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Anatol J Cardiol: 11 (7)
Volume: 11  Issue: 7 - November 2011
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EDITORIAL
1.Events that have not been addressed in the previous issue
Bilgin Timuralp
PMID: 21979107  doi: 10.5152/akd.2011.184  Pages 571 - 572
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
2.The particular interactions of the traditional cardiovascular risk factors with different circulating specific leukocyte subtype counts in blood: an observational study
Sinan Altan Kocaman, Asife Şahinarslan, Tolga Kunak, Serhat Balcıoğlu, Mustafa Çetin, Mustafa Cemri, Timur kaynak, Bülent Boyacı, Atiye Çengel
PMID: 21911321  doi: 10.5152/akd.2011.158  Pages 573 - 581
Original Article The particular interactions of the traditional cardiovascular risk factors with different circulating specific leukocyte subtype counts in blood: an observational study Sinan Altan Kocaman 1, Asife Şahinarslan 2, Tolga Kunak 2, Serhat Balcıoğlu 3, Mustafa Çetin 1, Mustafa Cemri 2, Timur Timurkaynak 4, Bülent Boyacı 5, Atiye Çengel 1 1 Clinic of Cardiology, Rize Education and Research Hospital, Rize-Turkey 2 Department of Cardiology, Faculty of Medicine, Gazi University, Ankara 3 Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey 4 Department of Cardiology, Faculty of Medicine, Gazi University, Ankara, Turkey 5 Gazi Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, Ankara, Türkiye Anatol J Cardiol 2011; 11: 573-581 DOI: 10.5152/akd.2011.158 This article was viewed 194 times, downloaded 232 times Key Words: Coronary artery disease, inflammatory cells, neutrophil, monocyte, lymphocyte, cardiovascular risk factors, neutrophil-to-lymphocyte ratio, regression analysis Full Text (PDF)Related ArticlesSend a commentShare Abstract Objective: The pathogenesis of atherosclerosis is multifactorial, however the impact of inflammatory cells in this process is well known. Different traditional cardiovascular risk factors (CVRFs) may have specifically different effects on leukocyte subtype. Thus, these special interactions may induce different vascular involvement forms due to the altered endothelial damage and vascular repair mechanisms. The aim of the present study was to investigate whether there is any specific relationship between the leukocyte subtypes and the traditional CVRFs and to evaluate the independency of possible relationships. Methods: The study had a cross-sectional observational design. The study population consisted of the patients who underwent coronary angiography with a suspicion of coronary artery disease (CAD) at our institution in an outpatient manner. We enrolled 677 consecutive eligible patients with CAD or normal coronary arteries (NCA) and investigated the associations of traditional CVRFs, demographic properties and biochemical parameters including fasting plasma glucose (FPG), creatinine, serum uric acid level (SUA) and lipids with total circulating inflammatory cell (WBC, leukocytes) and subtype counts including neutrophils (N), lymphocytes (L) and monocytes (M). As a dependent variable, total leukocyte count and subtypes, and neutrophil/lymphocyte ratio (N/L ratio) which has been found to being related with increased vascular risk and events were investigated in the groups determined by the presence or absence of CVRFs and CAD by the univariate analyses and then multiple linear regression analyses. Results: When we performed multiple linear regression analyses to determine the independent associations of inflammatory cell subtypes, we have found that FPG had an independent incremental association with WBC (β±SE: 4.2±1.4, p=0.004) and N (β±SE: 4.2±1.2, p=0.001). Current smoking had an independent incremental association with WBC and all cell subtypes (for WBC, N, L, and M: β±SE: 748±161, p<0.001; β±SE: 556±136, p<0.001; β±SE: 185±69, p=0.007; β±SE: 38±20, p=0.061, respectively) and SUA had an independent incremental association with WBC (β±SE: 115±43, p=0.008), N (β±SE: 107±38, p=0.005) and M (β±SE: 26±6, p<0.001). Hypertension had an independent incremental association with WBC (β±SE: 431±140, p=0.002) and N (β±SE: 315±118, p=0.008). Male gender had an independent incremental association with only M (β±SE: 52±20, p=0.010). Family history of CAD had an independent decremental association with WBC (β±SE: -327±139, p=0.019) and N (β±SE: -326±121, p=0.007). Finally, age had an independent decremental association with WBC (β±SE: -32±7, p<0.001) and L (β±SE: -16±3, p<0.001). The N/L ratio was independently related with increased age (p<0.001), FPG (p=0.003) and SUA (p=0.012). Conclusion: Our study results demonstrate that leukocyte subtypes have different specific associations with traditional CVRFs. We found that FPG affects specifically N while SUA affects specifically N and M, and current smoking affects nonspecifically on all cell subtypes. While hypertension with N and male gender with M were specifically related, age and family history of CAD were only related to L. These different interactions may lead to different endothelial damage and vascular repair mechanisms.

