EDITORIAL | |
1. | On publication language and international publishing, success of Professor Özaydın and Anatolian Journal of Cardiology, peer-review and academic depression Bilgin Timuralp PMID: 23676661 doi: 10.5152/akd.2013.135 Pages 202 - 203 Abstract |Full Text PDF |
2. | Shinya Yamanaka, M.D., Ph.D. - 2012 Nobel Prize Laureate: How his dream of a research career provides vision for the next generation of young scientists Robert W. Mahley PMID: 23618992 doi: 10.5152/akd.2013.132 Pages 204 - 206 Abstract |Full Text PDF |
ORIGINAL INVESTIGATION | |
3. | Use of cardiac CT angiography imaging in an epidemiology study - the Methodology of the Multicenter AIDS Cohort Study cardiovascular disease substudy Yalçın Hacıoğlu, Mohit Gupta, Tae-Young Choi, Richard T. George, Christopher R. Deible, Lisa P. Jacobson PMID: 23376648 doi: 10.5152/akd.2013.065 Pages 207 - 214 Objective: The methodology for use of cardiac CT angiography (CTA) in low risk populations is not well defined. In order to present a reference for future studies, we present CTA methodology that is being used in an epidemiology study- the Multicenter AIDS Cohort Study (MACS). Methods: The Multicenter AIDS Cohort Study (MACS) is an on-going multicenter prospective, observational cohort study. The MACS Cardiovascular Disease substudy plans to enroll 800 men (n= 575 HIV seropositive and n=225 HIV seronegative) age 40-70 years for coronary atherosclerosis imaging using cardiac CTA. The protocol includes heart rate (HR) optimization with beta blockers; use of proper field of view; scan length limitation; prospective ECG-gating using the lowest beam voltage possible. All scans are evaluated for presence, extent, and com- position of coronary atherosclerosis, left atrial volumes, left ventricular volume and mass and non-coronary cardiac pathology. Results: The first 498 participants had an average radiation dose of 2.5±1.6 milliSieverts (mSv) for the cardiac CTA study. Overall quality of scans was fair to excellent in 98.6% of studies. There were three significant adverse events-two allergic reactions to contrast and one subcutaneous contrast extravasation. Conclusion: Cardiac CTA was safe and afforded a low effective radiation exposure to these asymptomatic research participants and provides valuable cardiovascular endpoints for scientific analysis. The cardiac CTA methodology described here may serve as a reference for use in future epidemiology studies aiming to assess coronary atherosclerosis and cardiac anatomy in low risk populations while minimizing radiation exposure. |
4. | A new approach to the measurement of heart rate in patients with chronic heart failure-Heart rate performance index: an observational study Aydın Akyüz, Şeref Alpsoy, Dursun Çayan Akkoyun, Niyazi Güler PMID: 23376649 doi: 10.5152/akd.2013.066 Pages 215 - 220 Objective: In order to evaluate the utility of the heart rate performance index (HRPI), which is obtained by dividing HR mean by the difference of HR max and HR min in the context of Holter monitoring, we sought to determine whether there was any correlation or relationship between the HRPI and LVEF values as determined by echocardiography and to compare the HRPI between the study and control groups. Methods: This study is a cross-sectional, controlled observational study. Thirty-two patients with symptomatic or asymptomatic left ventricular systolic dysfunction (LVEF <45%) were included as study group and 32 subjects without chronic heart failure (CHF) were included as a control group. In the study group, 10 patients were in NYHA class I (31.2%), 12 - were in NYHA class II (37.6%) and 10 - were in NYHA class III (31.2%). Heart rate analysis was measured using 24-hour Holter ambulatory electrocardiography. To determine the HRPI, the difference between maximum (HR max) and minimum heart rate (HR min) was divided by mean heart rate (HR mean) (beats/minute): HRPI=(HR max-HR