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Anatol J Cardiol: 20 (4)
Volume: 20  Issue: 4 - October 2018
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1.Long-term results of some interesting studies and more…
Çetin Erol
PMID: 30297595  doi: 10.14744/AnatolJCardiol.2018.10  Page 197
Abstract | Full Text PDF

2.microRNA-29a inhibits cardiac fibrosis in Sprague-Dawley rats by downregulating the expression of DNMT3A
Run- He Qin, Hui Tao, Shi- Hao Ni, Peng Shi, Chen Dai, Kai- Hu Shi
PMID: 30297596  doi: 10.14744/AnatolJCardiol.2018.98511  Pages 198 - 205
Objective: This study aims to investigate the effect of miR-29a targeting the regulation of DNMT3A on the development of cardiac fibrosis in Sprague-Dawley (SD) rats.
Methods: In vivo experiment: SD rats were randomly divided into model and control groups. The cardiac and left ventricular indices in each group were calculated. The pathological changes of the myocardium were observed. The expression levels of miR-29a, CollA1, α-SMA, and DNMT3A in the myocardium of each group were detected. In vitro experiment: The cardiac fibroblasts (CFs) of SD rats were isolated from the myocardial tissue of SD rats and cultured. The miR-29a mimics, inhibitors, DNMT3A-siRNA, and control-siRNA were transfected into CFs. The expression levels of miR-29a, DNMT3A, CollA1, and α-SMA were detected, and the proliferation of CFs after transfection was observed.
Results: The heart weight index of the rats in the model group increased significantly compared with that in the control group. Obvious collagen deposition was observed in the myocardial tissue of the model group. The expression levels of CollA1, α-SMA, and DNMT3A in the model group were significantly higher than those in the control group (p<0.05).
Conclusion: miR-29a reduced the activation and proliferation of CFs to improve cardiac fibrosis probably by the downregulation of DNMT3A.

3.Time-dependent cervical vagus nerve stimulation and frequency-dependent right atrial pacing mediates induction of atrial fibrillation
Mingliang Rao, Jialu Hu, Yan Zhang, Feng Gao, Feng Zhang, Zhi Yang, Xiaoya Zhang, Yuemei Hou
PMID: 30297578  doi: 10.14744/AnatolJCardiol.2018.73558  Pages 206 - 212
Objective: This study aimed to investigate the effects of right cervical vagus trunk simulation (RVTS) and/or right atrial pacing (RAP) on the induction of atrial fibrillation (AF).
Methods: Twenty-four healthy adult dogs were randomly divided into four groups: RAP groups comprising RAP500 (RAP with 500 beats/min) and RAP1000 (RAP with 1000 beats/min) and RVTS groups comprising RVTS and RAP500+RVTS. All dogs underwent 12-h intermittent RAP and/or RVTS once every 2 h. The AF induction rate, AF duration, atrial effective refractory period (ERP), and dispersion of ERP (dERP) were compared after every 2 h of RAP or/and RVTS.
Results: All groups had successful AF induction. The RAP1000 group had the highest AF induction rate and the longest AF duration. The RAP1000 group also had a shortened ERP in comparison to the other groups as well as the maximum dERP. Compared to the RAP500 group, RAP500+RVTS had an increased capacity to induce AF as measured by the AF induction rates, AF duration, ERP, and dERP.
Conclusion: Increased tension in the vagus nerve and the intrinsic cardiac autonomic nervous system plays an important role in AF induction through different potential mechanisms. Interventions involving the vagus nerve and/or intrinsic cardiac autonomic nervous system can be a future potential therapy for AF.

