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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 12/2012; · 0.44 Impact Factor
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Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 10/2012; 40(6):557.
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ABSTRACT: The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease.
In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P < or = 0.001), but all scores had good specificity and positive predictive value. For 3-vessel disease, the FRS had better predictive value than the other scores (area under curve, 0.74, P < or = 0.001), but all scores had good specificity and negative predictive value.
The risk scores (FRS, MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.
Acta cardiologica 10/2012; 67(5):557-63. · 0.61 Impact Factor
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ABSTRACT: Cor triatriatum sinister is a rare congenital heart anomaly. We present an elderly patient with cor polyatriatum, which is a variant of cor triatriatum. The patient was admitted to our hospital with symptoms of congestive heart failure. Echocardiographic evaluation revealed that the left atrium was divided into three spaces of the fibromuscular membrane, resembling a railway. Diagnosis was confirmed by cardiac magnetic resonance imaging. The patient did not accept surgical treatment and was followed medically.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 09/2012; 40(5):444-6.
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Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 09/2012; 40(5):473.
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Echocardiography 07/2012; 29(9):E245-6. · 1.24 Impact Factor
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ABSTRACT: Prolongation of the peak and the end of T wave (Tp-e) has been reported to be associated with ventricular arrhythmias. Tp-e/QT ratio and Tp-e/QTc ratio are used as an index of ventricular arrhythmogenesis. An increased incidence of ventricular arrhythmias has been reported in patients with obstructive sleep apnea (OSA). The aim of this study was to assess ventricular repolarization in patients with OSA by using Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
We have studied 72 patients who underwent overnight polysomnography (PSG) between the years 2010-2011 at our institution. Patients with moderate and severe OSA (23 patients; mean age: 45±10), according to the apnea-hypopnea index, constituted the study group. Patients with normal PSG (23 patients; mean age: 42±11) were used as the control group. In all patients, Tp-e interval, Tp-e/QT ratio, Tp-e/QTc ratio, as well as some other electrocardiogram intervals were measured. Independent samples t-tests were used for comparison of continuous and categorical variables and correlations were calculated by Spearman rank correlation.
Although QT and QTc intervals were not different between the groups, mean Tp-e interval (81.6±11.1 msn; 63.9±7.3 msn; respectively; P < 0.001), Tp-e/QT ratio (0.21±0.03; 0.17±0.02; respectively; P < 0.001), and Tp-e/QTc ratio (0.20±0.03; 0.16±0.02; respectively; P < 0.001) were prolonged in the study group compared to the control group. Correlation analysis showed a significant positive correlation between the presence of moderate and severe OSA and Tp-e interval (r = 0.72; P < 0.001), Tpe/QT ratio (r = 0.70; P < 0.001), and Tp-e/QTc ratio (r = 0.70; P < 0.001).
Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio are prolonged in patients with moderate and severe OSA patients. There is a positive correlation between the presence of OSA and Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio.
Pacing and Clinical Electrophysiology 06/2012; 35(8):966-72. · 1.35 Impact Factor
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ABSTRACT: We present a 20-year-old male patient with cor triatriatum sinistrum with fenestrations and long-standing dyspnea on exertion, fatigue, and palpitation. An apical early to mid-systolic murmur of grade I-II/VI was heard on cardiac auscultation. Electrocardiography showed sinus rhythm and an incomplete right bundle branch block. Transthoracic echocardiography showed a membrane dividing the left atrium into two compartments. Transesophageal echocardiography showed a membrane with fenestrations originating from the left upper pulmonary vein, extending to the interatrial septum, and dividing the left atrium into two compartments as proximal and distal. Cardiac MR imaging for further detailed anatomical assessment demonstrated similar findings without additional anomaly. Medical follow-up was conducted due to no pressure gradient across the membrane.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 06/2012; 40(4):347-9.
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 04/2012; 12(4):361-2. · 0.44 Impact Factor
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Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 04/2012; 40(3):286.
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ABSTRACT: We wanted to compare the values of clinical risk assessments and scoring systems for predicting three-vessel diseases and culprit lesions by coronary angiography in patients with unstable angina pectoris (UAP), or non-ST segment elevation myocardial infarction (NSTEMI).