min) / HR mean. Statistical analysis was performed using t-test for independent samples, Mann-Whitney U test, Chi-square test, Kruskal-Wallis test, Pearson’s correlation and linear regression analyses. Results: The HRPI index value was markedly decreased [0.83 (0.58-1.1) and 1.10 (0.74-1.3), p<0.001] in the study group as compared to the control group. The data collected for the study group and the control group (n=64) demonstrated a positive correlation between the HRPI and LVEF (r=0.62, p<0.001) as well as a negative correlation between the HR mean and LVEF (r=-0.39, p<0.003). The HR mean was higher (80.2±11.3 and 75.2±6.7, p<0.007) and HR max-HR min (67.9±11.6 and 83.3±14.3, p<0.001) were lower in the study group as compared to the control group. Linear regression analysis demonstrated no significant relationship between LVEF and HRPI and other heart rate derivatives (unstandardized β=42.43 95% CI: 21.98-50.51, p=0.231). Conclusion: According to our findings, patients with CHF exhibited higher HR mean values, reduced HR max-min values and significantly decreased HRPI values. There is a positive correlation between HRPI and LVEF, a decreased HRPI is associated with a decreased LVEF, but there is no relationship between these two variables. Therefore HRPI values may represent a viable option for assessing daily exercise activity and potentially sympathetic activation in patients with CHF. The assessment of HRPI may be helpful the evaluation of CHF patients, as well as resting HR. |
5. | The relationship between adiponectin, NT-pro-BNP and left ventricular ejection fraction in non-cachectic patients with systolic heart failure: an observational study İstemihan Tengiz, Uğur Önsel Türk, Emin Alioğlu, Bahadır Kırılmaz, Gülden S. Tamer, Nurullah Tüzün, Ertuğrul Ercan PMID: 23376650 doi: 10.5152/akd.2013.067 Pages 221 - 226 Objective: NT-pro-brain natriuretic peptide (NT-proBNP) has been shown to be an accurate diagnostic marker in patients with heart failure (HF). Adiponectin (Adp) levels are increased in HF but its diagnostic value is still uncertain in these patients. The study was designed to investigate the possible association of these markers in non-cachectic patients with newly diagnosed systolic heart failure. Methods: Fifty-seven systolic HF patients and 20 matched controls were enrolled in an observational cross-sectional study. Physical and echocardiographic examinations were performed and serum Adp, NT-proBNP, tumor necrosis factor-alpha (TNF-α) levels were measured. Study variables were compared between the groups. Correlation analyses were done and the diagnostic validity of the markers was compared with ROC analysis. Results: Adp and NT-proBNP levels were significantly higher in HF group (20.19±12.9 vs. 7.65±4.6 μg/mL; p<0.001 and 1051.74±606.2 vs. 222.53±65.6 pg/mL; p=0.002; respectively). TNF-α levels were similar between the groups (2.83±1.8 vs. 2.08±1.2 pg/mL; p=0.582). Correlation analysis showed significant association among Adp and NT-proBNP levels, (r=0.448; p<0.001), and left ventricular ejection fraction (LVEF) values (r=-0.466; p<0.001). The Adp and NT-proBNP showed comparable diagnostic performances with mean [95% confidence interval] areas under the curves of 0.857 (0.771-0.944) and 0.888 (0.815-0.960), respectively. Conclusion: There were significant correlation between Adp levels with NT-proBNP levels and LVEF values but no any association between Adp levels with body mass index values and TNF-α levels in patients with newly diagnosed systolic heart failure. The result may arouse suspicion about the hypothesis, which proposes that Adp levels simply reflects disease severity or cardiac cachexia in patients with HF. |
