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Anatol J Cardiol: 21 (4)
Volume: 21  Issue: 4 - April 2019
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1.Focusing on echocardiographic findings
Çetin Erol
PMID: 30930456  doi: 10.14744/AnatolJCardiol.2019.4  Page 179
Abstract | Full Text PDF

2.Evaluation of subclinical left ventricular dysfunction in overweight people with 3D speckle-tracking echocardiography
Mustafa Doğduş, Salih Kılıç, Ertan Vuruşkan
PMID: 30930446  doi: 10.14744/AnatolJCardiol.2018.40456  Pages 180 - 186
Objective: Obesity is associated with cardiovascular risk factors and is a major predictor of cardiovascular disease and mortality. This global burden affects myocardial function by inducing structural and functional alterations. Although subclinical left ventricular (LV) dysfunction is known in obese subjects, there is not sufficient information about overweight people. The aim of the present study was to evaluate subclinical LV dysfunction in overweight people with three-dimensional speckle-tracking echocardiography (3D-STE).
Methods: One hundred eighteen consecutive patients between 18 and 80 years old were enrolled into the study. Patients were divided into three groups according to body mass index (BMI): normal (BMI: 18.5–24.9 kg/m2) (n=35), overweight (BMI: 25–29.9 kg/m2) (n=43), and obese (BMI ≥30 kg/m2) (n=40). 3D-STE was performed, and global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), and global area strain (GAS) were measured. 3D-STE results were compared between the groups.
Results: The mean age of the patients was 60.97±8.94 years, and 55.1% of the patient population were male. Mean GCS was −13.5, GLS was −11.9, GRS was 32.3, and GAS was −22. As BMI increased, GCS and all other strain parameters were significantly worse [p<0.001 (normal–overweight), p<0.001 (normal–obese), and p<0.001 (overweight–obese) for GCS, GLS, GRS, and GAS]. A positive linear correlation was observed between BMI and all measured strain parameters (r=0.673, p<0.001 for BMI and GCS).
Conclusion: 3D-STE is a non-invasive parameter to detect subclinical LV dysfunction, and global strain values are significantly correlated with BMI. Subclinical LV dysfunction was detected in overweight people in addition to obese subjects.

3.Endo/epicardial ablation of ventricular arrhythmias with contact force-sensing catheters in arrhythmogenic right ventricular dysplasia/cardiomyopathy
Dursun Aras, Fırat Özcan, Serkan Çay, Özcan Özeke, Meryem Kara, Serkan Topaloğlu
PMID: 30930451  doi: 10.14744/AnatolJCardiol.2018.58534  Pages 187 - 195
Objective: To control ventricular arrhythmia in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C), ablation may be required both from the endocardial and epicardial side. In this study, we analyzed the results of contact force–sensing (CFS) catheters in the endo/epicardial ablation of ventricular arrhythmias in ARVD/C.
Methods: We included 17 patients with ARVD/C, 5 of whom had premature ventricular contractions (PVC), and the rest of them were admitted with a ventricular tachycardia (VT) storm, between September 2014 and October 2016. We divided patients into two groups: the PVC and VT groups. Irrigated CFS catheters (Smart Touch, Biosense Webster, Inc.) were utilized in all procedures.
Results: In the PVC group, the mean ratio of PVC during the 24-hour Holter monitoring was 31.8±7.6%. The mean contact force during mapping and ablation in the right ventricle was 13±1.2 and 12.8±1.9 grams, respectively. The mean follow-up duration was 15±3.1 months for the PVC group. The left ventricular ejection fraction improved in all patients (52.8±10%). All patients in the VT group underwent endo/epicardial ablation, except one. The mean contact force during the endocardium and epicardium mapping was 12.5±1.2 and 12.5±4.6 grams, respectively. The mean contact force during ablation for the endocardium and epicardium was 12.1±1.4 and 12.8±1.9 grams, respectively. All clinical and non-clinical VTs were ablated successfully, except in 2 patients who still had non-clinical VTs. The mean follow-up was 15.5±4.5 months. None of the VT patients experienced electrical storm or death. Two patients had single shock, and 1 patient had two shocks during the follow-up.
Conclusion: Endo/epicardial ablation of ventricular arrhythmias with CFS catheters in ARVD/C seems to be promising.

