Objective: This study aimed to evaluate the protective effects of bosentan, a dual endothelin receptor antagonist, against skeletal muscle ischemia-reperfusion injury (IRI) in rats. Methods: A total of 24 male Wistar Albino rats were divided into four groups: control (C, n=6), bosentan-treated (B, n=6), ischemia-reperfusion (IR, n=6), and bosentan plus ischemia-reperfusion (B+IR, n=6). Bosentan (10 mg/kg) was administered 30 minutes prior to reperfusion. In the IR and B+IR groups, ischemia was induced using vascular bulldog clamps for 45 minutes, followed by 120 minutes of reperfusion. Results: Histological and biochemical assessments revealed significant differences among the groups. The disorganization and degeneration scores of the muscle cells in the B+IR group were significantly lower than those in the IR group (P = 0.001). The degree of interstitial edema in the IR group was markedly more severe than in the C and B groups (all P < 0.001), while the interstitial edema score in the B+IR group was significantly lower than that in the IR group (P < 0.001). The total muscle injury scores were markedly reduced in the B+IR group compared to the IR group (P < 0.001). Biochemically, TAS levels were significantly higher in the B+IR group compared to the IR group (1.03 ± 0.18 vs 0.59 ± 0.10 mmol/L, P = 0.016). Conversely, TOS (1.97 ± 0.39 vs 2.86 ± 0.43 IU/mg, P < 0.001) and OSI levels (P < 0.001) were significantly lower in the B+IR group. Additionally, paraoxonase (PON-1) enzyme activity was significantly reduced in the B+IR group compared to the IR group (P < 0.001). These findings suggest that bosentan exerts its protective effects by antagonizing endothelin-1 receptors, thereby mitigating vasoconstriction, oxidative stress, and inflammation. The observed reductions in muscle cell disorganization, interstitial edema, hemorrhage, neutrophil infiltration and oxidative stress markers underscore bosentan’s potential as a therapeutic agent for managing ischemia-reperfusion injury. Conclusion: Bosentan demonstrates significant protective effects against skeletal muscle IRI by reducing oxidative stress and inflammation through endothelin receptor antagonism. These findings underscore bosentan’s potential as a therapeutic agent for mitigating ischemia-reperfusion injury in vascular surgeries and managing critical limb ischemia in clinical settings. Further research is warranted to explore the long-term effects of bosentan on muscle recovery and systemic health following ischemia-reperfusion injury.

Constrictive pericarditis is quite rare complication of messenger ribonucleic acid-based severe acute respiratory syndrome-Coronavirus 2 (SARS-CoV-2) vaccine. It is a severe clinical picture with clinical symptoms of right ventricular failure. Initial physical examination, laboratory work-up, and chest X-ray may yield non-specific findings. Echocardiography, computed tomography, and cardiac catheterization are other diagnostic tools. Surgery with pericardiectomy is the definitive treatment option. Herein, we report a case of pericardiectomy after constrictive pericarditis associated with the second dose of BNT162b2 vaccine.

Objective: This study aimed to investigate the effects of ozone therapy on myocardial ischemia/reperfusion injury in a diabetic rat model. Methods: The experimental study included 38 male Wistar Albino rats weighing between 200 and 250 g. The rats were randomly assigned to five groups. The sham group included six rats, while the other groups had eight rats each. The other groups were the diabetic ozone group, the diabetic group, the diabetic ischemia/reperfusion group (DIR), and the diabetic ischemia/reperfusion ozone group (DIRO). A total of 32 rats received 65 mg/kg streptozotocin, and a week after the administration, diabetes was confirmed by measuring blood sugar. The rats were fed ad libitum for 40 days to reveal macrovascular complications of diabetes. Malondialdehyde, catalase, superoxide dismutase, paraoxonase-1, total oxidative status, total antioxidant status, and oxidative stress index were assessed. A TUNEL (terminal deoxynucleotidyl transferase dUTP nick end labeling) assay was employed to assess apoptosis. Results: Histologic and biochemical assessments showed the benefits of ozone in myocardial ischemia/ reperfusion injury in diabetic rats. The DIRO group was found to be superior to the DIR group. Conclusion: Ozone has cardioprotective effects in streptozotocin-induced diabetic rats through its antioxidant properties against oxidative stress. The study is unique in terms of ozone's protective effects in diabetic rats against myocardial ischemia/reperfusion injury. However, further studies are needed to confirm our findings.

Background and Objectives: Valvular heart disease (VHD) is a major cause of morbidity and mortality worldwide, and valve replacement surgery performed under cardiopulmonary bypass (CPB) with full sternotomy remains an important treatment modality. Colchicine has well-established anti-inflammatory effects in ischemic heart disease and pericardial disease, but its association with postoperative morbidity in patients undergoing valvular heart surgery has not been well studied. This study aimed to investigate the association of perioperative colchicine use with clinical morbidity and inflammatory parameters in patients undergoing valvular heart surgery with CPB. Materials and Methods: In this retrospective study, 82 patients who underwent elective on-pump valvular heart surgery through full sternotomy were divided into a control group (n = 42) who did not receive colchicine and a colchicine group (n = 40) who received oral colchicine (0.5 mg once daily) for three days before and ten days after surgery. Demographic, clinical, and laboratory data, including length of hospital and intensive care unit (ICU) stay, transfusion requirements, sternal wound complication, surgical re-exploration, and inflammatory parameters on postoperative day 5 (C-reactive protein [CRP], white blood cell count, albumin, platelet-to-lymphocyte ratio [PLR], and neutrophil-to-lymphocyte ratio [NLR]), were compared between the groups. Results: Length of ICU stay was significantly shorter in the colchicine group than in the control group (4.1 ± 1.6 vs. 5.3 ± 2.4 days; p = 0.009), and fresh frozen plasma transfusion requirement was significantly lower in the colchicine group (4.2 ± 2.1 vs. 6.9 ± 3.3 units; p < 0.001). Total hospital stay, erythrocyte transfusion requirement, and inflammatory parameters (CRP, white blood cell count, NLR, PLR, and albumin) did not differ significantly between the two groups (all p > 0.05). Conclusions: Perioperative colchicine was associated with a shorter ICU stay and a reduced requirement for fresh frozen plasma transfusion in patients undergoing valvular heart surgery with CPB, suggesting that colchicine may have a potential role in this surgical population. After correction for multiple comparisons, the difference in ICU length of stay was no longer statistically significant. Larger prospective studies are warranted to confirm these findings.

Constrictive pericarditis is a rare clinical entity often presenting with signs of right heart failure. Diagnosis typically involves the use of transthoracic echocardiography, computed tomography, and magnetic resonance imaging. Pericardiectomy is the cornerstone of treatment, but in cases of end-stage disease, it may not be feasible. In complex surgical procedures, such as those involving valve and coronary artery surgery, surgeons must carefully weigh the potential benefits and risks. In our case, we opted to perform a mitral valve replacement while avoiding manipulation of the pericardial calcification to protect the myocardium. We believe that this surgical approach was the most beneficial method for the patient, and its novelty makes our case noteworthy.