6. | Impaired coronary flow reserve evaluated by echocardiography is associated with increased aortic stiffness in patients with metabolic syndrome: an observational study Derya Tok, Fırat Özcan, İskender Kadife, Osman Turak, Kumral Çağlı, Nurcan Başar, Zehra Gölbaşı, Sinan Aydoğdu PMID: 23376651 doi: 10.5152/akd.2013.068 Pages 227 - 234 Objective: Metabolic syndrome (MetS) is a strong predictor of cardiovascular events and coronary flow reserve (CFR), an indicator of microvascular function, has been found to be impaired in MetS. Aortic stiffness (AS) is a simple and effective method for assessing arterial elasticity. The aim of this study was to evaluate whether there is an independent association of impaired coronary flow and aortic elasticity in patients with MetS. Methods: Forty-six patients (mean age 47.3±6.6 years) with the diagnosis of MetS according to the ATP III update criteria and 44 age and gender matched controls (mean age 46.0±6.1 years) were included into the cross-sectional observational study. Peak diastolic coronary flow velocities were measured in left anterior descending artery by pulsed wave Doppler at baseline and after adenosine infusion, and CFR was calculated as the ratio of hyperemic to baseline velocities. Aortic strain, distensibility and stiffness were calculated by M-mode echocardiography. Statistical analysis was performed by using Student t-test, Chi-square test, Pearson correlation and linear regression analyses. Results: CFR was significantly lower in patients with MetS than in controls (2.3±0.2 vs 2.7 ±0.2, p<0.001). In the MetS group, aortic distensibility (10.4±3.5 cm2.dyn-1.10-6 vs 12.7±3.4 cm2.dyn-1.10-6, p=0.002) was decreased and AS was significantly increased (6.5±2.0 vs 3.2±0.8, p<0.001). In multivariate linear regression analysis, AS (β=-0.217, p=0.047), systolic blood pressure (β=-0.215, p=0.050) and waist circumference (β=-0.272, p=0.012) had an independent relationship with impaired CFR. Conclusion: This study demonstrated that coronary flow reserve is impaired in patients with MetS and there is an independent relationship between impaired CFR and increased aortic stiffness, systolic blood pressure or waist circumference. |
EDITORIAL COMMENT | |
7. | Relations between microvascular function and aortic stiffness in metabolic syndrome Tae Joon Cha, Kyoung Im Cho PMID: 23395703 doi: 10.5152/akd.2013.069 Pages 235 - 236 Abstract |Full Text PDF |
ORIGINAL INVESTIGATION | |
8. | Relationship between hospital volume and risk-adjusted mortality rate following percutaneous coronary intervention in Korea, 2003 to 2004 Yong Hoon Kim, Ae-Young Her PMID: 23395704 doi: 10.5152/akd.2013.070 Pages 237 - 242 Objective: There have been a large number of studies that have investigated the relationship between outcomes and provider volume for a wide variety of medical conditions and surgical conditions. The objective of this study was to explore the relation between hospital volume and risk-adjusted mortality following percutaneous coronary intervention between 2003 and 2004 in Korea. Methods: This is a retrospective analysis of database in National Health Insurance Review & Assessment Service and Korean National Statistical Office. The study data set confined to the ICD-10 diagnosis and procedure codes that were recorded in the National Health Insurance Review Agency. Risk modeling was performed through logistic regression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistics, R2, and Hosmer-Lemeshow statistic. Crude and risk-adjusted 30-day mortality was evaluated among patients who underwent Percutaneous Coronary Intervention (PCI) between 2003 and 2004 at low (less 200 cases/year), medium (200~399 cases/year), and high (400 cases or more/year) PCI volume hospitals. Results: The final risk-adjustment model consisted of ten risk factors for 30-day mortality. These factors were found to have statistically significant effects on patient mortality. The c-statistic and Hosmer-Lemeshow χ2 goodness-of-fit test and the model’s performance were good [R2=0.147, c-statistic 0.823, 4.1037 (p=0.8476)]. A total number of 60 low-volume hospitals (9.071 patients) and 27 medium-volume hospitals (15.623 patients) and 15 high-volume hospitals (19.669 patients) were included. Crude 30-day mortality rate was 1.4%, 1.1%, and 1.0% (p=0.0106) in each volume hospitals. But risk-adjusted mortality rate was not significantly different among three groups (1.3%, 1.0%, and 1.1% in each volume hospitals). Conclusion: Although we found a significant different crude 30-day mortality rates according to hospital PCI volume, but did not find a relationship between hospital volume and 30-day risk-adjusted mortality rates following PCI in Korea. |
