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The Anatolian Journal of Cardiology - Anatol J Cardiol: 3 (2)
Volume: 3  Issue: 2 - June 2003
EDITORIAL
1.Responsibility to be an Editor and Human, Unfairness and Supportive Forces of the Journal
Bilgin Timuralp
PMID: 12826521  Pages 89 - 90
Abstract | Full Text PDF

INVITED EDITORIAL
2.Please Pay Attention to the Turkish Language
İnan Soydan
PMID: 12826498  Page 91
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
3.A New Echocardiographic Approach in Assessing Pulmonary Vascular Bed in Patients with Congenital Heart Disease: Pulmonary Artery Stiffness
Şevket Görgülü, Mehmet Eren, Aydın Yıldırım, Orhan Özer, Nevzat Uslu, Seden Çelik, Bahadır Dağdeviren, Zekeriya Nurkalem, Bayram Bağırtan, Tuna Tezel
PMID: 12826499  Pages 92 - 97
Objective: The state of pulmonary vascular bed in congenital heart disease is the predictor of the patients’ clinical condition, prognosis and outcome of surgical intervention.This study aims to investigate the condition of pulmonary vascular bed analysing pulmonary artery stiffness by means of Doppler echocardiography. Method: Thirty-three patients (16 females, mean age 26±15 years) with various congenital heart diseases such as atrial septal defect (20 patients), ventricular septal defect (10 patients), patent ductus arteriosus (2 patients), atrioventricular septal defect ( 1 patient) were enrolled in this study. Systemic flow (Qs), pulmonary flow (Qp), systemic vascular resistance, pulmonary vascular resistance were calculated according to Fick method by using data obtained during left and right heart catheterization. Echocardiographically, pulmonary artery stiffness (PAS) was calculated by using maximal frequency shift (MFS) and accelleration time (AcT) of the pulmonary artery flow trace. PAS (kHz/sec)= MFS/AcT. Results: Invasively, the average Qp/Qs ratio, mean pulmonary artery pressure, and pulmonary vascular resistance were found as 2.58 ± 1.25, 25±20 mmHg, and 135±217 dyn.sec.cm-5, respectively. Echocardiographically, PAS was found to be 33±17 kHz/sec. Pulmonary artery stiffness was correlated with mean pulmonary artery pressure (r=0.63; p<0.001) and pulmonary vascular resistance (r=0.55, p<0.001), while no relation was found with Qp/Qs. Conclusion: Estimation of pulmonary artery stiffness by using pulmonary flow maximal frequency shift and acceleration time obtained by means of Doppler echocardiography may give us an idea about the state of pulmonary vascular bed.

4.The Effect of Pre-procedural Captopril on Contrast-Induced Nephropathy in Patients Who Underwent Coronary Angiography
Ömer Toprak, Mustafa Cirit, Serdar Bayata, Murat Yeşil, S.Leyla Aslan
PMID: 12826500  Pages 98 - 103
Objective: Contrast media induced nephropathy (CIN) is diagnosed as the acute renal failure developed following intravenous contrast media usage when all other causes of renal failure are excluded. In this study, we investigated the effects of captopril given before coronary angiography (CA) on CIN development. Methods: A total of 80 patients, 43 males and 37 females, mean age: 58 ± 8 years (range: 18-80), with serum creatinine level below 2 mg/dl, who underwent coronary angiography in Cardiology Clinic of Izmir Atatürk Training and Research Hospital between October 2000- February 2002, were included into the study. Captopril was administered in 48 patients 8 hours and an hour before CA (Captopril group). Remaining 32 patients had no captopril treatment (Control group). There were no significant differences between the groups by means of clinical and biochemical parameters. The levels of serum creatinine and serum urea and creatinine clearance in 24 hours urine were measured before CA application and 48 hours after the procedure. Results: Five patients (8.3%) in the Captopril group and 1 patient (3%) in Control group developed CIN and this difference was statistically significant (p=0.02). Conclusion: Captopril is a risk factor for development of contrast media induced nephropathy.

