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Volume : 12 Issue : 6
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Anatol J Cardiol: 12 (6)
Volume: 12  Issue: 6 - September 2012
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1.More happy news will be in the next issue; our new place at the SCI-E
Bilgin Timuralp
PMID: 22948050  doi: 10.5152/akd.2012.212  Page 456
Abstract | Full Text PDF

2.The degree of premature hair graying as an independent risk marker for coronary artery disease: a predictor of biological age rather than chronological age
Sinan Altan Kocaman, Mustafa Çetin, Murtaza Emre Durakoğlugil, Aytun Çanga, Yüksel Çiçek, Sıtkı Doğan, İsmail Şahin, Ömer Şatıroğlu
PMID: 22677402  doi: 10.5152/akd.2012.150  Pages 457 - 463
Objective: Age is the most important and uncorrectable coronary risk factor at the moment. The concept of measuring aging biologically rather than only chronologically may be of importance in clinical practice. Hair graying is the most apparent sign of biological aging in humans, yet its mechanism is largely unknown. Today, it is known that cardiovascular risk factors (CVRFs), especially in combination, cause premature atherosclerosis. In our opinion, premature hair graying or whitening may represent early atherosclerotic changes as a surrogate of host response to the CVRFs. In this study, we planned to investigate the relationship of hair graying with CVRFs and coronary atherosclerotic burden in order to determine whether it is an independent marker for coronary artery disease (CAD). Methods: The current study has a cross-sectional observational design. Two hundred and thirteen men who underwent coronary angiography with a suspicion of CAD were enrolled in the study. The patients were evaluated in terms of age, demographical properties and the CVRFs. Hair whitening score (HWS) was defined according to extent of gray/white hairs (1: pure black; 2: black>white; 3: black=white; 4: white>black; 5: pure white). Coronary atherosclerotic burden was assessed by the Gensini score. Analyses were performed in age-matched normal coronary arteries (NCA) and CAD groups. Linear and logistic regression analyses were used for the multivariate analyses of independent variables associated with hair greying. Results: The CVRFs were higher in CAD group. Hair whitening score (2.7±1.3 vs. 3.3±1.2, p=0.002), hair losing score (1.2±0.9 vs. 1.5±1.0, p=0.038) and xanthelasma rate (24% vs. 45%, p=0.013) were also significantly different between NCA and CAD groups. Age (p<0001), Gensini score (p<0.001) and coronary severity score (p=0.001) were higher in the categories of increased HWS. In multiple logistic regression analysis, only diabetes mellitus (OR: 3.240, 95% CI: [1.017-10.319], p=0.047), low-density lipoprotein cholesterol, (OR: 1.014, 95%CI: [1.001-1.027], p=0.029) and HWS (OR: 1.513, 95% CI: [1.054-2.173], p=0.025) were independently related to presence of CAD. Age (p<0.001), family history of CAD (p=0.004), hyperlipidemia (p=0.02) and serum creatinine levels (p=0.019) were found as independent predictors of hair graying. Conclusion: In our study, we found that the degree of gray/white hairs is related to extent of CAD. Our findings also suggested that hair graying is a risk marker for CAD independent of age and other traditional risk factors. Biological age may be important in determining total risk of patients. During assessment of cumulative CVRF effects on human body, presence of biological aging signs may be useful in identifying individuals with increased risk of cardiovascular disease.

