ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 6 (4)
Volume: 6  Issue: 4 - December 2006
EDITORIAL
1.New developments in AKD, numbers, Scopus, Thomson Gale and CONSORT
Bilgin Timuralp
Page 307
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
2.Coronary angioplasty induced oxidative stress and its relation with metoprolol use and plasma homocysteine levels
Dilek Çiçek, Lülüfer Tamer, Hasan Pekdemir, V.Gökhan Cin, Hatice Yıldırım, Asuhan Aksoy Kara, Mustafa Yurtdaş
PMID: 17162274  Pages 308 - 313
Objective: Short episodes of myocardial ischemia during coronary angioplasty may induce oxidative stress and increase lipid peroxida- tion. The aim of this study was to determine the effect of metoprolol on lipid peroxidation by measurements of malondialdehyde (MDA) and total antioxidant capacity (TRAP) in patients undergoing angioplasty. The relations between homocysteine level and lipid peroxida- tion were also studied. Methods: Forty-six patients (mean age 57 years, 37 males) undergoing elective angioplasty were enrolled. Metoprolol treatment was ini- tiated in 27 patients (group 1), meanwhile 19 patients could not take metoprolol due to diverse contraindications (group 2). Results: Following angioplasty, while venous MDA levels decreased in group 1 (0.188±0.021 vs. 0.159±0.020 nmol/ml, p=0.05), an increase was detected in group 2 (0.203±0.025 vs. 0.229±0.024 nmol/ml, p=0.045) as compared with baseline levels. In group 1, TRAP levels marked- ly increased after angioplasty in venous samples (1.201±0.036 vs. 1.478±0.044 mmol/L, p=0.0001). However, small increase was observed for TRAP in group 2 (1.274±0.043 vs. 1.363±0.053 mmol/L, p=0.05). There was no significant change in plasma homocysteine levels with angioplasty. There was no significant correlation between homocysteine, changes in MDA and TRAP levels either. Conclusion: Administration of metoprolol may cause a reduction in the oxidative stress and an increase in the antioxidant activity in patients undergoing elective angioplasty.

3.Prevalence, incidence, predictors and outcome of type 2 diabetes in Turkey
Altan Onat, Gülay Hergenç, Hüseyin Uyarel, Günay Can, Hakan Özhan
PMID: 17162275  Pages 314 - 321
Objectives: To investigate prospectively the incidence, certain predictors and outcomes of type 2 diabetes (DM), as well as to determine its prevalence cross-sectionally, in a representative sample of Turkish men and women. Methods: Prospective evaluation of 3401 male and female participants (aged 48.2 ±12 years). Follow-up constituted 19,050 person-years. In- dividuals with DM were diagnosed with criteria of the American Diabetes Association. Fatal and nonfatal coronary heart disease (CHD) was identified by clinical findings and Minnesota coding of resting electrocardiograms. Cut-points of ≥95 cm in males and ≥91 cm in females we- re selected for abdominal obesity. For prospective evaluations, cases with DM or CHD were excluded. Results: Prevalence of DM in Turkish adults was estimated as 2.89 million (11.0% of the population aged ≥35 years). Over a mean follow-up of 5.9 years, incident DM developed in 223 subjects, yielding an incidence per 1000 person-years of 11.0 in women and 12.4 in men. This cor- responded to a 300,000 annual incidence. Following risk parameter levels but not HDL-cholesterol were significantly elevated at baseline in subjects developing DM compared to those without: age (5 years), waist girth (7 cm), blood pressure (12/6 mmHg), apolipoprotein B (7 mg/dl), total cholesterol (14 mg/dl), and fasting triglycerides (only in women, 52 mg/dl). Abdominal obesity (RR 2.61 [95%CI 1.87; 3.63]) and age in both genders, hypertension (RR 1.81 [95%CI 1.10; 2.98]) and low HDL-cholesterol in men alone were significant independent predictors of DM. Di- abetes mellitus was a significant and independent predictor of fatal and nonfatal CHD, with a RR of 1.81 (95%CI 1.19; 2.75), after adjustment for sex, age, hypertension, waist circumference, serum total cholesterol and smoking status. Conclusions: The annual incidence of DM in Turkey rises very rapidly, currently stands at 300,000, and, hence, its prevalence also rises cor- respondingly. Insulin resistance appears to be a weak determinant of DM in Turkish women while abdominal obesity is the main determi- nant. Multivariately adjusted DM is a significant independent predictor of fatal and nonfatal CHD. These observations emphasize that me- asures to reverse or stop the “epidemic” of abdominal obesity are severely required.

