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Sumer C, Okumus G, Isik EG, Turkmen C, Bilge AK, Inanc M. (18)F-fluorodeoxyglucose uptake by positron emission tomography in patients with IPAH and CTEPH. Pulm Circ 2024; 14:e12363. [PMID: 38618292 PMCID: PMC11009453 DOI: 10.1002/pul2.12363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 02/26/2024] [Accepted: 03/24/2024] [Indexed: 04/16/2024] Open
Abstract
Pulmonary arterial hypertension (PAH) is driven by pathologies associated with increased metabolism such as pulmonary revascularization, vasoconstriction and smooth muscle cell proliferation in pulmonary artery wall. 18-fluorodeoxyglucose positron emission tomography (18FDG-PET) is an imaging technique sensitive to glucose metabolism and might be considered as a non-invasive method for diagnosis due to significant role of inflammation in idiopathic pulmonary artery hypertension (IPAH) and chronic thromboembolic pulmonary hypertension (CTEPH). The present study aimed to investigate the role of PET/CT imaging of patients with IPAH and CTEPH as an alternative diagnosis method. Demographic characteristics, FDG uptake in lungs, pulmonary artery and right ventricle (RV) of 17 patients (10 IPAH, 7 CTEPH), and 30 controls were evaluated. PET scanning, 6-min walk test, pro-BNP level, right heart catheterization of patients were performed both at the onsert and after 6-month PAH specific treatment. IPAH and CTEPH patients had significantly higher left lung FDG (p = 0.006), right lung FDG (p = 0.004), right atrial (RA) FDG (p < 0.001) and RV FDG (p < 0.001) uptakes than controls. Positive correlation was detected between the RV FDG uptake and the mean pulmonary artery pressure (mPAP) (r = 0.7, p = 0.012) and between the RA FDG uptake and the right atrial pressure (RAP) (r = 0.5, p = 0.02). Increased RV FDG and RA FDG uptakes predicts the presence of pulmonary hypertension and correlates with mPAP and RAP, respectively, which are important indicators in the prognosis of PAH. Further studies are required whether FDG PET imaging can be used to diagnose or predict the prognosis of pulmonary hypertension.
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Affiliation(s)
- Celik Sumer
- Department of Pulmonary DiseasesIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Gulfer Okumus
- Department of Pulmonary DiseasesIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Emine Goknur Isik
- Department of Nuclear MedicineIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Cuneyt Turkmen
- Department of Nuclear MedicineIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Ahmet Kaya Bilge
- Department of CardiologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
| | - Murat Inanc
- Department of RheumatologyIstanbul University Istanbul Faculty of MedicineIstanbulTurkey
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Yalin K, Soysal AU, Aksu T, Onder SE, Ozturk S, Yalman H, Mutlu D, Ercan OT, Ikitimur B, Cimci M, Durmaz E, Karadag B, Bilge AK, Huang H, Karpuz H. Safety and efficacy of coronary angiographic image integration tool-guided ablation of left sided outflow tract ventricular arrhythmias. J Interv Card Electrophysiol 2024; 67:31-34. [PMID: 37578671 DOI: 10.1007/s10840-023-01619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Affiliation(s)
- Kivanc Yalin
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ali Ugur Soysal
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tolga Aksu
- Department of Cardiology, Yeditepe University Hospital, Istanbul, 34100, Turkey.
| | | | - Sila Ozturk
- Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Hakan Yalman
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Deniz Mutlu
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Osman Talha Ercan
- Johnson and Johnson, Biosense Webster-Turkey Office, Istanbul, Turkey
| | - Baris Ikitimur
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Murat Cimci
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Eser Durmaz
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Bilgehan Karadag
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Istanbul Faculty of Medicine, Department of Cardiology, Istanbul University, Istanbul, Turkey
| | - Henry Huang
- Division of Cardiology, Rush University Medical Center, 1717 West Congress Parkway, Chicago, IL, 60612, USA
| | - Hakan Karpuz
- Cerrahpasa Faculty of Medicine, Department of Cardiology, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Ozer PK, Govdeli EA, Nalbant A, Yavuz ML, Bayraktar BB, Karaayvaz EB, Elitok A, Bilge AK, Adalet K, Oncul A. Negativity of the electromechanical window: relation to frequent premature ventricular complexes. Eur Rev Med Pharmacol Sci 2023; 27:2385-2393. [PMID: 37013757 DOI: 10.26355/eurrev_202303_31773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
OBJECTIVE The electromechanical window (EMW) was investigated as a new predictor of arrhythmia in the presence of long QT. However, the use of EMW to predict idiopathic frequent ventricular premature complexes (PVCs) in those with normal QT intervals has not been clarified. PATIENTS AND METHODS This single-center study included consecutive patients who presented to the Cardiology Clinic with palpitations and were found to have idiopathic PVC on 24-hour Holter monitoring. Those with a PVC/24-hour frequency of < 1% were defined as group 1, 1-10% as group 2, and > 10% as group 3. The EMW was defined as the time difference (in ms) between the aortic valve closure and the end of the QT interval, measured from an ECG on the concurrent echocardiogram. RESULTS A total of 148 patients were included in the study, 64% (n = 94) of which were female. The patients' mean age was 50.11 ± 14.7. The groups were similar in terms of the patients' age, BMI, and comorbidities. There was a statistically significant difference between the three groups in terms of the EMW measurements (group 1: 3.78 ± 19.6, group 2: -7 ± 30.9, group 3: -34.83 ± 55.2 ms: p < 0.001). In the multivariate regression analysis, the EMW (OR 0.971, p = 0.007) and every 10-ms decrease in the EMW (OR 1.254, p = 0.011) were thus determined to be independent predictors of PVC > 10%. An EMW value of ≤ -15 ms was associated with the frequency of 24-h PVC > 10%, with a sensitivity of 70% and a specificity of 70% (AUC 0.716, 95% CI: 0.636-0.787 p < 0.001). CONCLUSIONS The results showed that a negative increase in the EMW may be associated with frequent idiopathic PVCs.