3.Ischemia-modified albumin and total antioxidant status in patients with slow coronary flow: a pilot observational study
Fatih Koç, Sami Erdem, Fatih Altunkaş, Kerem Özbek, Enes Elvin Gül, Sevil Kurban, Erkan Taşyürek, Ekrem Erbay, Erkan Söğüt
PMID: 21911320  doi: 10.5152/akd.2011.159  Pages 582 - 587
Objective: Slow coronary flow (SCF) is defined as late opacification in the epicardial coronary arteries without significant stenosis. The underlying mechanism of SCF is similar to coronary atherosclerosis. Free radical damage may be responsible for the pathology. In this study, we aimed to investigate ischemia-modified albumin (IMA) levels and differences with regard to total antioxidant status (TAS) between patients with normal coronary arteries and patients with SCF without significant stenosis. Methods: Thirty patients who were diagnosed with SCF using coronary angiography were included in this cross-sectional observational study (13 male; mean age, 56±10 years). The control group consisted of 30 patients who had normal coronary arteries as shown by coronary angiography (13 male; mean age, 53±11 years). In this study, we assessed serum IMA levels, albumin-adjusted IMA and TAS. The Student t-test was used to compare serum IMA levels and TAS between the two groups. Pearson’s correlation test was used to explore the relationship between TAS and serum IMA levels. Results: Serum IMA levels and albumin-adjusted IMA were similar in both groups (p=0.432, p=0.349). The mean value of TAS was significantly lower in the SCF group compared to control group (p=0.011). The TAS was negatively correlated with the levels of IMA and albumin-adjusted IMA in the SCF group (r=-0.457, p=0.011; r=-0.509, p=0.004). Conclusion: This study shows that serum IMA levels and albumin-adjusted IMA were similar between the groups, however the mean value of TAS was significantly lower in the SCF group compared to control group and negatively correlated with IMA. These results are important in terms of understanding the pathophysiological basis of SCF.

