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The Anatolian Journal of Cardiology - Anatol J Cardiol: 1 (2)
Volume: 1  Issue: 2 - June 2001
EDITORIAL
1.The Second Breath

Page 72
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EDITORIAL
2.Cover: Coronary-Pulmonary Fistula
Ömer Göktekin
Page 73
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EDITORIAL
3. In Memory of Professor Dr. Güngör Ertem

Page 74
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ORIGINAL ARTICLE
4.Profesör Dr.Güngör ERTEM
Önal Özsaruhan
Page 75
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5.The Relation Between Infarction Localization and Late Potentials
Kenan İltümür, Aziz Karabulut, Ali Vahip Temamoğulları, Abdülaziz Karadede, Sait Alan, Mehmet Sıddık Ülgen, Nizamettin Toprak
PMID: 12101812  Pages 76 - 79
Objective: There are controversies about the relation between infarction localizaton and late potentials (LP) following acute myocardial infarction (AMI). To evaluate this issue 124 consecutive patients with first Q- wave AMI fulfilling the inclusion criteria were enrolled in this signal - averaged ECG (SAECG) study. Methods: The patients were divided into three groups according to infarction localization: anterior (Group I n=62; 50%), inferior (Grop II: n=42; 34%) and both inferior and right ventricular (RV) involvement (Group III n=20; 16%). SAECG records were performed during the second week. LP results were evaluated as positive when at least two of the major criteria (QRS > 114 ms, LAS 40>38 ms, RMS < 20v) were obtained. Tukey - Cramer multivariate analysis was performed. Results: Positive LP results were obtained in 29% of group I, 35.7 % of group II and 55 % of group III patients. Patients with both inferior and RV involvement had a significantly higher positive LP results independent from left ventricular ejection fraction. Conclusion: Therefore, increased risk of arrhythmia in those patients with both inferior MI localization and RV involvement should be taken into consideration.

6.Relation of HLA Antigens and Myocardial Infarction
Yüksel Doğan, Dilek Ural, Nergiz Domaniç, Erkan Yılmaz
PMID: 12101813  Pages 80 - 84
Objective: Genetic predisposition and chrnoic inflammation play the leading role in the early stages and in the development of atherosclerosis. Previous studies have shown that substantial amounts of T-lymphocytes are present in both early fatty lesions and advanced fibrous lesions in humans. This observation suggests that HLA antigens may be used as genetic markers for the tendency to coronary artery disease. The aim of our study was to investigate the relation of atherosclerosis and HLA antigens in patients with acute myocardial infarction. Methods: Thirty consecutive patients with acute myocardial infarction (15 male, 15 female, aged 548 years) and 30 subjects (15 male, 15 female, aged 527 years) without evidence of coronary artery disease-according to physical, fundoscopic, electrocardiographic and radiological examination-were enrolled to the study. Histocompatibility antigens (HLA-AB, -DR, -DQ) were studied with lymphocytotoxicity method. Results: Age, gender, smoking, alcohol consumption, frequency of obesity and diabetes mellitus were similar between the two groups. In patients with myocardial infarction frequency of hypertension, family history and hyperlipidemia were significantly higher than the controls (p<0.0003, p<0.0001, p<0.01 respectively). Frequency of HLA antigens in patients and in controls was 50% and 23% for HLA-A2, 63% and 20% for HLA-DQ4 and 90% and 50% for HA-DQ7. Logistic regression anlysis revealed a significant relation with the disease and the presence of these antigens (p=0.02, p=0.02 and p=0.03 respectively). Conclusion: It is concluded that in the Turkish population presence of HLA-A2, HLA-DQ4 ve HLA-DQ7 (3) may be used as genetic markers for the tendency to coronary artery disease.