3.Biological aging and coronary artery disease
Jen Lou Cheng, Shih-Ying Lee
PMID: 22677403  doi: 10.5152/akd.2012.151  Page 464
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4.Effect of termination of the left anterior descending coronary artery (wrapped or non-wrapped property) on tissue Doppler echocardiography findings in patients with anterior myocardial infarction: an observational study
Osman Sönmez, Mehmet A. Vatankulu, Mehmet Kayrak, Şükrü Karaarslan, Gökhan Altunbaş, Kurtuluş Özdemir, Hasan Gök
PMID: 22677404  doi: 10.5152/akd.2012.152  Pages 465 - 471
Objective: We aimed to evaluate effect of termination property of left anterior descending (LAD) on tissue Doppler echocardiography (TDE) parameters in patients experiencing their first anterior myocardial infarction (AMI) who had undergone successful primary percutaneous coronary intervention (PCI) Methods: A prospective, cross-sectional observational study was performed. Eighty-four patients were enrolled in the study. Echocardiography was performed during the first three days of AMI. Conventional TDE measurements were obtained from right ventricular (RV) and four left ventricular (LV) walls: for the systolic function - mitral annular TDE systolic velocity - Sm, for diastolic function - mitral annular TDE early and late diastolic velocities - Em, Am, transmitral early and late diastolic velocities ratio - E/A, and combined systolic and diastolic function - myocardial performance index (MPI). Coronary arteries were evaluated and patients were divided into two groups (non-wrapped LAD and wrapped LAD) according to the termination properties. Student-t, Mann-Whitney U and Chi-square tests, bivariate Pearson and Spearman correlation analyses were used for statistical analysis. Results: Baseline characteristics and conventional echocardiographic parameters of the patients were similar. There was a statistically significant difference for the anterior wall Sm parameter, whereas there was no substantial difference for Em, Am and MPI values. The anterior wall Sm was more affected in patients with non wrapped LAD than in patients with wrapped LAD (6.70±1.66 and 7.44±1.66 cm/s; p=0.036,).The anterior Sm parameter was uniquely correlated with LAD termination status when compared with other independent parameters (r=0.236, p=0.036). Conclusion: We showed that termination of LAD is important for the anterior wall systolic functions in the early stage of AMI treated successfully. (Anadolu Kardiyol Derg 2012; 12: 465-71)

5.Assessment of agreement between transthoracic and transesophageal echocardiography techniques for left ventricular longitudinal deformation imaging and conventional Doppler parameters estimation: a cross-sectional study
Enbiya Aksakal, Ahmet Kayal, Eftal Murat Bakırcı, Mustafa Kurt, İbrahim Halil Tanboğa, Serdar Sevimli, Mahmut Açıkel
PMID: 22677405  doi: 10.5152/akd.2012.153  Pages 472 - 479
Objective: Studies investigating the comparison and interchangeability of transthoracic (TTE) and transesophageal echocardiography (TEE) regarding left ventricular (LV) systolic and diastolic function are limited. Therefore, in this study, we aimed to investigate agreement between TTE and TEE in the assessment of LV systolic functions by longitudinal myocardial deformation imaging (strain-S and strain rate-Sr) and LV diastolic functions by conventional Doppler parameters. Methods: Thirty-five patients underwent a clinically indicated cross-sectional study on agreement between two methods. All the patients underwent TEE right after TTE. From both TTE and TEE Doppler parameters such as early and late diastolic velocities (E, A, E’ and A`) deceleration time (DT), averaged mitral annular systolic velocity (Sm), isovolumic relaxation time (IVRT), isovolumic contraction time (IVCT), ejection time (ET), myocardial performance index (MPI) and longitudinal deformation imaging parameters (S, Sr) and systolic velocities were recorded. Agreement between TTE and TEE were evaluated by Bland-Altman analysis. Results: Bland-Altman analysis showed good agreement between TEE and TTE in terms of E, A, DT, E’, A’, IVRT, IVCT, ET and MPI measurements. However, there was poor agreement in segmental systolic velocities and segmental Sr parameters assessed by TTE and TEE. Besides, septal wall segmental S analysis showed a better agreement than lateral wall segmental analysis between TTE and TEE recordings. Conclusion: TTE and TEE conventional Doppler parameters are compatible in the assessment of LV diastolic function; however, agreement was poor in longitudinal deformation parameters that have been used in the quantitative assessment of LV systolic function between two methods and cannot be used interchangeably.

6.Assessment of tissue Doppler parameters via transesophageal echocardiography: how necessary?
Köksal Ceyhan, Fatih Altunkaş
PMID: 22677406  doi: 10.5152/akd.2012.154  Pages 480 - 482
Abstract | Full Text PDF

7.Decreased aortic root elasticity-as a novel systemic manifestation of the pseudoexfoliation syndrome: an observational study
Mete Alpaslan, Aylin Karalezli, Mehmet Borazan, Bengü Ekinci Köktekir, İbrahim Haldun Müderrisoğlu
PMID: 22677407  doi: 10.5152/akd.2012.155  Pages 483 - 487
Objective: To assess the aortic root function in patients with pseudoexfoliation syndrome (PEXS). Methods: In this case- controlled observational study, aortic root function in 31 PEXS patients (mean age 71±9 years) and 29 controls of similar ages (mean age 69±9 years) were evaluated by M-mode transthoracic echocardiography. Aortic cross-sectional compliance (CSC), Peterson’s elastic modulus (index beta), aortic stiffness index (ASI) and aortic root distensibility (ARD) were calculated by M-mode echocardiography to evaluate the aortic root function. The findings of two groups of patients were compared by Mann-Whitney U test. Results: The CSC and ARD were significantly decreased in patients with PEXS. The CSC was 12.2±6.3 cm2/mmHg in patients with PEXS and 17.5±11.6 cm2/mmHg in the control group (p=0.015). The ARD was 1.56±0.80 cm2/dyne in patients with PEXS and 2.23±1.48 cm2/dyne in the control group (p=0.021). The other two indices of aortic root function were not significantly different between the two groups. Conclusion: Aortic root function decreases in patients with PEXS. PEXS may be regarded as a risk factor for cardiovascular and cerebrovascular events.