4.Comparative diagnostic accuracy of serum levels of neutrophil activating peptide-2 and pentraxin-3 versus troponin-I in acute coronary syndrome
Mehmet Üstündağ, Murat Orak, Cahfer Güloğlu, Mustafa Burak Sayhan, Ömer Alyan, Ebru Kale
PMID: 21911319  doi: 10.5152/akd.2011.160  Pages 588 - 594
Objective: We measured the levels of neutrophil activating peptide-2 (NAP-2) and pentraxin-3 (PTX-3) in acute coronary syndromes (ACS) patients and compared their diagnostic accuracy with cardiac troponin I (cTnI). Methods: We conducted a prospective cohort study to determine the diagnostic accuracy of PTX-3, NAP-2 and cTnI for the prediction of ACS. Consecutively eighty-three patients with sudden chest pain admitted to Dicle University Emergency Department within the first six hours of symptom onset were included in our study. Mean serum levels of PTX-3, NAP-2 and cTnI were compared between control and patient groups and ACS subgroups. Their sensitivities and specificities in early diagnosis of ACS were identified. Receiver operating characteristic (ROC) analysis was used to assess the diagnostic validity of the markers, and areas under the ROC curve (AUC) were compared. Results: In the patient group, mean serum concentrations of NAP-2 (53.03+22.77 ng/ml) and PTX-3 (1.73+0.82 ng/ml) were considerably higher than those of the control group (24.54+9.50 and 0.50+0.39 ng/ml, respectively) (p<0.01). When compared with the control group, PTX-3 levels of all three ACS subtypes (unstable angina pectoris (USAP) - 1.62+0.41 ng/ml, non-ST elevation myocardial infarction (NSTEMI) -1.63+0.31 ng/ml and ST-elevation myocardial infarction (STEMI) - 1.75+0.89 ng/ml) were higher, whereas NAP-2 levels were higher in USAP (56.29+22.60 ng/ml) and STEMI (52.05+20.99 ng/ml) patients (p<0.01). For diagnosing ACS within the first six hours of presentation, PTX-3 sensitivity was 98.5% and specificity was 92.3%, and NAP-2 sensitivity - 98.1% and specificity - 41.3%. The ROC curve AUC values were: 0.962 for PTX-3 (95% CI 0.802 - 1.073), 0.840 for NAP-2 (95% CI 0.684 - 0.991), and 0.683 for cTnI (95% CI 0.610 - 0.940). Conclusion: Pentraxin-3 is a sensitive and specific marker for ACS diagnosis when compared with cardiac markers in patients admitted to the emergency department (ED) within the first six hours of onset of chest pain.

5.The evaluation of mean platelet volume levels in patients with idiopathic and ischemic cardiomyopathy: an observational study
Nusret Açıkgöz, Necip Ermiş, Jülide Yağmur, Mehmet Cansel, Halil Ataş, Hasan Pekdemir, Ramazan Özdemir
PMID: 21911318  doi: 10.5152/akd.2011.161  Pages 595 - 599
Objective: Cardiomyopathy (CMP) is a disorder associated with an increased risk of thromboembolism due to blood stasis, platelet activation and altered coagulation status. In this study, we aimed to investigate mean platelet volume (MPV) in patients with idiopathic CMP and ischemic CMP and to compare with those of the controls, and aimed to determine whether there is a relationship between MVP and echocardiographic parameters in patients with CMP. Methods: This study was designed as an observational cross-sectional study. A total of 100 subjects with idiopathic CMP (n=35), ischemic CMP (n=35) and controls (n=30) were included in the study. The MPV values were measured in all participants. All subjects underwent transthoracic echocardiography and angiographic evaluation. We used Chi-square test, one-way ANOVA and Pearson correlation tests for statistical analysis. Results: The MPV values were significantly higher in patients with idiopathic CMP and ischemic CMP than those of the controls (9.03±1.3 and 8.77±0.9 vs. 7.95±1.0 fl, respectively, p<0.001). The MPV values were although not statistically significant also tend to be higher in patients with idiopathic CMP than in patients with ischemic CMP (p=0.328). The MPV values were found to be positively correlated with left ventricular end-diastolic and end-systolic diameters (r=0.369, p<0.0001; r=0.325, p=0.001, respectively), and left atrial diameter (r=0.403, p<0.0001), but inversely correlated with left ventricular ejection fraction (r=-0.392, p<0.0001). Conclusion: Patients with idiopathic or ischemic CMP have higher MPV values indicating tendency to platelet aggregation regardless of the etiology, when compared to controls and an enlarged dysfunctional left ventricle may also be associated with higher MPV values.

