ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 18 (5)
Volume: 18  Issue: 5 - November 2017
EDITORIAL
1.Scientific competition, impact factor, and Altmetrics
Adnan Abacı
PMID: 29145234  PMCID: PMC5731277  doi: 10.14744/AnatolJCardiol.2017.11  Page 313
Abstract |Full Text PDF

INVITED EDITORIAL
2.Medicine and cardiology can have a high innovative potential in Turkey
Ayhan Olcay, Serdar B. Albayrak, Erdem Tezcan, Vedat Öztürk
PMID: 29145235  PMCID: PMC5731278  doi: 10.14744/AnatolJCardiol.2017.8167  Page 314
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
3.Protection by nitrite against the ischemic effects induced by acute myocardial infarction in mice
Yafei Wang, Xin Song, Xia Yue, Hong Su, Yuanliang Gu, Linda Bowman, Min Ding, Baobo Zou, Jinshun Zhao, Xialu Lin
PMID: 29145236  PMCID: PMC5731279  doi: 10.14744/AnatolJCardiol.2017.7952  Pages 315 - 320
Objective: This research was aimed to investigate the correct dose of nitrite that would act as a protection against the ischemic effects induced by acute myocardial infarction (AMI).
Methods: Mice were randomly divided into a sham-operation group (sham), an AMI operation group (AMI), and a nitrite pretreatment+AMI operation group (N+AMI). Seven days before the AMI operation, mice in the N+AMI group were pretreated with sodium nitrite in drinking water.
Results: One week after the AMI operation, serum lactate dehydrogenase (LDH) and creatine kinase (CK) activities in both AMI and N+AMI group were significantly higher than those in the sham group, but there were no significant differences between AMI and N+AMI mice. Contents of inducible nitric oxide synthase (iNOS) in the noninfarct area of the left ventricle in the N+AMI mice were significantly higher than those in the AMI mice, with no difference in the infarct area. Coagulation necrosis in the cardiomyocytes was observed in both AMI and N+AMI mice; however, it was less severe in the N+AMI mice. Western blot analyses showed that nitrite pretreatment resulted in up-regulation of antiapoptotic factors Bcl-2 and p21waf1/cip1 signal proteins, but down-regulation of the proapoptotic factor Bax signal protein. Furthermore, nitrite pretreatment also showed significant alleviation of AMI-induced signal protein expressions of inflammatory factors of NF-KB and oxidative factors of Hsp 70 and HO-1.
Conclusion: These results suggest that nitrite show certain protective effects against the ischemic effects induced by AMI in mice, which might be attributed to the synthesis of NO induced by iNOS through up-regulation of antiapoptotic factors and down-regulation of proapoptotic and inflammatory factors.

4.Prospective evaluation of the feasibility, safety, and efficacy of Cocoon Duct Occluder for transcatheter closure of large patent ductus arteriosus: A single-center study with short- and medium-term follow-up results
Santosh Kumar Sinha, Mahmadula Razi, Rama Niwas Pandey, Prakash Kumar, Vinay Krishna, Mukesh Jitendra Jha, Vikas Mishra, Mohammad Asif, Nasar Abdali, Pradyot Tewari, Ramesh Thakur, Umeshwar Pandey, Chandra Mohan Varma
PMID: 29145233  PMCID: PMC5731280  doi: 10.14744/AnatolJCardiol.2017.7814  Pages 321 - 327
Objective: To evaluate the feasibility, safety, and efficacy of a novel Cocoon Duct Occluder device for the transcatheter closure (TCC) of large patent ductus arteriosus (PDA).
Methods: In this prospective, non-randomized study, consecutive patients with large PDA (narrowest diameter: ≥3.5/4.0 mm in symptomatic/asymptomatic patients, respectively), who underwent TCC with Cocoon Duct Occluder at our institute between November, 2012 and June, 2016 were examined. TCC was performed using the standard technique, and devices were antegradely delivered via 6–10F delivery sheaths. Device embolization, residual shunt, hemolysis, left pulmonary artery (LPA) stenosis, procedural and fluoroscopy time, and mortality were assessed. Patients were followed-up by transthoracic echocardiography with color Doppler imaging at 24 h (D1), 1 month (D30), and 6 months (D180) after implantation.
Results: A total of 57 patients (age: 11.7±2.8 years; weight: 22.3±3.5 kg) were enrolled. The mean narrowest diameter was 7.4±0.7 mm. The PDA closure was successfully performed in each patient. Fluoroscopy and procedural time was 6.7±3.2 min and 23.9±2.7 min, respectively. Postprocedural angiography revealed that 49 (85.9%) patients had immediate and complete closure, whereas 8 (14.1%) had residual shunt. Color Doppler imaging at D1 revealed complete closure in 52 (91.3%) patients. At D30, complete closure was reported in all patients and was maintained at D180. Hemolysis, embolization, obstruction of LPA or descending aorta, and death were not reported till D180.
Conclusion: TCC using Cocoon Duct Occluder is feasible, safe, and effective in the management of patients with large PDA, with excellent results on short- and medium-term follow-up.

