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Anatol J Cardiol: 13 (8)
Volume: 13  Issue: 8 - December 2013
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1.Editorial board meeting of Anatolian Journal of Cardiology, stable coronary and ethic
Bilgin Timuralp
PMID: 24370730  doi: 10.5152/akd.2013.201312  Page 751
Abstract | Full Text PDF

2.Association of mitral annular calcification with endothelial dysfunction, carotid intima-media thickness and serum fetuin-A: an observational study
Murat Ziyrek, Yelda Tayyareci, Selen Yurdakul, Şükrü Taylan Şahin, Özlem Yıldırımtürk, Saide Aytekin
PMID: 24108756  doi: 10.5152/akd.2013.235  Pages 752 - 758
Objective: Mitral annular calcification (MAC) is characterized by degenerative calcification of the mitral valve annulus. Atherosclerosis plays role in progression of MAC. Fetuin A is the inhibitor of pathological calcification. In the present study, we investigated the relationship between MAC and fetuin A with carotid intima media thickness (CIMT) and endothelial dysfunction. Methods: In this observational cross-sectional study, 40 patients with documented MAC on transthoracic echocardiography (TTE) and 40 without MAC were included. All patients had coronary artery disease (CAD). Endothelial functions were assessed by brachial artery Doppler ultrasound (USG) and carotid artery Doppler USG. Serum fetuin-A level was also measured. Linear regression analysis and receiver operator curve (ROC) analysis were performed. Results: Endothelial derived vasodilatory response (EDVR) was significantly decreased and CIMT value was increased in MAC group. There was a strong positive correlation between EDVR and serum fetuin-A value. There was a strong negative correlation between CIMT and EDVR, moderately negative correlation between CIMT and serum fetuin-A level. Simple linear regression analysis revealed that CIMT (β=0.367, p=0.001) and serum fetuin-A level (β=-0.291, p=0.009) were independent factors associated with MAC. The area under the curve (AUC) for serum fetuin-A level was 0.731 (95% 0.620-0.824) and AUC for CIMT was 0.724 (95% CI 0.613-0.818). Conclusion: We observed that MAC is closely related with CIMT and serum fetuin-A level. Serum fetuin-A and CIMT can be used as independent markers in the diagnosis of MAC. We suggest that MAC can be used as an early determinant of CAD.

3.Effect of shisha vs. cigarette smoking on endothelial function by brachial artery duplex ultrasonography: an observational study
Ghada M. Selim, Remon Z. Elia, Ayman S. El Bohey, Khalid A. El Meniawy
PMID: 24287354  doi: 10.5152/akd.2013.4499  Pages 759 - 765
Objective: In this study, we sought to investigate the effect of shisha smoking on endothelial function compared to cigarettes, using brachial artery ultrasound (BAUS) imaging in asymptomatic young adults with no other cardiovascular risk factors. Methods: This is an observational case-control study where 30 young shisha smokers, 30 cigarette smokers and 10 healthy, non-smokers, age- matched subjects between 25-35 years old with no cardiovascular risk factors were recruited from all around Egypt. Flow-mediated dilation was assessed using brachial artery duplex ultrasonography. Results: FMD% was significantly impaired among shisha smokers compared to cigarette smokers and non-smokers cigarettes (7.9±3.8% vs. 12±3.4% and 21.5±2.5% respectively p<0.001). Conclusion: Shisha smoking has a more hazardous effect on brachial artery endothelial- dependent flow mediated vasodilation compared to cigarette.

4.Assessment of cardio-ankle vascular index in patients with cardiac syndrome-X: an observational study
Ahmet Çağrı Aykan, Tayyar Gökdeniz, İlker Gül, Faruk Boyacı, Turhan Turan, Duygun Altıntaş Aykan, Şükrü Çelik, Mustafa Yıldız
PMID: 24172834  doi: 10.5152/akd.2013.263  Pages 766 - 771
Objective: Arterial stiffness is associated with major adverse cardiovascular events. Cardio-ankle vascular index (CAVI), a novel marker of arterial stiffness, which is weakly influenced by systolic blood pressure, is a sensitive marker the atherosclerosis and arteriolosclerosis. The aim of this study is to investigate arterial stiffness by CAVI in patients with cardiac syndrome X (CSX). Methods: The present study was observational and cross sectional, and involved 49 patients (26 male) with CSX (angina-like chest pain, positive electrocardiographic ischemic changes at treadmill exercise test, angiographically normal coronary arteries) and 54 healthy subjects (21 male). CAVI was measured by VaSera-1000 CAVI instrument. Statistical analysis was performed using the Chi-square, Student t-test, correlation analysis and logistic regression analysis. Results: The CAVI and pulse pressure were significantly increased in patients with CSX compared to control group (7.50±1.50, 6.49±0.77, p<0.001; 53.00±10.06, 47.39±8.17, p=0.002, consecutively). In contrast, there were no significant differences in the age, weight, height, body mass index, waist circumference, hip circumference, systolic blood pressure, diastolic blood pressure, mean blood pressure, glucose, low density lipoprotein level, high density lipoprotein level (HDL), triglyceride, estimated creatinine clearance, hemoglobin, left atrium diameter, left ventricular mass (LVM), LVM index and ejection fraction. CAVI was the only independent predictor of CSX in logistic regression analysis (OR=1.780, 95% CI: 1.157-2.737, p=0.009). Conclusion: CAVI is increased in syndrome X patients and is an independent predictor of this syndrome.

