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Volume : 17 Issue : 3
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Anatol J Cardiol: 17 (3)
Volume: 17  Issue: 3 - March 2017
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EDITORIAL
1.Study titles
Zeki Öngen
PMID: 28321107  PMCID: PMC5864974  doi: 10.14744/AnatolJCardiol.2017.03  Page 167
Abstract | Full Text PDF

META ANALYSIS
2.Efficacy and safety of short-term (≤6 months) duration of dual antiplatelet therapy after drug-eluting stents: a meta-analysis of randomized controlled trials
Chun - Lin Xiang, Yi - Zhen Gong, Long - Jia Zeng, Bei - Bei Luo, Jian Xu, Yan He
PMID: 27849188  PMCID: PMC5864975  doi: 10.14744/AnatolJCardiol.2016.7285  Pages 168 - 175
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
3.The effect of nandrolone treatment with and without enforced swimming on histological and biochemical changes in the heart and coronary artery of male rats
Asghar Tofighi, Minoo Shirpoor, Mohammad Hasan Khadem Ansari, Alireza Shirpoor, Mitra Zerehpoosh
PMID: 27752030  PMCID: PMC5864976  doi: 10.14744/AnatolJCardiol.2016.7333  Pages 176 - 183
Objective: Chronic anabolic androgenic steroid (AAS) consumption increases incidence of cardiovascular abnormalities in athletes and mechanisms underlying those abnormalities continue to be investigated. This study examines whether nandrolone consumption induced cardiac and coronary artery wall abnormalities via oxidative stress. It was also designed to determine whether enforced swimming augmented possible cardiotoxic effects of nandrolone in rat heart.
Methods: Twenty-four male Wistar rats were divided into 3 groups: control, nandrolone, and nandrolone with enforced swimming. Nandrolone group received 10 mg/kg body weight nandrolone 3 times a week for 6 weeks. Nandrolone group with enforced swimming received the same amount of nandrolone and was forced to swim with excess weight of 20% body weight.
Results: After 6 weeks of treatment, results indicated proliferation of heart muscle and coronary smooth muscle cells and lipid peroxidation; significant rise in levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), nicotinamide adenine dinucleotide phosphate oxidase, homocysteine (Hcy), apolipoprotein B, low-density lipoprotein, and cholesterol, as well as severe fibrosis in heart tissue and around coronary arteries of nandrolone and nandrolone with enforced swimming groups compared with control group.
Conclusion: These findings strongly support idea that nandrolone intake by sedentary rats and exercised rats induced heart abnormality mediated by oxidative stress, which was manifest in increased lipid peroxidation, Hcy, and 8-OHdG in heart tissue. (Anatol J Cardiol 2017; 17: 176-83)

4.The evaluation of the clinical utility of urocortin 1 and adrenomedullin versus proBNP in systolic heart failure
Erkan Yıldırım, Mahir Cengiz, Nilgün Yıldırım, Kürşat Aslan, Emrah İpek, Ali Fuat Korkmaz, Fatih Rıfat Ulusoy, Engin Hatem
PMID: 25868038  PMCID: PMC5864977  doi: 10.5152/akd.2014.5793  Pages 184 - 190
Objective: Urocortin 1 (UCN1) has vasodilator, diuretic, and natriuretic effects, and its expression increases in heart failure (HF). Adrenomedullin (ADM) increases cardiac output and lowers blood pressure in healthy men and in patients with heart failure. The aim of the study was to determine UCN1 and ADM levels in patients with HF, to evaluate the relationship of UCN1 and ADM with various clinical parameters, and to assess UCN1 and ADM as diagnostic markers in HF, in comparison with pro-brain natriuretic peptide (pro-BNP).
Methods: We investigated serum levels of UCN1, ADM, and pro-BNP in 86 consecutive patients with systolic HF [ejection fraction (EF) ≤45%] and 85 healthy controls. Serum UCN1, ADM, and pro-BNP levels were measured with the ELISA method. Transthoracic echocardiography was performed to determine left ventricular EF and pulmonary artery systolic pressure.
Results: UCN1 and ADM levels were higher in HF patients (446.2±145.7 pg/mL, p<0.001; 87.9±4.2 pg/mL, p<0.001 respectively). UCN1 was positively correlated with pro-BNP (r=0.963, p<0.001), ADM (r=0.915, p<0.001), and NYHA (r=0.879, p<0.001); ADM was positively correlated with pro-BNP (r=0.956, p<0.001) and NYHA (r=0.944, p<0.001). Receiver operating characteristic curves yielded an area under the curve of 1.00 (p<0.001) for UCN1, 1.00 (p<0.001) for ADM, and 0.99 (p<0.001) for pro-BNP in the diagnosis of HF.
Conclusion: UCN1 and ADM increase with worsening HF and left ventricular dysfunction. They may be used as diagnostic biomarkers in systolic HF, but the incremental value of measuring UCN1 and ADM in patients tested for pro-BNP is questionable. (Anatol J Cardiol 2017; 17: 184-90)