4.Demographics of patients with heart failure who were over 80 years old and were admitted to the cardiology clinics in Turkey
Gülay Gök, Mehdi Zoghi, Ümit Yaşar Sinan, Salih Kılıç, Lale Tokgözoğlu
PMID: 30930455  doi: 10.14744/AnatolJCardiol.2018.94556  Pages 196 - 205
Objective: Heart failure (HF) has a high prevalence and mortality rate in elderly patients; however, there are few studies that have focused on
patients older than 80 years. The aim of this study is to describe and compare the age-specific demographics and clinical features of Turkish
elderly patients with HF who were admitted to cardiology clinics.
Methods: The Epidemiology of Cardiovascular Disease in Elderly Turkish population (ELDER-TURK) study was conducted in 73 centers in Turkey, and it recruited a total of 5694 patients aged 65 years or older. In this study, the clinical profile of the patients who were aged 80 years or older and those between 65 and 79 years with HF were described and compared based on the ejection fraction (EF)-related classification: HFrEF and HFpEF (is considered as EF: ≥50%).
Results: A total of 1098 patients (male, 47.5%; mean age, 83.5±3.1 years) aged ≥80 years and 4596 patients (male, 50.2 %; mean age, 71.1±4.31 years) aged 65-79 years were enrolled in this study. The prevalence of HF was 39.8% for patients who were ≥80 years and 27.1% for patients 65–79 years old. For patients aged ≥80 years with HF, the prevalence rate was 67% for hypertension (HT), 25.6% for diabetes mellitus (DM), 54.3% for coronary artery disease (CAD), and 42.3% for atrial fibrilation. Female proportion was lower in the HFrEF group (p=0.019). The prevalence of HT and DM was higher in the HFpEF group (p<0.01), whereas CAD had a higher prevalence in the HFrEF group (p=0.02). Among patients aged 65–79 years, 43.9% (548) had HFpEF, and 56.1% (700) had HFrEF. In this group of patients aged 65-79 years with HFrEF, the prevalence of DM was significantly higher than in patients aged ≥80 years with HFrEF (p<0.01).
Conclusion: HF is common in elderly Turkish population, and its frequency increases significantly with age. Females, diabetics, and hypertensives are more likely to have HFpEF, whereas CAD patients are more likely to have HFrEF.

5.Higher ultrafiltration rate is associated with right ventricular mechanical dispersion
Serkan Ünlü, Efstathios Pagourelias, Burak Sezenöz, Asife Şahinarslan, Orhan Mecit Uludağ, Gökhan Gökalp, Turgay Arınsoy, Atiye Çengel
PMID: 30930445  doi: 10.14744/AnatolJCardiol.2019.26243  Pages 206 - 213
Objective: Ultrafiltration rate is one of the major determinants of adverse outcomes in patients undergoing hemodialysis (HD) therapy. Previous studies have focused on the impact of HD on right ventricular (RV) peak strain values. However, the influence of HD on the temporal characteristics of deformation has not been reported yet. The aim of the present study was to evaluate the impact of high ultrafiltration rate (HUR) on RV mechanical dyssynchrony.
Methods: Echocardiographic images focused on the RV and left ventricle (LV) were obtained from 60 patients (49.2±17.3 years, 22 female) before and after HD. Patients were divided into two groups according to ultrafiltration rate. Changes in echocardiographic parameters with HD were examined. Two-dimensional speckle-tracking strain analysis was used to assess deformation. Mechanical dispersion was measured as the standard deviation of time to peak longitudinal strain of six segments for RV and 18 segments for LV.
Results: The average ultrafiltrated volume and ultrafiltration rate were 3000.1±1007.9 mL and 11.4±2.9 mL/kg/h, respectively. Global longitudinal strain (GLS) of the RV and LV decreased after HD in both groups. A significant difference was observed in RV mechanical dispersion with HD for patients in the high ultrafiltration group. A mild statistically insignificant increase in LV mechanical dispersion was also observed after HD.
Conclusion: HUR has a substantial impact on LV and RV GLS and RV dyssynchrony. Ultrafiltration rates and volumes should be kept as low as possible to achieve hemodynamic stability and tolerability.

