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Anatol J Cardiol: 6 (3)
Volume: 6  Issue: 3 - September 2006
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EDITORIAL
1.Important letters, burning Middle East, on-line in December
Bilgin Timuralp
PMID: 16943103  Page 215
Abstract | Full Text PDF

ORIGINAL INVESTIGATION
2.Trace element status (Se, Zn, Cu) in heart failure
Feridun Koşar, İbrahim Şahin, Çağatay Taşkapan, Zehra Küçükbay, Hakan Güllü, Hülya Taşkapan, Şengül Çehreli
PMID: 16943104  Pages 216 - 220
Objective: It has been speculated that trace elements may play a role in the pathogenesis of heart failure. In the present study, we aimed to assess serum concentrations of selenium (Se), zinc (Zn) and copper (Cu) in patients with heart failure (HF) and to compare idiopathic dilated cardiomyopathy (IDCM) and ischemic cardiomyopathy (ICM) patients with healthy controls. Methods: This study population included 54 HF patients (26 IDCM patients and 28 ICM patients) and 30 healthy subjects. Serum levels of selenium, zinc, and copper were assessed by atomic absorption spectrophotometry method. Results: Serum concentrations of Se and Zn in HF patients were significantly lower than in healthy controls (p=0.000 and p<0.01, respec- tively). However, serum Cu concentrations in these patients were significantly higher than in controls (p=0.000). There were no significant difference in the trace elements status between IDCM and ICM patients (p>0.05 for all parameters). Relationships of the serum trace ele- ment concentrations studied with echocardiographic and hemodynamic parameters were not statistically significant. Conclusion: Our study showed that heart failure is associated with lower Se and Zn concentrations, and higher Cu concentration, and se- rum Se, Zn and Cu element profiles were similar in IDCM and ICM.

3.Is the myocardial performance index a reliable parameter in patients with restrictive filling pattern?
Mustafa Gür, Recep Demirbağ
PMID: 16943105  Pages 221 - 228
Objective: The myocardial performance index (MPI) enables noninvasive estimation of combined systolic and diastolic function. The only di- astolic function parameter used in the index is the isovolumic relaxation time (IRT). We assessed the impact of shortened IRT in restrictive filling pattern on MPI. Methods: The MPI was defined as the sum of the isovolumic contraction time (ICT) and the IRT divided by the ejection time (ET), and was calculated in 13 controls (group 1), and 39 patients with ischemic heart disease with left ventricular systolic dysfunction (ejection fracti- on<50%). The patients were classified into two groups according to mitral early filling deceleration time (DT): group 2 with DT>140 ms (n = 20), and group 3 with DT ≤140 ms (n = 19). Results: The ICT was longer and the ET was shorter in group 2 and group 3 than in group 1. The ICT and ET were not different in group 2 and group 3. The IRT was longer in group 2 (130±23 ms) compared to group 1 (82±10 ms, p<0.001) and group 3 (85±19 ms, p<0.001), but did not differ between group 1 and group 3. The MPI was higher in group 2 and group 3 compared to group 1 (0.79±0.25 and 0.65±0.19 vs 0.42±0.08, p<0.001 and p<0.001; respectively). However, it was lower in group 3 than in group 2 (p=0.03) due to significantly shortened IRT. Conclusion: Shortened IRT in patients with restrictive filling pattern results in reduction of the MPI. Therefore, the MPI may not reflect true level of ventricular dysfunction in these patients.

4.An experience on radial versus femoral approach for diagnostic coronary angiography in Turkey
Fatma Yiğit, Alpay Turan Sezgin, Tansel Erol, Şenol Demircan, Göknur Tekin, Tuna Katırcıbaşı, Abdullah Canataroğlu, Haldun Müderrisoğlu
PMID: 16943106  Pages 229 - 234
Objective: The radial approach has been increasingly used as an alternative to femoral access. The purpose of the present study was to assess the feasibility, success, and safety of the transradial approach (TRA) for diagnostic coronary angiography, and to describe the dif- ficulties associated with the technique as compared with transfemoral approach (TRF). Methods: A series of 180 consecutive patients were divided to TRA or TFA groups by two operators. We compared the groups regarding procedural time, access time, fluoroscopy time, procedural failure, complications, contrast volume, length of hospital stay, and number of used coronary catheters. Results: The number of used coronary catheters was not different between the two groups (p = 0.6). Total hospital length of stay was sig- nificantly shorter in the radial group (p < 0.0001) than in femoral one. We found differences between the radial and femoral groups in the success rate (p<0.0001), contrast volume (p = 0.012), procedural time (p<0.0001), access time (p<0.0001), and fluoroscopy time (p<0.0001). We did not find any major complication in the radial group. There was a major bleeding in the femoral group. Conclusion: The TRA is a safe alternative to femoral catheterization although with lesser procedural success, longer procedural access, and radiation time, and more contrast volume.