6.Pharmacological conversion of recent atrial fibrillation: a randomized, placebo-controlled study of three antiarrhythmic drugs
Idriz Balla, Elizana Petrela, Anesti Kondili
PMID: 21911317  doi: 10.5152/akd.2011.162  Pages 600 - 606
Objective: In this study, we randomly compared single oral doses of flecainide, amiodarone and propafenone versus placebo for the conversion of recent atrial fibrillation (AF) (within 48 hours). Methods: This is a randomized prospective, placebo-controlled single-blind study that included 160 consecutive patients with recent AF who were randomly assigned to single oral doses of flecainide (3 mg/kg of weight, n=40), amiodarone (30 mg/kg weight, n=40), propafenone (8.5 mg/kg of weight, n=40) or placebo (n=40). The primary end-point was conversion rate at 24 hours after the drug intake. The association between antiarrhythmic use and conversion rate was tested with multiple logistic regressions. Results: The primary end-point was achieved in 87.5% of patients with flecainide, 85% of patients with amiodarone, 85% of patients with propafenone and 17.5% of patients with placebo (p<0.001 compared with placebo for all 3 drugs). Conversion rate within 3 hours after drug intake was greater with propafenone (57.5%) or flecainide (45%) compared with amiodarone (0%) or placebo (10%). Between 6 and 24 hours, significantly more patients were converted to sinus rhythm with amiodarone than with flecainide or propafenone. The use of antiarrhythmic drugs was a significant predictor of conversion to sinus rhythm compared to placebo (adjusted OR=19.53, 95% CI 3.14-121.55, p<0.001). No serious side effect occurred. Conclusion: In patients with recent-onset AF, oral flecainide, amiodarone or propafenone are superior to placebo in restoring sinus rhythm within the 24-hour period following the drug intake.

7.Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study
Muhammad Tariq Farman, Naveed Ullah Khan, Jawaid Akber Sial, Tahir Saghir, Syed Nadeem Hasan Rizvi, Khan Shah Zaman
PMID: 21959874  doi: 10.5152/akd.2011.163  Pages 607 - 612
Objective: Radial route of access is increasingly being used for coronary angiograms and intervention. However, radiation exposure of operators was not known in our set up with either transfemoral or transradial procedures. The objective of the study was to compare related peripheral arterial route radiation exposure of operators by assessing fluoroscopy time. The secondary objective was to determine the relationship of operator experience with fluoroscopy time. Methods: This observational study was conducted in a tertiary care center - Cardiovascular Institute of Karachi (Pakistan) during the period of July 1st 2009 to September 30th 2009. We studied 1016 consecutive adult patients referred for coronary angiography (CA) or percutaneous coronary intervention (PCI). Patients who underwent right heart catheterization or for valvuloplasty were excluded from the study. Out of these 1016 patients, 928 were diagnostic CAs (734 via femoral route [f-CA] and 194 via radial route [r-CA]) and 88 were PCI (64 via femoral route [f-PCI] and 24 via radial route [r-PCI]). Fluoroscopy time was recorded as a surrogate of radiation exposure. Statistical analysis was performed using unpaired t, Mann-Whitney U, Chi-square and ANOVA tests. Results: Mean fluoroscopy time was found to be significantly higher in patients who underwent r-CA (6.3±3.8 vs 4.0±2.9 min; p<0.001) and r-PCI (15.1±11.8 vs 10.3±7.4 min; p=0.02) as compared with those underwent f-CA and f-PCI. Mean fluoroscopy time of well experienced operators was also high in r-CAs (5.4±2.9 vs 4.2±3.5 min; p=0.004). Conclusion: Radial procedures are associated with longer fluoroscopy time that may result in high radiation exposure to radial operators. Even well experienced radial operators cannot minimize their fluoroscopy time to the level of well experienced femoral operators.

