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The Anatolian Journal of Cardiology - Anatol J Cardiol: 11 (6)
Volume: 11  Issue: 6 - September 2011
EDITORIAL
1.Adventures at the Anatolian Journal of Cardiology
Bilgin Timuralp
PMID: 21827983  doi: 10.5152/akd.2011.157  Pages 477 - 478
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
2.Involvement of galectin-3 in cadmium-induced cardiac toxicity
Nuray Yazıhan, Mehtap Kaçar Koçak, Ethem Akçıl, Ahmet Sayal, Cengiz Güven, Nalan Akyürek, Onur Erdem
PMID: 21788204  doi: 10.5152/akd.2011.130  Pages 479 - 484
Objective: Accumulation of the wide spread environmental toxin cadmium (Cd) in tissues results in toxicity. Heart is one of the most effected tissues. Cd exposure induces inflammation in effected tissues. The present study was focused to evaluate roles of tumor necrosis factor alpha (TNF-α) and interleukin-6 (IL-6) in Cd toxicity and their relationships with galectin-3 levels. Methods: In this experimental study, male Wistar rats were divided randomly to control and experimental groups. Experimental group was exposed to Cd at the dose of 15 ppm for 8 weeks (n=10/group). Inflammatory status in hearts was evaluated with measurement of tissue TNF-α and IL-6 levels. Histopathological examination of heart was carried out by light microscopy. Heart tissue caspase-3 level was used to identify apoptosis. Tissue galectin-3 level was evaluated by ELISA. Statistical difference between groups was evaluated by unpaired Student t-test, correlation was analyzed by Pearson’s test. Results: Heart sizes were increased after Cd toxicity. A significant increase in galectin-3 tissue levels was seen after Cd toxicity, this was accompanied with a significant increase in the TNF-α (control: 402±39, Cd: 793±26 pg/g tissue, p<0.001) and IL-6 (control: 150±78, Cd: 325±65 pg/g tissue, p<0.001) levels. Histopathological examination under light microscope suggested a combination of ongoing necrosis and apoptosis. Increased caspase-3 levels were measured after Cd toxicity (control: 12±2, Cd: 18±3 pmol/µg/min, p<0.001). Conclusion: Chronic Cd administration induces inflammation and apoptosis in rat hearts. Cadmium causes increased galectin-3 production from heart tissue. The formation of TNF-α due to Cd exposure may likely trigger this mechanism.

3.Application of Healthy Heart program in the two semi-rural areas in Eskişehir
İnci Arıkan, Selma Metintaş, Cemalettin Kalyoncu
PMID: 21788203  doi: 10.5152/akd.2011.131  Pages 485 - 491
Objective: The purpose of this study was to raise awareness of people in two semi-rural regions of Eskişehir in terms of cardiovascular diseases (CVD) risk factors and to promote related heart-healthy behaviors. Methods: The study was a semi-experimental intervention and featured as a two-phase design. In the first phase of the study, participants received visits at home. Individuals in intervention and control areas were given a participation form that indicated the Framingham Risk Score (FRS). Other training materials were distributed throughout the intervention area. The second phase was planned as a nested case- control study. The first phase included 2.766 persons and the second phase included 778 persons. In the evaluation of the data the Pearson Chi-square and Student’s t-test for independent samples, Mc-Nemar Chi-square and the paired t-test for dependent samples were applied. Results: During the first phase, the frequency of FRS metrics above 10% was 26.2% for males, 18.1% for females in the intervention area, 22.9% for males, and 14.9% for females in the control area. There was no difference between males and females in terms of scoring for control and intervention areas (p>0.05). Based on the FRS data, the second phase revealed a decrease of 15.4% in males (p<0.001) and 10.2% in females (p<0.001) in the intervention area and an increase of 8.2% in males (p=0.011) and 3.8% in females (p=0.078) in the control area. Conclusion: In this study, teaching individuals who were older than twenty years of age about cardiac health seemed to be an effective method for decreasing CVD risk factors.