5.Fasting glycemia and glycated hemoglobin categories: Relationship to serum lipoprotein(a) level and disparity in 2 geographic regional groups of Turkey
Altan Onat, Yusuf Karadeniz, Günay Can, Süleyman Karakoyun, Fatma Özpamuk Karadeniz, Ayşem Kaya, Hüsniye Yüksel
PMID: 27849191  PMCID: PMC5864978  doi: 10.14744/AnatolJCardiol.2016.7190  Pages 191 - 199
Objective: The goal of the present study was to determine covariates of serum lipoprotein (Lp) (a) within fasting glucose and glycated hemoglobin (HbA1c) categories, and to detect features that were different among covariates based on residence in Marmara and Central Anatolia (Marm-CA) regions or remaining 5 geographic regions of Turkey.
Methods: Data of randomly-selected group of 1167 men and women (mean age 61 years) who participated in biennial surveys of 2013 and 2015 were cross-sectionally analyzed in 6 categories.
Results: In multiple linear regression analysis of nondiabetic women, homeostatic model assessment (HOMA) index score was inversely associ- ated with Lp(a) (β coefficient 0.49; p=0.001); this was not true for men. In the whole sample, Lp(a) was significantly positively associated with female sex and with serum creatinine, and inversely in each sex with HOMA index (β coefficient 0.63; p<0.001). Linear models within separate categories showed significant associations of Lp(a) only in individuals with no evidence of diabetes other than HbA1c >6.5%: in women, positive association with total cholesterol and inverse relationship with creatinine were found, and in men, positive association with apolipoprotein (apo) B was determined. Similar age, diastolic blood pressure, fasting glucose, triglyceride, uric acid, and C-reactive protein values were obtained from participants of 2 regional groups. Residents of the Marm-CA region who were nondiabetic exhibited significantly (by 23%) lower serum Lp(a) among individuals with HbA1c ≥5.7%, significantly higher HOMA index score, concentrations of apoB, and low-density lipoprotein cholesterol.
Conclusion: Hallmark of prediabetic and diabetic glycemia/HbA1c categories seems to be an independent inverse association between Lp(a) protein (yet not of apoB) and HOMA score, this being primarily so in residents of Marm-CA region. (Anatol J Cardiol 2017; 17: 191-9)