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Affiliation(s)
- P K Ozer
- Department of Cardiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
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Ertan O, Aslan GK, Akinci B, Bilge AK, Inanc M, Okumus G. Effect of Ground-Based Walk Training in Pulmonary Hypertension. Am J Cardiol 2022; 174:172-178. [PMID: 35473778 DOI: 10.1016/j.amjcard.2022.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 11/29/2022]
Abstract
This study aimed to determine the effect of ground-based walking training on exercise capacity, physical activity, quadriceps muscle strength, and quality of life (QoL) in patients with pulmonary hypertension. A total of 24 patients were included in the study. Patients were randomly assigned to 2 groups as the walking group or the control group. The walking group participated in 30-minute supervised ground-based walking training 2 days/week for 8 weeks. Also, they walked unsupervised at least 1 day/week. The control group received no intervention. The number of weekly steps taken in both groups was recorded using a pedometer. In addition to the sociodemographic and clinic characteristics of the patients, the endurance shuttle walk test, incremental shuttle walk test, and 6-minute walk test were used for the evaluation of exercise capacity, and an activity monitor and pedometer for physical activity, a dynamometer for quadriceps muscle strength, and emPHasis-10 for QoL. After 8 weeks, endurance capacity, maximal exercise capacity, and the number of steps significantly improved in the walking group (p <0.05). The 6-minute walk distance, physical activity, quadriceps muscle strength, and QoL were similar in both groups (p >0.05). The results of the study showed that ground-based walking could improve endurance capacity, maximal exercise capacity, and the number of steps. Quadriceps muscle strength also improved in the walking group. No adverse effects were reported during the training period. Ground-based walking training can be performed safely in patients with pulmonary hypertension.
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Affiliation(s)
- Ozge Ertan
- Department of Physiotherapy and Rehabilitation, Istanbul University-Cerrahpasa, Institute of Graduate Studies, Istanbul, Turkey
| | - Goksen Kuran Aslan
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
| | - Buket Akinci
- Division of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Biruni University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Murat Inanc
- Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Aksan G, Tezcan M, Cevrim O, Elitok A, Bilge AK. Coexistence of Brugada and Wolff Parkinson White syndromes: A case report and review of the literature. Turk Kardiyol Dern Ars 2022. [DOI: 10.5543/tkda.2017.77834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Bugra Z, Emet S, Umman B, Ozer PK, Sezer M, Baykiz D, Atilgan D, Tireli E, Dursun M, Yılmazbayhan D, Karaayvaz EB, Elitok A, Bilge AK, Goren T, Umman S, Kumrular M, Yilmaz M, Sonsoz MR, Engin B, Ayduk E, Aydogan M, Cevik E, Kavak I, Orta H, Tasdemir M, Tuncozgur A, Topcak Z, Gorgun OD, Oztas DM. Intracardiac masses: Single center experience within 12 years: I-MASS Study. Am Heart J Plus 2022; 13:100081. [PMID: 38560087 PMCID: PMC10978191 DOI: 10.1016/j.ahjo.2021.100081] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 11/27/2021] [Accepted: 12/07/2021] [Indexed: 04/04/2024]
Abstract
Objective The aim of this cross-sectional, retrospective, descriptive study was to review and classify cardiac masses systematically and to determine their frequencies. Methods The medical records of 64,862 consecutive patients were investigated within 12 years. Every patient with a cardiac mass imaged by transthoracic echocardiography (TTE) and confirmed with an advanced imaging modality such as transesophageal echocardiography (TEE), computed tomography (CT) and/or cardiac magnetic resonance imaging (CMR) was included. Acute coronary syndromes triggering thrombus formation, vegetations, intracardiac device and catheter related thrombi were excluded. Results Data demonstrated 127 (0.195%) intracardiac masses consisting of 33 (0.050%) primary benign, 3 (0.004%) primary malignant, 20 (0.030%) secondary tumors, 3 (0.004%) hydatid cysts and 68 (0.104%) thrombi respectively. The majority of primary cardiac tumors were benign (91.67%), predominantly myxomas (78.79%), and the less malignant (8.33%). Secondary cardiac tumors were common than the primary malignant tumors (20:3), with male dominancy (55%), lymphoma and lung cancers were the most frequent. Intracardiac thrombi was the majority of the cardiac masses, thrombi accompanying malignancies were in the first range (n = 17, 25%), followed by autoimmune diseases (n = 13, 19.12%) and ischemic heart disease with low ejection fraction (n = 12, 17.65%). Conclusions This retrospective analysis identified 127 patients with cardiac masses. The majority of benign tumors were myxoma, the most common tumors that metastasized to the heart were lymphoma and lung cancers, and the thrombi associated with malignancies and autoimmune diseases were the most frequent.
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Affiliation(s)
- Zehra Bugra
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Samim Emet
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Berrin Umman
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Pelin Karaca Ozer
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Murat Sezer
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Derya Baykiz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Dursun Atilgan
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Emin Tireli
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
| | - Memduh Dursun
- Istanbul University, Istanbul Medical Faculty, Department of Radiology, Turkey
| | - Dilek Yılmazbayhan
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | | | - Ali Elitok
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ahmet Kaya Bilge
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Taner Goren
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Sabahattin Umman
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Collaborators
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Radiology, Turkey
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | - Merve Kumrular
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mustafa Yilmaz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mehmet Rasih Sonsoz
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Berat Engin
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Elif Ayduk
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mehmet Aydogan
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Erdem Cevik
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ilyas Kavak
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Huseyin Orta
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Mucahit Tasdemir
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Asli Tuncozgur
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Zeynep Topcak
- Istanbul University, Istanbul Medical Faculty, Department of Cardiology, Turkey
| | - Ozerk Dogus Gorgun
- Istanbul University, Istanbul Medical Faculty, Department of Pathology, Turkey
| | - Didem Melis Oztas
- Istanbul University, Istanbul Medical Faculty, Department of Cardiovascular Surgery, Turkey
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Karaca Özer P, Ayduk Gövdeli E, Engin B, Atıcı A, Baykız D, Orta H, Demirtakan ZG, Emet S, Elitok A, Tayyareci Y, Umman B, Bilge AK, Buğra Z. Role of global longitudinal strain in discriminating variant forms of left ventricular hypertrophy and predicting mortality. Anatol J Cardiol 2021; 25:863-871. [PMID: 34866580 DOI: 10.5152/anatoljcardiol.2021.21940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE In this study, we aimed to compare the functional adaptations of the left ventricle in variant forms of left ventricular hypertrophy (LVH) and to evaluate the use of two-dimensional speckle tracking echocardiography (2D-STE) in differential diagnosis and prognosis. METHODS This was a prospective cohort study of 68 patients with LVH, including 20 patients with non-obstructive hypertrophic cardiomyopathy (HCM), 23 competitive top-level athletes free of cardiovascular disease, and 25 patients with hypertensive heart disease (HHD). All the subjects underwent 2D transthoracic echocardiography (TTE) and 2D-STE. The primary endpoint was all-cause mortality. Global longitudinal strain (GLS) below -12.5% was defined as severely reduced strain, -12.5% to -17.9% as mildly reduced strain, and above -18% as normal strain. RESULTS The mean LV-GLS value was higher in athletes than in patients with HCM and HHD with the lowest value being in the HCM group (HCM: -11.4±2.2%; HHD: -13.6±2.6%; and athletes: -15.5±2.1%; p<0.001 among groups). LV-GLS below -12.5% distinguished HCM from others with 65% sensitivity and 77% specificity [area under curve (AUC)=0.808, 95% confidence interval (CI): 0.699-0.917, p<0.001]. The median follow-up duration was 6.4±1.1 years. Overall, 11 patients (16%) died. Seven of these were in the HHD group, and four were in the HCM group. The mean GLS value in patients who died was -11.8±1.5%. LV-GLS was significantly associated with mortality after adjusting age and sex via multiple analysis (RR=0.723, 95% CI: 0.537-0.974, p=0.033). Patients with GLS below -12.5% had a higher risk of all-cause mortality compared with that of patients with GLS above -12.5% according to Kaplan-Meier survival analysis for 7 years (29% vs. 9%; p=0.032). The LV-GLS value predicts mortality with 64% sensitivity and 70% specificity with a cut-off value of -12.5 (AUC=0.740, 95% CI: 0.617-0.863, p=0.012). CONCLUSION The 2D-STE provides important information about the longitudinal systolic function of the myocardium. It may enable differentiation variable forms of LVH and predict prognosis.