4.Evaluation of the effects of chronic biomass fuel smoke exposure on peripheral endothelial functions: an observational study
Ali Buturak, Ahmet Genç, Özden Sıla Ulus, Egemen Duygu, Arda Şanlı Ökmen, Hüseyin Uyarel
PMID: 21788202  doi: 10.5152/akd.2011.132  Pages 492 - 497
Objective: To evaluate the effect of chronic biomass fuel (BMF) smoke exposure on peripheral endothelial functions. Methods: Forty-seven healthy subjects who have been exposed to BMF smoke since birth (mean age 31.6±6.8 years, 21 male) were enrolled in the present cross-sectional observational study. The control group consisted of 32 healthy subjects (mean age 27.9±4.4 years, 11 male). The carotid intima media thickness (CIMT), flow associated dilatation (FAD %) and endothelium independent vasodilatation (GTN %) were assessed in all subjects. The carotid CIMT was defined as the distance between the leading edge of the lumen–intima and the media–adventitia interfaces. FAD % was defined as the percentage change in the internal diameter of the brachial artery during reactive hyperemia related to the baseline. GTN % was defined as the change in diameter in response to the application of 400 µg of glyceril trinitrate relative to the baseline scan at the end of the fourth minute. Statistical analysis was performed using Student’s t-test, Chi-square test and Spearman rank order correlation analysis. Results: The average exposure time of the subjects to biomass fuel smoke was 31.7±6.6 years. They have been exposed to dung inhalation products meanly 8.3±1.8 months in a year seasonally. The average daily exposure time was 15.7±3.3 hours. CIMT values of the two groups were not statistically different from each other (0.47±0.09 vs. 0.49±0.06 mm, p=0.138). However, a markedly reduced FAD % was determined in the study group (5.06±4.95 vs. 10.7±4.64, p<0.001). And GTN % of the BMF exposed group was significantly lower than the control group (14.41±8.47 vs. 21.85±7.87, p<0.001). Conclusion: FAD % and GTN % are markedly reduced in the individuals who have been exposed to BMF smoke inhalation products. Therefore, chronic BMF smoke exposure may be a risk factor for the development of endothelial dysfunction.

5.Neutrophil gelatinase-associated lipocalin levels in right and left heart failure: an observational study
Fatih Koca, İbrahim Halil Tanboğa, Mehmet Mustafa Can, Alper Özkan, Nurşen Keleş, Hacer Ceren Tokgöz, Tahir Bezgin, Cihangir Kaymaz
PMID: 21788201  doi: 10.5152/akd.2011.133  Pages 498 - 503
Objective: Neutrophil gelatinase-associated lipocalin (NGAL) is a novel marker for early detection of renotubular deterioration. Despite the limited data concerning the NGAL in heart failure (HF), significance of NGAL in right-sided HF remains unknown. We assessed serum and urinary NGAL in left and right-sided HF due to non-ischemic cardiomyopathy (NICMP) and severe pulmonary arterial hypertension (PAH). Methods: In this cross-sectional observational study, we compared three groups; 35 patients with NICMP, 28 patients with PAH and 27 healthy controls. None had a serum creatinine ≥1.5 mg/dL. Plasma brain natriuretic peptide (BNP) levels, estimated glomerular filtration rate (eGFR) by Cockroft-Gault (CG) and Modification of Diet in Renal Disease Study formulas, echocardiographic measures of left and right ventricles (LV, RV) and non-invasive measurement of cardiac index (CI) by echocardiography and impedance cardiography were assessed. Differences among the groups for continuous variables were evaluated by the ANOVA and the Kruskal-Wallis test as appropriate. The Chi-square test was used for comparison of categorical variables. Results: Despite eGFR with CG formula was lower in NICMP and PAH subsets as compared to those in controls (102±27 and 99.4±29.4 vs 122.4±25.9 mL/min, p<0.05 and p<0.005 in order), serum NGAL [141 (113-151), 174 (130-192) and 132 (95-181) ng/mL] and urinary NGAL [15 (12-18), 15 (12-22) and 13 (8-18) ng/mL] levels were not different among groups (p=0.15 and p=0.35, respectively). Conclusion: Despite the mildly impaired eGFR in left-sided HF due to NICMP and right-sided HF due to PAH, neither serum, nor urinary NGAL levels are elevated in these patients.

