ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 9 (4)
Volume: 9  Issue: 4 - August 2009
EDITORIAL
1.On our painful losses, supplement and the letter from Prof. Dr. Çetin Erol
Bilgin Timuralp
PMID: 19666425  Page 259
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
2.Reversal of doxorubicin-induced vascular dysfunction by resveratrol in rat thoracic aorta: Is there a possible role of nitric oxide synthase inhibition?
Murat Olukman, Cenk Can, Ayşe Erol, Gülperi Öktem, Onur Oral, Mehtap Gülcihan Çınar
PMID: 19666426  Pages 260 - 266
Objective: The natural antioxidant, resveratrol has been suggested to protect against doxorubicin-induced cardiotoxicity. Although derangements in nitric oxide (NO) synthesis contribute to vascular endothelial dysfunction caused by doxorubicin, the effects of resveratrol on these parameters have not been evaluated yet. We investigated the impact of resveratrol on doxorubicin-induced vascular dysfunction in rat thoracic aorta with regard to NO synthesis in an experimental, prospective, controlled study. Methods: Wistar rats were assigned to 5 groups; doxorubicin (n=9), vehicle (dimethylsulphoxide) (n=8), resveratrol (n=8), doxorubicin+resveratrol (n=10), controls (n=9). Contractile and relaxant responses were evaluated on the isolated thoracic aortas. The expressions of endothelial (eNOS) and inducible (iNOS) isoforms of NO-synthase were also examined histopathologically on the aortas. Statistical analysis was performed by ANOVA for repeated measures for the response curves and one-way ANOVA for the pD2 (-log EC50) and Emax (maximum phenylephrine contraction) values with subsequent Bonferroni test. Results: Doxorubicin (20 mg/kg, i.p), not only decreased the contractile responses to phenylephrine (p<0.001), but also attenuated the relaxant responses to acetylcholine (ACh) (p=0.002), calcium ionophore (A23187) (p=0.002) and sodium nitroprusside (SNP) (p=0.007). Immunohistochemistry revealed increased (p<0.05) eNOS and iNOS protein expressions after doxorubicin treatment. Coadministration of resveratrol (10 mg/kg/i.p.) reversed the increased expression of both NOS isoforms (p<0.05). Similarly, it prevented the doxorubicin-induced attenuation in ACh- (p=0.013) and A23187- (p=0.038) induced responses. In healthy rats the antioxidant did not cause significant changes. Conclusion: Prevention of excessive NO formation through eNOS and iNOS overexpression by resveratrol might contribute to the reversal of vascular endothelial dysfunction associated with doxorubicin treatment.

3.Relationship between two estrogen receptor-? gene polymorphisms and angiographic coronary artery disease
Bilgehan Karadağ, Mehmet Güven, Yalçın Hacıoğlu, Erdinç Öz, Bahadır Batar, Nergiz Domaniç, Turgut Ulutin, Vural Ali
PMID: 19666427  Pages 267 - 272
Ob­jec­ti­ve: To investigate the association of estrogen receptor-α PvuII and BtgI polymorphisms with angiographic presence and severity of coronary artery disease (CAD). Methods: Our cross-sectional study included 140 patients with ≥50% coronary stenoses (CAD group) and 47 patients with normal angiograms (CAD-free group) (total n=187, age 59.6±13.2 years; 66 women). PvuII and BtgI genotype and allele distributions were determined by standard method of polymerase chain reaction and restriction fragment length polymorphism. The CAD subgroups by the number of diseased vessels were also defined. Variable associations and group differences were analyzed by independent t test, one-way ANOVA, Pearson's Chi-square (χ2), Spearman’s correlation tests and logistic regression analyses. Results: While there was no association between PvuII polymorphism and angiographic CAD (p=0.384), BtgI polymorphism was more prevalent in CAD-free group (23.4% vs. 10% (CAD group), OR=2.75, 95% CI=1.150 to 6.579, p=0.019). This difference was more pronounced in women (28.6% vs. 4.4%; OR=8.6; 95% CI=1.564 to 47.303; p=0.005) compared to men (p=0.391). Logistic regression analysis confirmed BtgI polymorphism as the most important predictor for a normal coronary angiogram among parameters such as body mass index, diabetes and age (OR 8.13, 95% CI 1.257 to 52.627, p=0.028). However, no significant association between BtgI polymorphism and the number of stenotic arteries was detected. Conclusion: ESR1 PvuII polymorphism is not associated with angiographically significant CAD. ESR1 BtgI polymorphism is strongly associated with the presence of normal coronary angiograms in women, which suggests protective effect. Further confirmation of these findings is required.

