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Volume : 13 Issue : 3
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Anatol J Cardiol: 13 (3)
Volume: 13  Issue: 3 - May 2013
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EDITORIAL
1.On publication language and international publishing, success of Professor Özaydın and Anatolian Journal of Cardiology, peer-review and academic depression
Bilgin Timuralp
PMID: 23676661  doi: 10.5152/akd.2013.135  Pages 202 - 203
Abstract | Full Text PDF

2.Shinya Yamanaka, M.D., Ph.D. - 2012 Nobel Prize Laureate: How his dream of a research career provides vision for the next generation of young scientists
Robert W. Mahley
PMID: 23618992  doi: 10.5152/akd.2013.132  Pages 204 - 206
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
3.Use of cardiac CT angiography imaging in an epidemiology study - the Methodology of the Multicenter AIDS Cohort Study cardiovascular disease substudy
Yalçın Hacıoğlu, Mohit Gupta, Tae-Young Choi, Richard T. George, Christopher R. Deible, Lisa P. Jacobson
PMID: 23376648  doi: 10.5152/akd.2013.065  Pages 207 - 214
Objective: The methodology for use of cardiac CT angiography (CTA) in low risk populations is not well defined. In order to present a reference for future studies, we present CTA methodology that is being used in an epidemiology study- the Multicenter AIDS Cohort Study (MACS). Methods: The Multicenter AIDS Cohort Study (MACS) is an on-going multicenter prospective, observational cohort study. The MACS Cardiovascular Disease substudy plans to enroll 800 men (n= 575 HIV seropositive and n=225 HIV seronegative) age 40-70 years for coronary atherosclerosis imaging using cardiac CTA. The protocol includes heart rate (HR) optimization with beta blockers; use of proper field of view; scan length limitation; prospective ECG-gating using the lowest beam voltage possible. All scans are evaluated for presence, extent, and com- position of coronary atherosclerosis, left atrial volumes, left ventricular volume and mass and non-coronary cardiac pathology. Results: The first 498 participants had an average radiation dose of 2.5±1.6 milliSieverts (mSv) for the cardiac CTA study. Overall quality of scans was fair to excellent in 98.6% of studies. There were three significant adverse events-two allergic reactions to contrast and one subcutaneous contrast extravasation. Conclusion: Cardiac CTA was safe and afforded a low effective radiation exposure to these asymptomatic research participants and provides valuable cardiovascular endpoints for scientific analysis. The cardiac CTA methodology described here may serve as a reference for use in future epidemiology studies aiming to assess coronary atherosclerosis and cardiac anatomy in low risk populations while minimizing radiation exposure.

4.A new approach to the measurement of heart rate in patients with chronic heart failure-Heart rate performance index: an observational study
Aydın Akyüz, Şeref Alpsoy, Dursun Çayan Akkoyun, Niyazi Güler
PMID: 23376649  doi: 10.5152/akd.2013.066  Pages 215 - 220
Objective: In order to evaluate the utility of the heart rate performance index (HRPI), which is obtained by dividing HR mean by the difference of HR max and HR min in the context of Holter monitoring, we sought to determine whether there was any correlation or relationship between the HRPI and LVEF values as determined by echocardiography and to compare the HRPI between the study and control groups. Methods: This study is a cross-sectional, controlled observational study. Thirty-two patients with symptomatic or asymptomatic left ventricular systolic dysfunction (LVEF <45%) were included as study group and 32 subjects without chronic heart failure (CHF) were included as a control group. In the study group, 10 patients were in NYHA class I (31.2%), 12 - were in NYHA class II (37.6%) and 10 - were in NYHA class III (31.2%). Heart rate analysis was measured using 24-hour Holter ambulatory electrocardiography. To determine the HRPI, the difference between maximum (HR max) and minimum heart rate (HR min) was divided by mean heart rate (HR mean) (beats/minute): HRPI=(HR max-HR min) / HR mean. Statistical analysis was performed using t-test for independent samples, Mann-Whitney U test, Chi-square test, Kruskal-Wallis test, Pearson’s correlation and linear regression analyses. Results: The HRPI index value was markedly decreased [0.83 (0.58-1.1) and 1.10 (0.74-1.3), p<0.001] in the study group as compared to the control group. The data collected for the study group and the control group (n=64) demonstrated a positive correlation between the HRPI and LVEF (r=0.62, p<0.001) as well as a negative correlation between the HR mean and LVEF (r=-0.39, p<0.003). The HR mean was higher (80.2±11.3 and 75.2±6.7, p<0.007) and HR max-HR min (67.9±11.6 and 83.3±14.3, p<0.001) were lower in the study group as compared to the control group. Linear regression analysis demonstrated no significant relationship between LVEF and HRPI and other heart rate derivatives (unstandardized β=42.43 95% CI: 21.98-50.51, p=0.231). Conclusion: According to our findings, patients with CHF exhibited higher HR mean values, reduced HR max-min values and significantly decreased HRPI values. There is a positive correlation between HRPI and LVEF, a decreased HRPI is associated with a decreased LVEF, but there is no relationship between these two variables. Therefore HRPI values may represent a viable option for assessing daily exercise activity and potentially sympathetic activation in patients with CHF. The assessment of HRPI may be helpful the evaluation of CHF patients, as well as resting HR.