6.Tricuspid annular motion in right coronary artery-related acute inferior myocardial infarction with or without right ventricular involvement
Serdar Bayata, Eyüp Avcı, Murat Yeşil, Erdinç Arıkan, Nursen Postacı, Selcen Yakar Tülüce
PMID: 21788200  doi: 10.5152/akd.2011.134  Pages 504 - 508
Objective: Tricuspid annular movement and velocities before and after thrombolytic therapy were investigated for the detection of right ventricular (RV) involvement in RCA (right coronary artery)-related acute inferior myocardial infarction (IMI). Methods: Patients with RCA-related acute IMI were evaluated for this pilot prospective cohort study. Annular movement was measured by TAPSE (tricuspid annular plane systolic excursion), and annular velocities were measured by tissue Doppler echocardiography. Data collected before and after thrombolysis and angiography. Diagnosis of RV myocardial infarction (RVMI) was defined by co-presence of electrocardiographic and angiographic criteria. Chi-square and Student’s t-tests were used in statistical analysis. Results: Thirty-one patients were included. Before thrombolysis, annular velocities and TAPSE were found significantly higher in patients without RVMI than in patients with RVMI. Comparison of tricuspid systolic velocity (Sa) and movement before and after thrombolytic therapy in patients without RVMI revealed no significant difference (21.6±2.1 mm vs. 21.8±2.0 mm p>0.05 and 136.1±8.8 mm/s vs. 137.5±9.0 mm/s p>0.05, for TAPSE and Sa respectively). Contrarily, in patients with RVMI, TAPSE and systolic velocity increased significantly after thrombolysis compared with pre-thrombolysis (16.2±2.0 mm vs. 17.6±1.8 mm p=0.001 and 110.0±12.6 mm/s vs. 113.08±12.7 mm/s p=0.027 for TAPSE and Sa respectively). Diastolic velocities did not change significantly after thrombolysis in patients with RVMI. Conclusion: Tricuspid annular movement and velocity measurement by echocardiography may contribute to echocardiographic diagnosis of RV involvement in RCA-related IMI. Patients without RVMI have significantly higher annular velocities and TAPSE than in patients with RVMI before thrombolysis. Only in IMI patients with RVMI, significant increases in TAPSE and Sa were observed after thrombolysis.

7.Influence of the severity of obstructive sleep apnea on nocturnal heart rate indices and its association with hypertension
Özcan Özeke, Mutlu Güngör, Serap Bilen Hızel, Dilek Aydın, Özcan Ertürk, Mehmet Kutlu Çelenk, Hazım Dinçer, Gürler İliçin, Fuat Özgen, Can Özer
PMID: 21788199  doi: 10.5152/akd.2011.135  Pages 509 - 514
Objective: Both heart rate (HR) and blood pressure parameters provide important information on the pathophysiology of the cardiovascular regulatory mechanisms, and are mainly affected by the autonomic nervous system. We sought to clarify whether the severity of obstructive sleep apnea (OSA) affects nocturnal HRs and whether there is a relationship between nocturnal HRs and the presence of hypertension. Methods: We retrospectively reviewed medical records of all patients who performed nocturnal polysomnography with monitoring of HRs, and examined whether there is a relationship among the nocturnal HRs, the severity of OSA and the presence of hypertension. Results: A total of 540 patients were included in the study. Nocturnal mean and maximal HRs were significantly higher in severe OSA group than in moderate (p=0.002 and p>0.05 in females; p<0.049 and p=0.044, in males, respectively) and mild OSA groups (p<0.001 and p=0.003, respectively in females, p<0.001 and p=0.004, respectively in males); and there was a positive correlation between the nocturnal mean HR and apnea-hypopnea index (Pearson’s p=0.504, p<0.001 in female group; Pearson’s p=0.254, p<0.001 in male group) and again the nocturnal mean HR and the presence of HT (Spearman’s p=0.090, p=0.394 in female group; Spearman’s p=0.272, p<0.001 in male group) in both gender groups. Conclusion: We found that nocturnal mean and maximal HRs to be associated with severity of OSA and the presence of hypertension. We speculated that increased nocturnal mean and maximal HRs caused by sympathetic nervous system activation in OSA might be one of the mechanisms in explaining the hypertension and OSA association.