5.Comparison of Warfarin use in terms of efficacy and safety in two different polyclinics
Salih Kılıç, Hatice Soner Kemal, Elif İlkay Yüce, Evrim Şimşek, Burcu Yağmur, Nuray Memişoğlu Akgül, Cahide Soydaş Çınar, Mehdi Zoghi, Cemil Gürgün
PMID: 29145216  PMCID: PMC5731281  doi: 10.14744/AnatolJCardiol.2017.7886  Pages 328 - 333
Objective: This study compared the efficacy and safety of warfarin in specialized international normalized ratio (INR) outpatient clinic (INR-C) and in general cardiology outpatient clinic (General-C).
Methods: Herein, 381 consecutive patients with a regular follow-up at INR-C (n=233) or General-C (n=148) for at least 1 year were retrospectively included. While INR-C patients were followed by a single experienced trained nurse, General-C patients were followed by a different cardiologist who worked in a rotational principle every month. During controls, demographic characteristics, INR levels, bleeding events, ischemic stroke, and transient ischemic attacks in the last 1 year were recorded. Primary endpoint was defined as the evaluation of the combined major bleeding and ischemic event, and secondary endpoint was defined as the evaluation of them separately.
Results: The mean age of the patients was 62±12.86 and 43.8% were male. Mean time in therapeutic range (TTR) level was statistically higher in INR-C than that in General-C (68.8%±15.88 and 51.6%±23.04, respectively; p<0.001). Primary outcomes were significantly higher in General-C than that in INR-C [13.5% (20) and 6.4% (15); respectively, p=0.020]. Overall, major bleeding was observed in 25 patients (6.5%) and (2.6%) ischemic event was observed in 10 patients. In General-C patients, both major bleeding (8.8% vs. 5.2%; p=0.163) and the ischemic event (4.7% vs. 1.3%; p=0.051) were more, and no statistically significant differences were detected between the two clinics.
Conclusion: The findings of our study demonstrate that patients followed in INR-C had higher TTR levels and lower bleeding and ischemic events rates that those followed in General-C.

6.Impact of continuation of metformin prior to elective coronary angiography on acute contrast nephropathy in patients with normal or mildly impaired renal functions
Veysel Oktay, İlknur Calpar Çıralı, Ümit Yaşar Sinan, Ahmet Yıldız, Murat Kazım Ersanlı
PMID: 29111980  PMCID: PMC5731282  doi: 10.14744/AnatolJCardiol.2017.7836  Pages 334 - 339
Objective: Discontinuation of metformin treatment in patients scheduled for elective coronary angiography (CAG) is controversial because of post-procedural risks including acute contrast-induced nephropathy (CIN) and lactic acidosis (LA). This study aims to discuss the safety of continuing metformin treatment in patients undergoing elective CAG with normal or mildly impaired renal functions.
Methods: Our study was designed as a single-centered, randomized, and observational study including 268 patients undergoing elective CAG with an estimated glomerular filtration rate of >60 mL/min/1.73 m2. Of these patients, 134 continued metformin treatment during angiography, whereas 134 discontinued it 24 h before the procedure. CIN was defined as either a 25% relative increase in serum creatinine levels from the baseline or a 0.5 mg/dL increase in the absolute value that measured 48 h after CAG. Logistic regression analysis was performed to identify independent predictors of CIN and LA after CAG.
Results: Both groups were comparable in terms of demographics and laboratory values. CIN at 48 h was 8% (11/134) in the metformin continued group and 6% (8/134) in the metformin discontinued group (p=0.265). Patients in neither of the groups developed metformin-induced LA. Based on multiple regression analysis, the ejection fraction [p=0.029, OR: 0.760; 95% CI (0.590–0.970)] and contrast volume [p=0.016, OR: 0.022 95% CI (0.010–0.490)] were independent predictors of CIN.
Conclusion: Patients scheduled for elective CAG with normal or mildly impaired renal functions and preserved left ventricular ejection fraction (>40%) may safely continue metformin treatment.