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Affiliation(s)
- Pelin Karaca Özer
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Elif Ayduk Gövdeli
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Berat Engin
- Department of Cardiology, Manavgat State Hospital; Antalya-Turkey
| | - Adem Atıcı
- Department of Cardiology, İstanbul Medeniyet University, Göztepe Training and Research Hospital; İstanbul-Turkey
| | - Derya Baykız
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Hüseyin Orta
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | | | - Samim Emet
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Ali Elitok
- Department of Cardiology, İstinye University, Liv Hospital; İstanbul-Turkey
| | - Yelda Tayyareci
- Department of Cardiology, İstinye University, Liv Hospital; İstanbul-Turkey
| | - Berrin Umman
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
| | - Zehra Buğra
- Department of Cardiology, İstanbul Medical Faculty, İstanbul University; İstanbul-Turkey
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Erdogan O, Karaayvaz E, Erdogan T, Panc C, Sarıkaya R, Oncul A, Bilge AK. A new biomarker that predicts ventricular arrhythmia in patients with ischemic dilated cardiomyopathy: Galectin-3. Rev Port Cardiol 2021. [DOI: 10.1016/j.repc.2020.12.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Yalın K, Bilge AK, İkitimur B, Öngen Z. AVNRT captured by smartphone ECG device. Turk Kardiyol Dern Ars 2021; 49:513. [PMID: 34523602 DOI: 10.5543/tkda.2021.02452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kıvanç Yalın
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Barış İkitimur
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Zeki Öngen
- Department of Cardiology, İstanbul University-Cerrahpaşa, Cerrahpaşa School of Medicine, İstanbul, Turkey
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Sonsöz MR, Yilmaz M, Cevik E, Orta H, Bilge AK, Elitok A, Onur I, Komurcu-Bayrak E. Circulating Levels of MicroRNAs in Hypertrophic Cardiomyopathy: The Relationship With Left Ventricular Hypertrophy, Left Atrial Dilatation and Ventricular Depolarisation-Repolarisation Parameters. Heart Lung Circ 2021; 31:199-206. [PMID: 34088630 DOI: 10.1016/j.hlc.2021.04.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 12/31/2020] [Accepted: 04/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND MicroRNAs are small, endogenous, non-coding RNAs that regulate the expression of many genes. It has recently been shown that circulating microRNAs may be biomarkers of hypertrophy and fibrosis in patients with hypertrophic cardiomyopathy (HCM). OBJECTIVE To determine whether circulating levels of microRNAs involved in HCM are associated with electrocardiographic and echocardiographic parameters. METHODS This study enrolled 20 patients with familial HCM and 20 blood donors. Peripheral serum levels of miR-29a-3p, miR-199a-5p and miR-451a were assessed by quantitative real-time polymerase chain reaction and compared with levels in the control group. Whether circulating levels of miRNAs in HCM patients correlated with electrocardiographic and echocardiographic parameters was also assessed. RESULTS Median circulating levels of miR-29a and miR-451a were significantly higher in HCM than the control group. Median miR-199a levels did not differ between groups. However, circulating levels of miR-199a negatively correlated with corrected QT duration (Bazett formula). Median miR-29a levels positively correlated with QRS duration. In addition, circulating levels of miR-29a correlated with maximal wall thickness, left ventricular mass index and left atrial volume index. CONCLUSIONS The data suggested that serum levels of miR-29a and miR-451a were significantly increased in HCM patients. As the circulating level of miR-29a correlated with QRS duration, left ventricular hypertrophy and left atrial dilatation, the serum miR-199a level negatively correlated with corrected QT duration. These miRNAs may be seen as potential biomarkers for further research in HCM pathophysiology.
