ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 12 (5)
Volume: 12  Issue: 5 - August 2012
1.On medical treatment vs revascularization, subscription, the Anatolian Journal of Cardiology awards, remembering Dr. Ersin
Bilgin Timuralp
PMID: 22626670  doi: 10.5152/akd.2012.149  Pages 375 - 376
Abstract |Full Text PDF

2.Quantitative assessment of the left atrial myocardial deformation in patients with chronic mitral regurgitation by strain and strain rate imaging: an observational study
Ahmet Kayal, Ziya Şimşek, Serdar Sevimli, Şule Karakelleoğlu, Mustafa Kemal Erol, İbrahim Halil Tanboğa, Mustafa Kurt
PMID: 22564267  doi: 10.5152/akd.2012.120  Pages 377 - 383
Objective: We evaluated regional left atrial (LA) myocardial deformations by strain (S) and strain rate (SR) imaging during LA pump, reservoir, and conduit phases in patients with chronic rheumatic mitral regurgitation (MR). Methods: This cross-sectional observational study included 42 patients with moderate-to-severe MR who had normal left ventricular (LV) function, and 36 healthy control subjects. Conventional echocardiographic data were used to calculate LV and LA dimensions, volumes and functional indices (LA ejection fraction, LA active and passive emptying fraction). Longitudinal S/SR indices of the mid and superior segments of LA walls were measured during the three LA phases. Student t-test, Mann-Whitney U test, Chi-square test and Bland-Altman analysis were used for statistical analysis. Results: LV systolic functions were similar in the patient and control groups. LV diameters, LA diameters and LA volumes were greater in the patient group compared with the control group (p<0.05, p<0.001, and p<0.001). LA ejection fraction and LA active emptying fraction values were lower in the patient group than in the control group (56±7 vs. 63±5%, 33±9 vs. 40±4%, p<0.05 for both). During the three LA phases, longitudinal S/SR values were significantly lower in all the segments in the patient group compared with the control group (p<0.001 for S, p<0.001 and p<0.05 for SR). Conclusion: Regional LA longitudinal myocardial deformations are observed to be impaired during all the mechanical phases in patients with moderate-to-severe MR. Volume overload, remodeling and rheumatic effects may be responsible for the LA myocardial dysfunction in these patients.

3.The frequency of embolic risk factors and adequacy of anti-embolic treatment in patients with atrial fibrillation: a single tertiary center experience
Emir Karaçağlar, İlyas Atar, Begüm Yetiş, Hafize Corut, Burcu Ersoy, Kerem Yılmaz, Bülent Özin, Haldun Müderrisoğlu
PMID: 22564270  doi: 10.5152/akd.2012.123  Pages 384 - 390
Objective: Though atrial fibrillation (AF) is the most common sustained arrhythmia permanently; there is not enough data about the prevalence, frequency of risk factors, and adequacy of anticoagulant therapy. We aimed to investigate the prevalence of AF, the frequency of risk factors, adequacy of anticoagulant therapy in patients who were admitted to our outpatient tertiary cardiology clinic according to current guidelines. Methods: Patients, admitted to our Cardiology outpatient clinic between January - June 2010 and had a history of AF were included to the study retrospectively. Patients’ demographic findings, clinical AF classification, CHA2DS2VASC scores, treatments the measured INR values in last 12 months retrospectively and the success of anticoagulant therapy were evaluated. Results: Overall, 432 (9.1%) of 4721 patients had AF. Among them 253 (58.5%) patients were female, mean age was 70.4 years. Permanent AF was the most common type. The most common risk factor was hypertension (71.9%). CHA2DS2VASC score was ≥ 2 in 377 patients (87.2%) and 254 (67.3%) of those patients had absolutely indicated for anticoagulation therapy, were taking warfarin. Sixteen of 37 patients with one risk factor, and 10 of 18 patients without risk factors were also receiving warfarin. Although warfarin was indicated in 123 patients, 36 patients had contraindications, 13 patients refused anticoagulation, and warfarin was stopped in 5 patients because of noncompliance with treatment. 15.9% of patients were not on warfarin although anticoagulation was indicated and no contraindication. 83.5% patients INR levels were between therapeutic ranges. Conclusion: Anticoagulation is applied successfully among an important part of AF patients in our tertiary center, but in a substantial group of patients the guidelines are still not implemented. New, cost-effective, safe, accessible treatments are needed for warfarin contraindicated patients