A total of 154 consecutive patients, (42 [27.3%] female, and 112 [72.7%] male, mean age: 63.0 ± 12.7 years) with UAP/NSTEMI were enrolled. Rizik and Braunwald classification, ACC/AHA risk assessment system, TIMI, GUSTO, GRACE and PURSUIT risk scores were determined, and the ROC curve was marked in accordance with the presence of three-vessel disease and culprit lesion.
In patients with NSTEMI, the rates of three-vessel disease and culprit lesion were demonstrated to be higher. With respect to the presence of three-vessel disease, only the ACC/AHA risk assessment was manifested to have a predictive value. All risk scoring systems were demonstrated to bear predictive values with different sensitivity and specificity. The TIMI and GRACE risk scores were discovered to have higher predictive values. The presence of culprit lesions could not be predicted by any of the risk assessment or scoring systems.
Among risk assessment systems, only the ACC/AHA system can be used to predict three-vessel disease. It is possible to use all risk scoring systems for the same purpose. The predictive values of the TIMI and GRACE risk scores are higher. The culprit lesions cannot be predicted by any of the risk assessment or scoring systems. The use of cardiac enzymes seems more appropriate with very low sensitivity and specificity.
Kardiologia polska 01/2012; 70(3):242-50. · 0.51 Impact Factor
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ABSTRACT: The aim of this study was to evaluate whether left ventricular size was increased in patients with classic bileaflet mitral valve prolapse (MVP) in the absence of significant mitral regurgitation (MR).
Patients with classic bileaflet MVP were included as the case group. Two different control groups were established. The first control group was composed of the patients with mild MR caused by the reasons except MVP. The second control group consisted of healthy individuals whose echocardiograms were normal. The patients with moderate or severe MR and having abnormality in the other valves were excluded.
There were 20 patients in each group. Systolic and diastolic diameters and volumes of left ventricle (LV) in the MVP group were significantly higher than those in the control groups. In 10 of the patients in the MVP group, LV internal diastolic diameter (LVIDD) values were measured as ≥5.7 cm, whereas increased LVIDD value was detected in only one patient in the other two control groups. There was a significant difference in terms of the presence of increased LVIDD values between the MVP group and the control groups. Despite this enlargement in the LV dimension, the LV ejection fractions were found similar in all groups. Furthermore, it was found that the lengths of both anterior and posterior mitral leaflets in MVP group were significantly higher than those in the control groups.
The LV diameters and volumes of patients with classic bileaflet MVP were found to be increased even in the absence of significant MR. These results need to be supported by large-scale clinical studies.
Echocardiography 11/2011; 29(2):123-9. · 1.24 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 10/2011; 11(7):E26. · 0.44 Impact Factor
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ABSTRACT: We present a case of peripheral pulmonary artery stenosis that was incidentally detected by agitated saline contrast study. A 19-year-old male patient underwent cardiologic examination to determine suitability for military service. He had exertional intolerance since early childhood. Physical examination showed a murmur over the entire right hemithorax. Echocardiography showed moderately enlarged right ventricle, right atrium, and main pulmonary artery, and color Doppler showed mild tricuspid regurgitation. Right ventricular systolic pressure was estimated as 55-60 mmHg from the tricuspid regurgitation jet. For further evaluation of the systolic murmur, agitated saline contrast echocardiography was performed. During continuous wave Doppler examination while there were remnants of bubbles in the right heart and pulmonary vascular bed, a systolodiastolic flow with a peak gradient of 30 mmHg was noted. After disappearance of the bubbles, the signal was not detectable. Repeat agitated saline contrast examination again showed a gradient of 35 mmHg. A stenosis in the distal branches of the right pulmonary artery was suspected. Finally, computed tomography revealed multiple stenoses in the pulmonary vascular bed. To our best knowledge, this is the first case in which agitated saline contrast examination enabled the diagnosis of peripheral pulmonary artery stenosis.
Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir 10/2011; 39(7):584-6.
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ABSTRACT: To simplify proximal isovelocity surface area (PISA) method for mitral valve area (MVA) calculation that does not necessitate the usage of a calculator and angle correction, and to compare values estimated using this novel method with the values obtained by the conventional PISA, planimetry and pressure half-time (PHT) methods.