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Affiliation(s)
- Mehmet Rasih Sonsöz
- Department of Cardiology, Basaksehir Pine and Sakura City Hospital, Istanbul, Turkey.
| | - Mustafa Yilmaz
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Cevik
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Orta
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Imran Onur
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Evrim Komurcu-Bayrak
- Department of Genetics, Aziz Sancar Institute of Experimental Medicine and Department of Medical Genetics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Karaayvaz EB, Engin B, Yalin K, Ozer PK, Baykiz D, Bilge AK. Association between integrated backscatter and arrhythmia in patients with ischemic dilated cardiomyopathy. Pacing Clin Electrophysiol 2021; 44:1010-1017. [PMID: 33969900 DOI: 10.1111/pace.14257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/30/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Ventricular scars due to myocardial infarction provide a substrate for ventricular arrhythmias, and cardiac magnetic resonance (CMR) is the golden standard for the quantification of scar tissue magnitude. CMR has still limitations with patients with ICD despite ICD's becoming MR-compatible. We investigated the association between calibrated integrated backscatter (cIBS) and arrhythmia frequency in patients with ICD. METHODS Thirty-two ischemic dilated cardiomyopathy (ICM) patients with VVI-ICD (mean age 66.56 ± 9.05, 28 male, and four female) were divided into three groups according to their arrhythmia frequency (ventricular arrhythmia-[VA -], VA + [VA +], and arrhythmia storm [AS]). Then with transthoracic echocardiography (TTE), all patients' cIBS values were calculated and these values were compared with the patients' arrhythmia frequency. RESULTS cIBS values of patients with VA + and AS were significantly higher in the apical-septal (0.66 ± 0.11 vs. 0.50 ± 0.16, p = .008) and apical-lateral (0.62 ± 0.19 vs. 0.46 ± 0.18, p = .041) segments compared to those of patients with VA -. The cIBS values of apical-septal (0.50 ± 0.16 vs. 0.65 ± 0.08 vs. 0.66 ± 0.13 respectively, p = .032) and apical-anterior (0.53 ± 0.22 vs. 0.48 ± 0.17 vs. 0.79 ± 0.23 respectively, p = .03) segments were significantly different between the groups. Furthermore, in the post hoc analysis, the difference was significantly higher in VA + than VA - in the apical-septal segment and higher in AS than VA + in apical-anterior segments. CONCLUSION Our findings suggest an association between the cIBS values and arrhythmia frequency in the study group.
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Affiliation(s)
- Ekrem Bilal Karaayvaz
- Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | | | - Kivanc Yalin
- Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Pelin Karaca Ozer
- Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Derya Baykiz
- Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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Atici A, Rasih-Sonsoz M, Ali-Barman H, Durmaz E, Demirkiran A, Gulsen K, Elitok A, Onur I, Sahin I, Kaya Bilge A. The role of Beta-1 receptor gene polymorphism in Beta-Blocker therapy for vasovagal syncope. Rev Invest Clin 2020; 72. [PMID: 33053571 DOI: 10.24875/ric.20003319] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 03/10/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Vasovagal syncope (VVS) is a common clinical condition involving genetic background. The role of beta-blockers in the treatment is controversial. OBJECTIVE The aim of this study was to investigate the effect of beta-1 gene polymorphism on beta-blocker therapy in patients with VVS. METHODS We included 123 patients who were diagnosed with VVS after the tilttable test. We searched for the polymorphism Arg389Gly (rs1801253) in the beta-1 adrenoceptor gene. RESULTS Overall, 64 patients (52%) had Arg389Arg with Arg389Arg genotype were more frequent compared with patients having Arg389Gly genotype (total syncopal episodes [TSE], 7.9 ± 3.7 vs. 6.4 ± 3.0; p = 0.012). TSE in patients with Arg389Arg genotype decreased significantly after 18 months of beta-blocker treatment (7.9 ± 3.7 vs. 3.0 ± 1.4, p < 0.001). After 18 months of beta-blocker treatment, patients with Arg389Arg genotype had significantly fewer syncopal episodes than patients with Arg389Gly genotype (3.0 ± 1.4 vs. 6.8 ± 3.2, p < 0.001). CONCLUSIONS Results of beta-blocker therapy in patients with Arg389Arg genotype suggest that VVS pathophysiology is a multifactorial condition, with genetic, psychological, and environmental components, and therefore, treatment selection can be based on gene polymorphism.
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Affiliation(s)
- Adem Atici
- Cardiology Department of Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Rasih-Sonsoz
- Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Eser Durmaz
- Cerrahpasa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Demirkiran
- Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Kamil Gulsen
- Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ali Elitok
- Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul
| | - Imran Onur
- Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul
| | - Irfan Sahin
- Training and Research Hospital, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Cardiology Department of Istanbul School of Medicine, Istanbul University, Istanbul
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Elitok A, Emet S, Karaayvaz EB, Erdogan O, Aydogan M, Engin B, Cevik E, Orta H, Okumus G, Bilge AK. The relationship between T-wave peak-to-end interval and hemodynamic parameters in patients with pulmonary arterial hypertension. Ann Noninvasive Electrocardiol 2020; 25:e12764. [PMID: 32304627 PMCID: PMC7507547 DOI: 10.1111/anec.12764] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022] Open
Abstract
Background T‐wave peak‐to‐end interval (TPEI) is a measure of repolarization dispersion on surface electrocardiogram (ECG). TPEI has been reported as a prognostic parameter with heart disorders. In this study, we aimed to evaluate the relationship between echocardiogram‐derived right heart parameters, right heart catheterization (RHC) measurements, and TPEI in patients with precapillary pulmonary arterial hypertension (PAH). Methods Thirty‐eight patients (29 females and 9 males, mean age of 54.9 ± 10.9 years) who had undergone RHC for a preliminary diagnosis of pulmonary hypertension (PH) were included in the study. We performed transthoracic echocardiography (TTE), and resting 12‐lead ECG was recorded before RHC. TPEI was measured from leads of V1‐V6, DII, DIII, and aVF, and these values are averaged to obtain the global TPEI. Results Duration of TPEI was significantly correlated with mean PAP, pulmonary vascular resistance (PVR), and cardiac index (CI). Longer TPEI was associated with higher N terminal probrain natriuretic peptide (NT pro‐BNP) level, lower 6‐min walk distance (6MWD), and lower tricuspid annular plane systolic excursion (TAPSE). Conclusion Prolongation of TPEI could be a new predictor of adverse outcome in PAH and may provide additional prognostic information for patients with PAH.