4.LOAD limits for ambulatory pulse pressure and double product in normotensive and hypertensive subjects
Mustafa Cemri, Mert Ceyhan, Uğur Hodoğlugil, Deniz Barlas Durakoğlugil, Halis Dörtlemez, Hakan Zengil
PMID: 17162276  Pages 322 - 326
Objective: The aim of this study was to to determine possible daytime (awake hours) and nighttime (sleeping hours) LOAD limits for am- bulatory pulse pressure (PP) and double product (DP) in hypertensive (HT) subjects and secondly to assess whether there were signifi- cant differences in the LOAD values between hypertensive (HT) and normotensive (NT) subjects. Methods: Seventy-eight untreated essential HT (46 female, 32 male; mean age 51.9±1.4 years) and 115 NT (89 female, 26 male; mean age 40.8±1.1 years) subjects participated in this study. Ambulatory blood pressure monitoring (ABPM) devices were applied to these subjects for 48 hours. Different possible ambulatory PP LOAD limits between 40 and 55 mmHg with 5 mmHg increments and ambulatory DP LOAD limits between 6000 and 12000 mmHg.beats/min with 1000 mmHg.beats/min increments were used. Then according to these limits, LOAD values of NT and HT subjects have been assessed for daytime, nighttime and 48 hours. Results: There were significant differences between NT and HT subjects in all the values for both ambulatory PP and DP. Although me- an (total, day and night mean) values of HT subjects were higher approximately by 20% than of NT subjects, LOAD values for ambulatory PP in HTs were 33%-415% higher than in NTs (p<0.001). Hypertensive subjects' mean (total, day and night mean) values of DP were by 23%-33% higher than NTs values, but LOAD values for ambulatory DP in hypertensives were approximately 43%-673% higher than in NT subjects (p<0.001). Conclusions: We showed that although there were significant differences in the 48- hour, daytime and nighttime PP and DP means bet- ween NT and HT subjects, these differences became more prominent when possible LOAD limits were used for ambulatory PP and DP, One of these possible ambulatory PP and DP LOAD limits can be used in the clinical settings if a relationship with the end-organ dama- ge will be showed by further studies.

5.Quality of life and functional status in congestive heart failure
Hale Karapolat, Berrin Durmaz, Sanem Nalbantgil, İsa Durmaz
PMID: 17162277  Pages 327 - 332
Objective: To assess health related quality of life of patients with congestive heart failure (CHF), to correlate quality of life with other func- tional parameters; maximal oxygen uptake (peak VO2) with submaximal tests (two minute walking test and shuttle walk test) and New York Heart Association (NYHA) with other clinical variables. Methods: We evaluated 35 stable congestive heart failure patients (NYHA II-III). Functional status was assessed by NYHA classification, maximal oxygen uptake (peak VO2) and submaximal tests (two minute walk test and shuttle walk test). Health related quality of life was measured with short form 36 health survey (SF 36). Results: NYHA functional class was correlated with social functioning of SF 36, peak VO2 and shuttle walk test. Peak VO2 was correlat- ed with most of the parameters of SF 36. On the other hand 2 minute walk test and shuttle walk test were correlated with social func- tioning of SF 36. There was a correlation between peak VO2 and submaximal test, but there was no correlation between left ventricular ejection fraction, peak VO2 and NYHA class. Conclusion: Social functioning is impaired in patients with congestive heart failure. There is a correlation between maximal and sub- maximal tests. The maximal and submaximal tests can explain some degree of quality of life. Functional status can be explained with peak VO2 and shuttle walk test apart from NYHA class.