EDITORIAL COMMENT
6.Are diabetes mellitus and lipoprotein(a) independently or causally associated with an increased cardiovascular risk?
Marija Vavlukis
PMID: 28321108  PMCID: PMC5864979  doi: 10.14744/AnatolJCardiol.2016.23434  Pages 200 - 201
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
7.Long-term prognostic significance of pentraxin-3 in patients with acute myocardial infarction: 5-year prospective cohort study
Servet Altay, Hüseyin Altuğ Çakmak, Tuğba Kemaloğlu Öz, Fatma Özpamuk Karadeniz, Ayça Türer, Hatice Betül Erer, Gülen Feyzan Kılıç, İbrahim Keleş, Günay Can, Mehmet Eren
PMID: 27488759  PMCID: PMC5864980  doi: 10.14744/AnatolJCardiol.2016.7307  Pages 202 - 209
Objective: A predictive role of serum Pentraxin 3 (PTX3) for short-term adverse cardiovascular events including mortality in acute myocardial infarction (AMI) was reported in recent studies. The aim of the study was to investigate long-term prognostic significance of serum PTX3 in an AMI with 5-year follow-up period in this study.
Methods: In this prospective study, 140 patients, who were admitted to the emergency department between January 2011 and December 2011 with acute chest pain and/or dyspnea and diagnosed with AMI and 60 healthy controls were included. PTX3 levels were measured at admission by using an ELISA method. The study group was divided into tertiles on the basis of admission PTX3 values: the high-PTX3 group (≥4.27 ng/mL), the middle-PTX3 groups (4.27–1.63 ng/mL), and the low-PTX3 group (≤1.63 ng/mL).
Results: PTX3 level was significantly more greatly increased in the AMI group than in the controls (2.27±0.81 vs. 0.86±0.50 ng/mL, p<0.001). PTX3 level was found to be significantly positively correlated with TIMI score (r=0.368, p=0.037), high sensitive C-reactive protein (hsCRP) (r=0.452, p=0.024), pro-BNP (r=0.386, p=0.029), troponin I (r=0.417, p=<0.001), and GRACE score (r=0.355, p=0.045), and negatively correlated with HDL cholesterol (r=–0.203, p=0.016) and LVEF (r=–0.345, p=0.028). In multivariate analysis, PTX3 (OR=1.12, 95% CI 1.04–1.20; p=0.001) was a significant independent predictor of long-term cardiovascular mortality, after adjusting for other risk factors.
Conclusion: PTX3 is a novel biomarker that may help to identify high risk individuals with AMI, who are potentially at risk of early major adverse cardiovascular events including mortality in the long-term period. (Anatol J Cardiol 2017; 17: 202-9)

8.The impact of protein oxidation on sustained and white coat hypertension
Erkan Yıldırım, Emrah İpek, Işıl Bavunoğlu, Nilgün Yıldırım, Mahir Cengiz, Serap Yavuzer, Hakan Yavuzer, Hayriye Erman, Hafize Uzun
PMID: 27684518  PMCID: PMC5864981  doi: 10.14744/AnatolJCardiol.2016.7174  Pages 210 - 216
Objective: The present study compared the unfavorable effects of protein oxidation and deoxyribonucleic acid damage on patients with white coat hypertension (WCH), sustained hypertension (HT), and normotensives.
Methods: Participants were allocated into 3 groups: 40 healthy controls, 36 patients with WCH, and 40 patients with sustained HT. Patients with risk factors for atherosclerosis, endocrine diseases, alcoholism, or masked hypertension were excluded. Plasma level of protein carbonyl (PCO), ischemia modified albumin (IMA), total thiol (T-SH), prooxidant-antioxidant balance (PAB), advanced protein oxidation products (AOPPs), and urinary level of 8-hydroxy-2'-deoxyguanosine (8-OHdG) were measured and relationship between these oxidative stress parameters and WCH and sustained HT was analyzed.
Results: Ambulatory 24-hour, daytime and night-time systolic and diastolic blood pressure readings of sustained HT group were significantly higher than those of WCH and control groups (p<0.001, all). AOPPs, PCO, IMA, 8-OHdG, and PAB levels were significantly higher in HT group than WCH and control groups (p<0.001, all). Additionally, T-SH level was significantly lower in HT group than WCH and control groups (p<0.001). A similar statistically significant relationship was detected between WCH and control groups.
Conclusion: Results indicate that increased level of AOPPs, PCO, IMA, 8-OHdG, PAB, and decreased level of T-SH are likely to be indicators of oxidative stress, which may play a key role both in WCH and sustained HT. (Anatol J Cardiol 2017; 17: 210-6)