5.Can we predict the severity of coronary artery disease in patients with stable angina using NT-ProBNP?
Murat Yeşil, Nursen Postacı, Erdinç Arıkan, Özgür Ceylan, Serdar Bayata, Mehmet Köseoğlu
PMID: 16943107  Pages 235 - 238
Objective: We aimed to investigate the value of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) in combination with tissue Dopp- ler imaging (TDI) to predict the presence of significant coronary artery (CAD) in patients with conventionally normal systolic and diasto- lic function. Methods: Plasma NT-proBNP concentrations were measured in 87 patients who had been referred to coronary angiography with stable anginal symptoms, and preserved systolic and diastolic LV function in conventional echocardiography. Regional diastolic function was additionally assessed by TDI in all patients. Patients were then divided into 2 groups according to having normal or abnormal diastolic function with TDI. Group 1 had preserved diastolic function with conventional and TDI methods. Group 2 had conventionally normal func- tion and abnormal regional function with TDI. Groups were divided into 2 subgroups according to the cut-off NT-proBNP value of 100pg/ml. Coronary artery disease was classified as 0 (absence of >70% diameter stenosis in any coronary artery), 1, 2 or 3 vessel dise- ase (with lesions >70%). Results: The NT-proBNP levels were positively correlated with the number of coronary vessels involved. There was statistically signifi- cant difference between 0-2, 0-3, 1-3 vessels involvement, but no significant difference between 0-1, 1-2, 2-3 vessels involvement. In gro- up 1 all patients with plasma NT-proBNP levels >100 pg/ml had severe CAD (p=0.003). But in group 2 only 60% of patients with NT- proBNP>100 pg/ml had severe CAD. Conclusion: In patients with stable angina who have normal systolic and diastolic function, NT-proBNP is useful to predict the angiog- raphic severity of CAD. In patients with unimpaired regional diastolic function, NT-proBNP may be valuable to predict the presence of se- vere CAD in stable angina.

6.Hepcidin is not a marker of chronic inflammation in atherosclerosis
Aytekin Oğuz, Mehmet Uzunlulu, Nezih Hekim
PMID: 16943108  Pages 239 - 242
Objective: To investigate the relationship between atherosclerosis, an inflammatory disease and hepcidin which is reported as an indi- cator of inflammation Methods: A total of 75 subjects between 40 and 70 years of age were included in the study. The patient group consisted of 40 stable pa- tients who had previously experienced an atherosclerotic event (18 women, 22 men; mean age 56.4±7.1 years). There were two control groups. The first control group consisted of 19 healthy subjects (11 women, 8 men; mean age 52.6± 7.4 years), while the second group inc- luded 16 patients (11 women, 5 men; mean age 56.5±9.3 years) with rheumatoid arthritis and anemia (diseased control group). Hepcidin measurement was performed using Hepcidin Prohormone ELISA (Solid Phase Enzyme-Linked Immunosorbent Assay) test kit. Results: Mean serum hepcidin levels were 243.2±48.8 ng/ml, 374.5±86.4 ng/ml, and 234±59.9 ng/ml in the patient group, in diseased cont- rols, and in healthy controls, respectively. Hepcidin levels were higher in diseased controls compared to the patient group and healthy controls (p=0.001). There were no significant differences between the patient group and healthy controls. Conclusion: These findings did not support the hypothesis that hepcidin levels could be increased in atherosclerotic cardiovascular di- seases as a marker of chronic inflammation.

7.Similar pattern of diastolic function adaptation of both ventricles to programmed atrioventricular interval modification in patients with DDD pacing
Ioannis H. Styliadis, Christodoulos E. Papadopoulos, Nicolaos I. Gouzoumas, Georgios Giannakoulas, Haralambos I. Karvounis, Mihail Karamouzis, Amalia Boufidou, Georgios E. Parharidis
PMID: 16943109  Pages 243 - 247
Objective: To evaluate both left ventricular (LV) and right ventricular (RV) diastolic performance adaptation to variable atrioventricular interval (AVI), in patients with DDD pacing for complete heart block and to investigate a possible interaction between LV and RV in this specific cohort of patients. Methods: We studied 22 consecutive patients (mean age 65.2 ± 14.3) who underwent DDD pacemaker implantation following admission for complete heart block. One day following implantation, patients were paced at 3 different pacing modes, under the same programmed heart rate and a different AVI (100, 150 and 200 ms respectively). Standard Doppler echocardiography of mitral and tricuspid valve inflow was performed to evaluate LV and RV diastolic function, during each pacing mode. Results: Left ventricular and RV diastolic performance adaptation to variable AVI modifications was similar, showing a progressive increase of late diastolic filling velocities and a subsequent decrease of E/A wave ratios following AVI prolongation. A short AVI of 100 or 150 ms was associated with improved LV and RV diastolic filling dynamics. Conclusions: In elderly patients with complete heart block and unimpaired systolic function undergoing DDD pacemaker implantation, both ventricles share a similar pattern of diastolic function adaptation to AVI modifications and that might be the reflection of ventricular interaction under this specific pacing mode.