EDITORIAL COMMENT | |
9. | Hospital volume and mortality relation in PCI-Is there a need for modification of ACC/AHA percutaneous coronary intervention guidelines in Asia? Ayhan Olcay PMID: 23395705 doi: 10.5152/akd.2013.071 Pages 243 - 244 Abstract |Full Text PDF |
ORIGINAL INVESTIGATION | |
10. | The effects of chronic usage of enzyme inhibitors and angiotensin receptor blockers on contrast-induced nephropathy in low-risk patients Nezihi Barış, Ebru Özpelit, Nazile Bilgin Doğan, Hande Kangül, Sefa Gül, Bahri Akdeniz, Sema Güneri PMID: 23261803 doi: 10.5152/akd.2013.050 Pages 245 - 250 Objective: There is conflicting data about the role of renin- angiotensin- aldosterone system (RAAS) blockers in contrast-induced nephropathy (CIN) pathophysiology. In this study, we aimed to investigate the effects of chronic usage of RAAS blocker drugs on development of CIN in low risk patients. Methods: Study was designed as a prospective cohort study. A total of 295 patients were enrolled in the study. Study population was consisted of three subgroups according to prior usage of RAAS blockers: no RAAS blocker group (n=95), angiotensin-converting enzyme inhibitor (ACEI) group (n=106), angiotensin receptor blocker (ARB) group (n=94). CIN was defined as an increase of ≥25% in creatinine over the baseline value or 0.5 mg/dL rise within 48-72 h of angiography. Mehran score was calculated for each patient. Baseline variables and percentage of CIN were compared with ANOVA, Mann-Whitney U, Kruskal-Wallis and Pearson Chi-square tests between groups. In order to determine the independent predictors of CIN, binary logistic regression analyses were performed. Results: CIN occurred in 18 patients (17.0%) in the ACEI group, 17 patients (18.1%) in ARB group and 7 patients (7.4%) in the no RAAS group. CIN occurrence was significantly higher in RAAS than no RAAS group (17.5% vs. 7.4%, p=0.01). Chronic RAAS blocker administration was an independent predictor of CIN (OR=2.69; 95% CI: 1.025-7.067; p=0.04). Mehran score was the only other independent predictor for CIN (OR=1.15; 95% CI: 1.019-1.310; p=0.02). Conclusion: In patients with near normal renal functions who are undergoing elective coronary procedure, chronic usage of ACEI and ARB increases the risk of CIN. |
11. | Evaluation of right ventricular functions in patients with nasal polyposis: an observational study Eda Şimşek, Ziya Şimşek, M. Hakan Taş, Cüneyt Kucur, Ersin Günay, Harun Üçüncü PMID: 23395706 doi: 10.5152/akd.2013.072 Pages 251 - 256 Objective: The aim of this study was to assess the right ventricular functions in patients with nasal polyposis using the strain (S) and strain rate (SR) echocardiography. Methods: A prospective, cross-sectional observational study was performed. The study included 40 patients with nasal polyposis (NP) (Group 1), and 25 healthy controls (Group 2). The study comprised patients with Stage 2 and Stage 3 nasal obstruction and no symptoms that could be associated with right ventricular heart failure. Longitudinal peak systolic strain (PSS) and peak systolic strain rate (PSSR) were measured from the basal-mid and apical segments of the right ventricle free wall. Student’s t-test, Pearson’s correlation analysis and Bland-Altman test were used for statistical analysis. Results: Pulmonary arterial systolic pressure was