4.Ultrasound evaluation of the inferior vena cava collapsibility index in congestive heart failure patients treated with intravenous diuretics: new insights about its relationship with renal function: An observational study
Renato De Vecchis, Carmelina Ariano, Adelaide Fusco, Antonio Ciccarelli, Carmela Cioppa, Anna Giasi, Claudia Esposito, Salvatore Cantatrione
PMID: 22564268  doi: 10.5152/akd.2012.121  Pages 391 - 400
Objective: In chronic heart failure (CHF), collapsibility index of the inferior vena cava (IVCCI) is used for noninvasive ultrasonographic appraisal of central venous pressure, but it also may be related both to estimated glomerular filtration rate (eGFR) and renal outcome. Methods: On the basis of retrospective observational cohort study, we analyzed 49 patients with right or biventricular CHF in III NYHA class, who had undergone intravenous intensive treatment with furosemide. Aggravated renal dysfunction (ARD) was defined by serum creatinine (Cr) increase of ≥0.3 mg/dL from baseline. IVCCI was categorized in three layers (IVCCI ≤15%, IVCCI 16-40% and IVCCI >40%). The predictors of ARD were searched for as well as any relation between basal IVCCI and both eGFR at admission and occurrence of ARD. Results: Overall, 15 cases and 34 controls were compared. Multivariate predictors of ARD were a lower basal eGFR (HR: 0.82 CI: 0.72-0.94 p=0.0045) and intravenous furosemide daily mean dose >80 mg (HR: 48.62 CI: 1.62-3841.5 p=0.0430). A very significant positive correlation was found between IVCCI at admission ≤ 15% and basal eGFR (r=0.96 p<0.0001), while a negative correlation with eGFR was detected in the IVCCI highest (>40%) range (r=-0.696 p=0.0013). Furthermore, the category with basal IVCCI >40% showed a higher rate of ARD compared to that with basal IVCCI 16-40% (p<0.05). Conclusion: On the basis of the demonstrated u-shaped relationship between IVCCI and eGFR both the stratum with the highest (>40%) and the one with the lowest (≤15%) basal IVCCI may be associated with increased risk of ARD

5.Central venous obstruction and clinical predictors in patients with permanent pacemaker
Murat Yeşil, Serdar Bayata, Erdinç Arıkan, Selim Ekinci, Erdal Gürsul, Nursen Postacı
PMID: 22564269  doi: 10.5152/akd.2012.122  Pages 401 - 405
Objective: This study investigated the proportion of silent venous obstruction in patients who underwent pacemaker or lead reimplantation for various reasons. We also investigated independent predictors or risk factor of venous obstruction in this patient population. Methods: Seventy-three patients who underwent pacemaker pulse generator and/or lead reimplantation in our institution between 2007 and 2010 were enrolled for this retrospective case-control study. Prior to procedure, patients underwent ipsilateral venography. Patients’ venographies were classified as non-significant obstruction (stenosis ≤70%, including normal venogram), significant obstruction (stenosis >70%) and complete obstruction. Continuous and categorical data were compared with Mann-Whitney U test and Chi-square statistics respectively. Logistic regression analysis was used to identify independent predictors of venous obstruction. Results: Complete or significant silent central venous obstruction (CVO) proportion was detected as 9.5% (n=7). Basal characteristics of patients with or without CVO were comparable. Significantly increased pacemaker pocket erosion incidence (57% vs 0%, p=0.001, in groups with and without CVO respectively) and significantly higher mean pacemaker age (15.3±10.2 years vs 10.4±5.1 years, p=0.047, in groups with and without CVO respectively) were found in group with CVO. Pacemaker pocket erosion (OR 3.00; 95% CI 1.024-9.302; p=0.001), higher pacemaker age (OR 1.33; 95% CI 1.026-1.733; p=0.02) were found as independent CVO predictors in multiple logistic regression analysis. Correlation analysis also revealed a significant correlation between previous or current pacemaker pocket erosion and CVO (r=0.80, p=0.001). Conclusion: Ipsilateral venography is a useful procedure prior to pacemaker or lead reimplantation to detect CVO. In addition to the increased pacemaker age, current or past history of erosion and infection at pacemaker pocket are probable clinical conditions related to CVO. These clinical conditions create a predisposition to CVO with unknown mechanisms, according to the results of this preliminary study.

