ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 22 (6)
Volume: 22  Issue: 6 - December 2019
Çetin Erol
PMID: 31789619  doi: 10.14744/AnatolJCardiol.2019.12  Page 281
Abstract |Full Text PDF

2.Review of the 2019 European Society of Cardiology Guidelines for the management of patients with supraventricular tachycardia: What is new, and what has changed?
Sercan Okutucu, Bülent Görenek
PMID: 31789617  doi: 10.14744/AnatolJCardiol.2019.93507  Pages 282 - 286
Supraventricular arrhythmias are frequent, and symptomatic patients often need medical therapy or catheter ablation. The recently published 2019 European Society of Cardiology (ESC) Guidelines for the management of patients with supraventricular tachycardia (SVT) give a comprehensive overview of current developments in the field and provides recommendations for the management of adults with SVT. In this paper, we briefly summarized major new recommendations and significant changes from the former ESC guideline published 16 years ago.

3.Role of interleukins in heart failure with reduced ejection fraction
Oliwia Anna Segiet, Adam Piecuch, Lukasz Mielanczyk, Marek Michalski, Ewa Nowalany-kozielska
PMID: 31789611  doi: 10.14744/AnatolJCardiol.2019.32748  Pages 287 - 299
Heart failure (HF) is the leading cause of morbidity and mortality in developed countries, and it is the primary cause of mortality in the elderly worldwide. The processes of inflammatory response activation, production and release of pro-inflammatory cytokines, activation of the complement system, synthesis of autoantibodies, and overexpression of Class II major histocompatibility complex molecules contribute to the HF development and progression. High levels of circulating cytokines correlate with the severity of HF, measured with the use of New York Heart Association’s classification, and prognosis of the disease. In HF, there is an imbalance between pro-inflammatory and anti-inflammatory cytokines. Concentrations of several interleukins are increased in HF, including IL-1β, IL-6, IL-8, IL-9, IL-10, IL-13, IL-17, and IL-18, whereas the levels of IL-5, IL-7, or IL-33 are down-regulated. Concentrations of inflammatory mediators are associated with cardiac function and can be HF markers and predictors of adverse outcomes or mortality. This review presents the role of interleukins, which contribute to the HF initiation and progression, the importance of their pathways in transition from myocardial injury to HF, and the role of interleukins as markers of disease severity and outcome predictors.

4.The prognostic value of altitude in patients with heart failure with reduced ejection fraction
Ahmet Kaya, Adil Bayramoğlu, Osman Bektaş, Mehmet Yaman, Zeki Yüksel Günaydın, Selim Topcu, Oktay Gülcü, Uğur Aksu, Kamuran Kalkan, Ibrahim Tanboğa
PMID: 31789616  doi: 10.14744/AnatolJCardiol.2019.81535  Pages 300 - 308
Objective: It is well known that the altitude may affect the cardiovascular system. However, there were a few data related to the effect of altitude on the adverse outcome in patients with heart failure with reduced ejection fraction (HFREF). The aim of the present study was to investigate the role of intermediate high altitude on the major adverse cardiovascular outcome in patients with HFREF.
Methods: Patients with HFREF admitted to the outpatient clinics at the first center at sea level and the second center at 1890 m were prospectively enrolled in the study. HFREF was defined as symptoms/signs of heart failure and left ventricular ejection fraction <40%. The major adverse cardiac outcome (MACE) was defined as all-cause death, stroke, and re-hospitalization due to heart failure. The median follow-up period of the study population was 27 months.
Results: The study included 320 (58.55% male, mean age 65.7±11.2 years) patients. The incidence of all-cause death was 8.5%, stroke 6.1%, re-hospitalization due to decompensated heart failure 34.3%, and MACE 48.9%. In Kaplan-Meier analysis, patients with HFREF living at high altitude had more MACE (71.1% vs. 25.3%, log rank p=0.005) and presented with more stroke (11.3% vs. 2.1%, log rank p=0.001) and re-hospitalization due to heart failure (65.1% vs. 20.1%, log rank p<0.001) rates than those at low altitude in the follow-up; however, the rate of all-cause death was similar (9.4% vs. 8.1%, log rank p=0.245).
Conclusion: In the present study, we demonstrated that the intermediate high altitude is the independent predictor of MACE in patients with HFREF. High altitude may be considered as a risk factor in decompensating heart failure.