7.Value of ‘Tissue Doppler’ Imaging in the Determination of the Right Ventricular Systolic Function
Bahadır Dağdeviren, Mehmet Eren, Şevket Görgülü, Özer Soylu, Nihat Özer, Aydın Yıldırım, Tuna Tezel
PMID: 12101814  Pages 85 - 89
Objective: Since there is a difficulty in the assesment of right ventricular systolic function by 2D echocardiogrphy, a noninvasive, practical and, cost effective method is desirable. Tisse Doppler technique enables to visualize systolic and diastolic velocities of the tissue through sample volume replacement. In this study, we aimed to evaluate the relationship between tricuspid annular tissue Doppler velocities and right ventricular systolic functional. Methods: For this purpose, tricuspid annular systolic (S), early diastolic (E) and, late diastolic (A) velocities were obtained from 38 patients (23 with dilated cardiomyopathy, 15 with mitral stenosis, all of them in sinus rhythm) and 15 healthy control subjects by placing the pulsed wave sample volume at the junction of right ventricular free wall and tricuspid annulus. The time velocity integral (TVI) of S, peak velocity of S and isovolumic contraction time (IVCT) were compared with right peak velocity of tricuspid regurgitation and dP/dt calculated from the spectral tracce of this regurgitation. Results: A significant correlation was determined between RVEF and peak S velocity, S TVI and IVCT (r: 0.76, p<0.001, r: 0.82, p<0.0001 and r: -0.85, p<0.0001 respectively). The peak S velocity <12 cm/sec, S TVI < 2 cm and IVCT>75 msec yielded 76%, 84%, 92% sensitivity and 84%, 84%, 80% specificity for predicting the patients with right ventricular ejection fraction <40%, respectively. A significant and powerful correlation was determined between the peak S velocities and dP/dt in 19 patients whose tricuspid regurgitation could be clearly recorded (r: 0.88, p<0.0001). Conclusions: The analysis of tricuspid annular velocities obbtained by tissue Doppler technique is a practical method of the assessment of right ventricular systolic functions.

8.The Evaluation of the Severity of Mitral Regurgitation Using the Color Doppler Echocardiographic Methods
Mehmet Eren, Osman Bolca, Tuğrul Norgaz
PMID: 12101815  Pages 90 - 97
Objective: This stduy was planned to assess the vena contracta (VC), flow convergence area (PISA) and jet area (JA) methods in evaluating the severity of mitral regurgitation 5MR) and to test the accuracy of a proposed algorithm using these methods. Methods: Eighty-seven patients with chronic MR were enrolled in the study. VC of < 0.3 cm, maximal MR flow rate calculated by PISA (Qmax) of < 72 cm3/sn and JA of < 4 cm2 were classified as mild MR. VC of > 0.5 cm, Qmax of > 240 cm3/sn and JA of > 8 cm2 were classified as severe MR. Whereas the values between these ranges were called to be moderate MR. The algorithm was planned as follows.: In the first step, VC width was measured. If a patient has VC = 0.3-0.5 cm, it was used Qmax in the eccentric jets and JA in the central jets in the second step. The severity of MR were considered as severe, moderate and mild for >50%, 21-49% and 20% of the regurgitant fraction calculated by the reference method (the quantitative Doppler method dopending on aortic and mitral stroke volumes), respectively. Results: The sensitivity of VC was low in difeeratiating between moderate and severe MR (63%). In eccentric jets, the regurgitant volume calculated by PISA was higher than that of reference method (70±49 vs. 59±29 cm3) and the JA was found to be less than that of cntral jets despite similar regurgitant fraction (6.8±3.2 vs. 8.5±3.3 cm2). The algorithm agreed well with the reference method and it was better than those of each three methods (Cappa coefficients 0.89 vs. 0.65, 0.63 and 0.45 for VC, Qmax and JA; respectively). The accuracies of the algorithm in discriminating between mild and moderate MR or severe and non-severe MR were high 598% and 95% respectively). Conclusions: The severity of MR can be determined accurately and simply by using VC, PISA and JA methods logether.