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Affiliation(s)
- Ali Elitok
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Onur Erdogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Aydogan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Berat Engin
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Erdem Cevik
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Huseyin Orta
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- Department of Chest Disease, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Bahat G, Ilhan B, Erdogan T, Halil M, Savas S, Ulger Z, Akyuz F, Bilge AK, Cakir S, Demirkan K, Erelel M, Guler K, Hanagasi H, Izgi B, Kadioglu A, Karan A, Kulaksizoglu IB, Mert A, Ozturk S, Satman I, Sever MS, Tukek T, Uresin Y, Yalcin O, Yesilot N, Oren MM, Karan MA. Turkish inappropriate medication use in the elderly (TIME) criteria to improve prescribing in older adults: TIME-to-STOP/TIME-to-START. Eur Geriatr Med 2020; 11:491-498. [PMID: 32297261 PMCID: PMC7280176 DOI: 10.1007/s41999-020-00297-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/04/2020] [Indexed: 01/30/2023]
Abstract
Aim To meet the current need in different European countries for improving prescribing in older adults, we aimed to create an update screening tool getting origin from the two user friendly criterion sets: the STOPP/STARTv2 criteria and CRIME criteria. Findings Based on thorough literature review, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified. As a result, 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Message TIME criterion set is an update screening tool reported from Eastern Europe that included experts from geriatrics and other specialties frequently giving care to older adults and some additional practical explanations for clinical use. Electronic supplementary material The online version of this article (10.1007/s41999-020-00297-z) contains supplementary material, which is available to authorized users. Purpose To improve prescribing in older adults, criterion sets have been introduced from different countries. While current criterion sets are useful to some extent, they do not meet the need in some European countries. Turkish inappropriate medication use in the elderly (TIME) criteria was planned to meet this need. Methods In phase 1, the user friendly sets: STOPP/START version2 and CRIME criteria were combined. National experts composed of geriatricians and non-geriatricians were invited to review and comment. In phase 2, thorough literature review was performed and reference-based revisions, omissions, and additions were made. Explanatory additions were added to some criteria to improve application in practice. In phase 3, all working group members reviewed the criteria/explanations and agreed on the final content. Results Phase 1 was performed by 49 expert academicians between May and October 2016. Phase 2 was performed by 23 working group academicians between October 2016 and November 2018 and included face-to-face interviews between at least two geriatrician members and one criterion-related specialist. Phase 3 was completed between November 2018–March 2019 with review and approval of all criteria by working group academicians. As a result, 55 criteria were added, 17 criteria were removed, and 60 criteria were modified from the first draft. A total of 153 TIME criteria composed of 112 TIME-to-STOP and 41 TIME-to-START criteria were introduced. Conclusion TIME criteria is an update screening tool that differs from the current useful tools by the interactive study of experts from geriatrics and non-geriatrics, inclusion of practical explanations for some criteria and by its eastern European origin. TIME study respectfully acknowledges its roots from STOPP/START and CRIME criteria. Studies are needed whether it would lead improvements in older adults’ health. Electronic supplementary material The online version of this article (10.1007/s41999-020-00297-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gulistan Bahat
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey.
| | - Birkan Ilhan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Tugba Erdogan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
| | - Meltem Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Sumru Savas
- Division of Geriatrics, Department of Internal Medicine, Ege University Faculty of Medicine, Izmir, Turkey
| | - Zekeriya Ulger
- Department of Internal Medicine, Kirikkale University Medical School, Kirikkale, Turkey
| | - Filiz Akyuz
- Division of Gastroenterology, Department of Internal Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Sibel Cakir
- Department of Psychiatry, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Kutay Demirkan
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Mustafa Erelel
- Department of Pulmonary Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Kerim Guler
- Department of Internal Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Hasmet Hanagasi
- Department of Neurology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Belgin Izgi
- Department of Ophthalmology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Ates Kadioglu
- Department of Urology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Ayse Karan
- Department of Physical Therapy and Rehabilitation, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | | | - Ali Mert
- Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Savas Ozturk
- Department of Nephrology, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ilhan Satman
- Division of Endocrinology, Department of Internal Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Mehmet Sukru Sever
- Division of Nephrology, Department of Internal Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Tufan Tukek
- Department of Internal Medicine, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Yagiz Uresin
- Department of Pharmacology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Onay Yalcin
- Department of Obstetrics and Gynecology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Nilufer Yesilot
- Department of Neurology, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Meryem Merve Oren
- Department of Public Health, Istanbul University Istanbul Medical School, Istanbul, Turkey
| | - Mehmet Akif Karan
- Division of Geriatrics, Department of Internal Medicine, Istanbul Medical School, Istanbul University, Capa, 34390, Istanbul, Turkey
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Atıcı A, Aciksari G, Baycan OF, Barman HA, Sonsöz MR, Sahin M, Asoglu R, Demirkıran A, Kul Ş, Gungor B, Durmaz E, Bilge AK, Sahin I. Serum Asymmetric Dimethylarginine Levels in Patients with Vasovagal Syncope. ACTA ACUST UNITED AC 2019; 55:medicina55110718. [PMID: 31671882 PMCID: PMC6915676 DOI: 10.3390/medicina55110718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/09/2019] [Accepted: 10/10/2019] [Indexed: 11/23/2022]
Abstract
Background and Objectives: Vasovagal syncope (VVS) is the most common cause of syncope and has multiple pathophysiological mechanisms. Asymmetric dimethylarginine (ADMA) is the major inhibitor of nitric oxide (NO). In this study, we aimed to investigate the relationship between plasma ADMA levels and syncope during the head-up tilt (HUT) test. Materials and Methods: Overall, 97 patients were included in this study. They were above 18 years of age and were admitted to our clinic with the complaint of at least one episode of syncope consistent with VVS. The HUT test was performed in all patients. Patients were divided into the following two groups based on the HUT test results: group 1 included 57 patients with a positive HUT test and group 2 included 35 patients with a negative HUT test. Blood samples were taken before and immediately after the HUT test to measure ADMA levels. Results: No significant intergroup differences were observed concerning gender and age (female gender 68% vs 60%; mean age 24.85 ± 4.01 vs 25.62 ± 3.54 years, respectively, for groups 1 and 2). ADMA values were similar between groups 1 and 2 before the HUT test [ADMA of 958 (544–1418) vs 951 (519–1269); p = 0.794]. In the negative HUT group, no significant differences were observed in ADMA levels before and after the HUT test [ADMA of 951 (519–1269) vs 951 (519–1566); p = 0.764]. However, in the positive HUT group, ADMA levels were significantly decreased following the HUT test [pretest ADMA of 958 (544–1418) vs post-test ADMA of 115 (67–198); p < 0.001]. Conclusion: ADMA levels significantly decreased after the HUT test in patients with VVS.