EDITORIAL COMMENT
5.Prevention of Radiocontrast Nephropathy
Alp İkizler, Alaattin Yıldız
PMID: 12826501  Pages 104 - 106
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
6.Clinical and Angiographic Predictors of Creatine Kinase Enzyme Elevation After Successful Coronary Stent Implantation: Effects on Subsequent Target Vessel Revascularization
Erhan Babalık, Kadriye Orta, Tevfik Gürmen, Murat Gülbaran, Servet Öztürk, Barış Ökçün
PMID: 12826502  Pages 107 - 112
Original Article Clinical and Angiographic Predictors of Creatine Kinase Enzyme Elevation After Successful Coronary Stent Implantation: Effects on Subsequent Target Vessel Revascularization Erhan Babalık 1, Kadriye Orta 1, Tevfik Gürmen 1, Murat Gülbaran 1, Servet Öztürk 1, Barış Ökçün 1 1 İstanbul Üniversitesi Kardiyoloji Enstitüsü, Kardiyoloji Anabilim Dalı, İstanbul Anatol J Cardiol 2003; 3: 107-112 This article was viewed 121 times, downloaded 0 times Key Words: Stent, koroner, kreatin kinaz, revaskülarizasyon Full Text (PDF) Related Articles Send a comment Share Abstract Objective: The aims of the present study are to evaluate clinical, angiographic, and procedural determinants of creatine kinase (CK) elevation following successful coronary stent implantation, and to assess the relationship between postprocedural CK release and subsequent target vessel revascularization. Methods: Study population was composed of 400 consecutive patients who underwent successful coronary stent implantation. Forty-six patients (11.5%) had CK enzyme levels >2 times the upper limit of normal. This group was compared to 100 patients with no CK release after stenting. Results: Baseline, angiographic and procedural characteristics did not differ between patients with and without postprocedural CK elevation. The significant predictors of CK elevation by multiple logistic regression analysis are unstable angina (p<0.001, OR=5.62 with 95% CI of 2.35-13.45), multiple stenting (p=0.04, OR=2.55 with 95% CI of1.02-6.40) and side branch occlusion (p=0.03,OR=12.20 with 95% CI of 1.22-121.71). By multivariate analysis, postprocedural CK release was found to be a significant determinant of subsequent target vessel revascularization (p=0.032,OR=3.84 with 95% CI of 1.12-13.18). Conclusion: Our results indicate that side branch occlusion, implantation of > 1 stents per lesion and coronary stenting in unstable angina pectoris are strong predictors of postprocedural CK release. There is a significant relationship between postprocedural CK elevation and subsequent target vessel revascularization.

EDITORIAL COMMENT
7.Effects of Creatine Kinase Enzyme Elevation After Successful Coronary Stent Implantation on Late Clinical Results
Ahmet Ünalır
PMID: 12826503  Pages 113 - 114
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
8.Endovascular Treatment of Abdominal Aortic Aneurysms
Harun Arbatlı, Naci Yağan, Ergun Demirsoy, Mehmet Ünal, Serap Tekin, Füruzan Numan, Bingür Sönmez
PMID: 12826504  Pages 115 - 121
Objective: Endovascular treatment of aortic aneurysms is getting popular in our country due to its less invasive nature and shortened hospital stay. The initial experience with endovascular stent-graft implantation procedures to treat abdominal aortic aneurysms and their results were evaluated retrospectively in this study. Methods: Eight patients with abdominal aortic aneurysms were treated with endovascular stent grafts. Seven patients were male and 1 was female with the mean age of 63.13±9.23 (48-72) years. Six patients were considered not proper for conventional surgical treatment. Results: The procedure was converted to conventional surgery in one patient due to traumatic rupture of the iliac artery during the intervention. Type I “endoleak” was detected in 1 patient in the first month and was treated successfully by balloon dilatation of the proximal neck. Type II “endoleak” in two patients resolved spontaneously in the postoperative follow-up. No mortality was occurred. The mean intensive care unit stay was 24.57±10.37 (20-48) hours, mean hospital stay was 4.00±1.83 (3-8) days, and mean use of blood and blood products was 456.25±722.81 ml, excluding the patient treated by conventional surgery. The mean follow-up period was 9.36±3.75 (4-15) months. Conclusion: Endovascular treatment of abdominal aortic aneurysms is a good therapeutic alternative with low morbitity even in complicated cases. More studies are needed to enlighten the safety, effectiveness and durability of this therapeutic modality