5.The relationship between adiponectin, NT-pro-BNP and left ventricular ejection fraction in non-cachectic patients with systolic heart failure: an observational study
İstemihan Tengiz, Uğur Önsel Türk, Emin Alioğlu, Bahadır Kırılmaz, Gülden S. Tamer, Nurullah Tüzün, Ertuğrul Ercan
PMID: 23376650  doi: 10.5152/akd.2013.067  Pages 221 - 226
Objective: NT-pro-brain natriuretic peptide (NT-proBNP) has been shown to be an accurate diagnostic marker in patients with heart failure (HF). Adiponectin (Adp) levels are increased in HF but its diagnostic value is still uncertain in these patients. The study was designed to investigate the possible association of these markers in non-cachectic patients with newly diagnosed systolic heart failure. Methods: Fifty-seven systolic HF patients and 20 matched controls were enrolled in an observational cross-sectional study. Physical and echocardiographic examinations were performed and serum Adp, NT-proBNP, tumor necrosis factor-alpha (TNF-α) levels were measured. Study variables were compared between the groups. Correlation analyses were done and the diagnostic validity of the markers was compared with ROC analysis. Results: Adp and NT-proBNP levels were significantly higher in HF group (20.19±12.9 vs. 7.65±4.6 μg/mL; p<0.001 and 1051.74±606.2 vs. 222.53±65.6 pg/mL; p=0.002; respectively). TNF-α levels were similar between the groups (2.83±1.8 vs. 2.08±1.2 pg/mL; p=0.582). Correlation analysis showed significant association among Adp and NT-proBNP levels, (r=0.448; p<0.001), and left ventricular ejection fraction (LVEF) values (r=-0.466; p<0.001). The Adp and NT-proBNP showed comparable diagnostic performances with mean [95% confidence interval] areas under the curves of 0.857 (0.771-0.944) and 0.888 (0.815-0.960), respectively. Conclusion: There were significant correlation between Adp levels with NT-proBNP levels and LVEF values but no any association between Adp levels with body mass index values and TNF-α levels in patients with newly diagnosed systolic heart failure. The result may arouse suspicion about the hypothesis, which proposes that Adp levels simply reflects disease severity or cardiac cachexia in patients with HF.