4.Evaluation of ultrasonographic fatty liver and severity of coronary atherosclerosis, and obesity in patients undergoing coronary angiography
Mahmut Açıkel, Sadık Sunay, Mustafa Koplay, Fuat Gündoğdu, Şule Karakelleoğlu
PMID: 19666428  Pages 273 - 279
Objective: Aims were to examine associations (1) between non-alcoholic fatty liver disease (NAFLD) and the presence and severity of coronary artery disease (CAD) and obesity, (2) between CAD and NAFLD with aspartate aminotransferase (AST), alanine aminotransferase (ALT) and gamma glutamiltransferase (GGT) levels. Methods: In this cross-sectional study, the study group consisted of 355 patients (mean age: 57.5±11.4 years), that comply with inclusion criteria and selected of 414 consecutive patients who underwent coronary angiographies. Coronary artery disease was defined as a stenosis at least 50% in at least one major coronary artery. Modified Gensini scoring was used to determine the severity of coronary atherosclerosis. Fatty liver was diagnosed by abdominal ultrasonography (4 stages: Grades 0, 1, 2 and 3). Obesity was defined as body mass index (BMI)≥30 kg/m2. Statistical evaluations were performed using Student’s t test, ANOVA, Chi- square, kappa tests and logistic regression analysis. Results: There were significant differences among Grades 0, 1 and 2-3 according to presence of CAD and Gensini score. In univariate analysis, age (OR=1.03, p=0.004), gender (OR=3.05, p<0.0001), dyslipidemia (OR=4.40, p<0.0001), diabetes mellitus (OR=2.15, p=0.048), smoking (OR=3.19, p<0.0001), AST (OR=1.01, p=0.042), GGT (OR=1.04, p<0.0001), NAFLD (OR=1.87, p=0.036) and obesity+NAFLD (OR: 2.1, p=0.018) have effects on presence of CAD. In multivariate model, age (OR=1.04, p<0.001), AST (OR=1.01, p<0.05), GGT (OR=1.04, p<0.001), NAFLD (OR=2.58, p<0.01) have independent effects on CAD; however BMI and obesity were ineffective. Non-alcoholic fatty liver disease has an independent effect on Gensini score (OR=2.02, p<0.05). Conclusions: Ultrasonographic fatty liver have independent effects on both the presence of CAD and severity of coronary atherosclerosis. In addition, increased serum AST and GGT levels may be independently associated with CAD.