8.The role of nebivolol in the prevention of contrast-induced nephropathy in patients with renal dysfunction
Eyüp Avcı, Murat Yeşil, Serdar Bayata, Nursen Postacı, Erdinç Arıkan, Mustafa Cirit
PMID: 21959875  doi: 10.5152/akd.2011.164  Pages 613 - 617
Objective: This prospective study was designed to evaluate the potential protective effect of nebivolol compared with metoprolol on the development of contrast-induced nephropathy (CIN) following coronary angiography in patients with renal dysfunction. Methods: Ninety patients with stable coronary angina pectoris with renal insufficiency (creatinine value ≥ 1.2 mg/dl) were included for this prospective study. Patients were divided into two groups. Patients in group 1 (n=55) received oral administration of nebivolol 5 mg/daily for coronary artery disease and/or hypertension. Group 2 consisted of 35 patients who received metoprolol 50 mg/daily for the same indications. All patients were hydrated with 0.9% NaCl at a rate of 1 mL/kg/hr for 12 hours before and 24 hours after the procedure. Patients were also given N-acetylcysteine (NAC) 600 mg twice a day, beginning 24 hours before and continuing 48 hours after the procedure. All patients underwent routine coronary angiography. Serum creatinine was assessed just before, immediately after and 48 hours after the procedure. CIN was defined as an increase in serum creatinine concentration of ≥25% within 48 hours after the procedure compared to the patient’s baseline value. Tests for significance between groups were conducted using the independent sample t-test for continuous variables and Chi-square test for categorical variables. Results: Baseline serum creatinine levels were statistically comparable in two groups. Following angiography, serum creatinine levels increased in both groups. Post-angiographic creatinine levels were not statistically different in the nebivolol and the metoprolol groups. Contrast induced nephropathy developed in 13 patients (24%) of the nebivolol group and in 12 patients (33%) of the metoprolol group. The incidence of CIN was statistically significantly lower in the nebivolol group comparing with the metoprolol group (p=0.03). Conclusion: The use of oral nebivolol for one week at a dose of 5 mg per day may decrease the incidence of contrast-induced nephropathy in patients who underwent coronary angiography with renal dysfunction. The small numbers of this study do not allow to draw final conclusion on the use of nebivolol in the prevention of CIN. Therefore, larger studies may be necessary to address the definite role of nebivolol in this setting.

EDITORIAL COMMENT
9.The role of nebivolol in the prevention of contrast-induced nephropathy
Rodney G. Bowden
PMID: 21959876  doi: 10.5152/akd.2011.165  Page 618
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
10.Evaluation of factors affecting healthy life style behaviors and quality of life in patients with heart disease
Nilay Küçükberber, Kürşat Özdilli, Hatice Yorulmaz
PMID: 21959877  doi: 10.5152/akd.2011.166  Pages 619 - 626
Objective: The aim of this cross-sectional study was to determine sociodemographic and disease related factors affecting the quality of life and life style behavior in patients with heart disease. Methods: Data are collected via information form, Healthy Life Style Behaviors Scale, and short form-36 life quality scale to 325 people with heart disease. T test for independent samples, one-way ANOVA and Pearson correlation analyzes are used in statistical evaluation of the data. Results: It has been determined that average age was 56.98±11.89 years, 58.2% were male, 48.6% were graduated from primary school, 30.2% were haven’t got any additional diseases of the patients in this study. Point average of healthy life style behaviors of people with heart disease obtained as 127.45±20.51 and physical main dimension mean score was 51.95±22.21, mental main dimension mean score was 52.71±19.48. It has been understood that, in general, that male patients in 49-60 age group and married, having bachelor and master degrees, in good socio-economic status, working, without any additional disease and took training related to their disease, received high point from healthy life style behavior scale, but patients with cardiac failure had lower points (p<0.05). There was a positive relation between life qualities and healthy life style behaviors of the patients (p<0.01). Conclusion: Increasing of life quality of the patients especially with cardiac failure will be ensured by executing studies on development of healthy life style behaviors for people with heart disease and arranging training programs to them related to their disease.