8.Acute and long-term follow-up results of percutaneous mitral balloon valvuloplasty: a single-center study
Şule Korkmaz, Burcu Demirkan, Yeşim Güray, Mehmet Birhan Yılmaz, Tolga Aksu, Hatice Şaşmaz
PMID: 21821502  doi: 10.5152/akd.2011.136  Pages 515 - 520
Objective: Percutaneous mitral balloon valvuloplasty (PMBV) is the method of choice in treatment of patients with hemodynamically significant mitral stenosis. We aimed to analyze acute and long-term clinical and echocardiographic consequences of PMBV. Methods: In this retrospective cohort study; 311 patients who underwent PMBV in our Cardiology Clinic at Türkiye Yüksek İhtisas Education and Research Hospital between January 2000 and March 2004 were evaluated for acute procedural outcomes and primary endpoints (death, rePMBV, mitral valve replacement (MVR)). All 311 patients were contacted by phone call or letter at least five years after the procedure. Of the 311 patients, 87 who defined NYHA class II-IV symptoms were invited for a control visit and detailed echocardiographic evaluation. Sixty-three patients out of 87 who completed follow-up were enrolled for long-term consequences. Those 63 patients were subclassified into two groups as those without any negative event (n=26) (Group 1) and those with mitral valve area (MVA) (<1.5 cm2), rePMBV or referral to MVR (n=37) (Group 2) on follow up to 6.4±1.6 years. Results: In the analysis of 311 patients, acute post procedural success, which was defined as mitral valve area (MVA) ≥1.5 cm2 without severe mitral regurgitation, was 94% and was only associated with preprocedural MVA (p=0.008). In the logistic regression analysis, preprocedural MVA was the only independent parameter, associated with acute procedural success (Expβ=0.004, 95%CI 0.0001-0.234, p=0.008). In the long-term follow up of 63 patients, the patients with uneventful course (Group 1) had significantly higher MVA (p<0.001), lower mean (p=0.001) and peak (p<0.001) transmitral gradients immediately after the procedure when we compared to the patients in Group 2. It was also noticed that patients with at least 60% improvement in MVA experienced composite end point much less frequently compared to those with less than 60% improvement in MVA (5% vs. 30.4%, p=0.009). Kaplan-Meier analysis yielded significantly diverging cumulative survival curves for those with and without at least 60% improvement in MVA (p=0.003). Conclusion: Concerning long-term follow up data of patients undergoing PMBV in a single center, it seems only acute postprocedural MVA was significantly associated with long-term consequences.

EDITORIAL COMMENT
9.Percutaneous mitral valvuloplasty: the debate is there
Wail Nammas
PMID: 21827998  doi: 10.5152/akd.2011.142  Pages 521 - 522
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
10.Value of IGF-I levels in the evaluation of response to treatment with levosimendan in patients with severe heart failure
Serhat Işık, Mustafa Çetin, Hülya Çiçekcioğlu, Özgül Uçar, Zehra Güven Çetin, Ufuk Özuğuz, Fatih Bakır, Dilek Berker, Serdar Güler
PMID: 21821501  doi: 10.5152/akd.2011.137  Pages 523 - 529
Objective: Levosimendan treatment has inotropic, anti-stunning, and cardioprotective effects in the setting of acute decompensated heart failure (HF). Among studies conducted on the treatment of heart failure, those based on the growth hormone axis are of particular interest. The aim of this study was to determine the value of baseline insulin-like growth factor 1 (IGF-I) measurements in predicting response to levosimendan treatment. Methods: The study population included patients on standard heart failure treatment who presented with functional capacity NYHA class 3-4 and left ventricular (LV) ejection fraction less than 35% were enrolled in this prospective, cohort study. Pre- and post-treatment symptoms of patients (72 hours after the completion of levosimendan infusion) and echocardiographic parameters were evaluated and blood samples were collected. Mann-Whitney U, Pearson Chi-square and Wilcoxon Sign Rank tests were used for statistical analysis. Correlations were determined using Spearman correlation analysis. Results: Thirty patients were enrolled in this study, 83.3% of whom were male and 16.7% were female, with a mean age of 62.6 ±10.1 years. Mean baseline IGF-I level was 106.9±47.0 µg/L. Statistically significant improvements were observed in NYHA class, mean brain natriuretic peptide (BNP) levels, LV ejection fraction and LV end-systolic volume values following treatment with levosimendan (respective pre-treatment and post-treatment values: 3.5±0.5 vs. 2.5±0.7, p<0.001; 1209.8±398.6 pg/ml vs. 704.1±344.6 pg/ml, p<0.001, and 25.7±6.6% vs. 29.0±6.8%, p=0.021, and 164.1±45.7 ml vs. 152.8±50.6 ml, p=0.012). Fourteen patients (46.7%) had low IGF-I levels, taking into consideration variations due to age and gender. Patients with normal baseline IGF-I values showed more significant decreases in BNP levels in response to treatment compared to those with low baseline IGF-I levels (650.5±367.2 pg/ml vs. 340.1±269.0 pg/ml, p=0.014). Conclusion: Baseline IGF-I levels may be used to predict response to levosimendan treatment in patients hospitalized for decompensated HF.