5.Which cut-off value of high sensitivity C- reactive protein is more valuable for determining long- term prognosis in patients with acute coronary syndrome?
Teoman Kılıç, Ertan Ural, Gökhan Öner, Tayfun Şahin, Metehan Kılıç, Şadan Yavuz, Muhip Kanko, Göksel Kahraman, Ulaş Bildirici, Kamil Turan Berki, Dilek Ural
PMID: 19666429  Pages 280 - 289
Objective: The aim of this study to investigate prognostic efficacy of high sensitivity C-reactive protein (hs-CRP) in patients with acute coronary syndrome (ACS) and to identify the most valuable cut-off value of hs-CRP for determining long term prognosis. Methods: A total of 240 ACS patients presenting within 6 h after the onset of chest pain were included to the study. Admission levels of hs-CRP were analyzed. Patients were followed for 1 year. Primary end-point of the study was new coronary event (NCE), defined as the combination of cardiac death, nonfatal myocardial infarction and recurrent rest angina. Risk factors for NCE were determined by logistic regression analysis. ROC-curve analysis was used to identify cut-off values of the risk factors. The prognostic efficacy of the cut-off value of hs-CRP was compared to other values determined from other studies. Kaplan Meier and log rank tests were used in survival analyses. Factors determining event-free survival were investigated by Cox regression analysis. Results: During the follow-up period, 65 NCEs occurred. In multivariate analysis, hs-CRP was strongly associated with the occurrence of NCE (OR=4.79, 95% CI=2.10–10.44, p<0.001). Cut-off value of hs-CRP for NCE was 1.1 mg/dl (AUC=0.68, 95% CI=0.62-0.74, p<0.001). Compared to other values of different studies, hs-CRP>1.1 mg/dl had the optimal positive and negative predictive values. In the Cox regression analysis, hs-CRP was emerged as the most important parameter for determining event-free survival (RR=3.44, 95% CI=1.91–6.21, p<0.001). Conclusion: Admission levels of hs-CRP were emerged as the most important parameter for prognosis and the cut-off value of hs-CRP for predicting NCE was found as 1.1 mg/dl in this cohort of the study population. Further studies are required to confirm the most risky cut off value of hs-CRP for predicting long term prognosis among ACS patients and in general population

6.The effects of nebivolol on P wave duration and dispersion in patients with coronary slow flow
Yılmaz Güneş, Mustafa Tuncer, Ünal Güntekin, Yemlihan Ceylan
PMID: 19666430  Pages 290 - 295
Objective: Coronary slow flow (CSF) is characterized by delayed opacification of coronary arteries in the absence epicardial occlusive disease. P wave duration and dispersion have been reported to be longer in patients with CSF. Nebivolol, besides its selective beta1-blocking activity, causes an endothelium dependent vasodilatation through nitric oxide release. In this study, we searched for the association between left ventricular diastolic functions and atrial conduction dispersion, the effects of nebivolol on P wave duration and dispersion in patients with CSF. Methods: This prospective case-controlled study included 30 patients having CSF and 30 subjects having normal coronary arteries in coronary angiography. The patients were evaluated with 12-leads electrocardiography and echocardiography before and three months after treatment with nebivolol. The difference between maximum and minimum P wave durations was defined as P-wave dispersion (PWD). Early diastolic flow (E), atrial contraction wave (A) and E deceleration time (DT) and isovolumetric relaxation time (IVRT) were measured. Unpaired and paired t-tests, Chi-square test, Mann-Whitney’s U-test and Pearson correlation analysis were used in statistical analysis. Results: Compared to control group maximum P wave duration (Pmax) (104.3±12.2 vs. 93.4±9.8 msec, p<0.001) and PWD (35.0±8.6 vs. 24.8±5.4 msec, p<0.001), DT (245.4±54.9 vs. 198.0±41.7 msec, p<0.001) and IVRT (112.9±20.8 vs. 89.5±18.2 msec, p<0.001) were significantly longer and E/A ratio (0.89±0.27 vs. 1.27±0.27, p<0.001) was lower in patients with CSF as compared with control subjects. There were no significant correlations of Pmax and PWD with clinical and echocardiographic variables. Systolic and diastolic blood pressures (130.5±15.5 mmHg to 117.8±12.3 mmHg and 84.5±9.8 mmHg to 75.0±6.2 mmHg, p<0.001), Pmax (to 98.7±11.7 msec, p=0.038), PWD (to 21.3±5.1 msec, p<0.001) and DT (to 217.3±41.4 msec, p<0.001) and IVRT (to 101.2±17.4 msec, p<0.001) significantly decreased and E/A ratio (to 1.1±0.23, p<0.001) significantly increased after treatment with nebivolol. Correlation analysis revealed that the change in PWD was not significantly correlated with any of the clinical and echocardiographic variables including decrease in blood pressures. Conclusions: Coronary slow flow is associated with prolonged P wave duration and dispersion and impaired diastolic filling. Nebivolol may be helpful in restoration of these findings. P wave duration and dispersion may not be associated with left ventricular function parameters in patients with CSF.