EDITORIAL COMMENT
6.Determination of functional capacity in heart failure
Çavlan Çiftçi
PMID: 17162278  Pages 333 - 334
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
7.Effects of gender and altitude on short-term heart rate variability in children
Ainash A. Sharshenova, Elvira J. Majikova, Omor T. Kasimov, Gulmira Kudaiberdieva
PMID: 17162279  Pages 335 - 339
Objective: We aimed to study short-term heart rate variability (HRV) in 113 apparently healthy children permanent residents of moderate alti- tudes, the effects of gender and altitude. Methods: Children were assigned into 3 groups according with altitude of residence: Group 1 - 1650 m/a/s/l (n=38), Group 2 - 1740 m/a/s/l (n=36) and Group 3 - 2030 m/a/s/l (n=39). All children underwent short-term electrocardiographic recordings with spectral analysis of HRV at rest and during standing. Statistical analysis was performed using multivariate ANOVA analysis. Results: Heart rate variability analysis showed significant increase in SDNN, high frequency and total powers in parallel with increase of the altitude of residence (p<0.0001, p<0.03 and p<0.01, respectively). The magnitude of the HRV response to posture did not differ between groups except index of sympathetic modulation, LFNU, which rose to a significantly lesser degree (F=3.45, p<0.03) in Group 3, as compared with Group 1 and 2. Girls had lower HRV as compared with boys. Conclusion: Thus, in apparently healthy children, residents of moderate altitudes, increase in altitude levels is accompanied by higher overall vari- ability and parasympathetic modulation of the sinus node and lower sympathetic response to posture. Heart rate variability in children, residents of moderate altitudes is also dependent of gender, resembling similar relationship in inhabitants of sea level.

8.Early-mid term results of the one and a half ventricle repair
Ece Salihoğlu, Ersin Erek, Yusuf K. Yalçınbaş, Tayyar Sarıoğlu, Ayşe Sarıoğlu
PMID: 17162280  Pages 340 - 344
Objective: The aim of this study is to investigate the early and mid term results of one and a half ventricle repair. Methods: Pathological and demographic data, prior palliative operations selection criteria and operative properties of six patients with right ventricular hypoplasia undergoing one and a half ventricle repair were investigated. Patients were followed for mean 55.6±18.9 months by clinical and echocardiographic examinations. Results: One patient died in the early-mid term follow-up period. The intensive care unit and hospitalization mean time were 2.8± 0.83 and 11.25± 6.55 days respectively. One patient had recurrent pleural effusion; she also had epicardial permanent pace implantation for atri- oventricular block within the postoperative second month. Another patient was reoperated for important tricuspid and pulmonic valve regurgitation at postoperative 3rd year. All other patients were followed with medical therapy in NYHA class I-II status. Conclusion: The early and mid-term results of one and a half ventricle repair seem to be acceptable. This method can be a good alterna- tive to Fontan repair in suitable patients.