11.The effect of streptokinase therapy in STEMI and conventional therapy in NSTEMI patients on TIMI risk index, B-type natriuretic peptide and high-sensitive C-reactive protein
İbrahim Halil Kurt, Mustafa Kemal Batur, İlker Ünal
PMID: 21821500  doi: 10.5152/akd.2011.138  Pages 530 - 535
Objective: In this study, it was aimed to investigate the effect of streptokinase therapy in ST elevation myocardial infarction (STEMI) and conventional therapy in non-ST elevation myocardial infarction (NSTEMI) patients on the thrombolysis in myocardial infarction (TIMI) risk index (TRI), B-type natriuretic peptide (BNP), and high-sensitive C-reactive protein (hs-CRP) levels. Methods: Eighty-six STEMI (male/female ratio: 65/21, mean age 57.52±9.87 years) and eighty NSTEMI patients (male/female ratio: 50/30, mean age 57.6±1.7 years) were included in this prospective observational study. Hs-CRP and BNP were measured and TIMI risk index was calculated in all patients. Coronary angiography was performed in all patients for principally determining TIMI flow rate. Chi-square test, paired t-test or Wilcoxon signed rank test, ANOVA and Spearman correlation analysis were used for statistical analysis where appropriate. Results: STEMI patients had higher systolic blood pressure, heart rate, BNP and hs-CRP values than NSTEMI patients at admission (p=0.04, p=0.01, p=0.001 and p=0.01, respectively). Thrombolytic therapy in STEMI patients resulted in statistically significant higher levels of BNP, hs-CRP and TRI values compared to baseline levels (p=0.001, p=0.001 and p=0.042, respectively). For NSTEMI patients conventional therapy yielded statistically significant decrease in systolic blood pressure levels and increase in TRI (p=0.001 and p=0.047, respectively). We found significantly lower BNP, hs-CRP in patients with higher TIMI flow rate (p=0.001 and p=0.001 respectively). Conclusion: Thrombolytic therapy with streptokinase failed to decrease BNP, hs-CRP and TRI values in STEMI patients. Conventional therapy in NSTEMI patients also resulted in higher TRI values than baseline values. We reached TIMI 3 flow in only 10.5% of the study patients, which may be responsible for our findings.