8.Is pseudoexfoliation syndrome a risk factor for cardiovascular diseases?
Mehmet Yokuşoğlu
PMID: 22677408  doi: 10.5152/akd.2012.156  Pages 488 - 489
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9.Relationship between ventricular function assessed by tissue Doppler imaging and exercise capacity in patients after repair of tetralogy of Fallot: an observational study
Berna Şaylan, Ayhan Çevik, Vedide Tavlı
PMID: 22699124  doi: 10.5152/akd.2012.157  Pages 490 - 497
Objective: The present study aims to study the relationship between tissue Doppler echocardiography (TDE) indices of right ventricle and exercise capacity in patients after total correction for tetralogy of Fallot (ToF). Methods: This cross-sectional observational study included 20 patients, after undergoing total correction procedure for ToF diagnosed with mild/moderate pulmonary regurgitation and 30 age-matched healthy children. In the postoperative period, patients were invited to hospital for evaluation of the ventricular functions by 2D, M-mode, Doppler (DE) echocardiography and TDE and exercise testing to evaluate the effort capacity. Statistical analysis was performed using Mann-Whitney U and Chi-square tests, and Pearson correlation analysis. Results: Compared with the controls; the mitral annular peak systolic flow velocity (Sm) value was significantly lower, while isovolumic contraction time (IVCT), isovolumic relaxation time (IVRT) and myocardial performance index (MPI) values obtained at the tricuspid and mitral (MV) valves were significantly higher (p<0.05 for all) in patients after ToF repair. There was a negative correlation between the exercise period and the total correction age (r=-0.20, p=0.015) and the same negative correlation existed between the exercise period and METS (r=-0.25, p=0.010). MV IVCT with DE and TDE was found to be correlated with METS (r=-0.45, p=0.04). Left ventricular MPI was found to be correlated with maximum heart rate (r=-0.20, p=0.03). By DE, tricuspid valve deceleration time and Sm peak flow velocity with TDE were significantly correlated with METS (r=-0.30, p=0.04; r=-025, p=0.005, respectively). MPI calculated with TDE was correlated with maximum heart rate (r=-0.15, p<0.01). Conclusion: Even if patients, undergone total correction surgery for ToF were asymptomatic or had minimal clinical symptoms, MPI index assessed by pulse wave TDE and exercise testing may allow early diagnosis of right ventricle dysfunction.

10.Effect of glycemic control on the progress of left ventricular hypertrophy and diastolic dysfunction in children with type I diabetes mellitus
Soha M. Abd El Dayem, Ahmed A. Battah
PMID: 22699125  doi: 10.5152/akd.2012.158  Pages 498 - 507
Objective: To evaluate progression of left ventricular (LV) structural and functional changes in patients with type 1 diabetes and effect of glycemic control on these changes. Methods: A prospective, longitudinal study consisted of 48 patients who were originally studied. At two years follow-up, 44 patients were reevaluated, 35 patients from the original study were reevaluated after another 2 years for the 3rd time using the same protocol. The control group comprised 30 age-and sex-matched healthy volunteers. All studied patients were subjected to full history taking, clinical and cardiac examination. M-mode echocardiography was done, blood samples were taken and examined for HbA1c and urine samples were tested for the presence of albuminuria. ANOVA for repeated measurements, t-test for dependent and independent variables, and Mann-Whitney U test were used for statistical analyses. Results: Seven (14.6%) of our patients had LV hypertrophy, 23 (47.9%) patients had diastolic dysfunction and ten patients only achieve improvement in glycemic control. Duration of diabetes was significantly higher in patients with LV hypertrophy (LVH) (p<0.05). Patients with no improvement in glycemic control had a significant increase in interventricular septum (IVS) and left ventricular posterior wall (LVPW) in the third examination (p<0.05 for both). Conclusion: Prevalence of LVH and diastolic dysfunction among diabetic patients is high. Glycemic control in diabetic patients could not improve LVH or diastolic dysfunction. On the other hand, failure to achieve glycemic control leads to deterioration in structural parameters.

