINICAL COURSE OF ANTERIOR MITRAL LEAFLET CHORDAL RUPTURE IN TWO PATIENTS HOSPITALIZED WITH MYOCARDIAL INFARCTION Taner Ulus 1 , Mustafa Yilmaz 1 , Mehmet Ali Kaygin 2 , Bilgehan Erkut 2 1 Department of Cardiology, Erzurum Region Education and Research Hospital, Erzurum, Turkey 2 Department of Cardiovascular Surgery, Erzurum Region Education and Research Hospital, Erzurum, Turkey Objective: Chordae tendineae rupture generally causes to new onset mitral regurgitation. The main symptom in patients with chordal rupture is dyspnea. A mild and slow clinical course is seen if the left atrium (LA) is enlarged and compliant. On the other hand, more rapid clinical course and the progression to the left-sided heart failure are seen if the LA is normal and in an otherwise normal heart. Methods: We present two cases who were seen anterior mitral leaflet (AML) chordal rupture in the course of myocardial infarction (MI) and who had different clinical picture. Results: The former case was 55-years old woman and she was admitted to our hospital with the diagnosis of subacute inferior MI. She had rheumatic mitral valve disease and an enlarged left atrium (LA) (48 mm). Chordal rupture of AML was demonstrated by transthoracic and transesophageal echocardiography (TTE and TEE). The symptoms of the patient had a mild clinical course. On the other hand, the latter case was a 45 years-old man and he was hospitalized with subacute anterior MI. He had a normal heart and LA was in the upper limit of the normal dimension (41 mm). Chordal rupture of AML was demonstrated by TTE and TEE. The symptoms of the latter case performed the rapid progression and the left-sided heart failure developed. The either cases underwent to mitral valve replacement and they were discharged from the hospital with no complaint. Conclusions: The patients hospitalized with MI, especially, if acute onset of dyspnea and apical systolic murmur or acute worsening in symptoms in any patient with known cardiac disease occurs, should be very cautiously evaluated in terms of chordae rupture. In these patients, the chordal in- tegrity should be carefully examined by TTE and if it is necessary, TEE must also be performed to them. The LA dimension, compliance and whether or not in an otherwise normal heart is exist determine the clinical course of chordal rupture. PP-037 PREMATURE ACUTE CORONARY SYNDROME IN A PATIENT WITH BEHCET’S DISEASE Sercan Okutucu 1 , Umut Kalyoncu 2 , Ali Akdogan 2 , Banu Evranos 1 , Ahmet Ates 1 , Edis Demiri 1 , Kudret Aytemir 1 , Ali Oto 1 1 Department of Cardiology, Hacettepe University, Ankara, Turkey 2 Department of Internal Medicine, Division of Rheumatology, Ankara, Turkey Objective: Behcet’s disease (BD) is a multisystem disease of unknown eti- ology characterized by chronic recurrent oral ulcers, genital ulcers, uveitis and systemic involvement that includes musculoskeletal, gastrointestinal, cardiopulmonary, neurological and vascular pathology. The incidence and nature of cardiac involvement are not clearly elucidated. Sporadic cases of endocarditis, myocarditis, pericarditis, acute myocardial infarction, aortic aneurysm, intracardiac thrombus, cardiomyopathy and valvular dysfunc- tion have been reported. In this paper we present an acute coronary syndrome in a patient with BD. Methods: A 27-year-old male patient was admitted to the Emergency Department with the complaint of retrosternal compressing like chest pain that started 9 h before admission. His chest pain decreased more than 90% with respect to onset. He had no history of smoking. He had diagnosis of BD for two years. Past medical history also revealed irregular use of oral steroids and colchicine. He did not have a family history of coronary artery disease or any prior symptom of other vascular or hematological disease. He was not known to have used any kind of narcotic drug. Cardiovascular system examination was normal, but pulmonary system examination re- vealed bilateral rales in the basal zone of the lungs. Electrocardiography revealed normal sinus rhythm with ST wave elevations in leads V2–V4 and 1mm ST segment depressions in leads II, III and aVF. Results: The diagnosis of subacute anteroseptal myocardial infarction was suspected and coronary CT angiography (CCTA) performed in order to show atherosclerotic lesion and exclude pulmonary aneurysm. CCTA revealed significant stenosis at middle segment of left anterior descending artery (LAD) and no other vascular pathology. Coronary angiography revealed occlusion of the distal part of LAD with full of thrombus. Heparin and acetylsalicylic acid treatment was initiated. Myocardial perfusion scintigra- phy revealed fixed defect at anteroapical region and no reversible defect could be detected. No intervention was performed. Genetic analysis for prothrombin gene mutation and factor V Leiden were negative. Screening test for hypercoagulability included normal levels of protein S and protein C. Interferon α-2a, colchicine, acetylsalicylic acid and benzathine penicillin treatment was started. Transthoracic echocardiography revealed apical hy- pokinesia with a left ventricular ejection fraction (LVEF) of 48% (calculated by modified Simpson’s method). Further clinical course of the patient was uneventful and he was discharged one week later. Conclusions: One of the major cardiac diseases in BD is coronary artery disease which is more common in men and under the age of forty as our patient. PP-038 SPONTANEOUS CORONARY ARTERY DISSECTION Arif Suner 1 , Sedat Koroglu 2 , Gurkan Acar 2 , Hakan Kaya 2 , Sila Yalcintas 2 , Murat Koleoglu 2 , Alper Bugra Nacar 2 , Abdullah Sokmen 2 1 Department of Cardiology, Osmaniye State Hospital, Osmaniye, Turkey 2 Department of Cardiology, Sutcu Imam University, Kahramanmaras, Turkey A 44 years old male was admitted to emergency department with retroster- nal chest pain. Smoking was the only coronary artery risk factor for him. Physical examination was entirely normal. There were 1 mm S-T segment depressions on derivations V3-4 on electrocardiogram. Cardiac enzymes were found elevated. He was hospitalized to coronary care unit with the diagnosis of acute coronary syndrome. Urgent coronary angiography showed dissection in left anterior descending artery (LAD) beginning after the second diagonal branch level. The other coronary arteries were normal. Because of the site of the dissection and clinical picture of the patient, a drug-eluted stent was implanted to the long lesion of LAD. Follow-up period for 4 months were uneventful. Spontaneous coronary artery dissection, described firstly by Pretty in 1931,