5.Relationship of QT dispersion with sex hormones and insulin in young women with polycystic ovary syndrome: an observational study
Emine Gazi, Meryem Gencer, Volkan Hancı, Ahmet Temiz, Burak Altun, Ayşe Nur Çakır Güngör, Ufuk Öztürk, Bahadır Kırılmaz
PMID: 24172835  doi: 10.5152/akd.2013.264  Pages 772 - 777
Objective: Polycystic ovary syndrome (PCOS) is a common endocrinopathy in reproductive women. Cardiovascular disease risk factors are more frequent in this population. We aimed in this study to investigate presence of QT dispersion and effects of sex hormones and insulin on QT duration in young PCOS patients. Methods: This present study was cross-sectional observational study. A total of 47 women, 25 patients with PCOS and 22 healthy, were included. Serum testosterone, estradiol and insulin levels were studied and electrocardiography was performed at 2nd or 3th days of menstrual cycle. The study population was divided into groups according to serum testosterone and estradiol levels. Sub-groups and pairwise groups were compared by Mann-Whitney U or student t-test. The associations of QTc durations with hormone levels were calculated using Spearman rank correlation analysis. The results were evaluated at the p<0.05 significance level. Results: No differences found between groups regarding to demographic parameters. Estradiol and testosterone levels were higher in patients with PCOS (41.12±13.59 vs. 35.57±19.29 pg/mL, p=0.09 and 105±58.5 vs. 17.6±10.9 ng/dL, p=0.01, respectively). QT dispersion was significantly longer in PCOS patients (47.1 vs. 32.7 ms, p=0.01). A positive correlation was found between the serum insulin level and QTc min, QTc max, and QTc mean (r=0.402, p=0.011; r=0.341, p=0.033; r=0.337, p=0.036; respectively). QT dispersion with serum testosterone and estradiol levels were positively correlated (r=0.525, p=0.001and r=0.326, p= 0.046; respectively). Conclusion: Our results suggest that QT dispersion is prolonged and testosterone, estradiol and insulin are associated with QT duration in young PCOS patients.

6.Predictors of functional capacity in younger and elderly chronic heart failure patients: an observational study
Nihat Polat, Fahrettin Öz, Derya Baykız, Ahmet Yaşar Çizgici, İbrahim Altun, Zehra Buğra, Berrin Umman, Fatih Tufan, Hüseyin Oflaz
PMID: 24172836  doi: 10.5152/akd.2013.265  Pages 778 - 783
Objective: The prevalence of chronic heart failure (CHF) in the elderly population is growing. Identification of risk factors in patients with CHF is important. Recent studies suggest that red cell distribution width (RDW) has prognostic significance in these patients. We aimed to evaluate the relationship of RDW with clinical and laboratory parameters in patients with young and elderly CHF patients. Methods: We evaluated patients with CHF with an ejection fraction (EF) of <50% in this observational cross-sectional study. Exclusion criteria were decompensated CHF, malignancy and end stage renal disease. Clinical information, functional capacity (FC), hemoglobin, RDW, EF, and pro-B type natriuretic peptide (proBNP) were recorded. The younger and elderly groups were compared and correlation of RDW with clinical and laboratory parameters were analyzed in each group. Ordinal regression analysis was performed to determine independent correlates of increased FC. Results: Seventy young and 47 elderly cases were enrolled. The groups were similar regarding EF, proBNP and FC. RDW showed stronger correlation with FC in the young group (r=0.627, p<0.001) compared to the elderly group (r=0.332, p=0.023). In the younger group, there was a negative correlation between RDW and EF (r=-0.278, p=0.021) and a positive correlation between RDW and proBNP (r=0.487, p<0.001). RDW (OR=16.36, 95% CI 0.33-0.96, p<0.001), EF [OR=7.75, 95% CI (-0.16)-(-0.03), p=0.005] and usage of RAS inhibitors (OR=6.7, 95% CI 0.57-3.36, p=0.007) were independent predictors of increased FC. Conclusion: We found a stronger correlation between RDW and EF, proBNP and FC in the younger patients compared the elderly group. RDW is a simple, inexpensive and easily accessible parameter that may be considered risk predictor especially in younger patients with CHF.