11.The effect of magnesium and vitamin E pre-treatments on irradiation-induced oxidative injury of cardiac and pulmonary tissues in rats: a randomized experimental study
Beste M. Atasoy, Zerrin Özgen, Korkut Bostancı, Meral Yüksel, Zeynep Özen, Roman İbrahimov, Ufuk Abacıoğlu
PMID: 22721827  doi: 10.5152/akd.2012.159  Pages 508 - 514
Objective: The aim of this study was to investigate the effect of pre-treatment with the free radical scavenging molecules, magnesium and vitamin E, on lipid peroxidation to limit radiation-induced heart and lung injury. Methods: Female Sprague-Dawley rats were divided into 4 groups by a simple randomization method as saline-treated control (n=4), saline-treated irradiated (IR; n=6), magnesium sulphate-treated irradiation (IR) (Mg+IR; n=6) and vitamin E-treated IR (vit E+IR; n=6), respectively. The animals were given either saline, Mg (600mg/kg/day) or vit E (100 mg/kg/day) intraperitoneally for five days prior to irradiation. Twelve hours after the fifth injection, animals in irradiation groups were irradiated to 20 Gy using 6 MV photons in linear accelerator. Twenty-four hours later cardiac and lung tissue samples were obtained for determination of myeloperoxidase activity (MPO), malondialdehyde (MDA) levels, and luminol and lucigenin levels measured by chemiluminescence (CL) methods. Results: No significant changes were observed between cardiac and pulmonary MDA and CL results of the experimental groups. However, cardiac and pulmonary MPO activities in the saline-treated IR group were increased as compared to control group (p<0.05 for all), while in the Mg-pretreated and vit E pretreated groups neutrophil infiltration was reduced, reaching to statistical significance only in the Mg-pretreated group (p<0.05). Conclusion: Prophylactic use of magnesium sulfate has limited the infiltration of neutrophils to both the cardiac and pulmonary tissues at the early 24 h of irradiation. However, how limiting neutrophils as the sources of free radicals and inflammatory mediators would alter oxidative stress of heart and lung tissues in the long-term is not clear yet.

12.Relationship between acute atrial fibrillation attack and intensive cigarette smoking
Erdal Aktürk, İsa Sincer, Aytekin Güven, İrfan Barutçu
PMID: 22699126  doi: 10.5152/akd.2012.160  Page 516
Abstract | Full Text PDF

13.Early onset “electrical” heart failure in myotonic dystrophy type 1 patient: the role of ICD biventricular pacing
Vincenzo Russo, Anna Rago, Antonello D'Andrea, Luisa Politano, Gerardo Nigro
PMID: 22728727  doi: 10.5152/akd.2012.161  Pages 517 - 519
Abstract | Full Text PDF

14.Successful catheter ablation of symptomatic premature ventricular contractions originating from mitral annulus
Ömer Uz, Fethi Kılıçaslan, Mehmet Tezcan
PMID: 22728728  doi: 10.5152/akd.2012.162  Pages 519 - 520
Abstract | Full Text PDF

15.Prolonged asystole during hypobaric chamber training
Cengiz Öztürk, Tolga Çakmak, Süleyman Metin, Ahmet Akın, Ahmet Şen
PMID: 22728729  doi: 10.5152/akd.2012.163  Pages 520 - 522
Abstract | Full Text PDF

16.Conventional and computed tomography angiography views of a rare type of single coronary artery anomaly: right coronary artery arising from distal left circumflex artery
Uğur Arslan, Murat Karamanlıoğlu, Ahmet Korkmaz
PMID: 22728730  doi: 10.5152/akd.2012.164  Pages 522 - 523
Abstract | Full Text PDF

17.Char syndrome, a familial form of patent ductus arteriosus, with a new finding: hyperplasia of the 3rd finger
Kadir Babaoğlu, Meral Oruç, Ayla Günlemez, Bruce D. Gelb
PMID: 22728731  doi: 10.5152/akd.2012.165  Pages 523 - 524
Abstract | Full Text PDF

18.Fever, dyspnea and chest pain with pericardial effusion
Burcu Demirkan
PMID: 22766238  doi: 10.5152/akd.2012.180  Page 525
Abstract | Full Text PDF