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Affiliation(s)
- Adem Atıcı
- Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey.
| | - Gonul Aciksari
- Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey.
| | - Omer Faruk Baycan
- Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey.
| | - Hasan Ali Barman
- Cardiology Department, Okmeydani Training and Research Hospital, 34384 Istanbul, Turkey.
| | - Mehmet Rasih Sonsöz
- Cardiology Department, Istanbul University Istanbul School of Medicine, 34093 Istanbul, Turkey.
| | - Mustafa Sahin
- Biochemistry Department, Hitit University, Erol Olcok Training and Research Hospital, 19040 Corum, Turkey.
| | - Ramazan Asoglu
- Cardiology Department, Adiyaman Training and Research Hospital, 02200 Adiyaman, Turkey.
| | - Ahmet Demirkıran
- Cardiology Department, Istanbul University Istanbul School of Medicine, 34093 Istanbul, Turkey.
| | - Şeref Kul
- Cardiology Department, Istanbul Medeniyet University, Goztepe Training and Research Hospital, 34722 Istanbul, Turkey.
| | - Baris Gungor
- Department of Cardiology, Siyami Ersek Cardiothoracic Surgery Center, 34668 Istanbul, Turkey.
| | - Eser Durmaz
- Cardiology Department, Istanbul University-Cerrahpasa, Cerrahpasa School of Medicine, 34096 Istanbul, Turkey.
| | - Ahmet Kaya Bilge
- Cardiology Department, Istanbul University Istanbul School of Medicine, 34093 Istanbul, Turkey.
| | - Irfan Sahin
- Cardiology Department, Bagcilar Training ve Research Hospital, Bagcilar Center, 34100 Istanbul, Turkey.
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Abstract
Objective: To examine the serum levels of leptin and adiponectin in different obstructive sleep apnea (OSA) phenotypes. Methods: Obese patients who were admitted to our sleep laboratory were included. All patients underwent spirometry, daytime arterial blood gas analysis, polysomnography and transthoracic echocardiography. Serum levels of adiponectin and leptin were recorded. Results: Analysis included 146 OSA patients (81 females, 65 males, age: 49.8 ± 10.7 years, body mass index: 40.3 ± 4.9 kg/m2, 47.9% severe OSA, 42.5% severe obesity). Females had higher leptin and adiponectin levels (p < 0.001; p < 0.001, respectively). Leptin levels were higher in patients with severe obesity (p < 0.001). Severe OSA patients had lower leptin and adiponectin levels (p = 0.023; p = 0.035, respectively). Conclusion: Adipokine levels were different especially in OSA patients with severe obesity, female gender and severe OSA.
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Affiliation(s)
- Zuleyha Bingol
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Ekrem Bilal Karaayvaz
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Aysegul Telci
- Department of Biochemistry, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Gulfer Okumus
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Esen Kiyan
- Department of Pulmonary Medicine, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
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Atıcı A, Panç C, Karaayvaz EB, Demirkıran A, Kutlu O, Kaşalı K, Kekeç E, Sarı L, Akyol Sarı ZN, Bilge AK. Author`s Reply. Anatol J Cardiol 2018; 20:308. [PMID: 30391975 DOI: pmid/30391975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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18
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Guler TE, Yalin K, Aksu T, Golcuk E, Sanli S, Kaya Bilge A, Adalet K. Prognostic value role of radiofrequency lesion size by cardiac magnetic resonance imaging on outcomes of ablation in patients with ischemic scar-related ventricular tachycardia: A single center pilot study. Medicine (Baltimore) 2018; 97:e12955. [PMID: 30431569 PMCID: PMC6257390 DOI: 10.1097/md.0000000000012955] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Inadequate ablation lesion formation may be responsible for post-ablation ventricular tachycardia (VT) recurrences.We aimed to evaluate whether visualisation of radiofrequency (RF) lesion size by cardiac magnetic resonance imaging (CMR) has any role in predicting adequacy of lesion and in estimating outcome.Retrospective pilot studyNine consecutive patients (8 male, age 60 ± 13 years) underwent ablation for sustained VT because of ischemic scar were evaluated for pre- and post-procedure scar tissue by CMR to characterize ablation lesions. Microvascular obstruction (MVO) surrounded by late gadolinium enhancement was defined as irreversible RF lesion. All patients were followed for at least 6 months for recurrences.Five of the patients had previous inferior myocardial infarction (MI), whereas remaining 4 had anterior MI. Acute procedural success, as defined by termination of the arrhythmia without recurrence in 30 minutes, was attained in all patients. Contrast enhancement and wall motion abnormality in presumed infarction area were confirmed by pre-ablation CMR images. MVO was detected at the reported ablation site in 6/9 patients, all arrhythmia- and symptom-free at median 24 months (range 8-38 months) follow-up. In remaining 3 patients who had VT recurrence (clinical VT in 2, sustain VT with a new morphology in 1), MVO was not detected despite achievement of acute procedural success. There was no correlation with pre-ablation scar size and clinical arrhythmia recurrence.CMR is a useful imaging modality to guide ablation procedures by detecting scar tissue. Additionally MVO seen by post-procedural imaging may be related to adequacy of RF ablation lesions and may correlate with clinical outcome.
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Affiliation(s)
- Tümer Erdem Guler
- University of Health Sciences, Kocaeli Derince Education and Research Hospital, Department of Cardiology, Kocaeli
| | - Kivanç Yalin
- Usak University, Faculty of Medicine, Department of Cardiology, Usak
| | - Tolga Aksu
- University of Health Sciences, Kocaeli Derince Education and Research Hospital, Department of Cardiology, Kocaeli
| | - Ebru Golcuk
- Balikesir University, Faculty of Medicine, Department of Cardiology, Balikesir
| | | | - Ahmet Kaya Bilge
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
| | - Kamil Adalet
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Istanbul, Turkey
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Aksan G, Tezcan M, Çevrim Ö, Elitok A, Bilge AK. Coexistence of Brugada and Wolff Parkinson White syndromes: A case report and review of the literature. Turk Kardiyol Dern Ars 2018; 46:488-493. [PMID: 30204140 DOI: 10.5543/tkda.2018.77834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 31-year-old male patient presented with complaints of palpitations, dizziness, and recurrent episodes of syncope. A 12-lead electrocardiogram (ECG) revealed manifest ventricular preexcitation, which suggested Wolff Parkinson White syndrome. In addition, an incomplete right bundle branch block and a 3-mm ST segment elevation ending with inverted T-waves in V2 were consistent with coved-type (type 1) Brugada pattern. An electrophysiological study was performed, and during the mapping, the earliest ventricular activation with the shortest A-V interval was found on the mitral annulus posterolateral site. After successful radiofrequency catheter ablation of the accessory pathway, the Brugada pattern on the ECG changed, which prompted an ajmaline provocation test. A type 1 Brugada ECG pattern occurred following the administration of ajmaline. Considering the probable symptom combinations of these 2 coexisting syndromes and the presence of recurrent episodes of syncope, programmed ventricular stimulation was performed and subsequently, ventricular fibrillation was induced. An implantable cardioverter-defibrillator was implanted soon after.