9.NKX2-5 molecular screening and assessment of variant rate and risk factors of secundum atrial septal defect in a Moroccan population
Ihssane El Bouchikhi, Laila Bouguenouch, Fatima Zohra Moufid, Mohammed Iraqui Houssaini, Khadija Belhassan, Imane Samri, Ayoub Tahri Joutei, Karim Ouldim, Samir Atmani
PMID: 27752029  PMCID: PMC5864982  doi: 10.14744/AnatolJCardiol.2016.7222  Pages 217 - 223
Objective: Secundum atrial septal defect (ASDII) has multifactorial etiology that is combination of environmental (e.g., mother’s exposure to toxicity, ethnicity) and genetic causes. Aim of the present study was to screen a Moroccan population with ASDII for NKX2-5 variants and to assess risk factors that may contribute to emergence of the disorder.
Methods: Thirty-two non-syndromic ASDII patients were screened for NKX2-5 variants using direct sequencing of polymerase chain reaction- amplified coding regions. Risk factor rates were compared to general population and assessed using Fisher’s exact and chi-square tests. In this retrospective study, criteria of exclusion were suggestive or confirmed syndrome association.
Results: Three heterozygous variants were detected in 4 patients. NKX2-5 variant rate in present cohort is estimated to be about 9.4%. Two prominent risk factors in the Moroccan population were highlighted: consanguinity, rate of which was significantly high at 30.8%, and previous maternal miscarriage or sibling sudden death, observed in 34.6% of cohort.
Conclusion: Impact of identified variants was discussed and possible disease-predisposing effect is suggested. Findings indicate that ASD may be favored by consanguineous marriage and that NKX2-5 variant rate in ASD patients may be affected by ethnicity. High level of maternal mis- carriage and sibling sudden death suggests potential non-sporadic nature as result of putative genetic defect. (Anatol J Cardiol 2017; 17: 217-23)

10.Release of mitochondrial DNA correlates with peak inflammatory cytokines in patients with acute myocardial infarction
Chaoyi Qin, Jun Gu, Ruiqi Liu, Fei Xu, Hong Qian, Qian He, Wei Meng
PMID: 27721319  PMCID: PMC5864983  doi: 10.14744/AnatolJCardiol.2016.7209  Pages 224 - 228
Objective: The present study is an exploration of the dynamic changes of plasma mitochondrial deoxyribonucleic acid (mtDNA) and inflammatory level in patients with acute myocardial infarction (MI).
Methods: Thirty-eight patients with acute MI and 33 control participants were included in the study. Blood samples were collected on admis- sion, 12 hours post-percutaneous coronary intervention (PCI), 24 hours post-PCI, and 48 hours post-PCI. White blood cell (WBC) count and C- reactive protein (CRP) level were determined. Plasma was isolated from whole blood. Plasma mtDNA was measured using real-time polymerase chain reaction, and tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) were measured using enzyme-linked immunosorbent assay kits. Bivariate correlation analysis was used to find correlation between plasma mtDNA and inflammatory level on admission.
Results: Plasma mtDNA was significantly higher in patients with acute MI than controls on admission (p<0.01). Plasma mtDNA decreased significantly after PCI treatment (p=0.01). WBC count, TNF-α, IL-6 and CRP showed similar pattern: elevation after onset of acute MI and contrac- tion after PCI treatment (p<0.05). Positive correlations between plasma mtDNA and WBC count (r=0.435; p<0.001), TNF-α (r=0.538; p<0.001), IL-6 (r=0.518; p<0.001), and CRP (r=0.524; p<0.001) were identified.
Conclusion: Plasma mtDNA elevated after onset of acute MI and positive correlation was observed between plasma mtDNA and inflammatory level, suggesting that mtDNA may play a key role in inflammatory responses in patients with acute MI. (Anatol J Cardiol 2017; 17: 224-8)