We evaluated patients with a wide range of mitral stenosis (MS) severity. The MVA was measured by the methods of PHT (MVA PHT), planimetry (MVApl), conventional PISA (MVAC-PISA) and the novel method of simple PISA (MVAS-PISA). Application of simple PISA was performed subsequently by division of the peak mitral inflow velocity by four; measurement of the radius by adjusting the aliasing velocity to this value; square of the radius gives the MVAS-PISA.
Twenty patients were enrolled in the study. Peak and mean pressure gradients of patients were 20 ± 6 mmHg and 10 ± 4 mmHg, respectively. The average values of MVApl, MVAPHT, MVAC-PISA, and MVA S-PISA were 1,54 ± 0,41, 1,65 ± 0,40, 1,58 ± 0,42, 1,57 ± 0,44 cm2, respectively. MVAS-PISA had a strong correlation with the MVAC-PISA, MVApl and MVAPHT . Furthermore, there was no significant difference between simple PISA and the other methods. The agreement between planimetry and simple PISA methods for detecting severe mitral stenosis (MVA <1.5 cm2) determined by ROC analysis was very good with a sensitivity and specificity of 100 % and 92%, respectively.
Simple PISA is a user friendly method which does not take time and gives simple and correct results. If the diagnostic power of the technique is proven by more comprehensive studies, it can supersede the conventional PISA method.
Medicinski glasnik 08/2011; 8(2):197-202. · 0.06 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 08/2011; 11(5):467; author reply 467-8. · 0.44 Impact Factor
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ABSTRACT: To assess the value of aortic flow propagation velocity (Vp) in detecting hypertensive patients with coronary risk.
The study included 120 patients with hypertension. According to the 10-year risk of coronary heart disease the patients were categorized in the three groups: 10-year risk < 10% (I),10 - year risk=%10 - 20 (II), and 10-year risk > 20% (III). The aortic flow propagation velocity (Vp) was measured from descending aorta with color M-mode echoardiography. The slope of the first aliasing contour was accepted as Vp. It was compared with Framingham coronary risk score, carotid intima media thickness and high sensitive C-reactive protein. Twelve patients were excluded from the study due to poor acoustic window.
The Vp was significantly lower (p<0.001), carotid intima media thickness and high sensitive C-reactive protein was significantly higher in group III (p=0.002 and p=0.014). The area under ROC curve of Vp, carotid intima media thickness and high sensitive C-reactive protein were 0.890, 0,700 and 0.664, respectively. There was a significant inverse relation between Vp and carotid intima media thickness (r=-0.37; p<0.001).
The aortic flow propagation velocity is a simple, feasible and reproducible marker of atherosoclerosis with an acceptable sensitivity and specificity. There is a need for longitudinal prospective studies to use it routinely.
Medicinski glasnik 08/2011; 9(1):42-8. · 0.06 Impact Factor
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ABSTRACT: Castleman disease is a non-malignant proliferative disease of the lymphoid system. It can be unicentric or multicentric. In this report, we present a case of multicentric Castleman disease to which coronary artery pseudoaneurysm, vena cava superior occlusion, and antiphospholipid antibody positivity was accompanying.
European Heart Journal – Cardiovascular Imaging 08/2011; 12(8):E35. · 2.32 Impact Factor
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ABSTRACT: This study designed to assess the effect of different positions of head of the bed on myocardial velocity by tissue Doppler echocardiography in healthy subjects.
Thirty-nine healthy subjects (32 males/7 females, mean age 24.7 ± 4.9 years) were studied. Tissue Doppler imaging (TDI) was performed and velocities were recorded during systole (Sm) and early (Em) and late (Am) diastole at the tricuspid annulus, septum, and mitral annulus in the four-chamber view. Measurements were performed from different positions of left lateral decubitus (0°, 30°, and 60°). Repeated-measures general linear models were used to assess the change in myocardial velocities.
No significant difference between myocardial velocities was found at the mitral anulus and septal TDI recordings in the different angles of left lateral decubitus positions (P > 0.05). However, there were statistically significant difference among tricuspid anulus myocardial tissue velocities in these positions (P < 0.05).
Tricuspid anulus myocardial tissue velocities may be significantly influenced by changing of position in healthy subjects. Effect of position changes should be considered in the assessment of these velocities.
Echocardiography 05/2011; 28(5):516-9. · 1.24 Impact Factor
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Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology 11/2010; 10(6):E25-6. · 0.44 Impact Factor