6.Effects of radiation emitted from mobile phones on short- term heart rate variability parameters
Metin Yıldız, Derya Yılmaz, İnan Güler, Çağdaş Akgüllü
PMID: 22564271  doi: 10.5152/akd.2012.124  Pages 406 - 412
Objective: In this study, the effects of radiation emitted from mobile phone (MP) on heart rate variability (HRV) which is accepted a non-invasive indicator of autonomic nervous system (ANS) were investigated with considering the deficiency of previous studies. Methods: A randomized controlled study has been designed and utilized with 30 young and healthy volunteers. During the experiment that had three periods, the electrocardiogram (ECG) and respiration signals were recorded and MP was attached to subjects’ right ear with a bone. Ten subjects selected randomly were exposed to high -level radiation during the second period (Experimental Group 1). Ten of others were exposed during the third period with maximum level radiation (Experimental Group 2). Ten records were also made while MP was closed as a control. Short -term HRV parameters were obtained and repeated measures ANOVA and suitable post-hoc tests applied to the results. Results: According to the results of the repeated measures ANOVA; there were no significant main effects of groups. However, there were some significant differences in measuring time periods and groups*period interactions. The post-hoc tests showed that mean R to R interval and HF power are significantly changed by maximum radiation emitted from MP. Conclusion: Due to the radiation emitted from MPs at maximum power, some changes may occur in HRV parameters that are associated with increased parasympathetic activity. But, the level of these changes is similar to daily activities as excitement, and stand up.

7.Elastic properties of the abdominal aorta in the children with bicuspid aortic valve: an observational study
Dolunay Gürses, Arif Ruhi Özyürek, Ertürk Levent, Zülal Ülger
PMID: 22591936  doi: 10.5152/akd.2012.125  Pages 413 - 419
Objective: Abnormalities of the aortic root and ascending aorta are common in patients with a bicuspid aortic valve (BAV). The aim of this study was to evaluate the stiffness of the abdominal aorta in children with BAV. Methods: In this cross-sectional observational study, we evaluated 35 children with normally functioning or mildly regurgitant BAV and 35 healthy children as controls. All children were noninvasively evaluated with transthoracic echocardiography. Annulus of aorta and abdominal aorta diameters were measured. Aortic strain (S), pressure strain elastic modulus (Ep), pressure strain normalized by diastolic pressure (Ep*), aortic stiffness β index (βSI) and, aortic distensibility (DIS) were calculated using the measured data. In evaluation of the data Student’s t-test, Chi-square test, Pearson’s correlation and multivariate linear regression analysis were used. Results: Diameter of the aortic annulus was found significantly larger in the children with BAV than the control group (p<0.05). The abdominal aorta systolic and diastolic diameters were similar in the two groups (p>0.05). The children with BAV exhibited significantly lower S (0.210±0.04/0.267±0.07, p<0.001) and DIS (1.04±0.2/1.4±0.4 10-6 cm2 dyne-1, p<0.001); and higher Ep (200±39/153±47 N/m-2, p<0.001), Ep* (3.42±0.9/2.5±0.9, p<0.001) and βSI (1.1±0.3/0.84±0.3, p<0.001) than the control group. There was no correlation between the systolic and diastolic diameters of abdominal aorta and aortic elasticity parameters (p>0.05). Conclusion: Bicuspid aortic valve is associated with an increased abdominal aortic stiffness in children. However, impaired abdominal aortic elasticity is not due to abdominal aortic dilatation. These findings require validation by further studies.

8.Pulsatile venous waveform quality in Fontan circulation-clinical implications, venous assists options and the future
Ergin Koçyıldırım, Onur Dur, Özlem Soran, Egemen Tüzün, Matthew W. Miller, Greggory J. Housler, Peter D. Wearden, Theresa W. Fossum, Victor O. Morell, Kerem Pekkan
PMID: 22591937  doi: 10.5152/akd.2012.126  Pages 420 - 426
Objective: Functionally univentricular heart (FUH) anomalies are the leading cause of death from all structural birth defects. Total cavopulmonary connection (TCPC) is the last stage of the palliative surgical reconstruction with significant late hemodynamic complications requiring high-risk heart transplantation. Alternative therapeutic options for these critically ill patients are crucial. In Phase I, we investigated the effect of pulsatility of venous flow (VF) waveform on the performance of functional and “failing” Fontan (FF) patients based on conduit power loss. In phase 2, the effect of enhanced external counter pulsation on Fontan circulation flow rates is monitored. Methods: In phase 1, Doppler VFs were acquired from FF patients with ventricle dysfunction. Using computational fluid dynamics (CFD), hemodynamic efficiencies of the FF, functional and in-vitro generated mechanically assisted VF waveforms were evaluated. In phase 2, Fontan circulation on sheep model was created and enhanced external counter pulsation (EECP) applied. Results: Variations in the pulsatile content of the VF waveforms altered conduit efficiency notably. High frequency and low amplitude oscillations lowered the pulsatile component of power losses in FF VF waveforms. The systemic venous flow, pulmonary artery and aorta flows increased by utilizing EECP. Conclusion: Our data highlighted the significance of VF pulsatility on energy efficiency inside SV circulation and the feasibility of VF waveform optimization. EECP assist in Fontan circulation can result in venous flow augmentation

