ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 20 (5)
Volume: 20  Issue: 5 - November 2018
1.International issue
Çetin Erol
PMID: 3039197  doi: 10.14744/AnatolJCardiol.2018.11  Page 257
Abstract |Full Text PDF

2.Blood type B antigen is associated with worse New York Heart Association classification in male patients with hypertrophic cardiomyopathy
Xiaowei Jiang, Jiansong Yuan, Jingang Cui, Shengwen Liu, Fenghuan Hu, Weixian Yang, Hongwei Tian, Shubin Qiao
PMID: 30391979  doi: 10.14744/AnatolJCardiol.2018.40607  Pages 258 - 265
Objective: ABO blood type is associated with cardiovascular diseases. Several studies have suggested sex-related differences in both hypertrophic cardiomyopathy (HCM) clinical features and ABO blood type. However, few data are available regarding the relationship between ABO blood type and HCM clinical features. We aimed to analyze the relationship between ABO blood type and HCM clinical features, and the potential effects of sex on these relationship.
Methods: A total of 549 patients with HCM were enrolled consecutively. Left ventricular outflow tract gradients at rest (LOVTG-R) were measured by echocardiography. Left ventricular end-diastolic dimension, interventricular septum, left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular mass (LVM) were assessed using cardiovascular magnetic resonance imaging.
Results: Compared with the non-B antigen group, patients with B antigen had significantly higher LOVTG-R and LVEF values, worse New York Heart Association (NYHA) classification, lower left ventricular volume index values, as well as no difference in LVM index values. After adjustments for sex, male patients with B antigen still had higher LOVTG-R values and frequency of NYHA classification III/IV as well as lower LVEDV and LVESV index values. These differences were not present in female patients. Additionally, patients with NYHA classification III/IV had lower LVEDV index values.
Conclusion: In males, not females, patients with HCM with blood type B antigens exhibited worse cardiac functional capacity, higher LOVTG-R values, and lower left ventricular volume index values. These relationships are a potential indicator for clinical prevention. We speculate that rehydration is more efficient in relieving symptoms in male patients with HCM with B antigens.

3.Ivabradine promotes angiogenesis and reduces cardiac hypertrophy in mice with myocardial infarction
Xiangqi Wu, Wei You, Zhiming Wu, Fei Ye, Shaoliang Chen
PMID: 30391964  doi: 10.14744/AnatolJCardiol.2018.46338  Pages 266 - 272
Objective: We investigated the underlying mechanism of ivabradine (IVA) in promoting angiogenesis and reducing cardiac hypertrophy in mice with myocardial infarction (MI).
Methods: Nineteen mice were randomly assigned into three groups as follows: sham group (10 ml/kg/day phosphate buffer saline (PBS), n=6), model group (MI and 10 ml/kg/day PBS, n=6) and IVA group (MI and 10 mg/kg/day IVA, n=7). All groups received an intragastric gavage for four weeks. Heart and body mass were measured. Cardiac function and heart rate were assessed by echocardiography and electrocardiography, respectively. The collagen deposition, area of cardiomyocytes, and number of capillaries were evaluated using Masson’s staining, anti-wheat germ agglutinin (WGA) staining, and platelet endothelial cell adhesion molecule-1 (CD31) staining, respectively. The protein kinase B (Akt)-endothelial nitric oxide synthase (eNOS) signaling and p-38 mitogen-activated protein kinase (MAPK) family in myocardium were determined by western blot.
Results: IVA treatment greatly improved cardiac dysfunction and suppressed cardiac hypertrophy at 4 weeks after MI (p<0.05). Heart rate and fibrotic area of IVA group declined notably compared to those of the model group (p<0.05). IVA administration substantially reduced cardiomyocyte size and increased capillary formation (p<0.05). Besides, IVA medication can enhance Akt-eNOS signaling and inhibit p38 MAPK phosphorylation in the heart of mice with MI (p<0.05).
Conclusion: IVA can perform two functions, the promotion of angiogenesis and the reduction of cardiac hypertrophy, both of which were closely associated with Akt-eNOS signaling activation and p38 MAPK inhibition.