significantly higher in group 1 than group 2 (31.2±5.8, 19.7±4.3, respectively, p<0.001). PSS and PSSR values at the basal, mid and apical segments of the right ventricular lateral wall of the group I were significantly lower compared to the control group (p<0.001, p=0.002 and p=0.002 for PSS, p=0.003, p<0.001 and p<0.001 for PSSR, respectively). The comparison of Stage 2 and Stage 3 NP patients revealed a significant difference only in the SR measurement of the right ventricular mid segment (p=0.002). There was a significant correlation between the systolic pulmonary arterial pressure (sPAP) and right ventricular S and SR values (p<0.001). Conclusion: In this study, S/SR echocardiography showed a subclinical deficit of the right ventricular longitudinal functions in patients with NP who are considered to have normal right ventricular functions. |
REVIEW | |
12. | Value of stress echocardiography in mitral stenosis Kadriye Orta Kılıçkesmez, Serdar Küçükoğlu PMID: 23395708 doi: 10.5152/akd.2013.074 Pages 257 - 260 Abstract |Full Text PDF |
13. | Epicardial adipose tissue: a review of physiology, pathophysiology, and clinical applications Cihan Şengül, Olcay Özveren PMID: 23395709 doi: 10.5152/akd.2013.075 Pages 261 - 265 Visceral fat tissue is an important predictor of cardio-metabolic diseases, carrying more risk than general fat accumulation. Epicardial fat, a particular form of visceral fat deposited around the heart, is considered an important cardiovascular risk predictor, in view of producing and releasing several adipo-cytokines. There is growing evidence about the physiological and metabolic importance of epicardial fat. Epicardial fat thickness and volume have both strong correlation between obesity, impaired fasting glucose, insulin resistance, metabolic syndrome, hypertension, diabetes mellitus, and atherosclerosis. Epicardial fat can be assessed by transthoracic echocardiography, cardiac magnetic resonance imaging, and computed tomography. In this article, we reviewed the anatomy, physiology, function, and the methods of assessment of epicardial fat tissue. We also have tried to discuss its relationship to metabolic syndrome and coronary atherosclerosis in the lights of recent findings. |
EDUCATION | |
14. | Recent and future innovations in the treatment of heart failure Alper Kepez, Bülent Mutlu PMID: 23395710 doi: 10.5152/akd.2013.076 Pages 266 - 274 Heart failure is still an important public health problem despite important advances regarding its treatment. Several new treatment strategies are being investigated in order to contend with this disease. Strategies proved to be safe and effective in clinical trials are being adapted to clinical practice. In this review, we will first focus on most recent treatment strategies that are recommended to be used in clinical practice and then try to mention novel strategies which are still being explored in preclinical studies. |
SCIENTIFIC LETTER | |
15. | The effect of distance-based learning on the fifth stage medical students’ perception in peripheral vascular diseases course: a questionnaire survey Mustafa Saçar, Gökhan Önem, Akile Sarıoğlu Büke, Ahmet Baltalarlı PMID: 23443855 doi: 10.5152/akd.2013.079 Pages 275 - 277 Abstract |Full Text PDF |
CASE REPORT | |
16. | Acute coronary syndrome with intraventricular thrombus after using erythropoietin Alparslan Kurtul, Mustafa Duran, Onur Kadir Uysal, Ender Örnek PMID: 23443856 doi: 10.5152/akd.2013.080 Pages 278 - 279 Abstract |Full Text PDF |
17. | Variant high origin of both right and left coronary arteries from the ascending aortic wall Raghavendra Rao, Bondel Shwetha PMID: 23443857 doi: 10.5152/akd.2013.081 Pages 279 - 280 Abstract |Full Text PDF |
18. | Worsening heart failure due to right ventricular apical pacing by ICD implanted after myocardial infarction and treatment with resynchronization Ali Deniz, Mehmet Kanadaşı, Mesut Demir, Ayhan Usal PMID: 23443858 doi: 10.5152/akd.2013.082 Pages 281 - 282 Abstract |Full Text PDF |