7.Aortic propagation velocity does not correlate with classical aortic stiffness parameters in healthy individuals
Hatem Arı, Fatih Kahraman, Yasin Türker, Serdar Güler, Hasan Aydın Baş, Doğan Erdoğan
PMID: 29083326  PMCID: PMC5731283  doi: 10.14744/AnatolJCardiol.2017.7306  Pages 340 - 346
Objective: Aortic stiffness is an important cardiovascular risk marker, which can be determined using different noninvasive techniques. Aortic propagation velocity (APV) has recently been established as a novel echocardiographic parameter of aortic stiffness. This study aimed to investigate the association between APV and the classical echocardiography-derived aortic stiffness parameters, aortic distensibility (AD) and aortic strain (AS), in a group of otherwise healthy individuals.
Methods: In total, 97 consecutive healthy subjects were recruited in this observational study. APV was measured using color M-mode echocardiography from the suprasternal window in the descending aorta. AS and AD were calculated using clinical blood pressure and the M-mode echocardiography-derived aortic diameters. Correlation analyses were performed between cardiovascular risk factors related to increased aortic stiffness (age, obesity, and blood pressure) and measured stiffness parameters (APV, AS, and AD). Correlation analyses were also performed among the measured stiffness parameters.
Results: Good correlation of age, blood pressure, and BMI with AS and AD was observed. One-on-one correlation of age, blood pressure, and BMI with APV was not observed. No correlation was observed between APV and AS (r=–0.05, p=0.6) or between APV and AD (r=–0.17, p=0.8).
Conclusion: Although APV has been proposed as a novel and practical echocardiographic parameter of aortic stiffness, especially in patients with coronary artery disease, correlations between classical stiffness parameters (AS and AD) and APV were absent in healthy individuals at low–intermediate risk. The clinical and research applicability of APV should be further evaluated.

8.Association of female sex and heart rate with increased arterial stiffness in patients with type 2 diabetes mellitus
Min- Kyung Kang, Jae Myung Yu, Kwang Jin Chun, Jaehuk Choi, Seonghoon Choi, Namho Lee, Jung Rae Cho
PMID: 29145217  PMCID: PMC5731284  doi: 10.14744/AnatolJCardiol.2017.7773  Pages 347 - 352
Objective: This study aimed to evaluate the factors associated with increased arterial stiffness (IAS) measured by pulse wave velocity (PWV) and its clinical implications in patients with type 2 diabetes mellitus (DM).
Methods: This was an observational, cross-sectional study. The ankle–brachial PWV was used to measure arterial stiffness, and 310 patients (mean age, 49±9 years; 180 men) with type 2 DM were divided into two groups according to the results of PWV: Group 1 (IAS; n=214) and Group 2 (normal arterial stiffness; n=96).
Results: Patients in Group 1 were predominantly females (48% vs. 28%, p=0.001) and showed higher blood pressure and faster heart rate (HR). The glomerular filtration rate was lower and the urine microalbumin level was higher in patients with IAS. In multiple regression analysis, female sex and faster HR were independently associated with IAS. In subgroup analysis among female patients, prior stroke was more common in patients with IAS, and faster HR and increased postprandial 2-h C-peptide level were independently associated with IAS.
Conclusion: Female sex and faster HR were independently associated with IAS in patients with type 2 DM. In a subgroup analysis among female patients, prior stroke was more common in patients with IAS, and faster HR and elevated postprandial 2-h C-peptide level were found to be independently associated with IAS.