11.Evaluation of diagnostic accuracy of portable echocardiography in newborns
Aslınur Özkaya Parlakay, Tevfik Karagöz, Süheyla Özkutlu, Sema Özen, Dursun Alehan, Şule Yiğit
PMID: 21959878  doi: 10.5152/akd.2011.167  Pages 627 - 632
Objective: Congenital heart disease is the most common life-threatening anomaly in the neonatal period. Screening for this disease with portable echocardiography is crucial to diagnose in the early period, and it has benefits in saving time and decreasing the cost. Portable echocardiography has advantages of rapid access and lower costs and also has advantage that in intensive care units there is no necessity to move patients. With these advantages, it is aimed to compare the sensitivity of portable echocardiography comparing to standard echocardiography. Methods: In this study, the portable echocardiography results of the sequentially enrolled newborns hospitalized in the neonatal departments are revised. Portable echocardiography results were verified with standard echocardiography in 83 (43%) female and 111 (57%) male patients. This study was planned as a study on diagnostic accuracy. Results: The gestational periods were between 24 weeks, 3 days and 42 weeks (average 35 weeks±4 weeks 3 days). Birth weights were between 500 and 4850 grams (average 2370±936 grams). The reason that portable echocardiography had been studied was murmur in 113 (58.2%) patients, cyanosis in 47 (24.2%) patients, prenatal anomaly in 12 (6.2%) patients, bradycardia in 12 (6.2%) patients, maternal diabetes in 6 (3.1%) patients and respiratory distress in 4 (2.1%) patients. Out of 194 patients 8 (4.1%) had differences between standard and portable echocardiography. Compared to standard echocardiography, portable echocardiography has the sensitivity values ranged between 99.3-100% and the specificity values ranged between 90.9-100% in diagnosis of specific CHD anomalies. Positive predictive value was between 50-100% whereas negative predictive value was between 97.9-100%. The agreement between results of two tests was determined as very good - kappa 0.886, 95%CI -0.821-0.951, p<0.0001. Conclusion: It is demonstrated that portable echocardiography has a high sensitivity especially diagnosing major heart defects, and with advantages of rapid access and lower costs it is estimated that increasing usage of portable echocardiography could be beneficial.

12.Factors associated with left atrial size in obese children: an observational study
Osman Özdemir, Ayhan Abacı, Şamil Hızlı, Ahmet Zülfikar Akelma, Cem Hasan Razi, Tülin Köksal, Sinef Aksoy, Kadir Ağladıoğlu
PMID: 21959879  doi: 10.5152/akd.2011.168  Pages 633 - 637
Objective: Left atrial size can be considered an independent risk factor for cardiovascular diseases. The measurements of left atrium may be used to assess obesity, which is an important risk factor of cardiovascular diseases. It is aimed to determine the factors that effect to the left atrial size, which is an indicator of cardiac risk in obese children without hypertension. Methods: The cross-sectional observational study was performed between April 2008 and September 2009 at the clinic of Pediatric Cardiology. Eighty obese and 82 lean children were studied. Diagnosis of obesity was defined according to the World Health Organization classification as the standard deviation score of body mass index being over + 2 standard deviation of the same gender and age. All subjects underwent two-dimensional, M-mode, and Doppler echocardiographic studies. Student’s t-test, Chi-square test, Pearson correlation analysis, and multiple stepwise regression analyses were used to compare the subjects, differences in group proportions, evaluate the relation of variables with the left atrial size, and examine the effects of significant independent variables, respectively. Results: The mean age of obese patients was 11.7±2.2 years and it of lean subjects was 11.7±2.2 years. Body weight, body mass index, standard deviation score of body mass index, waist circumference, systolic and diastolic blood pressure, fasting insulin, and insulin resistance statistically increased in obese children (p<0.05). The left atrial size statistically correlated (p<0.05) with age (r=0.523), body mass index (r=0.394), waist circumference (r=0.421), diastolic blood pressure (r=0.230), insulin resistance (r=0.350), and left ventricular mass (r=0.535). It was determined that age (beta=0.491; 95% CI=0.091-0.892; p=0.001) and left ventricular mass (beta=0.055; 95% CI=0.026-0.085; p=0.017) were the most effective independent factors associated with left atrial size among other independent factors in multiple regression analysis. Conclusion: We found that left atrial size was mostly influenced by age and left ventricular mass in obese children. Therefore, it is important that left atrial size is follow up in childhood obesity.