5.Prognostic significance of brain-derived neurotrophic factor levels in patients with heart failure and reduced left ventricular ejection fraction
Hasan Ali Barman, Irfan Şahin, Adem Atıcı, Eser Durmaz, Ece Yurtseven, Barış Ikitimur, Ertuğrul Okuyan, Ibrahim Keleş
PMID: 31789613  doi: 10.14744/AnatolJCardiol.2019.37941  Pages 309 - 316
Objective: Brain-derived neurotrophic factor (BDNF) is a member of the neurotrophin family. The aim of the present study was to investigate the relationship between BDNF levels and prognostic markers in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF), considering death or rehospitalization due to HF.
Methods: Patients with severe left ventricular systolic dysfunction (LVEF ≤35%) and individuals with no history of cardiac disease (control group) were included in the study conducted between 2013 and 2017. Of the included patients, 52 were classified as mildly symptomatic [New York Heart Association (NYHA) I–II], and 108 were classified as severely symptomatic (NYHA III). The control group comprised 50 individuals. The primary endpoints of the study consisted of cardiovascular death during long-term follow-up and hospitalization for worsening of HF.
Results: The mean age of the patient group was 67.60±11.45 years and 58% were male, whereas that of the control group was 66.28±11.30 years and 48% were male. The N-terminal pro-brain-type natriuretic peptide (NT-pro-BNP) serum levels in patients with HF were higher, whereas the BDNF values were lower than those in the control group (NT-pro-BNP: 5010±851 pg/mL vs. 33±11 pg/mL, p<0.001; BDNF: 8.64±1.12 ng/mL vs. 17.58±4.51 ng/mL, p<0.001). Multivariable analysis suggested that there was a significant association between BDNF levels and clinical status, generating the primary endpoints of death [BDNF levels: Odds ratio (OR)=0.17, 95% confidence interval (CI): 0.05–0.53, p=0.002], and rehospitalization (BDNF levels: OR=0.702, 95% CI: 0.54–0.92, p=0.010).
Conclusion: Decreased serum BDNF levels were associated with death and rehospitalization in patients with HF, suggesting that these levels can be useful prognostic biomarkers.

6.Brain-derived neurotrophic factor in heart failure
Mehmet Birhan Yılmaz
PMID: 31789615  doi: 10.14744/AnatolJCardiol.2019.49393  Pages 317 - 318
Abstract |Full Text PDF

7.Is trans-apical off-pump neochord implantation a safe and effective procedure for mitral valve repair?
Salih Salihi, Bilhan Özalp, Hakan Saçlı, İbrahim Kara, Cengiz Köksal
PMID: 31789607  doi: 10.14744/AnatolJCardiol.2019.17055  Pages 319 - 324
Objective: Trans-apical off-pump mitral valve repair is a new minimally invasive surgical technique for the correction of mitral regurgitation caused by mitral leaflet prolapse. The purpose of this study is to evaluate, using clinical and echocardiographic follow-up data, the mid-term results of patients undergoing this procedure.
Methods: A total of 26 patients diagnosed with severe mitral regurgitation underwent mitral valve repair with trans-apical off-pump neochord implantation using the NeoChord device at our hospital from July 2015 to July 2017. All patients were examined by transthoracic and transesophageal echocardiography. Eighteen (69.2%) patients had type A anatomy, 4 (15.4%) had type B anatomy, and 4 (15.4%) had type C anatomy. Preoperative, intraoperative, and postoperative demographic, echocardiographic, and clinical data were collected.
Results: The patients’ age ranged from 33 to 76 years (mean: 56±10.1 years). The average preoperative EuroSCORE II was 1.04%±0.7%. Acute procedural success was achieved in 25 (96.15%) patients. There was only 1 early death (30-day mortality rate: 3.8%) due to postoperative low cardiac output syndrome. Transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation in 87.5% of the patients and moderate regurgitation in 12.5% of the patients. During the follow-up period, transthoracic echocardiography examinations revealed trivial/mild mitral regurgitation (MR) in 14 (58.3%) patients. Six (25%) patients presented with moderate MR and 4 (16.7%) patients had severe MR. At the 30-month follow-up, freedom from residual severe MR was 78.8%±10.3% and freedom from reoperation was 87.5%±6.8%.
Conclusion: Trans-apical off-pump mitral valve repair with neochord implantation may be a suitable treatment option in patients with isolated posterior mitral valve leaflet prolapse.