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Affiliation(s)
- Gökhan Aksan
- Department of Cardiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
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20
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Emet S, Dadashov M, Sonsoz MR, Cakir MO, Yilmaz M, Elitok A, Bilge AK, Mercanoglu F, Oncul A, Adalet K, Onur I. Galectin-3: A Novel Biomarker Predicts Sudden Cardiac Death in Hypertrophic Cardiomyopathy. Am J Med Sci 2018; 356:537-543. [PMID: 30342718 DOI: 10.1016/j.amjms.2018.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 08/03/2018] [Accepted: 08/24/2018] [Indexed: 01/12/2023]
Abstract
BACKGROUND Hypertrophic cardiomyopathy is a primary cardiac disease characterized by left ventricular hypertrophy, myocyte hypertrophy and irregularities and interstitial fibrosis in the absence of any cardiac or systemic diseases and may lead to sudden cardiac death (SCD). Galectin-3 is a β-galactoside-binding lectin that has been associated with cardiac fibrosis and inflammation. In this study, we aimed to investigate the relationship between serum galectin-3 levels and the criteria for 5-year sudden death risk, recently defined in the European Society of Cardiology guidelines (2014), in patients with hypertrophic cardiomyopathy. MATERIALS AND METHODS A total of 52 hypertrophic cardiomyopathy patients were enrolled in the study. Patients were questioned for sudden death risk predictors as outlined in the 2014 European Society of Cardiology guideline. A standardized clinical evaluation was carried out on the basis of previously described prognostic variables to calculate the 5-year risk of SCD. Blood samples were taken from all patients to measure serum galectin-3 levels. A statistical significance level of P < 0.05 was accepted in all tests. RESULTS We found that there was a significant correlation between the estimated 5-year risk of SCD and serum levels of galectin-3. CONCLUSIONS Galectin-3 may be an inexpensive and easily accessible parameter to predict arrhythmia risk. In addition, it can be used to determine antiarrhythmic prophylaxis as a predictor of an arrhythmia storm in implantable cardioverter defibrillator-implanted patients who are not available for magnetic resonance imaging.
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Affiliation(s)
- Samim Emet
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey.
| | - Mubariz Dadashov
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Mehmet Rasih Sonsoz
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Mustafa Ozan Cakir
- Department of Cardiology, Zonguldak Bulent Ecevit University Medical Faculty, Zonguldak, Turkey
| | - Mustafa Yilmaz
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Fehmi Mercanoglu
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Aytac Oncul
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Kamil Adalet
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey
| | - Imran Onur
- Department of Cardiology, Istanbul University Istanbul Medical Faculty, Istanbul, Turkey; Department of Cardiology, Zonguldak Bulent Ecevit University Medical Faculty, Zonguldak, Turkey
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Atici A, Emet S, Bilge AK, Adalet K. Unexpected effect of mad honey poisoning on accessory pathway. Pacing Clin Electrophysiol 2018; 41:663-665. [DOI: 10.1111/pace.13267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 12/03/2017] [Accepted: 12/13/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Adem Atici
- Department of Cardiology, İstanbul Faculty of Medicine; İstanbul University; İstanbul Turkey
| | - Samim Emet
- Department of Cardiology, İstanbul Faculty of Medicine; İstanbul University; İstanbul Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, İstanbul Faculty of Medicine; İstanbul University; İstanbul Turkey
| | - Kamil Adalet
- Department of Cardiology, İstanbul Faculty of Medicine; İstanbul University; İstanbul Turkey
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22
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Yalin K, Golcuk E, Karaayvaz EB, Aksu T, Arslane M, Tiryakioglu SK, Bilge AK, Adalet K. Postpacing Interval During Right Ventricular Overdrive Pacing to Discriminate Supraventricular from Ventricular tachycardia. J Atr Fibrillation 2017; 10:1619. [PMID: 29250234 DOI: 10.4022/jafib.1619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 07/19/2017] [Accepted: 08/24/2017] [Indexed: 11/10/2022]
Abstract
Introduction Failure to differentiate supraventricular from ventricular arrhythmias is the most frequent cause of inappropriate implantable cardioverter-defibrillator (ICD) therapies. We hypothesized that the postpacing interval (PPI) after overdrive right ventricular pacing may differentiate ventricular (VT) from supraventricular tachycardia (SVT) such as sinus tachycardia, atrial flutter and atrial tachycardia. This hypothesis is based on the entrainment maneuver. Reentrant tachycardia circuit for VTs would haveshorter distance to RV apex than SVTs have, and the conduction time between a ventricular pacing site and the tachycardia origin is expected to be shorter in VTs than in SVTs. Methods 220episodes from 38 patients with single chamber ICDs that RV overdrive pacing could not terminate or change the tachycardia cycle length (TCL) were retrospectively reviewed. Episodes were classified as VTs (n=115) and SVTs (n=105). TCLs, PPIs and PPI-TCL were compared between groups. Results The cycle length of VTs was shorter than SVTs (320.6±30.3 vs 366.5±40 ms, p=0.001). PPI and PPI-TCL of VTs were shorter than SVTs (504.7±128.3 vs 689.2±121.8 ms, p=0.001, 184±103 vs 322.6±106.6 ms, p=0.001; respectively). ROC curve analysis demonstrated a 525 ms cut-off value for PPI has 89% sensitivity and 57.4% specificity to predict inappropriate ICD therapies due to SVTs (AUC:0.852). Similarly, A PPI-TCL <195 ms favored VT as a diagnosis rather than SVT with a 90% sensitivity, and 51% specificity (AUC:0.838). Conclusion Analyzing of PPI during overdrive pacing from RV apex may discriminate supraventricular from ventricular tachycardia. This criterion may have a potential role in implantable devices that use a single ventricular lead.