4.Evaluation of the effect of non-ergot dopamine agonists on left ventricular systolic function with speckle tracking echocardiography
Hilal Erken Pamukcu, Demet Menekşe Gerede Uludağ, Bahar Tekin Tak, Mine Hayriye Sorgun, Tolga Han Efe, Aynur Acıbuca, Cenk Akbostancı, Sibel Turhan
PMID: 30297579  doi: 10.14744/AnatolJCardiol.2018.65983  Pages 213 - 219
Objective: Parkinson's disease (PD) is a neurological disorder, and ergot dopamine agonists (DAs) are no longer usually preferred in the treatment due to the increased risk of valvular heart disease. Some recent studies have shown that commonly used non-ergot DA also increases the risk of heart failure. On the other hand, there are studies showing conflicting data about this relationship. The aim of the present study was to investigate the cardiac effects of non-ergot DAs in patients with PD using echocardiography.
Methods: Conventional echocardiography and two-dimensional (2D) speckle tracking strain echocardiography were performed to determine the possible systolic dysfunction prior to the development of apparent systolic heart failure. Ninety-one (55 male, 64±10 years) patients with PD were included in the study. Furthermore, 25 subjects with newly diagnosed PD and using no drug were enrolled as the control group. All patients were divided into groups according to their medication. Patients using levodopa were classified as Group 1 (36), levodopa+pramipexole as Group 2 (27), and levodopa+ropinirole as Group 3 (28).
Results: Left ventricle dysfunction with non-ergot DA use in patients with PD was not established with conventional echocardiographic evaluation. For 2D strain analysis, global longitudinal strain values were obtained as −18.5%, −18.5%, and −18.9% in the groups, respectively. Strain and strain rate values of the left ventricle were not different between the groups (p=0.816 and p=0.881, respectively).
Conclusion: There was no significant relationship between left ventricular dysfunction and use of non-ergot DA in patients with PD. Similar results were obtained in strain analysis showing left ventricular subclinical dysfunction. Our study appears to confirm the safety of non-ergot DA in the point of heart failure risk. To our knowledge, this is the first study to evaluate the effect of this group of drugs on subclinical left ventricular systolic function.

5.Role of microcirculatory function and plasma biomarkers in determining the development of cardiovascular adverse events in patients with peripheral arterial disease: A 5-year follow-up
Muzaffer Akkoca, Suzan Emel Usanmaz, Serhat Tokgöz, Cüneyt Köksoy, Emine Demirel Yilmaz
PMID: 30297580  doi: 10.14744/AnatolJCardiol.2018.04578  Pages 220 - 228
Objective: The aim of this long-term follow-up study was to investigate the association of local and systemic cardiovascular complications with endothelium-dependent and-independent microvascular relaxations and blood biomarkers and biochemicals in patients with peripheral arterial disease (PAD) caused by atherosclerosis.
Methods: This prospective study included 67 patients with PAD who had not undergone any endovascular intervention, peripheral arterial surgery, or major amputation. Changes in the microvascular blood flow were measured using laser Doppler imaging after iontophoresis of acetylcholine (ACh) and sodium nitroprusside (SNP). The biochemical markers of high sensitivity C reactive protein (hs-CRP), nitric oxide (NO), total antioxidant capacity (TAC), asymmetric dimethyl arginine (ADMA), and hydrogen sulfide (H2S) levels were measured from blood samples. All the patients were followed up for 5 years to determine the development of cardiovascular adverse events (CVAEs) and major amputation. At the end of the follow-up period, the patients were classified into two groups: those who had a CVAE [CVAE (+)] and those who did not experience CVAE [CVAE (−)]. Parameters such as demographic features, atherosclerotic risk factors, chronic ischemia category, microvascular endothelial functions, and plasma biomarkers were compared between the groups.
Results: A total of 67 patients comprising 61 (91%) males and 6 (9%) females with a mean age of 62.3±9.7 years were included. During the follow-up period, 29 patients had CVAE (43.3%) and 38 patients did not have CVAE (56.7%). There was no difference between the groups in terms of ACh and SNP-induced vasodilation responses. Plasma high density lipoprotein (HDL) cholesterol values were lower in the CVAE (+) group [(CVAE+HDL: 38.4±9.1), (CVAE−HDL: 44.7±11.1), p=0.02]. Plasma hs-CRP values were significantly higher in the CVAE (+) group [(CVAE+ hs-CRP: 14.3±20.6), (CVAE−hs-CRP: 5.9±10.9), p=0.004]. No significant difference was observed between the groups in terms of plasma biomarkers and other biochemical levels.
Conclusion: Based on the study findings, it was concluded that only low plasma HDL and high hs-CRP levels were risk factors for the development of CVAEs during follow-up of patients with PAD.