6.Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study
Derya Tok, Fırat Özcan, İskender Kadife, Osman Turak, Kumral Çağlı, Nurcan Başar, Zehra Gölbaşı, Sinan Aydoğdu
PMID: 23376651  doi: 10.5152/akd.2013.068  Pages 227 - 234
Objective: Metabolic syndrome (MetS) is a strong predictor of cardiovascular events and coronary flow reserve (CFR), an indicator of microvascular function, has been found to be impaired in MetS. Aortic stiffness (AS) is a simple and effective method for assessing arterial elasticity. The aim of this study was to evaluate whether there is an independent association of impaired coronary flow and aortic elasticity in patients with MetS. Methods: Forty-six patients (mean age 47.3±6.6 years) with the diagnosis of MetS according to the ATP III update criteria and 44 age and gender matched controls (mean age 46.0±6.1 years) were included into the cross-sectional observational study. Peak diastolic coronary flow velocities were measured in left anterior descending artery by pulsed wave Doppler at baseline and after adenosine infusion, and CFR was calculated as the ratio of hyperemic to baseline velocities. Aortic strain, distensibility and stiffness were calculated by M-mode echocardiography. Statistical analysis was performed by using Student t-test, Chi-square test, Pearson correlation and linear regression analyses. Results: CFR was significantly lower in patients with MetS than in controls (2.3±0.2 vs 2.7 ±0.2, p<0.001). In the MetS group, aortic distensibility (10.4±3.5 cm2.dyn-1.10-6 vs 12.7±3.4 cm2.dyn-1.10-6, p=0.002) was decreased and AS was significantly increased (6.5±2.0 vs 3.2±0.8, p<0.001). In multivariate linear regression analysis, AS (β=-0.217, p=0.047), systolic blood pressure (β=-0.215, p=0.050) and waist circumference (β=-0.272, p=0.012) had an independent relationship with impaired CFR. Conclusion: This study demonstrated that coronary flow reserve is impaired in patients with MetS and there is an independent relationship between impaired CFR and increased aortic stiffness, systolic blood pressure or waist circumference.

EDITORIAL COMMENT
7.Relations between microvascular function and aortic stiffness in metabolic syndrome
Tae Joon Cha, Kyoung Im Cho
PMID: 23395703  doi: 10.5152/akd.2013.069  Pages 235 - 236
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
8.Relationship between hospital volume and risk-adjusted mortality rate following percutaneous coronary intervention in Korea, 2003 to 2004
Yong Hoon Kim, Ae-Young Her
PMID: 23395704  doi: 10.5152/akd.2013.070  Pages 237 - 242
Objective: There have been a large number of studies that have investigated the relationship between outcomes and provider volume for a wide variety of medical conditions and surgical conditions. The objective of this study was to explore the relation between hospital volume and risk-adjusted mortality following percutaneous coronary intervention between 2003 and 2004 in Korea. Methods: This is a retrospective analysis of database in National Health Insurance Review & Assessment Service and Korean National Statistical Office. The study data set confined to the ICD-10 diagnosis and procedure codes that were recorded in the National Health Insurance Review Agency. Risk modeling was performed through logistic regression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistics, R2, and Hosmer-Lemeshow statistic. Crude and risk-adjusted 30-day mortality was evaluated among patients who underwent Percutaneous Coronary Intervention (PCI) between 2003 and 2004 at low (less 200 cases/year), medium (200~399 cases/year), and high (400 cases or more/year) PCI volume hospitals. Results: The final risk-adjustment model consisted of ten risk factors for 30-day mortality. These factors were found to have statistically significant effects on patient mortality. The c-statistic and Hosmer-Lemeshow χ2 goodness-of-fit test and the model’s performance were good [R2=0.147, c-statistic 0.823, 4.1037 (p=0.8476)]. A total number of 60 low-volume hospitals (9.071 patients) and 27 medium-volume hospitals (15.623 patients) and 15 high-volume hospitals (19.669 patients) were included. Crude 30-day mortality rate was 1.4%, 1.1%, and 1.0% (p=0.0106) in each volume hospitals. But risk-adjusted mortality rate was not significantly different among three groups (1.3%, 1.0%, and 1.1% in each volume hospitals). Conclusion: Although we found a significant different crude 30-day mortality rates according to hospital PCI volume, but did not find a relationship between hospital volume and 30-day risk-adjusted mortality rates following PCI in Korea.