19.Patient prosthesis mismatch effect on survival/ The effects of implanted valve sizes on ventricular hypertrophy in aortic stenosis
Orhan Gökalp, Levent Yılık, Ali Gürbüz, Hikmet Selçuk Gedik
PMID: 22728732  doi: 10.5152/akd.2012.166  Page 526
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20.Patient prosthesis mismatch effect on survival/ The effects of implanted valve sizes on ventricular hypertrophy in aortic stenosis
Orhan Gökalp, Levent Yılık, Ali Gürbüz
PMID: 22728732  doi: 10.5152/akd.2012.167  Pages 526 - 527
Abstract | Full Text PDF

21.Mobile right heart thrombus as a manifestation of homozygous mutation of MTHFR 1298 A>C
Enes Elvin Gül, Halil İbrahim Erdoğan, Ufuk Tan Bayram, Kurtuluş Özdemir
PMID: 22728734  doi: 10.5152/akd.2012.168  Pages 527 - 528
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22.Paroxysmal supraventricular arrhythmias during hypokalemic episodes in a patient with hypokalemic periodic paralysis
Uğur Canpolat, Hamza Sunman, Kudret Aytemir, Ali Oto
PMID: 22728735  doi: 10.5152/akd.2012.169  Pages 528 - 529
Abstract | Full Text PDF

23.Metabolic syndrome without overt diabetes is associated with prolonged pro-arrhythmogenic electrocardiographic parameters
Turgay Işık, Mustafa Kurt, Hüseyin Uyarel
PMID: 22728736  doi: 10.5152/akd.2012.170  Page 529
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24.Congenitally corrected transposition of the great vessels: A case of very late presentation at old age and survival till 9th decade
Oladipupo Olafiranye, Louis Salciccioli, Jason M. Lazar
PMID: 22728737  doi: 10.5152/akd.2012.171  Page 530
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25.Transcatheter aortic valve implantation applications in Turkey; the role of the heart team approach
Sinan Dağdelen, Cem Alhan
PMID: 22728738  doi: 10.5152/akd.2012.172  Page 531
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26.Migration of a foreign body to the right ventricle following traumatic penetration to the right subclavian vein
Muzaffer Bahçıvan, Latif Duran, Serkan Çelik, Muzaffer Elmalı, Zühtü Karagöz
PMID: 22728739  doi: 10.5152/akd.2012.173  Pages 531 - 532
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27.Fever, dyspnea and chest pain with pericardial effusion
Burcu Demirkan, Anıl Özen, Nesrin Turhan, Yeşim Güray, Levent Birincioğlu
PMID: 22766238  Page 533
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28.Interview with Prof. Dr. Navin C. Nanda
Gültekin Karakuş
PMID: 22728740  doi: 10.5152/akd.2012.174  Pages 534 - 538
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29.The 9th International Scientific Summer School 2012 in Makov, Slovakia
Doğu Kılıç, Ljuba Bacharova
PMID: 22877919  doi: 10.5152/akd.2012.X  Pages 539 - 541
Abstract | Full Text PDF

30.Coronary artery-left ventricular micro-fistulas associated with apical hypertrophic cardiomyopathy
Samet Yılmaz, Fatih Mehmet Uçar, Zehra Gölbaşı, Omaç Tüfekçioğlu
PMID: 22728741  doi: 10.5152/akd.2012.175  Page E28
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31.A rare localization of muscular bridge causing myocardial ischemia
Gülaçan Tekin, Ali Rıza Erbay, Hasan Turhan
PMID: 22728742  doi: 10.5152/akd.2012.176  Page E29
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32.Unsuccessful elective coronary angiography in a hypertensive patient: Aortic coarctation with aberrant right subclavian artery arising from descending aorta
Ali Rıza Akyüz, Turhan Turan, Levent Korkmaz, Zeydin Acar
PMID: 22728743  doi: 10.5152/akd.2012.177  Pages E29 - E30
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33.Hydatid cyst of the interventricular septum presenting as supraventricular tachycardia
Uğur Canpolat, Hikmet Yorgun, Levent Şahiner, Kudret Aytemir
PMID: 22728744  doi: 10.5152/akd.2012.178  Pages E30 - E31
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34.A patient with severe congenital pulmonary stenosis and severe right ventricular hypertrophy
Cengiz Öztürk, Ali Deniz
PMID: 22728745  doi: 10.5152/akd.2012.179  Pages E31 - E32
Abstract | Full Text PDF

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