[Show abstract][Hide abstract] ABSTRACT: Objective: Deterioration in atrial functions can lead to acute hemodynamic decompensation in patients with hypertrophic cardiomyopathy (HCM). The question of whether the atrial dysfunction may be explained primarily by the hemodynamic impact of left ventricle on atria or an underlying cardiomyopathic process remains unresolved. We aimed to investigate atrial functions in patients with HCM by using atrial myocardial color doppler imaging. Material and Methods: Left atrial (LA) and right atrial (RA) functional parameters in 15 patients with HCM and 15 age matched healthy controls were compared echocardiographically. Left atrial volumes and LA ejection fraction (LA ejection volume/Vmax X 100) were calculated. Atrial myocardial systolic, early and late diastolic velocities, peak systolic strain (SI) and strain rate (SR) were all measured by color doppler myocardial imaging. Results: Left atrial diameter was higher and LA ejection fraction was lower in the HCM group compared with those of the control group (p<0.05). Peak systolic and diastolic atrial myocardial velocities were compromised in HCM patients compared to healthy subjects. The peak systolic atrial myocardial strain and strain rate values in each studied atrial wall was lower in the HCM group but the difference reached statistically significance only for the RA wall. (RA SI; 62.6±42.2% vs. 97.9±45.1%, p=0.047, RA SRI; 2.3 ±1.7 vs. 3.7±1.2, p=0.031). Conclusion: Atrial myocardial deformation properties were impaired in patients with HCM. These results support the idea of increase in atrial stiffness in HCM and the hypothesis that HCM is a cardiac myopathic disease that involves the entire heart muscle.
No preview · Article · Jan 2012 · Turkiye Klinikleri Cardiovascular Sciences
[Show abstract][Hide abstract] ABSTRACT: Atrial septal defect (ASD) is a common form of congenital heart defect in adults, which affects all cardiac chambers. Atrial myocardial function in patients with ASD has not yet been clearly elucidated. The aim of this study was to investigate atrial myocardial deformation properties in patients with ASDs.
The study involved 24 patients with a secundum type ASD, and 22 healthy subjects. Color Doppler myocardial imaging was used to measure left and right atrial myocardial systolic strain and strain rate values, together with peak systolic velocity, early velocity, and late diastolic velocity.
There was no significant difference between the two groups with regard to age, gender, body mass index, heart rate, blood pressure, left atrial diameter, and ventricular function. The peak systolic atrial myocardial strain and strain rate values in each of the atrial walls studied were lower in the ASD group compared to those of the control group, but the difference reached statistical significance only in the case of the right atrial wall (right atrial strain: 48.0 +/- 32.7% vs 100.2 +/- 46.6%, P = 0.006; right atrial strain rate: 2.6 +/- 1.2/sec vs 3.8 +/- 1.2/sec, P = 0.024).
The left to right cardiac shunt that results from ASD leads to a reduction in the right atrial myocardial longitudinal lengthening that occurs during ventricular ejection. These findings demonstrate that the reservoir function of the atrium is impaired and atrial stiffness increases in patients with ASDs.
No preview · Article · May 2008 · Echocardiography
[Show abstract][Hide abstract] ABSTRACT: We evaluated exercise capacity and other exercise parameters in patients with metabolic syndrome and angiographically normal coronary arteries.
Sixty-one patients with angiographically normal coronary arteries were evaluated in two groups according to the presence (n=32; 24 females, 8 males; mean age 59+/-10 years) or absence (n=29; 18 females, 11 males; mean age 59+/-9 years) of metabolic syndrome as proposed by the International Diabetes Federation. All the patients underwent exercise treadmill testing with the modified Bruce protocol, whereby the following variables were determined: workload achieved in metabolic equivalents, total exercise time, percentage of target heart rate achieved, double product, heart rate recovery, chronotropic response and incompetence. The relationships between exercise parameters and echocardiographic and clinical variables were evaluated.
The two groups were similar with respect to age, left ventricular dimensions, left ventricular mass index, ejection fraction, and left atrial diameters. The incidence of diastolic dysfunction was significantly higher in patients with metabolic syndrome (71.9% vs 41.4%; p=0.016). The maximum workload achieved was significantly lower (10+/-2 ml/kg/min vs 12+/-2 ml/kg/min; p=0.024) and the initial double product was significantly higher (11.6x10(3) mmHg.pulse/min vs 10.1x10(3) mmHg.pulse/min, p=0.04) in patients with metabolic syndrome. Hypertensive patients exhibited significantly lower maximum workload and total exercise time (p<0.05). Hyperglycemic subjects had significantly lower maximum workload (p<0.05).
Metabolic syndrome is associated with decreased exercise capacity and each component of this syndrome affects exercise test parameters individually.
No preview · Article · Jan 2008 · Turk Kardiyoloji Dernegi arsivi: Turk Kardiyoloji Derneginin yayin organidir
[Show abstract][Hide abstract] ABSTRACT: Right ventricular rupture is a rare complication after myocardial infarction and a few cases were reported. We present the case of a 65-year-old Caucasian man with inferior and right ventricular myocardial infarction which was complicated by right ventricular rupture following successful percutaneous revascularization. The transthoracic echocardiography revealed right ventricular free wall rupture with pericardial effusion. The patient underwent a pericardial drainage by pericardiotomy without myocardial repair because of the self-limiting pattern of the right ventricular free wall rupture. The formation of a mural thrombus at the small rupture site limited the leakage and contributed to the outstanding favourable prognosis of the patient with early revascularization even without surgical repair.
No preview · Article · Sep 2007 · Acta cardiologica
[Show abstract][Hide abstract] ABSTRACT: In this study we aimed to examine the angiographic findings, traditional risk factors and natural history of Turkish patients <40 and >or=40 years old with coronary heart disease (CHD).
The records of 491 patients with stable angina pectoris or acute coronary syndrome (ACS), who had undergone coronary angiography (CAG) were reviewed. The patients <40 years (group 1) and >or=40 years (group 2) were compared.
The study population was classified as group 1 with 240 patients (mean age 35.7+/-3.4 years) and group 2 with 251 patients (mean age 61.0+/-9.7 years). Smoking, family history, hypercholesterolemia, hypertriglyceridemia and low levels of high-density lipoprotein cholesterol were more prevalent in group 1 while diabetes mellitus, hypertension was higher in group 2. The common presentation among <40 years patients was ACS whereas stable angina was the most common presentation in patients >or=40 years old. Patients in group 1 showed a preponderance of single-vessel disease whereas patients of group 2 showed dominance of multivessel disease. Early clinical course of patients with ACS in group 1 was better than in group 2.
Our study shows a significantly different clinical, angiographic and biochemical profile in <40 years patients with CHD compared with >or=40 years patients. Dominance of smoking and dyslipidemias that are the preventable risk factors in premature CHD patients is an important threat for our community health. Healthy life styles should be encouraged beginning from young ages and new precautions about smoking must be taken.
No preview · Article · Jun 2007 · Anadolu kardiyoloji dergisi: AKD = the Anatolian journal of cardiology