12.Clinical significance of intestinal type fatty acid binding protein in patients undergoing coronary artery bypass surgery
Aynur Camkıran, Aslı Dönmez, Derya Aldemir, Rauf Agah İşgüzar, Bahadır Gültekin
PMID: 21821499  doi: 10.5152/akd.2011.139  Pages 536 - 541
Objective: The aim of this study was to determine whether serum levels of intestinal type fatty acid binding protein (I-FABP) are related to intestinal ischemia in patients undergoing coronary bypass surgery. Methods: The study was planned as prospective, observational. Elective coronary artery bypass candidate patients between ages of 50 and 70 were consecutively included in the study. Thirty-five patients scheduled for cardiopulmonary bypass (CPB) were identified as the CPB group and 16 patients not scheduled for CPB were identified as the off-pump coronary artery bypass surgery (OPCAB) group. The variables between and within the groups were analyzed with Student’s t, Mann-Whitney U, Friedman and Wilcoxon tests respectively. Results: In both CPB and OPCAB groups, I-FABP level at the end of the operation was significantly higher than that noted at the beginning of the operation (p<0.005). In the CPB group, there was a significant drop in I-FABP from the end of the operation to each of the postoperative time points (12th hour and 24th hour) (respectively p<0.001, p<0.001). In the OPCAB group, the I-FABP levels at both postoperative time points were lower than that at the end of the operation (p<0.001), and the level at 24-hour post-surgery was significantly lower than at both the end-of-operation I-FABP value (p<0.001) and the 12-hour post-surgery I-FABP value. Conclusion: Since we have not observed any intestinal ischemia through our research, slight changes of I-FABP measurements make us believe that I-FABP would be a valuable way to monitor for intestinal ischemia in patients who undergo cardiac surgery.

13.Clinical outcomes of mitral valve repair in mitral regurgitation: a prospective analysis of 100 consecutive patients
Aşkın Ali Korkmaz, Burak Onan, Ali Soner Demir, Sevim İndelen Tarakçı, Recep Gündoğdu, İlyas Akdemir, Mustafa Güden
PMID: 21821498  doi: 10.5152/akd.2011.140  Pages 542 - 550
Objective: Mitral valve repair has become the procedure of choice for almost every type of mitral regurgitation (MR) in the current surgical era. We assessed clinical outcomes of mitral valve repair in severe MR. Methods: In this prospective cohort study, 103 patients (61 male, 42 female, mean age 53.2±14.8 years), who were planned to undergo valve repair were included. Mitral valve pathology was regurgitant in 86% and mixed in 14% of patients. The intention to perform mitral repair was successful in 100 (97.1%) of patients. Concomitant procedures were performed in 57 (57%) patients including 31 coronary artery bypass grafting and 13 tricuspid valve repairs. After surgery, early (<30 days) and late (>30 days) complications were recorded. Postoperative echocardiography was performed in all patients at discharge and during clinical follow-up. Late survival and freedom from adverse events including thromboembolism, endocarditis, reoperation, and residual severe MR were estimated by using the Kaplan-Meier survival analysis. Results: There was no early mortality. Echocardiographic assessment of patients at discharge revealed no/trivial regurgitation in 89% and mild (1+) MR in 11% of all patients. Late mortality occurred in only one patient at 14 months because of renal failure. The mean follow-up period of patients was 21.2±10.3 months. Echocardiographic examination during follow-up revealed that mitral insufficiency was none or mild in 96% of patients. Three (3%) patients had moderate (2+) MR and were treated medically. Mitral insufficiency recurrence with severe (3+) regurgitation occurred in one (1%) patient undergoing coronary artery revascularization and concomitant left ventricular aneurysmectomy. Re-operation was needed in only one (1%) case because of infective endocarditis that was treated with mechanical valve replacement. Kaplan-Meier estimates were 99±2.7% for late survival and 98±2.2%, 99±2.7%, 99±2.7% and 99±0.9% for freedom from thromboembolism, endocarditis, reoperation, and residual severe MR, respectively. Conclusion: This study showed that mitral valve repair provides excellent surgical outcomes. Repair procedures are safe, and highly effective, but operations require a considerable surgical experience.