7.Subclinical left ventricular dysfunction in women with polycystic ovary syndrome: an observational study
Ercan Erdoğan, Mehmet Akkaya, Ahmet Bacaksız, Abdurrahman Tasal, Murat Turfan, Şeref Kul, Osman Sönmez, Mehmet Akif Vatankulu, Gökhan Ertaş, Gonca Batmaz, Mehmet Ergelen, Hüseyin Uyarel, Ömer Göktekin
PMID: 23996806  doi: 10.5152/akd.2013.196  Pages 784 - 790
Objective: Cardiac involvement has been increasingly recognized in patients with polycystic ovary syndrome (PCOS). Identification of the earliest asymptomatic impairment of left ventricular (LV) performance may be important in preventing progression to overt heart failure. Our aim was to investigate LV function with different echocardiographic techniques in patients with PCOS. Methods: Thirty patients with PCOS and 30 age and body mass index matched healthy subjects were enrolled to this cross-sectional observational study. All subjects underwent echocardiography for assessment of resting LV function as well as two-dimensional speckle tracking echocardiography (2D-STE) and real-time three-dimensional echocardiography (3D-Echo). Global longitudinal strain (GLS) was calculated from 3 standard apical views using 2D-STE. Student t-test, Chi-square test, Pearson’s, and Spearman’s correlation analysis were used for statistical analysis. Results: The early mitral inflow deceleration time (DT), isovolumetric relaxation time (IVRT) and E/Em ratio were increased in the PCOS group (p<0.05 for all). Waist-to-hip ratio, fasting insulin, homeostasis model assessment of insulin resistance (HOMA-IR) and low-density lipoprotein (LDL) levels were higher in PCOS group (p<0.05 for all). Significant correlation was observed between DT, IVRT and insulin value, HOMA-IR (p<0.05 for all). On 3D-Echo evaluation, none of the patients in both groups had LV systolic dysfunction with comparable LV ejection fraction and LV volumes. 2D-STE showed that GLS was significantly reduced in the PCOS group compared to control group (-16.78±0.56% vs. -18.36±1.04%, p<0.001). The GLS was found to be negatively correlated with waist-to-hip ratio and LDL values (p<0.05 for all). Conclusion: These results indicate that PCOS may be related to impaired LV systolic function detected by 2D-STE. In addition, PCOS may lead to diastolic dysfunction. Reduced GLS might be an early indicator of cardiac involvement in this patient population.

8.The evaluation of relationship between adiponectin levels and epicardial adipose tissue thickness with low cardiac risk in Gilbert`s syndrome: an observational study
Erkan Cüre, Yüksel Çiçek, Medine Cumhur Cüre, Süleyman Yüce, Aynur Kırbaş, Arif Yılmaz
PMID: 24172837  doi: 10.5152/akd.2013.266  Pages 791 - 796
Objective: Atherosclerotic heart diseases are less frequently seen in patients with Gilbert’s syndrome (GS). We aimed to investigate whether serum adiponectin (APN) and epicardial adipose tissue (EAT) thickness have an effect beside the antioxidant effect of bilirubin in lowering the incidence of the atherosclerotic process. Methods: Sixty-eight patients diagnosed with GS (39 females and 29 males) who had applied at the internal medicine clinic of the hospital were included in this cross-sectional, observational study. The control group included 63 healthy people (39 females and 24 males). EAT thickness was measured by echocardiography. The serum APN levels were also checked. Statistical analysis was performed by using independent sample t-test, Pearson correlation and linear regression analyses. Results: The mean age of the GS group was 28±9 years, and the average EAT thickness was found to be 2.5±0.1 mm. The mean age of the control group was 26±6 years, and the average EAT thickness was found to be 4.2±0.5 mm. When comparing the two groups, the EAT thickness of the GS group was found to be significantly lower (p<0.001) than that of the control group. In the GS group the APN was 14.9±4.2 mg/L, and in the control group the APN was 12.6±4.5 mg/L (p<0.022). We found that total bilirubin (β=-1,607, p<0,001) and indirect bilirubin (β=1,086, p<0,001) have an independent association with decreased EAT thickness. Conclusion: EAT thickness is associated with coronary atherosclerosis. Low EAT thickness may be related with low release of proinflammatory cytokine. High levels of APN may be related high anti-inflammatory effect. Therefore, low EAT thickness and high levels of APN may demonstrate protective effect on atherosclerotic heart diseases in GS patients.