8.Diagnosis and treatment of abnormal left coronary artery originating from the pulmonary artery: A single-center experience
Kahraman Yakut, Niyazi Kursad Tokel, Murat Ozkan, Birgul Varan, Ilkay Erdogan, Mehmet Sait Aslamaci
PMID: 31789610  doi: 10.14744/AnatolJCardiol.2019.30670  Pages 325 - 331
Objective: We aimed to review symptoms, findings, surgical treatment options, short- and mid-term outcomes, and reoperation rate of patients diagnosed with of left coronary artery from the pulmonary artery (ALCAPA) of an anomalous origin in our institution.
Methods: From May 2000 to March 2018, 33 patients who had left coronary artery originating from the pulmonary artery were retrospectively examined. The clinical features of patients, diagnostic tools and their efficacy, outcomes of surgical repair, and problems during follow-up were evaluated.
Results: Thirty-three patients (22 females, 11 males) were included in the study. At the time of surgery, the median age and weight of patients were 6 months (minimum/maximum, 1–166 months) and 6.5 kg (minimum/maximum, 3–38.5 kg), respectively. The mean follow-up was 5±3.5 years (range, 1–16 years). Dyspnea, tachypnea, diaphoresis, prolonged feeding time, and developmental delay were common presenting signs and symptoms. It was determined that all the patients who were diagnosed at another center reached our center for surgical treatment within 1 month. Twenty-three (69.7%) patients had pathologic Q wave with anterior and/or anterolateral myocardial infarction signs on an electrocardiogram (ECG), whereas 22 (66.6%) patients had ST-T segment changes. Twenty-one (63.6%) patients had cardiomegaly on the telecardiogram. A reimplantation surgery was performed to 22 patients and 10 patients underwent the Takeuchi procedure. In addition to ALCAPA repair, 5 patients needed mitral valve plasty. Atrial septal defect (ASD) and ventricular septal defect (VSD) were closed in one patient, and Tetralogy of Fallot was totally corrected in another. At discharge, there was a significant improvement in left ventricular (LV) systolic functions. At the last visit, all patients had normal LV systolic functions except four who had mild dysfunction. The mean follow-up of the four patients was 2.8 years. In the early postoperative period, complications were seen in 10 patients. Five patients died in the early postoperative period, while one patient died 9 months after the ALCAPA surgery because of low cardiac output syndrome that developed after mitral repair.
Conclusion: Patients with ALCAPA commonly present with congestive heart failure symptoms. When the diagnosis is confirmed in these patients, surgical treatment should not be delayed. The availability of surgical center and surgery outcomes for ALCAPA diagnosed patients are comparable with other countries, but the delay in the diagnosis of disease is still a problem in our country.

9.Late recognition and transcatheter closure of ventriculopulmonary artery shunts in Fontan patients
Mohamed Kasem, Jamie Bentham, Grazia Delle Donne, Antigoni Deri, Tomasso Generali, John Thomson
PMID: 31789612  doi: 10.14744/AnatolJCardiol.2019.33581  Pages 332 - 333
Abstract |Full Text PDF

10.Recurrent spontaneous right coronary artery dissection in the postpartum period-Think twice before you revascularize
Kerim Esenboga, Emir Baskovski, Nil Özyüncü, Türkan Seda Tan, Durmuş Eralp Tutar
PMID: 31789618  doi: 10.14744/AnatolJCardiol.2019.93562  Pages 334 - 335
Abstract |Full Text PDF

11.A unique late complication of transcatheter atrial septal defect closure
Gökhan Altunbaş, Mehmet Adnan Celkan, Ertan Vuruşkan, Murat Sucu
PMID: 31789609  doi: 10.14744/AnatolJCardiol.2019.30388  Pages 335 - 337
Abstract |Full Text PDF | Video

12.Effects of obstructive sleep apnea and atrial fibrillation on blood pressure variability
Yusuf Ziya Şener, Metin Okşul, Fatih Akkaya
PMID: 31789605  doi: 10.14744/AnatolJCardiol.2019.12689  Page 338
Abstract |Full Text PDF

13.Author`s Reply
Ziad A. Taher, Waleed W. Khayyat, Marwan M. Balubaid, Mohamed Y. Tashkandi, Haifaa A. Khayyat, Abdulhalim Jamal Kinsara
PMID: 31789620  Pages 338 - 339
Abstract |Full Text PDF

14.How to improve the management of a patient with heparin-induced thrombocytopenia?
Anetta Undas
PMID: 31789608  doi: 10.14744/AnatolJCardiol.2019.28455  Page 339
Abstract |Full Text PDF

15.Author`s Reply
Ahmet Güner, Anıl Avcı, Ezgi Gültekin Güner, Semih Kalkan, Mehmet Özkan
PMID: 31789621  Pages 339 - 340
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16.Rupture of an isolated septal artery during diagnostic angiography in a patient with myocardial noncompaction
Mutlu Vural, Fahrettin Katkat
PMID: 31789614  doi: 10.14744/AnatolJCardiol.2019.47347  Page E13
Abstract |Full Text PDF | Video

17.Left atrial appendage: The uncommon origin of focal atrial tachycardia in a pregnant woman
Mehmet Rasih Sonsöz, Ahmet Kaya Bilge, Ali Elitok
PMID: 31789606  doi: 10.14744/AnatolJCardiol.2019.17748  Pages E13 - E14
Abstract |Full Text PDF

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