REVIEW
14.Cardiovascular risk assessment and risk stratification- guided therapy: Predict, prevent and individualize
Dilek Ural
PMID: 21821497  doi: 10.5152/akd.2011.141  Pages 551 - 556

SCIENTIFIC LETTER
15.The effects of penetration and dose on in vivo imaging
Ahmet Tulga Ulus, Nilüfer N. Turan, Ferda Pınarlı, Burak Erdolu, Serdar Tuncer, Ersin Fadıllıoğlu, Tuncay Delibaşı
PMID: 21827997  doi: 10.5152/akd.2011.143  Pages 557 - 558
Abstract | Full Text PDF

CASE REPORT
16.A rare cause of atrial fibrillation: a European hornet sting
Sercan Okutucu, Cingiz Şabanov, Enis Abdulhayoğlu, Nalan Metin Aksu, Bülent Erbil, Kudret Aytemir, Hilmi Özkutlu
PMID: 21827996  doi: 10.5152/akd.2011.144  Pages 559 - 560
Abstract | Full Text PDF

17.Moxifloxacin-dependent Torsades de Pointes
Selma Kenar Tiryakioğlu, Osman Tiryakioğlu, Faruk Aktürk, Ertuğrul Mehmetoğlu, Ethem Kumbay
PMID: 21827995  doi: 10.5152/akd.2011.145  Pages 560 - 562
Abstract | Full Text PDF

18.An inferior myocardial infarction due to single dose paracetamol use
Hasan Korkmaz, Mehtap Gürger
PMID: 21827994  doi: 10.5152/akd.2011.146  Pages 562 - 563
Abstract | Full Text PDF

LETTER TO THE EDITOR
19.Microorganisms and valve tissue
Vedat Davutoğlu, Süleyman Ercan, Muhammed Oylumlu
PMID: 21827993  doi: 10.5152/akd.2011.147  Pages 564 - 565
Abstract | Full Text PDF

20.Complete cure with medical treatment of prosthetic mitral valve endocarditis, which is initially diagnosed as mitral valve thrombus
Ahmet Karabulut, Özgür Sürgit, Özgür Akgül, Aydın Yıldırım
PMID: 21827992  doi: 10.5152/akd.2011.148  Pages 565 - 566
Abstract | Full Text PDF

21.Nuclear leakage and hypertension: Is there any relationship?
Viroj Wiwanitkit
PMID: 21827991  doi: 10.5152/akd.2011.149  Page 566
Abstract | Full Text PDF

22.RF ablation of WPW syndrome using Ensite Array balloon mapping and Hansen-Sensei robotic Cool-path catheter
Ritvan Chasan, Nedim Soydan, Mehmet K. Burgazlı, Wolfgang Franzen, Mariana S. Parahuleva, Ali Erdoğan
PMID: 21827990  doi: 10.5152/akd.2011.150  Page 567
Abstract | Full Text PDF

MISCELLANEOUS
23.Building the international network of mentors and young scientists: The international Scientific Summer School in Romania 2011
Ljuba Bacharova, Ioana Mozos, Lubica Palkovicova
doi: 10.5152/akd.2011.156  Pages 568 - 570
Abstract

E-PAGE ORIGINAL IMAGES
24.Kissing thrombi on the mitral prosthetic valve and in the left atrial appendix
İbrahim Halil Kurt, Sait Demirkol, Oben Baysan
PMID: 21827988  doi: 10.5152/akd.2011.152  Page E23
Abstract | Full Text PDF

25.A giant broccoli-like thrombus secondary to patent foramen ovale
Onur Kadir Uysal, Durmuş Yıldıray Şahin, Buğra Özkan, Mevlüt Koç, Mehmet Necati Zincirli, Murat Çaylı
PMID: 21827989  doi: 10.5152/akd.2011.151  Page E23
Abstract | Full Text PDF

26.Venous spasm during pacemaker implantation
Xu Duan, Yun Shen, Hai-ying Xu
PMID: 21827987  doi: 10.5152/akd.2011.153  Page E24
Abstract | Full Text PDF

27.Challenging electrocardiography
Ahmet Vural, Umut Çelikyurt, Ayşen Ağaçdiken
PMID: 21827986  doi: 10.5152/akd.2011.154  Pages E24 - E25
Abstract | Full Text PDF

28.Incidental finding on coronary multidetector CT angiography; a quadricuspid aortic valve
İrem Okçular, Deniz Sevinç, Semih Aytaçlar, Muzaffer Değertekin
PMID: 21827985  doi: 10.5152/akd.2011.155  Page E25
Abstract | Full Text PDF