13.The outcome of the vertical vein left intact during the surgery for total anomalous venous connection and its effects on ventricular functions
Bülent Sarıtaş, Mehmet Çelik, Tolga Tatar, Murat Özkan, Kürşad Tokel, Sait Aşlamacı
PMID: 21959880  doi: 10.5152/akd.2011.169  Pages 638 - 642
Objective: We examined the fate of intact vertical vein during long-term follow-up and its effects on ventricular functions. Methods: Eighty one patients with all types of total anomalous pulmonary venous connection (TAPVC) were operated. Thirty-one patients with supracardiac type TAPVC were examined in our retrospective cohort study. Groups were evaluated with respect to left ventricle area, volume, end-systolic, end diastolic diameter, early and late term mortality and properties of pulmonary hypertensive crisis. Vertical vein was left open in 14 patients and it was ligated in 17 patients. Wilcoxon rank and Mann- Whitney U tests were used to compare variables between groups. Results: After mean follow up of 48±36 months, vertical vein closed spontaneously in 3 patients. Two of them were closed surgically due to elevated shunt flow and there was spontaneous closure in one patient who had the highest pulmonary artery pressure amongst others postoperatively. Preoperative left ventricular area, volume, end-systolic diameter and end-diastolic diameter values of the patients increased from 3.5± 0.9 mm2-2.9±0.9 mm3-14±5 mm-8±4.5 mm to 8±3.3 mm2 -16±8.7 mm3-27±6.7 mm-17±4.8 mm at the postoperative period in Group 1, and from 6.8±3.5mm2-8.4±8.7 mm3-15±6.4 mm-9±5.3 mm to 7.4±5.2 mm2-16±1.7 mm3-21.7±5 mm-13.5±4.1 mm in Group 2, respectively (p=0.02, p=0.039, p=0.054, and p=0.07, respectively). Conclusion: Vertical vein remains intact in most of the patients and may be closed spontaneously in patients with elevated pulmonary resistance. Intact vertical vein both decompresses the left ventricular cavity in patients with decreased left ventricular compliance until the ventricular muscle adapts to new workload and improves ventricular functions on long term follow up. Therefore, we conclude that vertical vein should be left open in selected patients.

REVIEW
14.Cardiovascular involvement in patients with systemic sclerosis: insights from electromechanical characteristics of the heart
Can Yücel Karabay, Tansu Karaahmet, Kürşat Tigen
PMID: 21959881  doi: 10.5152/akd.2011.170  Pages 643 - 647
Systemic sclerosis is a severe, life threatening autoimmune disease involving the skin and visceral organs, including the lungs, gastrointestinal tract, kidneys and heart. Cardiac involvement in systemic sclerosis, which is an important mortality predictor may involve myocardium, conduction system, vascular wall, pericardium, pulmonary vessels causing pulmonary hypertension. Thus, the detection of cardiac involvement is necessary in systemic sclerosis. With the more widespread use of novel non-invasive imaging techniques, the cardiac involvement is more frequently encountered in daily practice. Noninvasive evaluation can offer an advantage in early prediction of poor prognosis and give a chance to apply new therapeutic approaches for cardiac involvement. In this review, we intend to present cardiac involvement of systemic sclerosis and clinical diagnostic modalities, including electromechanical properties of the atrium and ventricles, for assessment this involvement.