9.Normal values correlates' of carotid intima- media thickness and affecting parameters in healthy adults
Fahri Halit Beşir, Sibel Yazgan, Gökhan Celbek, Mesut Aydın, Ömer Yazgan, Melih Engin Erkan, Mesut Erbaş, Adem Güngör
PMID: 22591938  doi: 10.5152/akd.2012.127  Pages 427 - 433
Objective: Early changes in atherosclerosis can be diagnosed by the carotid artery intima-media thickness (CIMT) measurement. Normal range of CIMT in healthy subjects has not been studied yet in our country. Therefore, the aim of this study was to measure the CIMT in healthy individuals and investigate affecting parameters of CIMT. Methods: Overall, 2298 subjects, aged 18 to 92 years were undergone CIMT measurement in this observational cohort study. 151 healthy adult subjects, aged 20 to 79 year without atherosclerotic risk factors, normal body mass index and normal metabolic parameters were selected to establish normative CIMT values. Correlations between CIMT and atherosclerotic risk factors were evaluated in the Turkish population. The independent variables associated with CIMT were evaluated with multiple linear regression analysis. Results: CIMT value was 0.458±0.116 mm in males and 0.47±0.104 mm in females. Mean values of CIMT (in mm) for healthy reference sample aged 20-29, 30-39, 40-49, 50-59, 60-69 and 70-79 years were 0.402; 0.466; 0.492; 0.586; 0.692 and 0.733, respectively. CIMT increased significantly (p<0.001) by 0.066 mm, in every decade. Correlates of CIMT were age, visceral fat level, fasting serum glucose, total and low-density lipoprotein cholesterol. Multiple linear regression analysis revealed that age was the single independent predictor of CIMT thickness in healthy individuals (β=0.007, 95% CI: 0.006-0.008, p<0.001). Conclusion: CIMT was 0.458±0.116 mm in men and 0.47±0.104 mm in Turkish healthy adults. Age was the only predictor of CIMT. CIMT measurement can be used in the assessment of early atherosclerosis burden in adults

10.Mid-term follow-up of pulmonary valve bioprostheses in adults with congenital heart disease
Anita Sadeghpour, Bahareh Javani, Mohammadmehdi Peighambari, Majid Kyavar, Zahra Khajali
PMID: 22591939  doi: 10.5152/akd.2012.128  Pages 434 - 436
Abstract |Full Text PDF

11.Percutaneous coronary intervention in a patient with situs inversus and dextrocardia
Mehmet Akif Çakar, Hüseyin Gündüz, Yusuf Can, Mehmet Bülent Vatan
PMID: 22591940  doi: 10.5152/akd.2012.129  Pages 437 - 438
Abstract |Full Text PDF

12.Angina and origin of three major coronary arteries from independent ostia in right coronary sinus
Jose Antonio Linares Vicente, Jose Ramón Ruiz Arroyo, Ruben Casado Arroyo
PMID: 22591941  doi: 10.5152/akd.2012.130  Pages 438 - 440
Abstract |Full Text PDF

13.Successful catheter ablation in a newborn with supraventricular tachycardia resistant to medical therapy
Celal Akdeniz, Neslihan Kıplapınar, Fatma Sevinç Şengül, Volkan Tuzcu
PMID: 22591942  doi: 10.5152/akd.2012.131  Pages 440 - 442
Abstract |Full Text PDF

14.Transcatheter antegrade perforation and covered stent implantation to subatretic coarctation
Nazmi Narin, Sertaç Hanedan Onan, Ali Baykan, Sadettin Sezer
PMID: 22591943  doi: 10.5152/akd.2012.132  Pages 442 - 443
Abstract |Full Text PDF

15.Ogilvie syndrome: a rare but lethal intestinal complication of coronary revascularization
Volkan Yurtman, Süreyya Talay, Sebahattin Dalga, Zakir Aslan
PMID: 22591944  doi: 10.5152/akd.2012.133  Pages 444 - 445
Abstract |Full Text PDF

16.Chest X-ray in a hypertensive patient with stage 2 diastolic dysfunction
Uğur Canpolat
PMID: 22626669  doi: 10.5152/akd.2012.148  Page 446
Abstract |Full Text PDF