EDITORIAL COMMENT
7.Nebivolol in patients with coronary slow flow: the right drug for the right case?
Gabriele Fragasso
PMID: 19666431  Pages 296 - 297
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
8.Comparison of antithyroid drugs efficacy on P wave changes in patients with Graves’ disease
Dilek Berker, Serhat Işık, Alper Canbay, Yusuf Aydın, Yasemin Tütüncü, Tuncay Delibaşı, Serdar Güler
PMID: 19666432  Pages 298 - 303
Objective: Some precursor P wave changes on electrocardiogram (ECG) before the atrial fibrillation (AF) episodes occur in the hyperthyroidism. Our aim was to compare the effect of two antithyroid drugs (ATD) on P wave duration and dispersion (PWD) in patients with hyperthyroidism. Methods: Fifty patients (13 men, 37 women; mean age 39.2±13.2 years) with newly diagnosed overt hyperthyroid patients with Graves’ disease (GD) were enrolled in the prospective, randomized study. The maximum P wave duration (Pmax) and the minimum P wave duration (Pmin) were measured in all 12-lead surface ECGs. The patients were consecutively randomized to propylthiouracil (PTU) (n=24) and methimazole (MMZ) (n=26) groups. Electrocardiogram was repeated within euthyroid state after the 18-month ATD treatment. Student t-test, Mann-Whitney U and Pearson Chi-square tests were used for comparisons of the data between groups. The differences between pre- and post-treatment measurements within groups were evaluated by Wilcoxon Sign Rank test. The correlation of data was tested by using Spearman correlation analysis. Results: The maximum P wave duration (Pmax) was 90 (80-110) and 90 (90-110) msec, (p=0.586), and PWD was 35 (22.5-48.7) and 40 (30-40) msec, respectively (p=0.952) in PTU and MMZ groups. After euthyroidism was achieved, Pmax was 80 (80-90) and 87.5 (80-90) msec (p=0.676), and PWD was 27.5 (20-35) and 27.5 (20-30) msec in PTU and MMZ groups, respectively (p=0.540). After ATD treatment PWD decreased (p=0.009 and p<0.001, respectively) in both of PTU and MMZ groups. However effects of ATD on PWD change were similar (p=0.486). Conclusion: P wave duration and PWD are found to be prolonged in hyperthyroid patients with GD. Both propylthiouracil and methimazole reduce the P wave duration and dispersion. Thus, we can conclude that improvements in atrial conduction properties are not associated with the type of ATD but with only achievement of euthyroidism.

9.A population- based study on awareness of heart attack in Aydın city-Turkey
Sakine Memiş, Emine Didem Evci, Filiz Ergin, Erdal Beşer
PMID: 19666433  Pages 304 - 310
Objective: The study was conducted to determine the level of knowledge and awareness of risk factors and warning signs of heart attack in a selected sample of the Turkish population. Methods: Population-based cross-sectional study was carried out with people over age 40 years in Aydın. The study group was determined by multi-stage sampling method (simple random and cluster sampling methods). Questionnaire was administered during face-to-face interviews in the participants’ homes. Chi-square and t-test were used for analytical evaluation. Risk assessments were performed utilizing logistic regression analysis. Results: The percentage of participants who did not know what a heart attack is and its warning signs were 42.3% and 23.2%, respectively. Overall, 11.8% were unaware of risk factors. Loss of consciousness/fainting, chest pain, radiation of pain were reported as three major warning signs. Among risk factors, stress was ranked as the most common, followed by smoking. It was determined that age, place of residence, education, occupation, self-reported risk factors had effect on the knowledge for major warning signs (p<0.05). In multivariate analysis, the factors having a negative effect on knowledge of major warning signs were having primary school/lower level of education (OR=2.447, 95%CI 1.773-3.378; p<0.0001), being older (OR=1.020, 95%CI 1.007-1.032, p=0.002), living in urban area (OR=1.493, 95%CI 1.133-1.968, p=0.004), being unemployed (OR=1.436, 95%CI 1.010-2.041, p=0.044) and absence of self-reported risk factors (OR=1.965, 95%CI 1.201-3.216, p=0.007). The percentage of participants stated that the first action to take for a person having heart attack was to put them on their back, open their collar, elevate their feet was 24.1%. They had learned information about the symptoms and the risk factors from television (28.6%) and neighbors/relatives (28.3%). Conclusion: This study revealed the need for increasing awareness utilizing community based education programs and the mass media.