11.Short-term outcome of acute inferior wall myocardial infarction with emphasis on conduction blocks: a prospective observational study in Indian population
Varun Kumar, Santosh Sinha, Prakash Kumar, Mohammed Razi, Chandra Mohan Verma, Ramesh Thakur, Umeshwar Pandey, Rajpal Singh Bhardwaj, Mohammed Ahmad, Rk Bansal, Shalini Gupta
PMID: 27752031  PMCID: PMC5864984  doi: 10.14744/AnatolJCardiol.2016.6782  Pages 229 - 234
Objective: The primary aim of the present study was to evaluate the complications, particularly conduction blocks, subsequent morbidity and mortality, and effect of thrombolytic therapy in Indian patients with inferior wall myocardial infarction (IWMI).
Methods: This was a prospective, observational, single-center study conducted at LPS Institute of Cardiology, Kanpur, from December 2011 to May 2014. Patients who presented with typical chest pain and were subsequently diagnosed by standardized diagnostic criteria as having IWMI were enrolled. Patients were grouped on basis of conduction abnormalities, right ventricular (RV) infarction and thrombolytic treatment. Each group was analyzed for comparison of complication profile and mortality.
Results: Of 573 patients with IWMI enrolled in the study (mean age: 58.90±12.3 years), 81.2% were male, 225 (39.3%) had conduction blocks, and 189 (32.9%) had RV infarction. In patients with conduction blocks, mortality occurred in 27 patients (12.0%) in contrast to 3.4% of patients without conduction block (p<0.03). Also, there were 27 cases of in-hospital mortality in patients with RV infarction compared with 9 cases in patients without RV infarction (p<0.01). Thrombolytic therapy significantly reduced mortality in patients with IWMI (p<0.001). A significant reduction was observed in cardiogenic shock (p=0.002), severe mitral regurgitation (p=0.007), and left ventricular failure (p<0.001) in patients undergoing thrombolytic therapy.
Conclusion: In Indian patients with IWMI, incidence of conduction blocks was higher than previously reported studies. Major complications such as atrioventricular block and RV infarction are associated with increased mortality and poor clinical outcomes. Thrombolytic therapy has a beneficial role in reduction of mortality rate and other complications. (Anatol J Cardiol 2017; 17: 229-34)

12.Sleep related bradyarrhythmic events and heart rate variability in apparently healthy individuals
Tolga Çimen, Hamza Sunman, Mehmet Erat, Tolga Han Efe, Ahmet Akyel, Murat Bilgin, Sadık Açıkel, Mehmet Doğan, Ekrem Yeter
PMID: 27849189  PMCID: PMC5864985  doi: 10.14744/AnatolJCardiol.2016.7300  Pages 235 - 240
Objective: It is thought that abnormal cardiac impulses of the autonomic nervous system during sleep are responsible for sleep-related bradyarrhythmias. Despite a proposed common etiopathogenesis and having common name of “sleep-related bradyarrhythmias,” precise importance of sinoatrial or atrioventricular (AV) node involvement remains elusive. This study aimed to determine whether there is a difference in sleeprelated bradyarrhythmias from the point of view of heart rate variability (HRV).
Methods: Patients were evaluated using 24-hour Holter electrocardiogram monitor. After careful medical evaluation, apparently healthy individuals with sleep-related sinus pauses ≥2 seconds on at least 1 occasion or those in whom Mobitz type I AV block occurred were included. Frequency and time domain analyses were conducted for daytime, nighttime, and 24-hour period.
Results: Total of 37 patients with sinus pause(s), 40 patients with Mobitz type I AV block(s), and 40 healthy controls were included. On HRV analyses, all time and frequency domain parameters were better in sinus pause group for daytime, nighttime, and 24-hour average (p<0.05 for all). Results of heart rate-corrected HRV analyses still showed significantly better total power (TP) and very low frequency (VLF) in the sinus pause group compared with AV block group (TP: 7.1x10-3 vs. 5.4x10-3, p=0.011; VLF: 4.9x10-3 vs. 3.7x10-3, p=0.007).
Conclusion: Despite proposed common autonomic mechanisms, sleep-related sinus pause cases demonstrated better HRV profile in comparison with Mobitz type I AV block. (Anatol J Cardiol 2017; 17: 235-40)