EDITORIAL COMMENT
9.Fenestration and its effects on the end-organs
İlker Alat
PMID: 17162281  Pages 345 - 346
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
10.Effects of different cardioplegic solutions on nitric oxide release from coronary vasculature in diabetic patients undergoing coronary artery bypass surgery
Pelin Karaca, Nurgül Yurtseven, Yavuz Enç, Tamer Aksoy, Onur Sokullu, Fuat Bilgen, Sevim Canik
PMID: 17162282  Pages 347 - 351
Objective: The aim of this study was to compare the effects of two different cardioplegic solutions on nitric oxide (NO) release from coro- nary vasculature in patients with type II diabetes mellitus undergoing coronary artery bypass grafting (CABG) surgery. Methods: Forty patients undergoing elective CABG surgery were randomized to be given crystalloid (Group 1 ) or blood (Group 2) cardiople- gia. Aortic and coronary sinus blood samples were taken at three different time periods and the release of NO from the coronary vascula- ture was determined by measuring its stable end-products, nitrite and nitrate. The difference between the aortic and coronary sinus con- centrations of nitrite and nitrate represents the amount of NO released by coronary vascular bed. Results: Before application of aortic cross-clamp, at T1 period, the levels of nitrite/nitrate from the coronary vasculature were similar in both groups (6.53±1.21 μM vs 6.07±1.24 μM, p> 0.05). However after the removal of cross-clamp, a significant decrease in NO was observed in Group 1 as compared with Group 2 (4.21±0.73 μM vs 4.92±1.02 μM, p< 0.01). This decrease persisted at T3 period, after 30 minutes of reper- fusion in group 1 being significantly different from group 2 (3.86±0.49 vs 4.37±0.72 μM, p<0.05). Conclusion: This study has shown that in patients with type II diabetes mellitus crystalloid cardioplegia causes a decrease in the release of NO from coronary vascular bed during aortic cross-clamp and reperfusion period whereas more physiologic blood cardioplegia did not. Our findingsindicatethatbloodcardioplegiaprotectsendothelialfunctionbetterthancrystalloidcardioplegiaindiabeticpatients.

EDITORIAL COMMENT
11.Cardioplegic solutions and nitric oxide in coronary artery bypass surgery
Rıza Türköz
PMID: 17162283  Page 352
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
12.Relationship between coronary risk calculation and distribution of the coronary artery lesions and risk factors
Cemal Sağ, Mustafa Özkan, Mehmet Uzun, Mehmet Yokuşoğlu, Oben Baysan, Kürşad Erinç, Ersoy Işık
PMID: 17162284  Pages 353 - 357
Objectives: Early diagnosis and treatment of coronary artery disease is gaining more importance because of its increasing incidence. The calculation of coronary risk score is one of the most important approaches. The aim of the study is to find out the relation between coro- nary risk score and vessel distribution of the coronary heart disease. Methods: The study included 49 patients (mean age= 63±8 years; 36 males) whose coronary disease was proven by coronary angiogra- phy. The severity of the disease is established according to the number of the vessels with >50% stenosis. Results: According to the results; age (p=0.548), gender (p=0.116), uric acid (p=0.091), and smoking (p=0.718) are not effective on diseased vessel distribution. Similarly, total coronary risk score and vessel involvement was not correlated (p=0.115). The ten year coronary risk and vessel involvement was not in good correlation, too (p=0.523). Low-density lipoprotein (LDL)-cholesterol levels were lower in patients with multiple vessel disease but the statistical significance was borderline (p=0.051). High-density lipoprotein (HDL)-cholesterol levels were lower in multiple vessel disease (p=0.004). Both LDL-cholesterol and HDL-cholesterol scores were decreasing with increased num- ber of involved vessels (p=0.035, p=0.001). Multivariate analysis revealed that blood pressure score, and HDL cholesterol score were directly related and LDL-score were inversely related to the number of the involved vessels. The height and vessel involvement was also in good correlation (p=0.024). Conclusion: The LDL-cholesterol, HDL-cholesterol, diastolic blood pressure and height are affective on the number of the involved ves- sels. The total coronary risk scores are not correlated with the severity and distribution of the disease.

REVIEW
13.How useful are β-blockers in cardiovascular disease?
Sripal Bangalore, Sanobar Parkar, Franz H. Messerli
PMID: 17162285  Pages 358 - 363
Recent studies have shown that β-blockers in patients with hypertension is associated with an increased risk of cardiovascular events, in particular stroke, leading to headlines speculating the end of theβ-blocker era. The objective of this review is to critically examine the use- fulness of β-blockers in cardiovascular diseases. We reviewed the currently available evidence for the usefulness of β-blockers in pati- ents with hypertension and also assessed the efficacy of its use for other indications, like, chronic heart failure, stable angina, myocardi- al infarction, arrhythmias etc. The review of the currently available literature shows that for patients with uncomplicated hypertension, the- re is paucity of data or absence of evidence to support use of β-blockers as monotherapy or as first line agent. Given the risk of stroke and numerous unacceptable adverse effects, the risk benefit ratio for β-blockers is not acceptable for this indication. However, β-bloc- kers are very efficacious agents for the treatment of heart failure, certain types of arrhythmia, and post myocardial infarction. The various guideline committees should seriously reconsider their decision about their endorsement of β-blockers as first line therapy for uncompli- cated hypertension. However, this is applicable for hypertension and β-blockers continue to be efficacious for other indications.