10.Discrete supravalvular aortic stenosis in children: Is it necessary to reconstruct the whole aortic root?
Ergin Koçyıldırım, Süleyman Özkan, Demet Karadağ, S. Kenan Köse, Enver Ekici, Coşkun İkizler
PMID: 19666434  Pages 311 - 317
Objective: Discrete supravalvular aortic stenosis (SAS) is known to involve the whole aortic root. Some surgeons have therefore changed their approach from relief of obstruction using a single-patch to symmetric reconstruction of the whole aortic root – three-patch technique. The advantages are said to be preserved long-term aortic valve function and allowance for growth. This is unproven. We compare growth and aortic root geometry in patients who have undergone relief of discrete SAS using either single-or three-patch technique. Methods: Twenty-five patients (14 male, 11 female, mean age of 11± 4 years, range 4-18) underwent surgery for discrete SAS. No patients with diffuse SAS were included in this retrospective analysis. Twelve patients had features of Williams syndrome. Five patients had other concomitant procedures. A single-patch was inserted into the longitudinal incision, which passed across the stenosis into the non-coronary sinus in 14. A three-patch technique was used in 11 patients. Changes in aortic root following repair were documented in patients using both echocardiography and magnetic resonance imaging (MRI). Results: There were no operative deaths. The mean preoperative gradient was 66 ±17 mmHg (range 50 – 100 mmHg), which decreased to 14±7 mmHg (range 4-18 mmHg) early postoperatively. The late mean gradient was 15±5 mmHg. There was no significant difference in the incidence of postoperative aortic regurgitation or gradient across the repair between two techniques according to the echocardiograms and MRI findings. Conclusion: According to our study, we cannot demonstrate any benefit in reconstructing the whole aortic root for discrete SAS. A single-patch technique is easy, safe and appears durable.

11.The effects of intra-operative amiodarone loading on the systemic inflammatory response syndrome induced by cardiopulmonary bypass
Ali Rahman, Handan Akbulut, Mustafa Kemal Bayar, Mehmet Özden, Oktay Burma, Ayhan Uysal
PMID: 19666435  Pages 318 - 324
Objective: Cardiopulmonary bypass (CPB) leads to systemic inflammatory response syndrome (SIRS). In vitro studies showed that amiodarone blocked cytokine production. The aim of this study was to evaluate the effect of intra-operative amiodarone loading on SIRS. Methods: This prospective randomized study included 24 patients who underwent on-pump coronary artery surgery. The patients were classified into control (n=12) and amiodarone (n=12) groups. Plasma levels of the pro-inflammatory (C-reactive protein - CRP, interleukin-6 - IL-6) and the anti-inflammatory markers (interleukin-10 - IL-10) were measured before the induction of anesthesia, 5 minutes after aortic declamping, after protamine administration and 24 hours after the CPB. The myocardial lactate production was calculated before CPB and 5 minutes after aortic declamping. Statistical analyses were performed using Mann-Whitney U, Fischer’s exact and ANOVA tests. Results: In both groups, the IL-6 levels significantly increased after declamping (91.18±16.27 pg/ml and 86.37±14.66 pg/ml, p<0.01) and reached peak values after infusion of protamine (329.07±32.24 pg/ml and 354.31±29.61 pg/ml, p<0.01). The highest values of IL-10 were detected after infusion of protamine in the control and amiodarone groups (265.58±85.63 pg/ml, p<0.01 and 287.44±65.26 pg/ml, p<0.01). Amiodarone did not have any significant effect on release of cytokines. The CRP levels were significantly elevated in both groups at 24th hour after CPB, but no significant difference was found between the groups. Compared with pre-CPB values, lactate production increased significantly in two groups after aortic declamping. However there was no significant difference between the groups. Conclusions: The results indicate that intraoperative loading of amiodarone, which is used for atrial fibrillation prophylaxis, does not seem to alter inflammatory response during CPB