EDITORIAL COMMENT
9.Abdominal Aortic Aneurysm: How and When to Treat in Light of New Knowledge
Ubeydullah Deligönül
PMID: 12826505  Pages 122 - 123
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
10.Effectiveness of Intraaortic Balloon Pumping in Patients Who Were Not Able to Be Weaned From Cardiopulmonary Bypass After Coronary Artery Bypass Surgery and Mortality Predictors in the Perioperative and Early Postoperative Period
Hilmi Tokmakoğlu, Bora Farsak, Serdar Günaydın, Özer Kandemir, Hakan Aydın, Cem Yorgancıoğlu, Kaya Süzer
PMID: 12826506  Pages 124 - 128
Objective: The intraaortic balloon pump (IABP) is usually the first choice of mechanical device used for perioperative cardiac failure. The aim of this retrospective study was to determine the effectiveness of intraoperative IABP use in patients who could not be weaned from cardiopulmonary bypass (CPB) and to determine the possible perioperative and early postoperative prognostic factors for mortality. Methods: Between June 1992-December 2001 a total of 69 patients who underwent coronary artery bypass grafting and required IABP support in weaning from CPB due to cardiac pump failure were included into the study. The mean age was 61.9±7.5 years. The effectiveness of IABP and preoperative, operative and postoperative risk factors for mortality were evaluated retrospectively. Results: Following the insertion of IABP, 59 (85.5%) patients could be weaned from CPB whereas 10 patients (14.5%) could not. In the early postoperative period, 13 (22%) patients died due to cardiac pump failure. The average in-hospital mortality rate for patients who were treated with an IABP was found as 33.3% (23 patients). Univariate analysis identified left ventricular enddiastolic pressure, ventricular performance score, urgent operation and perioperative myocardial infarction as the risk factors for early death. The minor and major IABP releated -complications occurred in only 8 patients. Conclusion: Due to the contributory effects, effectiveness and low complication rate, IABP may be used in patients who cannot be weaned from CPB

11.Frequency and Predictors of Atrial Fibrillation in Severe Mitral Regurgitation
Nilüfer Ekşi Duran, İbrahim Duran, Kenan Sönmez, Murat Gençbay, Ahmet Akçay, Fikret Turan
PMID: 12826507  Pages 129 - 134
Objective: The aim of this study was to assess the frequency and the predictive factors for atrial fibrillation (AF) in patients with severe mitral regurgitation (MR). Methods: This study is a retrospective evaluation involving of 199 patients (100 females, 99 males, mean age 53.8±18.5) with severe MR who had been admitted to our clinic between 1997 and 2001. Etiologies of MR were; rheumatic heart disease (n=132), ischemic heart disease (n=44), mitral valve prolapsus (n=14), mitral annular calcification (n=9). Patients who had AF (n=95), sinus rhythm (n=98) or recurrent AF (n=6) were determined according to ECG. Age, gender, smoking, hypertension, diabetes mellitus, electrocardiographic left ventricular hypertrophy (LVH), echocardiographic left atrial (LA) diameter, left ventricular end-systolic dimension (LVESD), left ventricular end-diastolic dimension (LVEDD), ejection fraction (EF), right atrial size, pulmonary artery pressure and presence or absence of mitral stenosis were recorded. Results: Atrial fibrillation was observed in 50.8% of the patients. Female gender (60% vs. 40%, p=0.009), LA diameter (5.6+1.0 cm vs. 4.8+0.6 cm, p<0.001) and right atrium size (30.7% vs. 11.2%, p=0.001) were found as the predictive factors of AF in univariate analysis. Multiple logistic regression analysis showed that advanced age (p<0.014), female gender (p=0.02), LA size (p<0.001) and coexistence of MR with mitral stenosis (p<0.013) were independent risk factors for AF in patients with rheumatic MR. None of variables could be predictive for AF in patients with ischemic MR. Atrial fibrillation was found more frequently in patients with rheumatic MR than that of ischemic MR (p<0.001). In rheumatic MR, left atrium cut-off value for AF was found to be 5.5 cm (sensitivity: 52.1%, specificity: 90.7%). Conclusion: Atrial fibrillation is a common arrhythmia in severe MR (50.8 %). Left atrial size is a powerful independent predictor for AF.