19. | Renal coloboma syndrome associated with double- chambered right ventricle Gökçen Gökçe, Yalçın Gökoğlan, Volkan Hürmeriç, Fazıl Cüneyt Erdurman, Osman Melih Ceylan, Ali Hakan Durukan, Güngör Sobacı PMID: 23443859 doi: 10.5152/akd.2013.083 Pages 282 - 283 Abstract |Full Text PDF |
20. | Thoraco-Omphalopagus conjoined twins Kadir Şerafettin Tekgündüz, Haşim Olgun, İbrahim Caner, Naci Ceviz PMID: 23443860 doi: 10.5152/akd.2013.084 Pages 284 - 285 Abstract |Full Text PDF |
LETTER TO THE EDITOR | |
21. | Ischemic stroke in the course of thrombolytic treatment of prosthetic valve thrombosis: thrombolysis is suggested Fidel Manuel Caceres Loriga PMID: 23443861 doi: 10.5152/akd.2013.085 Pages 286 - 287 Abstract |Full Text PDF |
22. | Influence of gender, C- reactive protein and triglycerides in risk prediction of coronary heart disease Altan Onat PMID: 23443862 doi: 10.5152/akd.2013.086 Pages 287 - 288 Abstract |Full Text PDF |
23. | Can isolated ST elevation in aVR lead be a sign of acute pulmonary embolism? Anita Sadeghpour, Azin Alizadeasl PMID: 23443863 doi: 10.5152/akd.2013.087 Pages 288 - 289 Abstract |Full Text PDF |
24. | A deadly chain of events in a case; Deep venous thrombosis, pulmoner embolism, patent foramen ovale and cerebral embolism Murat Eroğlu, Murat Yalçın, Zafer Işılak, Murat Velioğlu PMID: 23443864 doi: 10.5152/akd.2013.088 Pages 289 - 291 Abstract |Full Text PDF |
25. | Successful endovascular stent-graft treatment in a patient with Marfan syndrome presenting with complicated acute Type B dissection Can Yücel Karabay, Cihan Dündar, Kürşat Tigen, Cevat Kırma PMID: 23443865 doi: 10.5152/akd.2013.089 Pages 291 - 292 Abstract |Full Text PDF |
26. | The effect of group education about drug usage in the patient's on warfarine therapy Türkay Özcan, Meral Altıok, Fatma Babalıklı PMID: 23443866 doi: 10.5152/akd.2013.090 Pages 292 - 293 Abstract |Full Text PDF |
27. | Successful surgical closure of aortopulmonary window in a very low birth weight premature infant Önder Doksöz, Savaş Demirpençe, Timur Meşe PMID: 23443867 doi: 10.5152/akd.2013.091 Page 294 Abstract |Full Text PDF |
ALMANAC SERIAL | |
28. | Almanac 2012: congenital heart disease. The journals present selected research that has driven recent advances in clinical cardiology Michael Burch, Nathalie Dedieu PMID: 23376647 doi: 10.5152/akd.2013.064 Pages 295 - 303 Abstract |Full Text PDF |
IN MEMORIAM | |
29. | In memoriam of Prof. Dr. A. Mithat Özer İstemi Nalbantgil doi: 10.5152/akd.2013.112 Page 304 Abstract |Full Text PDF |
E-PAGE ORIGINAL IMAGES | |
30. | Coexistence of accessory mitral papillary muscle and ventricular septal defect Zafer Işılak, Onur Sinan Deveci, Murat Yalçın, Mehmet İncedayı PMID: 23443868 doi: 10.5152/akd.2013.092 Pages E15 - E16 Abstract |Full Text PDF |
31. | All-in-one case: constrictive pericarditis, secundum atrial septal defect, persistent left superior vena cava and anomalous drainage of hemiazygos vein to coronary sinus Abdurrahman Tasal, Osman Sönmez, Ercan Erdoğan, Ömer Göktekin PMID: 23443869 doi: 10.5152/akd.2013.093 Pages E16 - E17 Abstract |Full Text PDF |
32. | Severe pulmonary vein stenosis due to invasion of metastatic lung cancer Mehmet Mustafa Cangülcan PMID: 23443870 doi: 10.5152/akd.2013.094 Page E17 Abstract |Full Text PDF |
33. | Free-floating intra-aortic thrombus causing coronary artery occlusion: appearance in ECG-gated computed tomography with cine-images Terman Gümüş, Sergin Akpek, Genco Yücel PMID: 23443871 doi: 10.5152/akd.2013.095 Pages E18 - E19 Abstract |Full Text PDF |
34. | Interventricular septal cardiac hydatid cyst mimicking hypertrophic cardiomyopathy Turhan Turan, Abdulkadir Çakmak, Mustafa Çapraz, Ahmet Çağrı Aykan PMID: 23443872 doi: 10.5152/akd.2013.096 Pages E19 - E20 Abstract |Full Text PDF |
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