14.Nitric oxide and cardiovascular system
Atiye Çengel
PMID: 17162286  Pages 364 - 368
Endothelium has many important functions including the control of blood-tissue permeability and vascular tonus, regulation of vascular sur- face properties for homeostasis and inflammation. Nitric oxide is the chief molecule in regulation of endothelial functions. Nitric oxide de- ficiency, which is also known as endothelial dysfunction, is the first step for the occurrence of many disease states in cardiovascular sys- tem including heart failure, hypertension, dyslipidemia, insulin resistance, diabetes mellitus, hyperhomocysteinemia and smoking. This re- view deals with the importance of nitric oxide for cardiovascular system. It also includes the latest improvements in the diagnosis and tre- atment of endothelial dysfunction.

SCIENTIFIC LETTER
15.Composite graft in cases of insufficient length of internal thoracic artery
Ufuk Tütün, Ferit Çiçekçioğlu, Ayşen Aksöyek, Ali İhsan Parlar, Ahmet Tulga Ulus, Salih Fehmi Katırcıoğlu
PMID: 17162287  Pages 369 - 371
Abstract |Full Text PDF

16.Surgical treatment of isolated cardiac echinococcosis,located in the right ventricular outflow tract
Bülent Meşe, Feragat Uygur, Mustafa B. Erdoğan, Rıza Asil, Birol Yamak
PMID: 17162288  Pages 372 - 373
Abstract |Full Text PDF

CASE REPORT
17.Muscular bridge causing non- ST-segment elevation myocardial infarction
Pelin Aytan, Gülay Ulusal, Ezgi Coşkun Yenigün, Özgür Yıldırım, Atakan Pırpır, Safa Yıldırım
PMID: 17162289  Pages 374 - 375
Abstract |Full Text PDF

EDITORIAL COMMENT
18.Myocardial bridging: a rare speciality without clinical significance?
Ali Erdoğan, Harald Greiss
PMID: 17162290  Page 376
Abstract |Full Text PDF

CASE REPORT
19.Coronary rupture to the right ventricle during PTCA for myocardial bridge
Ergun Demirsoy, Harun Arbatlı, Mehmet Ünal, Naci Yağan, Oğuz Yılmaz, Faruk Tükenmez, Deniz Şener, Bingür Sönmez
PMID: 17162291  Pages 377 - 379
Abstract |Full Text PDF

20.Spinal epidural hematoma associated with streptokinase therapy
Nermin Çakıcı, Nihal Akar, Kürşad Öneç, Sinan Aydoğdu, Erdem Diker
PMID: 17162292  Pages 380 - 382
Abstract |Full Text PDF

21.An uncommon congenital anomaly of coronary arteries misdiagnosed as intracoronary thrombus: woven coronary artery disease
Dayimi Kaya, Celal Kilit, Ersel Onrat
PMID: 17162293  Pages 383 - 384
Abstract |Full Text PDF

22.Exercise-induced coronary artery dissection treated with an anticoagulant and antiaggregants
Sabahattin Umman, Ayhan Olcay, Murat Sezer, Do¤an Erdoğan
PMID: 17162294  Pages 385 - 386
Abstract |Full Text PDF

23.Asymptomatic congenital pericardial defect: an aspect of diagnostic modalities and treatment
Cem Barçın, Ayhan Olcay, Murat Kocaoğlu, Kaan Ataç, Hürkan Kurşaklıoğlu
PMID: 17162295  Pages 387 - 389
Abstract |Full Text PDF