6.Long-term outcomes in patients who underwent surgical correction for atrioventricular septal defect
Özlem Sarısoy, Canan Ayabakan, Kürşad Tokel, Murat Özkan, Rıza Türköz, Saıt Aşlamaci
PMID: 30297581  doi: 10.14744/AnatolJCardiol.2018.39660  Pages 229 - 234
Objective: The follow-up results of patients operated for atrioventricular septal defect (AVSD) during 1996–2016 at Başkent University are presented.
Methods: Data obtained from hospital records consists of preoperative echocardiographic and angiographic details, age and weight at surgery, operative details, Down syndrome presence, postoperative care details, early postoperative and latest echocardiographic findings and hospitalization for reintervention.
Results: A total of 496 patient-files were reviewed including 314 patients (63.4%) with complete and 181 (36.6%) with partial AVSD (48.4% of all patients had Down syndrome). Atrioventricular (AV) valve morphology was Rastelli type A in 92.2%, B in 6.5%, and C in 1.3% of patients. The operative technique used was single-patch in 21.6% (108), double-patch in 25.8% (128), and modified single-patch (Wilcox) in 52.5% (260) of patients. The follow-up time was 37.79±46.70 (range, 0–198) months. A total of 64 patients (12.9%) had arrhythmias while in the intensive care unit; pacemaker was implanted in 12 patients. A total of 78 patients (15.7%) were treated for pulmonary hypertensive crisis. The early morbidity and mortality in the postoperative first month were calculated as 38% and 10%, and the late morbidity and mortality (>1 month) were calculated as 13.1% and 1.9%, respectively. The rate of reoperation in our cohort was 8.9%.
Conclusion: Although the early morbidity and mortality are low in AVSD operations, the rate of reoperations for left AV valve insufficiency are still high. Although Down syndrome is not a risk factor for early mortality, the co-morbid factors, such as longer postoperative mechanical ventilator or inotropic support, lead to higher risk for morbidity. The frequency of pulmonary hypertension and consequent complications are also high.

7.Modeling the burden of cardiovascular disease in Turkey
Yucel Balbay, Isabelle Gagnon-arpin, Simten Malhan, Mehmet Ergun Öksüz, Greg Sutherland, Alexandru Dobrescu, Guillermo Villa, Gulnihal Ertuğrul, Mohdhar Habib
PMID: 30297582  doi: 10.14744/AnatolJCardiol.2018.89106  Pages 235 - 240
Objective: This study aims to estimate the current and future burden of cardiovascular diseases (CVD) in Turkey.
Methods: A burden-of-disease model was developed that included inputs on population growth, prevalence, and incidence of ischemic disease (IHD) and cerebrovascular disease (CeVD), prevalence of modifiable risk factors, mortality rates, and relationship between risk factors and IHD/CeVD. Direct costs to the public health-care system and indirect costs from lost production due to premature mortality, hospitalizations, disability, and absenteeism were considered.
Results: We estimated that in 2016, 3.4 million Turkish adults were living with CVD, including 2.5 million affected by IHD, and 0.9 million by CeVD. This prevalence is projected to increase to 5.4 million by 2035. The economic burden of CVD was estimated at US$10.2 billion in 2016, projected to increase twofold to US$19.4 billion by 2035.
Conclusion: Our study confirms that the current burden of CVD is significant, and that it is projected to increase at a steep rate over the next two decades. This growing burden of disease will likely create significant pressure on the public health-care system in the form of direct health-care costs, as well as on society in the form of lost productivity.