REVIEW
13.Unusual aspects of cardiac myxoma
Shi - Min Yuan, Song - Li Yan, Ning Wu
PMID: 28321109  PMCID: PMC5864986  doi: 10.14744/AnatolJCardiol.2017.7557  Pages 241 - 247
A cardiac myxoma may manifest as miscellaneous and uncharacteristic presentations. These unusual aspects of cardiac myxomas can be rare clinical presentations, special patient populations, unusual locations, and special pathology, which may lead to a delayed diagnosis, improper checkups, and subsequent untimely treatment, eventually resulting in unexpected poor prognosis. Therefore, the diagnosis of cardiac myxomas can be challenging because of these unusual aspects. In order to get a better understanding of a cardiac myxoma and to facilitate an early diagnosis and proper treatment, the unusual aspects of cardiac myxomas are described here. (Anatol J Cardiol 2017; 17: 241-7)

LETTER TO THE EDITOR
14.Electromagnetic interference of mobile phones: insight into heart rate variability
Kadir Uğur Mert, Muhammet Dural, Gurbet Özge Mert, Kemal İskenderov
PMID: 28321097  PMCID: PMC5864987  doi: 10.14744/AnatolJCardiol.2017.7617  Page 248
Abstract | Full Text PDF

15.Subclinical left ventricular systolic function in rheumatic mitral stenosis: What is the role for clinical practice?
Uyanga Batnyam, Esra Gücük İpek
PMID: 28321098  PMCID: PMC5864988  doi: 10.14744/AnatolJCardiol.2017.7635  Page 249
Abstract | Full Text PDF

16.Author`s Reply
Demet Menekşe Gerede
PMID: 28321099  PMCID: PMC5864989  Pages 249 - 250
Abstract | Full Text PDF

17.Prognostic value of high on-treatment platelet reactivity
Ali Doğan, Serkan Kahraman, Emrah Özdemir, Nuri Kurtoğlu
PMID: 28321100  PMCID: PMC5864990  doi: 10.14744/AnatolJCardiol.2017.7665  Page 250
Abstract | Full Text PDF

18.Author`s Reply
Adnan Kaya
PMID: 28321101  PMCID: PMC5864991  Pages 250 - 251
Abstract | Full Text PDF

19.Fractional flow reserve guided stenting of a myocardial bridge
György Barczi, Ibolya Csecs, Zoltan Ruzsa, Bela Merkely
PMID: 28321102  PMCID: PMC5864992  doi: 10.14744/AnatolJCardiol.2017.7406  Pages 251 - 252
Abstract | Full Text PDF

20.Pulmonary valve and pulmonary artery myxomas
Shi - Min Yuan
PMID: 28321103  PMCID: PMC5864993  doi: 10.14744/AnatolJCardiol.2017.7534  Pages 252 - 253
Abstract | Full Text PDF

21.Defibrillator lead dislocation after manual lumbar traction
Murat Sucu, Gökhan Altunbaş, Esra Polat
PMID: 28321104  PMCID: PMC5864994  doi: 10.14744/AnatolJCardiol.2017.7671  Pages 253 - 254
Abstract | Full Text PDF

MISCELLANEOUS
22.In memoriam of Professor Ömer Aydın Karamehmetoğlu
S. Sırrı Kes
PMID: 28321105  doi: 10.14744/AnatolJCardiol.2017.7759  Page 255
Abstract | Full Text PDF

23.In memoriam of Professor Mahmut Şevket Uğurlu
S. Sırrı Kes
PMID: 28321106  doi: 10.14744/AnatolJCardiol.2017.7758  Page 256
Abstract | Full Text PDF



 
 
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