8.The effects of insulin given prior to release of cross-clamp on coronary sinus lactate levels in coronary artery surgery
Dilek Savaşkan, Nurgül Yurtseven, Abdullah Kemal Tuygun, Pelin Aksoy, Sevim Canik
PMID: 16943110  Pages 248 - 252
Objective: The aim of this study is to evaluate the effects of single dose insulin, given prior to reperfusion, in patients undergoing coro- nary artery bypass surgery (CABG). Methods: One hundred and twenty patients were prospectively randomized to be given either insulin (Group 1;n=60), or saline (Group 2;n= 60). Blood samples were taken 15 minutes before the reperfusion and insulin was given (0.3 IU/kg) to the patients in Group 1. Arterial and coronary sinus blood samples were taken, after the release of aortic cross-clamp (0. min), and 5th -10th -15th minutes of reperfusion. Arterial and coronary sinus lactate and glucose levels, postoperative insulin, inotropic and intraaortic balloon pump requirements, need for defibrillation and postoperative dysrhythmia, creatine kinase- MB (CPK-MB) levels, and length of stay in intensive care unit (ICU) and hospital were compared. Results: In Group 1, arterial lactate levels were found to be lower at 0.min, coronary sinus lactate levels were found to be lower at 0-5-10th minutes of reperfusion compared to Group 2. Similarly, defibrillation, glucose, postoperative insulin and inotrop requirements, postoperative arrhythmia and length of ICU stay were lower in Group 1. The CPK-MB levels and length of hospital stay were similar in all patients. Conclusions: We conclude that single dose insulin given before the reperfusion period, has positive perioperative effects. Therefore it can be used in patients undergoing CABG surgery to decrease ischemia-reperfusion injury.

EDITORIAL COMMENT
9.Coronary sinus lactate levels and insulin in coronary artery bypass surgery
İbrahim Gökşin
PMID: 16943111  Pages 253 - 254
Abstract | Full Text PDF

REVIEW
10.Current management of no-reflow
Bilal Boztosun, Yılmaz Güneş, Cevat Kırma
PMID: 16943112  Pages 255 - 260
Restoration of epicardial blood flow is not necessarily associated with microvascular and tissue perfusion. The mechanisms responsib- le for no-reflow are uncertain and prevailing mechanism operating in the individual patient may also differ. Restoration of perfusion at the tissue level is expected to have beneficial effects on left ventricular function. Therapeutic approach to such a phenomenon requires knowledge of mechanisms, methods of diagnosis and response to treatment modalities.

11.G-CSF in acute myocardial infarction - Experimental and clinical findings
Hüseyin İncedere, Michael Petzsch, Tim C. Rehders, Simone Dunkelmann, Christoph A. Niernaber
PMID: 16943113  Pages 261 - 263
Early data from clinical studies suggest that intracoronary injection of autologous progenitor cells may beneficially affect postinfarction remodeling and perfusion. Beyond intracoronary infusion of autologous bone marrow mononuclear CD34+ cells (MNCCD34+), mobiliza- tion of stem cells by G-CSF has recently attracted attention because of various advantages such as the noninvasive nature of MNCCD34+ mobilization by subcutaneous injections. It is the aim of the present work to give an overview about the current experimental and clinical findings of G-CSF treatment in acute myocardial infarction.

MISCELLANEOUS
12.Sexual activity in cardiac patients
Özgür Kartal, Ersan Tatlı, Volkan İnal, Levent Yamanel
PMID: 16943114  Pages 264 - 269
The question “extents of sexual activity”, especially for a cardiac patient, seems enigmatic for patient himself and his physician. Cardiac patient`s prejudice is that limitation of sexual activity is necessary to avoid complications like myocardial infarction. This misconception worsensquality of life of patient which is already limited. In this kind of situations, a physician is supposed to answer lots of questions. Pa- tient's risk status should be interpreted and stratified by further examinations, before deciding to treat. Pharmacological and rehabilitati- ve modalities can be applied when indicated, on the other hand, majority of the patients are classified as low risk status that are assumed to be safe. A routine follow- up is recommended for this kind of patients by 6 months intervals, regardless the patient is under medication or not.