8.Tips for management of arrhythmias in endocrine disorders from an European Heart Rhythm Association position paper
Emin Evren Özcan, Muhammet Dural, Bülent Görenek
PMID: 30297583  doi: 10.14744/AnatolJCardiol.2018.87260  Pages 241 - 245
In endocrine diseases, hormonal changes, electrolyte abnormalities, and the deterioration of heart structure can lead to various arrhythmias. In
diabetic patients, hypoglycemia, hyperglycemia, and hypokalemia can trigger arrhythmias, and diabetic cardiomyopathy can also cause electrical and structural remodeling to form substrates for arrhythmias. The risk of atrial fibrillation (AF) increases in hyperthyroidism; however, the prevalence of ventricular arrhythmias in hypothyroidism is higher. Besides AF and ventricular tachycardias, bradycardias and atrioventricular blocks can also be seen in pheochromocytoma due to the desensitization of adrenergic cardiovascular receptors. The correction of metabolic and electrolyte disturbances in patients with adrenal cortex disease should be the main approach in the prevention and treatment of arrhythmias. Early initiation of treatment in patients with acromegaly seems to decrease the development of cardiac remodeling and ventricular arrhythmia. Early and late after depolarizations due to hypercalcemia in hyperparathyroidism can lead to life-threatening ventricular arrhythmias. This elegant position paper provides important recommendations regarding prevention and treatment of arrhythmias for specific endocrine disorders.

9.Intravascular leiomyoma with intracardiac extension associated with hepatorenal polycystic disease
Ioana Mihaela Dregoesc, Serban Mihai Balanescu, Madalin Constantin Marc, Adrian Corneliu Iancu
PMID: 30297584  doi: 10.14744/AnatolJCardiol.2018.20726  Pages 246 - 248
Abstract | Full Text PDF | Video

10.Biventricular non-compaction cardiomyopathy with pulmonary stenosis, interatrial septal aneurysm, atrial septal defect, bradycardia, and mental retardation in a single case: A case report
Bülent Özlek, Oğuzhan Çelik, Cem Çil, Volkan Doğan, Murat Biteker
PMID: 30297585  doi: 10.14744/AnatolJCardiol.2018.22571  Pages 248 - 251
Abstract | Full Text PDF | Video

11.Author`s Reply
Aykut Demirkıran, Neslihan Albayrak, Yakup Albayrak, Cafer Sadık Zorkun
PMID: 30297587  Page 252
Abstract | Full Text PDF

12.Strain can hide some states
Ali Karagöz, İbrahim Halil Tanboğa
PMID: 30297586  doi: 10.14744/AnatolJCardiol.2018.46006  Page 252
Abstract | Full Text PDF

13.Bizarre ST elevation
Özgür Yaşar Akbal, Berhan Keskin, Aykun Hakgör, Ali Karagöz
PMID: 30297588  doi: 10.14744/AnatolJCardiol.2018.38202  Pages 252 - 253
Abstract | Full Text PDF

14.Author`s Reply
Gökhan Altunbaş, Ertan Vuruşkan, Murat Sucu
PMID: 30297589  Pages 253 - 254
Abstract | Full Text PDF

15.Does the country of origin matter for finding research internships in the United States?
Bahadir Simsek
PMID: 30297590  doi: 10.14744/AnatolJCardiol.2018.50024  Pages 254 - 255
Abstract | Full Text PDF

16.Evaluation of renal dysfunction after ST-elevation myocardial infarction
Şahin İşcan, Börteçin Eygi, Yüksel Beşir, Orhan Gökalp
PMID: 30297591  doi: 10.14744/AnatolJCardiol.2018.80922  Pages 255 - 256
Abstract | Full Text PDF

17.Author`s Reply
Lidija Savic, Igor Mrdovic, Milika Asanin, Sanja Stankovic, Gordana Krljanac, Ratko Lasica
PMID: 30297592  Page 256
Abstract | Full Text PDF

18.Ruptured aortic dissection into the pulmonary artery: A case study
Serkan Sivri, Erdoğan Sökmen, Mustafa Çelik, Canan Şahin
PMID: 30297593  doi: 10.14744/AnatolJCardiol.2018.98403  Page E5
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19.Interventricular septal dissection sustained by an aneurysmal sac
Fernando Sabatel- Perez, Finn Akerström, Miguel A Arias
PMID: 30297594  doi: 10.14744/AnatolJCardiol.2018.83031  Pages E5 - E6
Abstract | Full Text PDF | Video

20.Appendix–Detailed Methods

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