REVIEW
12.Drug-eluting stents in multivessel coronary artery disease: Was one of the important fortresses of surgery conquered?
Arda Şanlı Ökmen, Ertan Ökmen
PMID: 19666436  Pages 325 - 330
Since the drug eluting stents have provided better results concerning restenosis and repeat revascularization comparing to bare metal stents, percutaneous coronary interventions are performing increasingly in more complex stenoses. However, drug eluting stents did not show any advantage on prevention of myocardial infarction and survival. Currently there is no any completed controlled randomized study showing the superiority or equality of drug eluting stents over coronary bypass surgery by means of efficacy and safety. While the long-term results of drug eluting stents still unclear, everyday progressively more patients with multivessel disease are undergoing percutaneous coronary intervention with drug eluting stent implantation. The aim of this review is to discuss the efficacy and safety of drug eluting stents in patients with multivessel disease.

MISCELLANEOUS
13.Differential diagnostic algorithm for diseases manifested with heart murmurs syndrome
Leonid B. Naumov
PMID: 19666437  Pages 331 - 339
Diagnostic interpretation at auscultation of heart murmurs is accompanied by frequent errors. It creates serious clinical, pedagogical, organizational and social problems. The standard nosological principle of a clinical information description from the diagnosis (a disease name) to the description of symptoms/signs contradicts to real clinical practice from revealing of symptoms through differential diagnostics to a diagnosis establishment. The differential diagnostic algorithm or diagnostic algorithm developed by the author, is based on the opposite syndromic principle of thinking – from the signs to the diagnosis. It completely corresponds to the practical purposes of reliable diagnostics of 35 illnesses, manifested by heart murmurs at a heart auscultation.

SCIENTIFIC LETTER
14.Excimer laser assisted implantable cardioverter defibrillator lead extraction: An alternative treatment to the surgery?
Hasan Güngör, Hamza Duygu, Bekir Serhat Yıldız, İlker Gül, Mehdi Zoghi, Mustafa Akın
PMID: 19666438  Pages 340 - 341
Abstract |Full Text PDF

15.Assessment and follow-up of coronary abnormalities in Turkish children with Kawasaki disease
İlkay Erdoğan, Alpay Çeliker, Süheyla Özkutlu, Dursun Alehan, Tevfik Karagöz
PMID: 19666439  Pages 342 - 344
Abstract |Full Text PDF

CASE REPORT
16.Periodic recurrence of wide QRS tachycardia in myocardial infarction and vasospasm: utility of heart rate variability to assess autonomic nervous system activity on vasospasm-induced lethal arrhythmia
Bonpei Takase, Kazuo Kimura, Akira Hamabe, Akimi Uehata, Hattori Hidemi, Masayuki Ishihara, Akira Kurita
PMID: 19666440  Pages 345 - 347
Abstract |Full Text PDF

17.Aortic dissection provoked by electrical storm
Oladipupo Olafiranye, Louis Salciccioli, Jason M. Lazar
PMID: 19666441  Pages 347 - 348
Abstract |Full Text PDF

18.Intravascular imaging of ruptured plaque by visual histology intravascular ultrasound in acute ST-elevation myocardial infarction
Mehmet Çilingiroğlu, Nuri Akkuş
PMID: 19666442  Pages 349 - 350
Abstract |Full Text PDF

19.Successful treatment of infected left ventricular pseudoaneurysm related to empyema
Ahmet Ümit Güllü, Yara Banz, Eva Krähenbühl, Thierry Carrel, Jurg Schmidli
PMID: 19666443  Pages 351 - 352
Abstract |Full Text PDF