CASE REPORT
13.Nonionic contrast media induced sialadenitis following coronary angiography
Doğan Erdoğan, Hakan Güllü, Mustafa Çalışkan, Taner Ulus, Haldun Müderrisoğlu
PMID: 16943115  Pages 270 - 271
Abstract | Full Text PDF

14.Familial Mediterranean fever and acute anterior myocardial infarction in a young patien
Hüseyin Uyarel, Ahmet Karabulut, Ertan Ökmen, Neşe Çam
PMID: 16943116  Pages 272 - 274
Abstract | Full Text PDF

15.Poor prognostic cardiac sequelae of possible Kawasaki disease mimicking dilated cardiomyopathy: the importance of extensive and serial cardiac evaluation and the significance of thromboembolic mechanisms
Hirokuni Etsuda, Akira Kurita, Fumitaka Ohsuzu, Masayuki Ishihara, Bonpei Takase
PMID: 16943117  Pages 275 - 278
Abstract | Full Text PDF

16.Hypertrophic cardiomyopathy with massive midventricular hypertrophy, midventricular obstruction and an akinetic apical chamber
Karl Duncan, Ajay Shah, Farooq Chaudhry, Mark V. Sherrid
PMID: 16943118  Pages 279 - 282
Abstract

17.An infant with severe mitral insufficiency and collapse of the left lung due to hammock mitral valve: emergency mitral valve replacement
F.Sedef Tunaoğlu, Velid Halid, Rana Olguntürk, Nazan Özbarlas, Serdar Kula, Volkan Sinci
PMID: 16943119  Pages 283 - 285
Abstract | Full Text PDF

LETTER TO THE EDITOR
18.Temporary blindness after coronary angiography
Namık Özmen, Bekir Sıtkı Cebeci, Ejder Kardeşoğlu, Mehmet Saraçoğlu, Mehmet Dinçtürk
PMID: 16943120  Page 286
Abstract | Full Text PDF

19.The effect of terminal warm blood cardioplegia on myocardial ischemia / reperfusion injury
İbrahim Gökşin
PMID: 16943121  Page 287
Abstract | Full Text PDF

20.Off-pump coronary artery bypass operation in a renal transplant patient
Harun Arbatlı
PMID: 16943122  Page 288
Abstract | Full Text PDF

21.Which application, complex or mini cardioplegia?/Cardioplegia by minicardioplegia technique
Kaan Kırali
PMID: 16943123  Pages 289 - 291
Abstract | Full Text PDF

22.Ebstein's anomaly with coarctation of the aorta and neonatal balloon angioplasty
Funda Öztunç
PMID: 16943124  Page 292
Abstract | Full Text PDF

23.Use of melatonin for cardiovascular diseases/Myocardial ischemia-reperfusion injury and melatonin
Selma Arzu Vardar
PMID: 16943125  Pages 293 - 294
Abstract | Full Text PDF

24.Previous percutaneous coronary intervention may increase symptom recurrence and adverse cardiac events following surgical revascularization
M.A. Aydın, T. Meinertz
PMID: 16943126  Pages 295 - 296
Abstract | Full Text PDF

E-PAGE ORIGINAL IMAGES
25.An aneurysm of the distal portion of the left anterior descending coronary artery associated with angina pectoris
Serkan Çaylı, Fatma Metin, Serkan Topaloğlu, Şule Korkmaz
PMID: 16943127  Page 297
Abstract | Full Text PDF

26.Iatrogenic pneumopericardium
Ercan Varol, Mehmet Özaydın, Cahit Ağçal
PMID: 16943128  Page 298
Abstract | Full Text PDF

27.Left atrial myxoma showing angiographic neovascularization
Tekin Yıldırım, Özer Selimoğlu, Cihan Çevik, Noyan Temuçin Oğuş, İsmet Dindar
PMID: 16943129  Pages 299 - 300
Abstract

28.A case of left atrial myxoma as a cause of platypnea
Hamza Duygu, Uğur Türk, Sanem Nalbantgil
PMID: 16943130  Page 301
Abstract | Full Text PDF

29.Giant sinus of Valsalva aneurysm
Hakkı Muammer Karakaş, Bayram Kahraman, Ayşegül Sağır, Ahmet Kemal Fırat
PMID: 16943131  Pages 302 - 303
Abstract | Full Text PDF

30.A surgical salvage case with active endocarditis and aortic coarctation
Ahmet Şaşmazel, Atıf Akçevin, Halil Türkoğlu, Cihangir Ersoy, Tijen Alkan, Tufan Paker, Vedat Bayer, Aydın Aytaç
PMID: 16943132  Page 304
Abstract | Full Text PDF

MISCELLANEOUS
31.Plagiarism notice

Page 305
Abstract | Full Text PDF

32.To editor
Oben Döven
Page 306
Abstract | Full Text PDF



 
 
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