4.Does nitric oxide mediate the effects of ivabradine in patients with heart failure?
Michal Maczewski
PMID: 30391965  doi: 10.14744/AnatolJCardiol.2018.61819  Pages 273 - 274
Abstract |Full Text PDF

5.Long-term graft patency after coronary artery bypass grafting: Effects of morphological and pathophysiological factors
Grigore Tinica, Raluca Ozana Chistol, Mihail Enache, Maria Magdalena Leon Constantin, Manuela Ciocoiu, Cristina Furnica
PMID: 30391966  doi: 10.14744/AnatolJCardiol.2018.51447  Pages 275 - 282
Objective: The aim of the present study was to identify morphological and pathophysiological factors associated with long-term patency of grafts used in coronary artery bypass grafting (CABG).
Methods: A total of 127 patients who underwent CABG between 2000 and 2006 and presented for computed tomography evaluation of graft patency at 139.78±36.64 months post-CABG were analyzed. Patients received 340 grafts (2.68 grafts/patient), 399 distal anastomoses (3.14 anastomoses/patient), 220 (55.14%) performed using arterial grafts, and 179 (44.86%) using saphenous vein grafts (SVGs).
Results: Graft patency varied according to vessel type and coronary territory. Overall graft patency was 90.16% for the left internal thoracic artery (LITA), 75.55% for the right internal thoracic artery (RITA), 79.25% for the radial artery (RA), and 74.3% for the SVG. The maximum patency rate was obtained with the RA (80.65%) for the right coronary territory, RITA (92.86%) for the anterolateral territory, and SVG (82.54%) for the circumflex territory. The LITA–left anterior descending artery graft occluded in 13 (7.93%) cases, 7 due to competitive flow. The influence of graft length on patency rates after indexing to height was not significant. The target vessel degree of stenosis influenced arterial graft patency rates with an occlusion odds ratio (OR) of 3.02 when anastomosed to target vessels with <90% stenosis. Target vessel caliber also influenced patency rates with occlusion ORs of 2.63 for SVGs and 2.31 for arterial grafts when anastomosed to ≤1.5 mm target vessels.
Conclusion: Morphological parameters, such as graft type, target territory, target vessel caliber, and degree of stenosis, are important factors conditioning long-term graft patency.

6.Comparison of minimally invasive cardiac surgery incisions: Periareolar approach in female patients
Mustafa Serkan Durdu, Çağdaş Baran, Fatih Gümüş, Gökay Deniz, Mehmet Çakıcı, Evren Özçınar, Ahmet Onat Bermede, Kemalettin Uçanok, Ahmet Rüçhan Akar
PMID: 30391967  doi: 10.14744/AnatolJCardiol.2018.37200  Pages 283 - 288
Objective: All innovations in cardiac surgery provide us with new techniques to perform surgery through smaller incisions with less invasive and best cosmetic results. After promising results in minimally invasive cardiac surgery (MICS), pain and cosmetic appearance became important end points, especially for female patients. In the current study, we intended to evaluate the surgical results and cosmetic satisfaction with the periareolar and submammary incision types in cardiac surgery.
Methods: Ninety-four female patients underwent MICS between July 2013 and March 2018. MICS was performed in 62 patients via periareolar incision and in 32 patients via submammarian incision. We investigated the incision size, wound infection, pain levels by using a postoperative standard pain-level questionnaire, the postoperative scar size, and patient satisfaction using a postoperative patient questionnaire.
Results: Periareolar incision size was smaller than the submammary incision (Group A: 5.6±0.6 vs. Group B: 6.7±0.8, p=0.001). Four patients from Group B had superficial wound infection (p=0.01). Patients who underwent MICS via periareolar incision and submammary incision had similar pain level (p=0.2). The scar tissue was smaller in size and postoperatively healed better in the following days for the patients with periareolar incision due to the elastic structure of breast tissue. (Group A: 4.3±0.4 vs. Group B: 5.3±0.2, p=0.001).
Conclusion: Our study suggests that the periareolar approach would be more aesthetic, show better healing, and have a smaller scar size in female patients.

7.Neovascularization with chronic inflammation characterizes ascending aortic dissection
Eetu Niinimäki, Ville Pynnönen, Ivana Kholova, Timo Paavonen, Ari Mennander
PMID: 30391968  doi: 10.14744/AnatolJCardiol.2018.42223  Pages 289 - 295
Objective: Neovascularization of the aortic wall may be associated with aortic dissection (AD). Aortic wall endothelial CD31 deposition together with chronic inflammation indicates angiogenesis that may lead to tissue disruption. We studied the presence of neovascularization of the ascending aortic wall by characterizing CD31 positive endothelial cells.
Methods: Aortic wall routine histology and immunohistochemistry for CD31, T- and B-lymphocytes, plasma cells, macrophages, endothelial cells, smooth muscle cells, and cell proliferation were performed on 35 selected patients who underwent surgery for the ascending aorta, and the samples were grouped according to the presence of AD.
Results: Three subjects with Marfan syndrome were excluded from the study. A total of 14 out of 32 patients had AD. A total of 18 patients were operated on due to dilatation only. Chronic inflammation of the adventitia (p=0.003), media (p=0.001), and intima (p=0.005) was increased in AD. Neovascularization was predominant in the outer third medial layer in AD (p=0.037), corresponding to the site of aortic wall disruption. A receiver operating characteristic curve analysis showed that neovascularization was associated with AD (AUC 0.750; SE 0.092; p=0.022; 95% CI 0.570–0.930).
Conclusion: Endothelial immunohistochemistry confirms neovascularization of the outer third medial layer during AD. Aortic wall remodeling including neovascularization characterizes AD. Chronic inflammation and neovascularization of the dilated ascending aorta suggest susceptibility for AD.