9.Lymphocyte Subsets in Patients with İdiopathic Dilated Cardiomyopathy
Abdi Bozkurt, Abdullah Canataroğlu, Salih Çetiner, Yurdaer Dönmez, Ayhan Usal, Mustafa Demirtaş
PMID: 12101816  Pages 98 - 100
Objective: Although chronic myocardial inflammatory process mediated by viral and autoimmune factors has been postulated in the pathogenesis of idiopathic dilated cardiomyopathy (IDC), the role of autoimmune mechanisms still remains unclear. The aim of the present study was to investigate the rates of various T cell subsets and natural killer (NK) cells in peripheral blood in order to see whether they had a role in the immunoregulation of IDC. Methods: The surface markers of peripheral T and B lymphocytes were detected and percentages of pan T and B cells as well as helper (CD4+) and suppressor (CD8+) T lymphocytes subsets in the peripheral blood and their ratio (CD4+/CD8+) were determined in 27 patients with IDC and in 20 healthy controls. NK cell percentage was also studied. Results: There were no significant differences between IDC and control groups with respect to T and B cell percentages. The percentages of CD4+ T cell subsets were similar in both groups (48.7±8.7 % vs. 43.5±9.7 % respectively; p=0.107). CD8+ T cell percentage was significantly decreased in patients with IDC than in controls (22.6±7.7 % vs. 28.2±8.2 %, respectively; p=0.044). CD4+/CD8+ ratio was markedly higher in patients with IDC than controls (2.6±1.8 vs. 1.6±0.6, respectively; p=0.006). There was no significant difference in the NK cell percentage between groups. Conclusion: Decreased CD8+ T cell subset is the cause of increased CD4+/CD8+ ratio, which may imply decreased self-tolerance and an immunoregulatory defect in the pathogenesis of IDC.

REVIEW
10.Disaster and Cardiac Disease
Bonpei Takase, Toshiaki Ishizuka, Akira Kurita
PMID: 12101804  Pages 101 - 106
Abstract | Full Text PDF

EDITORIAL
11.Are Antioxidants Effective in the Prevention of Coronary Events?
Bilgin Timuralp
PMID: 12109460  Pages 107 - 108
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12.Vasovagal Syncope and Beta-Blockers
Bilgin Timuralp
PMID: 12109461  Page 109
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MISCELLANEOUS
13.New Aspects of Anticoagulant Treatment for Pregnant Women with a Mechanical Heart Valve Prosthesis - European Cardiologist
G. Hanania
Page 110
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14.Hypertension to Heart Failure: High Incidence and Poor Prognosis - European Cardiologist

Page 111
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SCIENTIFIC CONGRESS
15.AHA Annual Scientific Sessions, 2000: Advances in the Treatment of Coronary Artery Disease - European Cardiologist
N. Danchin
Pages 112 - 113
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E-PAGE ORIGINAL IMAGES
16.CYST-Like Thrombi in the Left Ventricle
Abdi Bozkurt, Murat Çaylı
PMID: 12101805  Page 114
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17.Prosthetic Valve Thrombi
Murat İkizler, Sadettin Dernek, Bülent Görenek
PMID: 12101806  Pages 115 - 116
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LETTER TO THE EDITOR
18.Qantitative Ultrasonic Myocardial Texture Analysis of the Diabetic Heart
Necmi Ata
PMID: 12101807  Pages 117 - 119
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19.Demographic and Clinical Features of Coronary Artery Disease Patients in the District of Antalya and Comparison of Them with Turkey's Averages
İnan Soydan
PMID: 12101808  Pages 120 - 123
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20.The Anatolian Journal of Cardiology
Hulki Meltem Sönmez
PMID: 12101810  Page 124
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21.Lymphocyte Subsets in Dilated Cardiomyopathy
Zafer Gülbaş
PMID: 12101811  Page 125
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SCIENTIFIC CONGRESS
22.65thAnnual Scientific Meeting of the Japanese Circulatory Society
Akira Kurita
Page 126
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MISCELLANEOUS
23.News From the Meeting of the Working Group on Echocardiography of the Turkish Society of Cardiology
M. Serdar Küçükoğlu
Page 127
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24.Summaries From ACC 2001 and Turkish Presentations
Vedat Sansoy
Pages 128 - 129
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