17.Endothelial progenitor cell and adhesion molecules determine the quality of the coronary collateral circulation
Taner Şen, Tolga Aksu
PMID: 22626655  doi: 10.5152/akd.2012.134  Pages 447 - 448
Abstract |Full Text PDF

18.Echocardiographic measurement of epicardial fat thickness: In search for a consensus/Correlation of echocardiographic epicardial fat thickness with severity of coronary artery disease-an observational study
Julio Oscar Cabrera-Rego
PMID: 22626656  doi: 10.5152/akd.2012.135  Pages 448 - 449
Abstract |Full Text PDF

19.Percutaneous renal denervation in patients with resistant hypertension-first experiences in Turkey
Ahmet Göktuğ Ertem, Ekrem Yeter, Mehmet Aytürk
PMID: 22626657  doi: 10.5152/akd.2012.136  Pages 449 - 450
Abstract |Full Text PDF

20.Can an observational case-controlled study assess survival benefits in a group of patients undergoing CABG or medical treatment sufficiently?
Tuğrul Norgaz, Şevket Görgülü
PMID: 22626658  doi: 10.5152/akd.2012.137  Pages 450 - 451
Abstract |Full Text PDF

21.The importance of right ventricular failure in pulmonary embolism/Clinical, laboratory and computerized tomography pulmonary angiography (CTPA) results in pulmonary embolism: Retrospective evaluation of 205 patients
Orhan Gökalp, Levent Yılık, Ali Gürbüz
PMID: 22626659  doi: 10.5152/akd.2012.138  Pages 451 - 452
Abstract |Full Text PDF

22.Description of a valve/The effects of implanted valve sizes on ventricular hypertrophy in aortic stenosis
Muhammet Akyüz, Serkan Yazman, Mert Kestelli
PMID: 22626660  doi: 10.5152/akd.2012.139  Pages 452 - 453
Abstract |Full Text PDF

23.Hypothyroidism leading to a syncopal episode: a reminder to check drug interactions/A case of iatrogenic hypothyroidism presented with cardio-inhibitory syncope and resolved by thyroxine supplementation
Aalok Patel, Yang Zhan
PMID: 22626661  doi: 10.5152/akd.2012.140  Pages 453 - 454
Abstract |Full Text PDF

24.Chest X-ray in a hypertensive patient with stage 2 diastolic
Uğur Canpolat, Asena Gökçay Canpolat, Necla Özer
PMID: 22626669  Page 455
Abstract |Full Text PDF

25.Ventricular pacing through coronary sinus in a patient with a prosthetic tricuspid valve
Mehdi Zoghi, Evrim Şimşek, Mustafa Özbaran
PMID: 22626662  doi: 10.5152/akd.2012.141  Page E21
Abstract |Full Text PDF

26.The role of real-time 3-dimensional transesophageal echocardiography in depiction of the concealed base of the iceberg
Ozan M. Gürsoy, Mehmet Özkan
PMID: 22626663  doi: 10.5152/akd.2012.142  Pages E22 - E23
Abstract |Full Text PDF

27.A parachute mitral valve accompanying persistent left superior vena cava: assessment by three-dimensional transthoracic echocardiography
Sait Demirkol, Zekeriya Arslan, Şevket Balta, Uğur Küçük
PMID: 22626664  doi: 10.5152/akd.2012.143  Pages E23 - E24
Abstract |Full Text PDF

28.Pseudocirrhosis; constrictive pericarditis due to huge calcific pericardial cystic mass compressing right cardiac chambers
İbrahim Akpınar, Omaç Tüfekçioğlu, Ertan Yücel, Rıza Sarper Ökten
PMID: 22626665  doi: 10.5152/akd.2012.144  Pages E24 - E25
Abstract |Full Text PDF

29.Ruptured covered stent in a ruptured coronary artery: A catheterization laboratory nightmare
Ahmet Çağrı Aykan, Tayyar Gökdeniz, Devrim Kurt, Şükrü Çelik
PMID: 22626666  doi: 10.5152/akd.2012.145  Pages E25 - E26
Abstract |Full Text PDF

30.“Spinning wheels’’ syndrome
İbrahim Kara, Fatih Gümüşer, Tekin Yıldırım
PMID: 22626667  doi: 10.5152/akd.2012.146  Pages E26 - E27
Abstract |Full Text PDF

31.Black aorta in a patient with alkaptonuric ochronosis
Alper Tosya, Pınar Köksal Çoşkun, Barış Uymaz, Onurcan Tarcan, Tayfun Aybek
PMID: 22626668  doi: 10.5152/akd.2012.147  Page E27
Abstract |Full Text PDF

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