SCIENTIFIC LETTER
15.Clinical outcome of B2/C type isolated proximal LAD disease treated with drug-eluting stents
Davran Çiçek, Hasan Pekdemir, Nihat Kalay, Haldun Müderrisoğlu
PMID: 21967787  doi: 10.5152/akd.2011.171  Pages 648 - 649
Abstract | Full Text PDF

CASE REPORT
16.Cardiac hydatid cyst case recovered with medical treatment
Recep Tekin, Ali Fuad Kara, Rojbin Ceylan Tekin, Derya Çimen
PMID: 21967788  doi: 10.5152/akd.2011.172  Pages 650 - 651
Abstract | Full Text PDF

17.Native mitral valve causing left ventricular outflow tract obstruction in an adult with Ebstein’s anomaly
Taner Ulus, Aydın Nadir, Alparslan Birdane, Necmi Ata
PMID: 21967789  doi: 10.5152/akd.2011.173  Pages 651 - 652
Abstract | Full Text PDF

18.Dental volumetric tomography in the radiological detection of carotid artery calcification
Binali Çakur, Muhammed Akif Sümbüllü, Ahmet Berhan Yılmaz
PMID: 21967790  doi: 10.5152/akd.2011.174  Pages 652 - 654
Abstract | Full Text PDF

LETTER TO THE EDITOR
19.Plagiarism and duplication / Two situations, which are difficult to differentiate from each other: plagiarism and duplication
Beuy Joob, Viroj Wiwanitkit
PMID: 21979105  doi: 10.5152/akd.2011.182  Page 655
Abstract | Full Text PDF

20.Maternal cardiovascular hemodynamics in a patient with mitral prosthetic heart valve evaluated with impedance cardiography and echocardiography
Dilek Çiçek Yılmaz, Belgin Büyükakıllı, Ali Rıza Yılmaz, Serkan Gürgül
PMID: 21967791  doi: 10.5152/akd.2011.175  Pages 655 - 656
Abstract | Full Text PDF

21.Two-year results of primary coronary intervention performed in a medium-scale primary percutaneous coronary intervention center by two cardiologists who are not formally trained in interventional cardiology
Ayhan Abacı, Ahmet Yıldız, Fatih Eren, Hüseyin Altuğ Çakmak
PMID: 21967792  Pages 656 - 657
Abstract | Full Text PDF

22.We built the first public radial angiography laboratory contrary to the hesitation that conventional coronary angiography could have been performed in Erzincan
Mutlu Vural
PMID: 21979106  doi: 10.5152/akd.2011.183  Pages 657 - 658
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
23.Cor triatriatum sinister with secundum atrial septal defect in a patient with recurrent pulmonary infections
Zafer Işılak, Mehmet Uzun, Serkan Çay
PMID: 21967793  doi: 10.5152/akd.2011.177  Page E26
Abstract | Full Text PDF

24.Libman-Sacks endocarditis mimicking cardiac myxoma
Necla Özer, Sercan Okutucu, Uğur Nadir Karakulak, Sırrı Kes, Sevgen Önder
PMID: 21967794  doi: 10.5152/akd.2011.178  Pages E26 - E27
Abstract | Full Text PDF

25.Double-chambered right ventricle associated with ventricular septal defect and subaortic stenosis in an adult
Giovanni Minardi, Giovanni Pulignano, Paolo Giuseppe Pino, Amedeo Pergolini, Francesco Musumeci
PMID: 21967795  doi: 10.5152/akd.2011.179  Pages E27 - E28
Abstract | Full Text PDF

26.Left main coronary artery compression by a giant pulmonary artery aneurysm associated with large atrial septal defect and severe pulmonary hypertension
Durmuş Yıldıray Şahin, Yahya Kemal İçen
PMID: 21967796  doi: 10.5152/akd.2011.180  Pages E28 - E29
Abstract | Full Text PDF

27.Diffuse coronary spasm mimicking acute thrombosis after stent implantation
Durmuş Yıldıray Şahin, Yahya Kemal İçen
PMID: 21967797  doi: 10.5152/akd.2011.181  Pages E29 - E30
Abstract | Full Text PDF



 
 
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