LETTER TO THE EDITOR
20.E-learning in cardiology education
Erol Gürpınar, İbrahim Başarıcı
PMID: 19666444  Page 353
Abstract |Full Text PDF

21.Hemodynamic performance of mechanical aortic valves in narrow aortic annulus cases
Mert Kestelli, İsmail Yürekli, Ahmet Özelçi, Orhan Gökalp, Şahin Bozok, Engin Tulukoğlu, Ali Gürbüz
PMID: 19666446  Page 354
Abstract |Full Text PDF

22.Does radial artery harvesting for coronary artery bypass grafting impair the hand circulation?
Şenol Yavuz
PMID: 19666445  Pages 354 - 355
Abstract |Full Text PDF

23.Response to the case report of pulmonary artery coil migration after management of patent ductus arteriosus in a 65-year-old female patient
Ayhan Pektaş, Serdar Kula
PMID: 19666447  Pages 355 - 356
Abstract |Full Text PDF

24.Do bone morphogenic protein-4 antagonists have any role in the treatment of human hypertension?
Ekrem Yeter, Mustafa Kurt, Bülent Özçakar, Ali E. Denktaş
PMID: 19666448  Pages 356 - 357
Abstract |Full Text PDF

25.Tako-tsubo syndrome complicating with atrial fibrillation
Namık Özmen, Bekir Serhat Yıldız, Alptuğ Tokatlı
PMID: 19666449  Pages 357 - 358
Abstract |Full Text PDF

26.Warfarin resistance induced by oxcarbamazepine
Oral Nevruz, Oben Baysan, Mehmet Yokuşoğlu
PMID: 19666450  Pages 358 - 359
Abstract |Full Text PDF

27.Utility of mild hypothermia during carotid artery surgery in patients with unilateral stenosis and contralateral total occlusion
Haydar Yasa, Levent Yılık, Kazım Ergüneş, Nagihan Karahan, Ufuk Yetkin, Çayan Çakır, Cengiz Özbek, Ali Gürbüz
PMID: 19666452  Page 359
Abstract |Full Text PDF

28.Mitral valve perforation: Is there a possible role for silent infective endocarditis?
Adem Güler, Oben Baysan, Mehmet Yokuşoğlu, Celal Genç, Hayrettin Karaeren
PMID: 19666451  Pages 359 - 360
Abstract |Full Text PDF

29.A concern on cardiac involvement in swine flu
Viroj Wiwanitkit
PMID: 19666453  Pages 360 - 361
Abstract |Full Text PDF

MISCELLANEOUS
30.In memory of Prof. Dr. Acar Tokcan (1942-2009)
Tümer Ulus
Page 362
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
31.Successful occlusion of reentry ring like coronary artery fistula with glue injection
Murat Çaylı, Durmuş Yıldıray Şahin, Erol Akgül, Mustafa Demirtaş
PMID: 19666421  Page E10
Abstract |Full Text PDF

32.Direct invasion of non-small cell lung cancer metastases to the right heart
Tayfun Şahin, Ulaş Bildirici, Umut Çelikyurt, Sabiye Sevinç, Kazım Uygun, Dilek Ural
PMID: 19666420  Pages E10 - E11
Abstract

33.Right ventricle and tricuspid valve metastasis in a patient with renal cell carcinoma
Mohammad Otahbachi, Cihan Çevik, Piraon Sutthiwan
PMID: 19666422  Pages E11 - E12
Abstract

34.Incidental detection of a lung tumor on Thallium-201 myocardial perfusion SPECT imaging
Georgios Meristoudis, Ioannis Ilias, Julia Christakopoulou
PMID: 19666423  Pages E12 - E13
Abstract |Full Text PDF

35.An uncommonly seen congenital heart defect: aortopulmonary window with pulmonary hypertension in a 19-year old male patient
Şenay Funda Bıyıkoğlu, Göksel Çağırcı, Ayça Ata Boyacı, Erdal Duru, Aysel Türkvatan
PMID: 19666424  Page E13
Abstract



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