8.PKP2 and DSG2 genetic variations in Latvian arrhythmogenic right ventricular dysplasia/cardiomyopathy registry patients
Luize Bidina, Kaspars Kupics, Emma Sokolova, Mihails Pavlovics, Zane Dobele, Laima Caunite, Oskars Kalejs, Linda Gailite
PMID: 30391969  doi: 10.14744/AnatolJCardiol.2018.35984  Pages 296 - 302
Objective: The Latvian arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD-C) registry was established to determine the genetic background of ARVD-C for analyzing discovered genetic variation frequencies in the European and Latvian populations.
Methods: In total, 38 patients with suspected ARVD-C were selected. The clinical parameters were defined according to the ARVD-C guidelines, PKP2 and DSG2 gene analysis was performed using the Sanger sequencing. Additionally, large deletions/duplications were analyzed using the multiplex ligation-dependent probe amplification (MLPA) analysis.
Results: Twenty symptomatic patients were enrolled in the study. Typical ARVD abnormalities were found in electrocardiography for 10 (50%) patients, in Holter monitoring for 19 (95%), in transthoracic echocardiography for 20 (100%), and in cardiac magnetic resonance for 6 (30%). Different benign genetic variations were found. Three novel, unregistered, possibly benign variations were found in the PKP2 gene: c.2489+131G>A, c.2489+72delA, and c.1035-5T>C and three in the DSG2 gene: c.404G>A, c.1107G>A, and c.379-15A>G. Two genetic variations in the PKP2 gene: c.1592T>G, c.2489+1G>A are possibly pathogenic. For the first time, variation c.1592T>G, has been discovered in the homozygote form. Using the MLPA analysis, large deletions or duplications were not found.
Conclusion: The prevalence of the majority of non-pathological genetic variations is similar in the Latvian ARVD-C patients and the European population. Possibly, pathogenic variations were found only in 10% of our registry patients, which could mean that PKP2 and DSG2 are not the most commonly affected genes in the Latvian population.

9.Coronary sinus ostial atresia: A rare associated anomaly that should be remembered in patients undergoing univentricular palliation
Ayhan Çevik, Murat Ertürk, Şule Turgut Balci, Kanat Yalçın, Ali Rıza Karaci
PMID: 30391970  doi: 10.14744/AnatolJCardiol.2018.84453  Pages 303 - 304
Abstract |Full Text PDF | Video

10.Myocardial infarction caused by a leukemic clot: A case report
Jing Li, Liang Dong, Chang-ling Li, Ya-bin Liu, Li-jun Feng
PMID: 30391971  doi: 10.14744/AnatolJCardiol.2018.64505  Pages 304 - 305
Abstract |Full Text PDF

11.About inflammatory activation during aortic dissection
Şahin İşcan, Orhan Gökalp, Köksal Dönmez, Banu Lafçı
PMID: 30391972  doi: 10.14744/AnatolJCardiol.2018.80575  Page 306
Abstract |Full Text PDF

12.Author`s Reply
Zhixuan Bai, Jun Gu, Yingkang Shi, Wei Meng
PMID: 30391973  Pages 306 - 307
Abstract |Full Text PDF

13.Discordant results about QT prolongation in patients with Turner syndrome
Berhan Keskin, Abdülkadir Uslu, Tahir Bezgin
PMID: 30391974  doi: 10.14744/AnatolJCardiol.2018.27164  Pages 307 - 308
Abstract |Full Text PDF

14.Author`s Reply
Adem Atıcı, Cafer Panç, Ekrem Bilal Karaayvaz, Ahmet Demirkıran, Orkide Kutlu, Kamber Kaşalı, Elmas Kekeç, Lütfullah Sarı, Zeynep Nur Akyol Sarı, Ahmet Kaya Bilge
PMID: 30391975  Page 308
Abstract |Full Text PDF

15.Unexpected complication of diaphragmatic hernia: Compression of the heart by liver
Yalçın Velibey, Sinan Şahin, Tolga Sinan Güvenc, Hakan Barutça, Özge Güzelburç
PMID: 30391976  doi: 10.14744/AnatolJCardiol.2018.05014  Page E7
Abstract |Full Text PDF | Video

16.Giant atrial septal aneurysm prolapsing into the right ventricle in an asymptomatic infant
Hayrullah Alp, Esma Keleş Alp
PMID: 30391977  doi: 10.14744/AnatolJCardiol.2018.36006  Pages E7 - E8
Abstract |Full Text PDF | Video

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