EDITORIAL COMMENT
9.Hospital volume and mortality relation in PCI-Is there a need for modification of ACC/AHA percutaneous coronary intervention guidelines in Asia?
Ayhan Olcay
PMID: 23395705  doi: 10.5152/akd.2013.071  Pages 243 - 244
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
10.The effects of chronic usage of enzyme inhibitors and angiotensin receptor blockers on contrast-induced nephropathy in low-risk patients
Nezihi Barış, Ebru Özpelit, Nazile Bilgin Doğan, Hande Kangül, Sefa Gül, Bahri Akdeniz, Sema Güneri
PMID: 23261803  doi: 10.5152/akd.2013.050  Pages 245 - 250
Objective: There is conflicting data about the role of renin- angiotensin- aldosterone system (RAAS) blockers in contrast-induced nephropathy (CIN) pathophysiology. In this study, we aimed to investigate the effects of chronic usage of RAAS blocker drugs on development of CIN in low risk patients. Methods: Study was designed as a prospective cohort study. A total of 295 patients were enrolled in the study. Study population was consisted of three subgroups according to prior usage of RAAS blockers: no RAAS blocker group (n=95), angiotensin-converting enzyme inhibitor (ACEI) group (n=106), angiotensin receptor blocker (ARB) group (n=94). CIN was defined as an increase of ≥25% in creatinine over the baseline value or 0.5 mg/dL rise within 48-72 h of angiography. Mehran score was calculated for each patient. Baseline variables and percentage of CIN were compared with ANOVA, Mann-Whitney U, Kruskal-Wallis and Pearson Chi-square tests between groups. In order to determine the independent predictors of CIN, binary logistic regression analyses were performed. Results: CIN occurred in 18 patients (17.0%) in the ACEI group, 17 patients (18.1%) in ARB group and 7 patients (7.4%) in the no RAAS group. CIN occurrence was significantly higher in RAAS than no RAAS group (17.5% vs. 7.4%, p=0.01). Chronic RAAS blocker administration was an independent predictor of CIN (OR=2.69; 95% CI: 1.025-7.067; p=0.04). Mehran score was the only other independent predictor for CIN (OR=1.15; 95% CI: 1.019-1.310; p=0.02). Conclusion: In patients with near normal renal functions who are undergoing elective coronary procedure, chronic usage of ACEI and ARB increases the risk of CIN.

11.Evaluation of right ventricular functions in patients with nasal polyposis: an observational study
Eda Şimşek, Ziya Şimşek, M. Hakan Taş, Cüneyt Kucur, Ersin Günay, Harun Üçüncü
PMID: 23395706  doi: 10.5152/akd.2013.072  Pages 251 - 256
Objective: The aim of this study was to assess the right ventricular functions in patients with nasal polyposis using the strain (S) and strain rate (SR) echocardiography. Methods: A prospective, cross-sectional observational study was performed. The study included 40 patients with nasal polyposis (NP) (Group 1), and 25 healthy controls (Group 2). The study comprised patients with Stage 2 and Stage 3 nasal obstruction and no symptoms that could be associated with right ventricular heart failure. Longitudinal peak systolic strain (PSS) and peak systolic strain rate (PSSR) were measured from the basal-mid and apical segments of the right ventricle free wall. Student’s t-test, Pearson’s correlation analysis and Bland-Altman test were used for statistical analysis. Results: Pulmonary arterial systolic pressure was significantly higher in group 1 than group 2 (31.2±5.8, 19.7±4.3, respectively, p<0.001). PSS and PSSR values at the basal, mid and apical segments of the right ventricular lateral wall of the group I were significantly lower compared to the control group (p<0.001, p=0.002 and p=0.002 for PSS, p=0.003, p<0.001 and p<0.001 for PSSR, respectively). The comparison of Stage 2 and Stage 3 NP patients revealed a significant difference only in the SR measurement of the right ventricular mid segment (p=0.002). There was a significant correlation between the systolic pulmonary arterial pressure (sPAP) and right ventricular S and SR values (p<0.001). Conclusion: In this study, S/SR echocardiography showed a subclinical deficit of the right ventricular longitudinal functions in patients with NP who are considered to have normal right ventricular functions.