9.Pre-ictal heart rate variability assessment of epileptic seizures by means of linear and non-linear analyses
Soroor Behbahani, Nader Jafarnia Dabanloo, Ali Motie Nasrabadi, Cesar A. Teixeira, Antonio Dourado
PMID: 24108758  doi: 10.5152/akd.2013.237  Pages 797 - 803
Objective: The purpose of the present study was to analyze the effects of epilepsy on the autonomic control of the heart in pre-ictal phase in order to find an algorithm of early detection of seizure onset. Methods: Overall 133 epileptic seizures were analyzed from 12 patients with epilepsy (seven males and five females; mean age 43.91 years, SD: 10.16) participated in this study. Single lead electrocardiogram recordings of epileptic patients were compiled. 240, 90-30, 30-10 and 5 minutes heart rate variability (HRV) signals of preseizure were chosen for analysis of heart rate. As HRV signals are non-stationary, a set of time and frequency domain features (Mean HR, Triangular Index, LF, HF, LF/HF) and nonlinear parameters (SD1, SD2 and SD2/SD1 indices derived from Poincaré plots) extracted from HRV is analyzed. Statistical analysis was performed using paired sample t-test for comparisons of the segments and differences between pre-ictal segments were evaluated by Tukey tests. Results: There was slight tachycardia in segments near the seizure (30 minutes before: 85.3517 bpm, 5 minutes before: 119.3630.82 bpm, p=0.0207) which significantly differ from baseline in segments far from seizure (240 minutes before: 66.5211.7 bpm). Also there was significant increase in LF/HF ratio (30 minutes before: 1.10.22, 5 minutes before: 2.120.5, p=0.0332) and SD2/SD1 ratio (30 minutes before: 1.20.15, 5 minutes before: 2.030.55, p=0.0431) when compared to segments far from the seizure (240 minutes before: 0.780.24 and 0.780.14) respectively. Although there was about decrease of triangular index in segments near the seizure the percentage of decrease was not comparable to segments far from the seizure. Conclusion: Significant changes of HRV parameters in pre-ictal (5 minutes before the seizure) are obviously higher in comparison to interictal baseline. Pre-ictal significant changes of HRV suggesting that this time can be considered as prediction time for designing an algorithm of early detection of seizure onset based on HRV.

10.The effects of antedgrade cerebral perfusion on immediate postoperative outcome in neonatal and infant aortic arch repair concomitant with intracardiac surgery
Ali Rıza Karacı, Ahmet Şaşmazel, Reyhan Dedeoğlu, Numan Ali Aydemir, Buğra Harmandar, Hasan Erdem, İbrahim Yekeler
PMID: 24172833  doi: 10.5152/akd.2013.262  Pages 804 - 805
Abstract | Full Text PDF

11.Obesity is a risk factor for acute mountain sickness: a prospective study in Tibet railway construction workers on Tibetan plateau
Bo Yang, Nin Li, Zhi-Jun Sun, Bin Chen, Xin Li, Yun-Dai Chen
PMID: 24287355  doi: 10.5152/akd.2013.4585  Pages 806 - 808
Abstract | Full Text PDF

12.Problems, nurses face within the intensive care units illustrated by four case reports
Aynur Koyuncu, Fatma Eti Aslan, Yasemin Uslu, Ufuk Demirkılıç
PMID: 24287356  doi: 10.5152/akd.2013.5035  Pages 809 - 811
Abstract | Full Text PDF

13.Radiofrequency ablation improving LV function in cardiomyopathy secondary to low burden of premature ventricular complexes
Nasir Shariff, Daniel Makowski, Vadim Levin
PMID: 24287357  doi: 10.5152/akd.2013.4744  Pages 812 - 814
Abstract | Full Text PDF

14.Bilateral pseudoaneurysm secondary to intraarterial tianeptine abuse
Gökhan İlhan, Şaban Ergene, Tuğba Durakoğlugil, Hakan Karamustafa, Ozan Karakişi, Şahin Bozok
PMID: 24287358  doi: 10.5152/akd.2013.4856  Pages 814 - 815
Abstract | Full Text PDF