EDITORIAL COMMENT
12.Severe Mitral Regurgitation and Atrial Fibrillation
Özgür Aslan
PMID: 12826508  Pages 135 - 136
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
13.Surgical Treatment of Isolated Cardiac Echinococciasis: Report of Five Cases
Djoshibaev S, Kudaiberdiev T, Maralov A, Shabraliev S, Djooshev K, Halikov UM, Yankovskaya L
PMID: 12826509  Pages 137 - 143
Objective: Cardiac echinococcosis is a rare pathology and in about half of cases it is not accompanied by other organs involvement. We report on our experience of surgical treatment of isolated cardiac echinococcosis (ICE). Methods: Among 5 patients with ICE operated in our clinic 1 had pericardial and epicardial involvement, 1 patient had the single cyst in the apicolateral wall of the left ventricle and 3 patients had singular cysts of the interventricular septum. All patients underwent chest X-Ray, transthoracic echocardiography, ultrasound examinations of the internal organs, hemagglutination tests and microbiologic evaluation of operative specimens. Results: Two operations were performed on a beating heart and three - using cardiopulmonary bypass. In cases of intramyocardial localizations the cyst enucleation and closure of residual cavities by plication were performed and in a case of peri- and epicardial involvement the extirpation of cysts and partial pericardiectomy were carried out. All patients postoperatively received therapy with albendazole. No intra- and postoperative complications were observed. Control echocardiography did not reveal any disturbances of myocardial performance. Two years follow-up showed absence of cyst recurrence. Conclusion: The prevailed localization of echinococci cysts in ICE is the myocardium of the LV and IVST, places with the highest myocardial mass and good perfusion. Ideal echinococcectomy is an effective surgical treatment of isolated cardiac echinococciasis

REVIEW
14.Ischemic Preconditioning
Harun Evrengül, Dursun oğlu, Ender Semiz
PMID: 12826510  Pages 144 - 149
Summary: It has been shown that repeated brief coronary occlusions increase myocardial resistance towards prolonged episodes of ischemia. This phenomenon, which renders the heart more tolerant to ischemia with subsequent limitation of infarct size, has been termed ischemic preconditioning. Ischemic preconditioning also protects the heart against postinfarction left ventricular dysfunction and ventricular arrhythmias. Ischemia induced activation of adenosine receptors, and opening of ATP-sensitive potassium channels and stress protein synthesis are thought to be the potential mechanisms of this phenomenon. The exploration of the exact mechanisms of ischemic preconditioning might improve the treatment strategies for acute myocardial infarction in the future.

15.Obstructive Sleep Apnea and Cardiovascular Diseases
Ahmet Ursavaş, Ercüment Ege
PMID: 12826511  Pages 150 - 155
Summary: Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by repetitive episodes of apnea or hypopnea during sleep. Apnea and hypopnea cause temporary elevations in blood pressure associated with blood oxygen desaturation, arousal, and sympathetic activation and may cause elevated blood pressure during the daytime. Numerous studies have shown that OSAS was associated with an increased cardiovascular morbidity and mortality. In this review, we describe the normal hemodynamic changes that occur during sleep, the acute hemodynamic events associated with OSAS and finally we summarize the evidence for causal connection between sleep apnea and cardiovascular disease.

16.Systematic Approach on Postoperative Care of the Cardiac Surgical Patients
Cüneyt Konuralp, Mustafa İdiz
PMID: 12826512  Pages 156 - 161
Summary: With the medical advances and rising expectations among cardiac surgeons and patients, older and sicker patients now undergo ever more complex operations. However, fortunately, postoperative care of cardiac surgical patients also have shown important changes parallel to the surgical improvements. Although, the events within the operating room are accepted as the main determinants for the faith of the patient, some patients, who are very ill upon arrival in the intensive care unit, may have a good long-term prognosis when postoperative care is meticulously provided. Conversely, patients who are doing well as they leave the operating room may be put at significant risk for complications by poor postoperative management. In this paper, we draw an outline of systematical approach of intensive care of cardiac surgical patients and summarize a practical manual for physicians. By applying this approach effectively, it should be expected that, the clinician is able to recognize an impending disaster earlier, initiate the proper treatment timely, and increase patient’s chances of survival.