9.Evaluation of Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio in patients with mitral valve stenosis before and after balloon valvuloplasty
Muhammet Dural, Kadir Uğur Mert, Kemal İskenderov
PMID: 29044094  PMCID: PMC5731285  doi: 10.14744/AnatolJCardiol.2017.7876  Pages 353 - 360
Objective: Sympathetic activity increases in patients with mitral stenosis (MS). The association between prolonged Tpeak-Tend (Tp-e) interval and increased sympathetic activity has been demonstrated. This study aimed to evaluate Tp-e interval, Tp-e/QT ratio, and Tp-e/corrected QT interval (QTc) ratio in patients with MS before and after balloon valvuloplasty.
Methods: Thirty patients with severe MS and 30 sex-, body mass index-, and and age-matched healthy control subjects were enrolled. The severity of MS was defined following clinical, transthoracic, and transesophageal echocardiographic examinations. All patients underwent successful mitral balloon valvuloplasty. Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios were measured using 12-lead electrocardiogram. First, the abovementioned parameters were compared between patients with MS and healthy control subjects. Second, these parameters were compared before and after balloon valvuloplasty in patients with MS.
Results: The mean Tp-e interval was significantly prolonged in patients with MS compared with healthy control subjects (85.02±9.12 ms vs. 75.38±6.04 ms; p<0.001). In addition, Tp-e/QT ratio and Tp-e/QTc ratio were significantly higher in patients with MS than in healthy control subjects (0.217±0.025 vs. 0.196±0.02 and 0.203±0.02 vs. 0.184±0.019; p<0.001).The mean valve area significantly increased after balloon valvuloplasty compared with that before balloon valvuloplasty (1.83±0.32 cm2 vs. 1.18±0.15 cm2; p<0.001). Compared with those before balloon valvuloplasty, Tp-e interval (85.02±9.12 ms vs. 78.06±9.2 ms; p<0.001), Tp-e/QT ratio (0.217±0.02 vs. 0.201±0.02; p<0.001), and Tp-e/QTc ratio (0.203±0.02 vs. 0.184±0.02; p<0.001) decreased after balloon valvuloplasty.
Conclusion: We revealed that Tp-e interval, Tp-e/QT ratio, and Tp-e/QTc ratio increased in patients with severe MS. Furthermore, balloon valvuloplasty had a favorable effect on parameters associated with myocardial repolarization.

10.Dynamic thiol/disulphide homeostasis as a novel indicator of oxidative stress in obese children and its relationship with inflammatory-cardiovascular markers
Bahri Elmas, Mehmet Karacan, Pınar Dervişoğlu, Mustafa Kösecik, Şükriye Pınar İşgüven, Ceylan Bal
PMID: 28761018  PMCID: PMC5731286  doi: 10.14744/AnatolJCardiol.2017.7740  Pages 361 - 369
Objective: Childhood obesity is an important cause of cardiovascular risk with chronic inflammation. Oxidative stress may contribute to the pathogenesis of obesity-related cardiovascular pathologies. We aimed to evaluate thiol/disulphide homeostasis as a novel and sensitive marker of oxidative stress and to evaluate its relationship with some inflammatory and cardiovascular markers in obese children.
Methods: In this case-controlled study, 65 children with exogenous obesity and 64 healthy children, as a control group, were included. In both groups, thiol/disulphide homeostasis parameters and inflammatory (white blood cells, platelets, mean corpuscular volume, neutrophil/lymphocyte ratio, and high-sensitivity C-reactive protein) and cardiovascular (epicardial adipose tissue thickness and left ventricular mass index) markers were studied. Correlation analyses of thiol/disulphide homeostasis parameters with body mass index standard deviation scores (BMI SDS) and inflammatory and cardiovascular markers were performed. Receiver-operating characteristic analysis was performed to determine the sensitivity, specificity, and optimal cut-off values of thiol/disulphide homeostasis parameters.
Results: Native thiol, total thiol, and native thiol/total thiol ratios (antioxidant parameters) were lower (p<0.05) and disulphide/native thiol and disulphide/total thiol ratios (oxidant parameters) were higher in the obese group than in the control group (p<0.01). A positive correlation of oxidant parameters with BMI SDS and inflammatory markers was found. However, a negative correlation of antioxidant parameters with BMI SDS and inflammatory markers was found. The specificities of disulphide/native thiol and disulphide/total thiol ratios were higher in the obese group.
Conclusion: The impairment in thiol/disulphide homeostasis, which is indicative of oxidative stress, is associated with inflammation in obesity. In addition, cardiovascular involvement may also contribute to this impairment.