REVIEW
12.Value of stress echocardiography in mitral stenosis
Kadriye Orta Kılıçkesmez, Serdar Küçükoğlu
PMID: 23395708  doi: 10.5152/akd.2013.074  Pages 257 - 260
Abstract | Full Text PDF

13.Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications
Cihan Şengül, Olcay Özveren
PMID: 23395709  doi: 10.5152/akd.2013.075  Pages 261 - 265
Visceral fat tissue is an important predictor of cardio-metabolic diseases, carrying more risk than general fat accumulation. Epicardial fat, a particular form of visceral fat deposited around the heart, is considered an important cardiovascular risk predictor, in view of producing and releasing several adipo-cytokines. There is growing evidence about the physiological and metabolic importance of epicardial fat. Epicardial fat thickness and volume have both strong correlation between obesity, impaired fasting glucose, insulin resistance, metabolic syndrome, hypertension, diabetes mellitus, and atherosclerosis. Epicardial fat can be assessed by transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography. In this article, we reviewed the anatomy, physiology, function, and the methods of assessment of epicardial fat tissue. We also have tried to discuss its relationship to metabolic syndrome and coronary atherosclerosis in the lights of recent findings.

EDUCATION
14.Recent and future innovations in the treatment of heart failure
Alper Kepez, Bülent Mutlu
PMID: 23395710  doi: 10.5152/akd.2013.076  Pages 266 - 274
Heart failure is still an important public health problem despite important advances regarding its treatment. Several new treatment strategies are being investigated in order to contend with this disease. Strategies proved to be safe and effective in clinical trials are being adapted to clinical practice. In this review, we will first focus on most recent treatment strategies that are recommended to be used in clinical practice and then try to mention novel strategies which are still being explored in preclinical studies.

SCIENTIFIC LETTER
15.The effect of distance-based learning on the fifth stage medical students’ perception in peripheral vascular diseases course: a questionnaire survey
Mustafa Saçar, Gökhan Önem, Akile Sarıoğlu Büke, Ahmet Baltalarlı
PMID: 23443855  doi: 10.5152/akd.2013.079  Pages 275 - 277
Abstract | Full Text PDF

CASE REPORT
16.Acute coronary syndrome with intraventricular thrombus after using erythropoietin
Alparslan Kurtul, Mustafa Duran, Onur Kadir Uysal, Ender Örnek
PMID: 23443856  doi: 10.5152/akd.2013.080  Pages 278 - 279
Abstract | Full Text PDF

17.Variant high origin of both right and left coronary arteries from the ascending aortic wall
Raghavendra Rao, Bondel Shwetha
PMID: 23443857  doi: 10.5152/akd.2013.081  Pages 279 - 280
Abstract | Full Text PDF

18.Worsening heart failure due to right ventricular apical pacing by ICD implanted after myocardial infarction and treatment with resynchronization
Ali Deniz, Mehmet Kanadaşı, Mesut Demir, Ayhan Usal
PMID: 23443858  doi: 10.5152/akd.2013.082  Pages 281 - 282
Abstract | Full Text PDF

19.Renal coloboma syndrome associated with double- chambered right ventricle
Gökçen Gökçe, Yalçın Gökoğlan, Volkan Hürmeriç, Fazıl Cüneyt Erdurman, Osman Melih Ceylan, Ali Hakan Durukan, Güngör Sobacı
PMID: 23443859  doi: 10.5152/akd.2013.083  Pages 282 - 283
Abstract | Full Text PDF

20.Thoraco-Omphalopagus conjoined twins
Kadir Şerafettin Tekgündüz, Haşim Olgun, İbrahim Caner, Naci Ceviz
PMID: 23443860  doi: 10.5152/akd.2013.084  Pages 284 - 285
Abstract | Full Text PDF