MISCELLANEOUS
17.Clinical Use of Fibrinolytic Drugs
Mehmet Akif Düzenli, Kurtuluş Özdemir, Abdullah Sökmen, Turgut Karabağ
PMID: 12826513  Pages 162 - 170
Abstract | Full Text PDF

CASE REPORT
18.A Case Report: Rhabdomyoma Caused Right Ventricular Outflow Tract Obstruction in an İnfant
Sevcan Erdem, Osman Küçükosmanoğlu, Orhan Kemal Salih, Hakan Poyrazoğlu, Şeyda Erdoğan, Nurdan Tunalı, Nazan Özbarlas
PMID: 12826514  Pages 171 - 173
Abstract | Full Text PDF

19.Coronary Perforation and Tamponade During Thrombectomy and Treatment with PTFE Coated Stent and Autotransfusion: A Case Report
Ahmet Bilge Kaya, Yılmaz Nişancı, Beste Özben, Ercüment Yılmaz, Berrin Umman
PMID: 12826515  Pages 174 - 176
Abstract | Full Text PDF

20.Cardiac Perforation Due to Crochet Hook: A Pediatric Patient with Penetrating Cardiac Injury
Ertürk Levent, Mehmet Tayyip Arslan, Arif Ruhi Özyürek, Yüksel Atay, Alp Alayunt, Aytül Parlar
PMID: 12826516  Pages 177 - 179
Abstract | Full Text PDF

LETTER TO THE EDITOR
21.Left Ventricular Hypertrophy Increases the Frequency of Ventricular Arrhythmia in Hypertensive Patients
Emrullah Başar
PMID: 12826517  Pages 180 - 181
Abstract | Full Text PDF

22.The Efficiency of Fast Track Protocol in Elderly Patients Underwent Coronary Artery Surgery
Fevzi Toraman, Cem Alhan
PMID: 12826518  Pages 182 - 183
Abstract | Full Text PDF

23.Efficacy of Handgrip Stress Test for Evaluation of Cilasapril Treatment in Patients with Heart Failure
Akira Kurita, Bonpei Takase
PMID: 12826519  Pages 184 - 185
Abstract | Full Text PDF

24.On the March 2003 Issue of the Anatolian Journal of Cardiology
İlke Sipahi
PMID: 12826520  Pages 186 - 187
Abstract | Full Text PDF

25.Responsibility to be an Editor and Human, Unfairness and Supportive Forces of the Journal

PMID: 12826521  Page 188
Abstract | Full Text PDF

26.Does the Short-Term Mortality Differ Between Men and Women with First Acute Myocardial Infarction?
Mustafa Akın
PMID: 12826522  Pages 189 - 190
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
27.Right Atrial Hemangioma
Ilgın Karaca, Mustafa Ferzeyn Yavuzkır, Erdoğan İlkay, Mehmet Akbulut, Ali Rahman, Bengü Çobanoğlu
PMID: 12826523  Page 191
Abstract | Full Text PDF

28.Surgical Management of the Coronary Artery to Pulmonary Artery Fistula
Işık Şenkaya, Abdulkadir Ercan, Arzu Gündoğdu, Ayhan Aliosman, Mete Cengiz
PMID: 12826524  Page 192
Abstract | Full Text PDF

29.A Case of Infective Endocarditis Presenting with Vegetations on Three Cardiac Valves
Ömer Göktekin, Erol Arslan, Necmi Ata
PMID: 12826525  Page 193
Abstract | Full Text PDF

30.Dissection of the Aortic Sinus of Valsalva During Coronary Angiography in a Patient with Spontaneous Coronary Artery Dissection
Rıdvan Yalçın, Gülten Taçoy, Timur kaynak, Atiye Çengel
PMID: 12826526  Page 194
Abstract | Full Text PDF

MISCELLANEOUS
31.Nitroglycerine
M. Zati Altay
Pages 195 - 196
Abstract | Full Text PDF