CASE REPORT
11.Endovascular coil treatment of a coronary artery aneurysm related to polyarteritis nodosa
Özgür Bayturan, Serdar Tarhan, Özge Çöpkıran, Fatih Düzgün, Uğur Kemal Tezcan
PMID: 29145218  PMCID: PMC5731287  doi: 10.14744/AnatolJCardiol.2017.7954  Pages 370 - 372
Abstract |Full Text PDF | Video

LETTER TO THE EDITOR
12.Simple electrocardiographic parameters predicting risk of hypertrophic cardiomyopathy: Too simple?
Serkan Çay, Özcan Özeke, Fırat Özcan
PMID: 29145219  PMCID: PMC5731288  doi: 10.14744/AnatolJCardiol.2017.8021  Page 373
Abstract |Full Text PDF

13.Author`s Reply
Mehmet Kadri Akboğa
PMID: 29145220  PMCID: PMC5731289  Pages 373 - 374
Abstract |Full Text PDF

14.Who are the main actors of cardiac device follow-up? Analysis of the super follow-up study
Enes Elvin Gül
PMID: 29145221  PMCID: PMC5731290  doi: 10.14744/AnatolJCardiol.2017.8027  Pages 374 - 375
Abstract |Full Text PDF

15.Author`s Reply
Çağın Mustafa Üreyen
PMID: 29145222  Pages 375 - 376
Abstract |Full Text PDF

16.Individualized intensified antiplatelet therapy based on platelet reactivity testing reduces the incidence of cardiovascular events in patients undergoing percutaneous coronary intervention
Michael Spartalis, Eleni Tzatzaki, Nikolaos I. Nikiteas, Eleftherios Spartalis
PMID: 29145223  PMCID: PMC5731292  doi: 10.14744/AnatolJCardiol.2017.8009  Pages 376 - 377
Abstract |Full Text PDF

17.Author`s Reply
Jae Seok Bae, Jong- Hwa Ahn, Young- Hoon Jeong
PMID: 29145224  PMCID: PMC5731293  Page 377
Abstract |Full Text PDF

18.Usefulness of left atrial speckle-tracking echocardiography in patients with atrial fibrillation
Razvan Gheorghita Mares, Dan Octavian Nistor, Mihai Vlad Golu
PMID: 29145225  PMCID: PMC5731294  doi: 10.14744/AnatolJCardiol.2017.8070  Pages 377 - 378
Abstract |Full Text PDF

19.Author`s Reply
Karolina Kupczynska, Piotr Lipiec
PMID: 29145226  PMCID: PMC5731295  Pages 378 - 379
Abstract |Full Text PDF

20.Ganglionated plexi interactions with atrio-ventricular node and right vagus nerve
Mariana Floria, Olivier Xhaet, Ileana Antohe
PMID: 29145227  PMCID: PMC5731296  doi: 10.14744/AnatolJCardiol.2017.8087  Page 379
Abstract |Full Text PDF

21.Author`s Reply
Tolga Aksu, Tümer Erdem Güler, Ferit Onur Mutluer
PMID: 29145228  PMCID: PMC5731297  Page 380
Abstract |Full Text PDF

22.Ibuprofen-induced Kounis syndrome with diffuse ST segment depression and atrial fibrillation
Murat Akçay
PMID: 29145229  PMCID: PMC5731298  doi: 10.14744/AnatolJCardiol.2017.8045  Pages 380 - 381
Abstract |Full Text PDF

MISCELLANEOUS
23.Who is Professor İlhan Paşaoğlu?
Cemil Sabuncu
PMID: 29145230  PMCID: PMC5731299  doi: 10.14744/AnatolJCardiol.2017.8246  Page 382
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
24.Right atrial ball thrombus associated with atrial septal occluder device: A late complication of transcatheter atrial septal defect closure
Belma Kalaycı, Süleyman Kalaycı
PMID: 29145231  PMCID: PMC5731300  doi: 10.14744/AnatolJCardiol.2017.8012  Page E9
Abstract |Full Text PDF | Video

25.Giant right coronary artery aneurysm mimicking sinus Valsalva aneurysm of the aorta
Nehir Sucu, Abdülkadir Bilgiç, Dilek Yılmaz, Ayten Öztaş
PMID: 29145232  PMCID: PMC5731301  doi: 10.14744/AnatolJCardiol.2017.8039  Pages E9 - E10
Abstract |Full Text PDF | Video



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