6.Comprehensive echocardiographic imaging of atrioventricular valves in children with atrioventricular septal defect: Accuracy of 2D and 3D imaging and reasons for disagreement
Nina Hakacova, Thomas Higgins, Torsten Malm, Per Wierup, Charles Maynard, Jens Ramgren Johansson
PMID: 30930449  doi: 10.14744/AnatolJCardiol.2019.49376  Pages 214 - 221
Objective: To compare the accuracy and reasons for disagreement of two-dimensional (2D) and three-dimensional (3D) echocardiography findings in the assessment of the atrioventricular valve complex in patients with atrioventricular septal defect.
Methods: A total of 20 children (mean age 8 months) with atrioventricular septal defect were enrolled prospectively into this study. The accuracy of and the reasons for disagreement in the assessment of the atrioventricular valve features were analyzed between 2D and 3D echocardiography and surgical findings.
Results: We found that in assessing the Rastelli type and the extension of the inferior leaflet into the right ventricle, 3D echocardiography was more accurate compared to 2D echocardiography. In all other features, 2D and 3D echocardiography showed similar accuracy. A significant reason for inaccuracy by both echo modalities was that the technique itself could not visualize the feature, although the image quality was considered to be adequate. In most cases, where it was not possible to visualize the atrioventricular feature by 2D, it was possible by 3D, and vice versa.
Conclusion: The accuracy of 2D and 3D echocardiography and understanding the potential reasons for disagreements in assessing the atrioventricular valve complex with 2D and 3D can guide the use of those two techniques when combining them in the clinical practice.

7.M235T polymorphism in the angiotensinogen gene and cardiovascular disease: An updated meta-analysis of 39 case–control comparisons
Chuannan Zhai, Hongliang Cong, Hong Zhang, Kai Hou, Ying Zhang, Yingyi Zhang
PMID: 30930452  doi: 10.14744/AnatolJCardiol.2019.75282  Pages 222 - 232
Abstract | Full Text PDF

8.Right atrial abscess: An unusual complication of intravascular catheter uncovered by transesophageal echocardiography
Shokoufeh Hajsadeghi, Aida Iranpour, Nasim Hoshangian Tehrani, Reza Askari, Hamed Motevalli
PMID: 30930450  doi: 10.14744/AnatolJCardiol.2019.54603  Pages 233 - 234
Abstract | Full Text PDF | Video

9.Acute fulminant eosinophilic myocarditis due to Giardia lamblia infection presented with cardiogenic shock in a young patient
Sahin Avsar, Ahmet Oz, Tufan Çınar, Altuğ Ösken, Tolga Sinan Güvenç
PMID: 30930448  doi: 10.14744/AnatolJCardiol.2019.48742  Pages 234 - 237
Abstract | Full Text PDF | Video

10.Management of prosthetic valve thrombosis concomitant with coronary embolism
Macit Kalçık, Ahmet Güner, Sabahattin Gündüz, Mehmet Özkan
PMID: 30930454  doi: 10.14744/AnatolJCardiol.2018.88288  Pages 238 - 239
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11.Author`s Reply
Ayhan Olcay
Page 239
Abstract | Full Text PDF

12.Factors associated with periprocedural myocardial infarction
Metin Okşul, Yusuf Ziya Şener, Vedat Hekimsoy
PMID: 30930453  doi: 10.14744/AnatolJCardiol.2019.75606  Pages 239 - 240
Abstract | Full Text PDF

13.Author`s Reply
Mingyang Yao, Linlin Zhao, Lili Wu, Wenbin Zhang, Yi Luan, Jiale Song, Guosheng Fu, Junhui Zhu
Page 240
Abstract | Full Text PDF

14.Extreme mechanical aortic valve dehiscence: “Rocking motion” clearly assessed with echocardiography and fluoroscopy
Hasan Kaya, Bayram Arslan, Mehmet Sait Coşkun, Faruk Ertaş
PMID: 30930444  doi: 10.14744/AnatolJCardiol.2019.01336  Pages E8 - E9
Abstract | Full Text PDF | Video

15.Chest pain after a cesarean -section with a puzzling ECG
Etienne Puymirat, Vincent Aidant
PMID: 30930447  doi: 10.14744/AnatolJCardiol.2019.45787  Page E9
Abstract | Full Text PDF

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