15.Right coronary artery spasm-a complication of cardiac pacemaker implantation
Diana Tint, Florin Ovidiu Ortan, Mihai Emil Ursu, Sorin Micu
PMID: 24287359  doi: 10.5152/akd.2013.4984  Pages 815 - 818
Abstract | Full Text PDF

16.Toothache uncovered the biatrial masses
Uğur Canpolat, Hikmet Yorgun, Necla Özer, Kudret Aydemir
PMID: 24287367  doi: 10.5152/akd.2013.4662  Page 819
Abstract | Full Text PDF

17.A cardiac cyst presented with subacute anterior myocardial infarction
Yavuzer Koza, Omaç Tüfekçioğlu, Levent Birincioğlu, Sarper Ökten, Veysel Başar
PMID: 24287368  doi: 10.5152/akd.2013.4813  Page 820
Abstract | Full Text PDF

18.Cardiology concern on new H3N2 influenza outbreak
Viroj Wiwanitkit
PMID: 24287360  doi: 10.5152/akd.2013.4820  Page 821
Abstract | Full Text PDF

19.Elective percutaneous coronary intervention without on-site cardiac surgery: an Iranian survey
Ramin Eskandari, Mir-Hossein Seyyed-Mohammadzad, Yousef Rezaei, Maryam Mehrpooya, Kamal Khademvatani, Alireza Rostamzadeh
PMID: 24287361  doi: 10.5152/akd.2013.4914  Pages 821 - 822
Abstract | Full Text PDF

20.Toothache uncovered the biatrial masses
Uğur Canpolat, Hikmet Yorgun, Necla Özer, Kudret Aydemir
PMID: 24287367  Page 823
Abstract | Full Text PDF

21.A cardiac cyst presented with subacute anterior myocardial infarction
Yavuzer Koza, Omaç Tüfekçioğlu, Levent Birincioğlu, Sarper Ökten, Veysel Başar
PMID: 24287368  Page 824
Abstract | Full Text PDF

22.Almanac 2013: acute coronary syndromes
Pascal Meirer, Alexandra J. Lansky, Andreas Baumbach
PMID: 24108759  doi: 10.5152/akd.2013.238  Pages 825 - 832
Unstable coronary artery plaque is the most common underlying cause of acute coronary syndromes (ACS) and can manifest as unstable angina, non-ST segment elevation infarction (NSTE-ACS), and ST elevation myocardial infarction (STEMI), but can also manifest as sudden cardiac arrest due to ischaemia induced tachyarrhythmias. ACS mortality has decreased significantly over the last few years, especially from the more extreme manifestations of ACS, STEMI, and cardiac arrest. This trend is likely to continue based on recent therapeutic progress which includes novel antiplatelet agents such as prasugrel, ticagrelor, and cangrelor.

23.Author Index

Pages 833 - 838
Abstract | Full Text PDF

24.Subject Index

Pages 839 - 855
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25.Referee Index

Pages 856 - 857
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26.Pseudoaneurysm of the mitralaortic intervalvular fibrosa and complementary role of 3D transesophageal echocardiographic imaging
Yalçın Velibey, Barış Güngör, Osman Bolca, Mehmet Eren
PMID: 24516864  doi: 10.5152/akd.2013.4853  Pages E44 - E45
Abstract | Full Text PDF

27.Rupture of posterior chordae following percutaneous mitral balloon valvuloplasty for rheumatic mitral stenosis
Cüneyt Toprak, Gökhan Kahveci, Mehmet Mustafa Tabakçı
PMID: 24516865  doi: 10.5152/akd.2013.4986  Page E45
Abstract | Full Text PDF

28.Hypoplastic aorta in a patient with familial hypercholesterolemia
Şevket Balta, İlknur Balta, Sait Demirkol, Fahri Gürkan Yeşil
PMID: 24516866  doi: 10.5152/akd.2013.4891  Page E46
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29.A case of malposition of ventricular electrode through atrial septal defect
Uğur Nadir Karakulak, Sercan Okutucu, Kudret Aytemir
PMID: 24516868  doi: 10.5152/akd.2013.4812  Pages E46 - E47
Abstract | Full Text PDF

30.Bivalvular calcification in a 9-year-old child presenting with syncope
Bülent Koca, Funda Öztunç, Sertaç Çiçek, Ayşe Güler Eroğlu, Resmiye Beşikçi
PMID: 24516869  doi: 10.5152/akd.2013.4848  Pages E47 - E48
Abstract | Full Text PDF

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