LETTER TO THE EDITOR
24.G-CSF in acute myocardial infarction - Experimental and clinical findings/ G-CSF in acute myocardial infarction: a word of caution
Ahmet Rüçhan Akar, Serkan Durdu, Pervin Topçuoğlu
PMID: 17162296  Pages 390 - 391
Abstract |Full Text PDF

25.How could sudden cardiac deaths on the athletic fields be prevented?
Erdem Kaşıkçıoğlu
PMID: 17162297  Pages 392 - 393
Abstract |Full Text PDF

26.Falls and myocardial infarction in diabetic elderly
İhsan Üstün, Levent Özçakar, Nilgün Üstün, Tuncay Delibaşı
PMID: 17162298  Page 394
Abstract |Full Text PDF

27.Cut-off values of BNP and NT-BNP for diagnosis of heart failure in emergency service
Onur Akpınar, Mehmet Kanadaşı, T.Fikret İlgenli
PMID: 17162299  Pages 395 - 396
Abstract |Full Text PDF

28.Pentalogy of Fallot in a patient with Down syndrome
Emine Dibek Mısırlıoğlu, Didem Aliefendioğlu, Mehmet Tolga Doğru, Cihat Şanlı
PMID: 17162300  Page 397
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
29.Bilateral subclavian vein thrombosis and vena cava superior syndrome with Behcet’s disease
Muzaffer Bahçivan, Semih Yücel
PMID: 17162301  Page 398
Abstract |Full Text PDF

30.Pulmonary embolism during echocardiography: thrombus in transit
Hakan Özhan, Ahmet Kaya, Mehmet Yazıcı, Sinan Albayrak, Enver Erbilen, Serkan Bulur
PMID: 17162302  Pages 399 - 400
Abstract |Full Text PDF

31.Infective endocarditis involving the pulmonary valve in a patient with malignant melanoma
Bahri Akdeniz, Özer Badak, Nezihi Barış
PMID: 17162303  Pages 401 - 402
Abstract |Full Text PDF

32.An unusual form of double outlet right ventricle
Mehmet Yokuşoğlu, Ali Cevat Tanalp, Mehmet Uzun, Nail Bulakbaşı, Ersoy Işık
PMID: 17162304  Pages 403 - 404
Abstract |Full Text PDF

33.Incidental diagnosis of Scimitar syndrome using 3-D chest computed tomography in a child
Ömer Faruk Doğan, Burak E. Onuk, Metin Demircin
PMID: 17162305  Pages 405 - 406
Abstract |Full Text PDF

34.Left ventricular mass
Mehmet Yokuşoğlu, Mehmet Uzun, Cem Köz, Nail Bulakbaşı
PMID: 17162306  Page 407
Abstract |Full Text PDF

35.Incidental diagnosis of membranous obstruction of the inferior vena cava using echocardiography in an asymptomatic child
Dursun Alehan, Ömer Faruk Doğan
PMID: 17162307  Page 408
Abstract |Full Text PDF

36.Ascending aorta aneurysm and type A dissection in association with aortic coarctation
Muzaffer Elmalı, Muzaffer Bahçivan, Mehmet Selim Nural
PMID: 17162308  Pages 409 - 410
Abstract |Full Text PDF

37.Report of a case with huge Osborn waves
Yeşim Hoşcan, Mustafa Özgül
PMID: 17162309  Pages 411 - 412
Abstract |Full Text PDF

MISCELLANEOUS
38.Dr. Nanda Honored with the Ellis Island Medal of Honor

Page 413
Abstract |Full Text PDF

39.Gladstone ranks No. 1

Page 414
Abstract |Full Text PDF

AUTHOR INDEX
40.Author Index

Pages 415 - 418
Abstract |Full Text PDF

SUBJECT INDEX
41.Subject Index

Pages 419 - 422
Abstract |Full Text PDF

REFEREE INDEX
42.Referee Index

Pages 423 - 424
Abstract |Full Text PDF



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