LETTER TO THE EDITOR
21.Ischemic stroke in the course of thrombolytic treatment of prosthetic valve thrombosis: thrombolysis is suggested
Fidel Manuel Caceres Loriga
PMID: 23443861  doi: 10.5152/akd.2013.085  Pages 286 - 287
Abstract | Full Text PDF

22.Influence of gender, C- reactive protein and triglycerides in risk prediction of coronary heart disease
Altan Onat
PMID: 23443862  doi: 10.5152/akd.2013.086  Pages 287 - 288
Abstract | Full Text PDF

23.Can isolated ST elevation in aVR lead be a sign of acute pulmonary embolism?
Anita Sadeghpour, Azin Alizadeasl
PMID: 23443863  doi: 10.5152/akd.2013.087  Pages 288 - 289
Abstract | Full Text PDF

24.A deadly chain of events in a case; Deep venous thrombosis, pulmoner embolism, patent foramen ovale and cerebral embolism
Murat Eroğlu, Murat Yalçın, Zafer Işılak, Murat Velioğlu
PMID: 23443864  doi: 10.5152/akd.2013.088  Pages 289 - 291
Abstract | Full Text PDF

25.Successful endovascular stent-graft treatment in a patient with Marfan syndrome presenting with complicated acute Type B dissection
Can Yücel Karabay, Cihan Dündar, Kürşat Tigen, Cevat Kırma
PMID: 23443865  doi: 10.5152/akd.2013.089  Pages 291 - 292
Abstract | Full Text PDF

26.The effect of group education about drug usage in the patient's on warfarine therapy
Türkay Özcan, Meral Altıok, Fatma Babalıklı
PMID: 23443866  doi: 10.5152/akd.2013.090  Pages 292 - 293
Abstract | Full Text PDF

27.Successful surgical closure of aortopulmonary window in a very low birth weight premature infant
Önder Doksöz, Savaş Demirpençe, Timur Meşe
PMID: 23443867  doi: 10.5152/akd.2013.091  Page 294
Abstract | Full Text PDF

ALMANAC SERIAL
28.Almanac 2012: congenital heart disease. The journals present selected research that has driven recent advances in clinical cardiology
Michael Burch, Nathalie Dedieu
PMID: 23376647  doi: 10.5152/akd.2013.064  Pages 295 - 303
Abstract | Full Text PDF

IN MEMORIAM
29.In memoriam of Prof. Dr. A. Mithat Özer
İstemi Nalbantgil
doi: 10.5152/akd.2013.112  Page 304
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
30.Coexistence of accessory mitral papillary muscle and ventricular septal defect
Zafer Işılak, Onur Sinan Deveci, Murat Yalçın, Mehmet İncedayı
PMID: 23443868  doi: 10.5152/akd.2013.092  Pages E15 - E16
Abstract | Full Text PDF

31.All-in-one case: constrictive pericarditis, secundum atrial septal defect, persistent left superior vena cava and anomalous drainage of hemiazygos vein to coronary sinus
Abdurrahman Tasal, Osman Sönmez, Ercan Erdoğan, Ömer Göktekin
PMID: 23443869  doi: 10.5152/akd.2013.093  Pages E16 - E17
Abstract | Full Text PDF

32.Severe pulmonary vein stenosis due to invasion of metastatic lung cancer
Mehmet Mustafa Cangülcan
PMID: 23443870  doi: 10.5152/akd.2013.094  Page E17
Abstract | Full Text PDF

33.Free-floating intra-aortic thrombus causing coronary artery occlusion: appearance in ECG-gated computed tomography with cine-images
Terman Gümüş, Sergin Akpek, Genco Yücel
PMID: 23443871  doi: 10.5152/akd.2013.095  Pages E18 - E19
Abstract | Full Text PDF

34.Interventricular septal cardiac hydatid cyst mimicking hypertrophic cardiomyopathy
Turhan Turan, Abdulkadir Çakmak, Mustafa Çapraz, Ahmet Çağrı Aykan
PMID: 23443872  doi: 10.5152/akd.2013.096  Pages E19 - E20
Abstract | Full Text PDF



 
 
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