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Affiliation(s)
- Kivanc Yalin
- Uşak University, Faculty of Medicine, Department of Cardiology, Uşak-Turkey
| | - Ebru Golcuk
- Balıkesir University, Faculty of Medicine, Department of Cardiology, Baslıkesir-Turkey
| | | | - Tolga Aksu
- Kocaeli Derince Education and Research Hospital, Cardiology Clinic, Kocaeli-Turkey
| | | | | | - Ahmet Kaya Bilge
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Istanbul-Turkey
| | - Kamil Adalet
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Istanbul-Turkey
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Aksan G, Elitok A, Tezcan M, Bilge AK, Adalet K. Recovery of cardiomyopathy induced by ventricular premature beats of paraHisian origin after successful radiofrequency catheter ablation. Turk Kardiyol Dern Ars 2017; 45:744-747. [PMID: 29226896 DOI: 10.5543/tkda.2017.06049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 51-year-old male patient presented with frequent and symptomatic premature ventricular complexes (PVCs) that had induced cardiomyopathy. Radiofrequency (RF) catheter ablation of the origin of the PVCs was planned and the patient underwent electrophysiological study. During activation mapping, the earliest ventricular activation was identified at the His bundle region. Small His bundle electrogram recording by the distal ablation electrode during sinus rhythm revealed that the earliest ventricular activation during PVC preceded the QRS onset by 58 milliseconds. The PVCs were successfully eliminated without occurrence of atrioventricular block using incremental application of RF energy to the para-Hisian region. At the conclusion of a 5-month follow-up period, the patient remained asymptomatic and transthoracic echocardiography demonstrated an improvement in left ventricular ejection fraction.
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Affiliation(s)
- Gökhan Aksan
- Department of Cardiology, Şişli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey.
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Oz F, Onur I, Elitok A, Ademoglu E, Altun I, Bilge AK, Adalet K. Galectin-3 correlates with arrhythmogenic right ventricular cardiomyopathy and predicts the risk of ventricular -arrhythmias in patients with implantable defibrillators. Acta Cardiol 2017; 72:453-459. [PMID: 28705047 DOI: 10.1080/00015385.2017.1335371] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background Arrhythmogenic right ventricular dysplasia (ARVD) is a heritable disorder characterized by fibro-fatty replacement of right ventricular myocytes, increased risk of ventricular arrhythmias, and sudden cardiac death. Galectin-3 (GAL3) is known to play an important role in a number of fibrotic conditions, including cardiac fibrosis. Many studies have focused on the association between GAL3 levels and cardiac fibrosis in heart failure. However, the role of GAL3 in the pathogenesis of ARVD and ventricular arrhythmias has not yet been evaluated thoroughly. The aim of this study was to explore GAL3 levels in patients with ARVD and its association with ventricular arrhythmias. Methods Twenty-nine patients with ARVD and 24 controls were included. All patients with ARVD had an implantable cardiac defibrillator (ICD) for primary or secondary prevention. Ventricular arrhythmia history was obtained from a chart review and ICD data interrogation. Galectin-3 levels were measured using an enzyme-linked immunosorbent assay. Results Patients with ARVD had higher plasma GAL3 levels (16.9 ± 2.6 ng/mL vs 11.3 ± 1.8 ng/mL, P < 0.001) than the control group. Ten patients had sustained or non-sustained ventricular arrhythmias during follow-up. In the multivariable analysis, left ventricular disease involvement (HR: 1.05; 95% CI: [1.01-1.12]; P = 0.03); functional capacity >2 (HR: 1.21; 95% CI: [1.13-1.31]; P < 0.005); and GAL3 levels (HR: 1.05; 95% CI: [1.00-1.11]; P = 0.01) independently predicted VT/VF. Conclusion We demonstrated that serum GAL3 was significantly elevated in patients with ARVD. Also, serum GAL 3 levels could be regarded as a candidate biomarker in the diagnosis of ARVD which needs to be tested in larger prospective studies. In addition, GAL3 levels were higher in patients with VT/VF as compared with those without VT/VF.
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Affiliation(s)
- Fahrettin Oz
- Department of Cardiology, Adana Numune Training and Research Hospital, Adana, Turkey
| | - Imran Onur
- Department of Cardiology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Evin Ademoglu
- Department of Biochemistry, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Ibrahim Altun
- Department of Cardiology, Mugla Sıtkı Kocman University, School of Medicine, Mugla, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
| | - Kamil Adalet
- Department of Cardiology, Istanbul University, Istanbul School of Medicine, Istanbul, Turkey
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Baysal-Kirac L, Serbest NG, Şahin E, Dede HÖ, Gürses C, Gökyiğit A, Bebek N, Bilge AK, Baykan B. Analysis of heart rate variability and risk factors for SUDEP in patients with drug-resistant epilepsy. Epilepsy Behav 2017; 71:60-64. [PMID: 28549245 DOI: 10.1016/j.yebeh.2017.04.018] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 04/08/2017] [Accepted: 04/08/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cardiac problems have been suggested as causes of sudden unexpected death in epilepsy (SUDEP). Our aim was to investigate possible associations of cardiac autonomic functions based on heart rate variability (HRV) parameters with risk factors of SUDEP in patients with drug-resistant epilepsy. METHODS Forty-seven patients with drug-resistant seizures and 45 healthy control subjects were enrolled in the study. Interictal time domain parameters of HRV were evaluated with 24-hour Holter recordings. Potential SUDEP risk in patients with epilepsy was estimated using an inventory of seven validated SUDEP risk factors (The SUDEP-7 inventory). RESULTS When compared with the healthy controls, all time domain measures (SDNN-24, SDNN-index, SDANN-index, RMSSD and pNN50) were significantly suppressed in the patient group. Scores of the SUDEP-7 inventory ranged from 1 to 9 with a median 4 out of a maximum possible risk score of 10. Maximum heart rate value in 24-hour Holter recordings and epilepsy duration were correlated with the SUDEP-7 scores (r=0.3, p=0.03). We found no significant association with HRV measures and SUDEP-7 risk factors. One patient diagnosed with Dravet syndrome died of SUDEP, which was autopsy confirmed; his SUDEP-7 inventory score was 7, HRV measures were significantly diminished, and his maximum heart rate (HR) was 208beats/min (maximum HR is between 104 and 188beats/min in normal subjects). CONCLUSION Patients with drug-resistant epilepsy present with significantly lower HRV measures, which may increase the risk for sudden cardiac death. Increased heart rate and diminished HRV measures may constitute one of the possible mechanisms underlying SUDEP and should be diagnosed in patients with epilepsy.
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Affiliation(s)
- Leyla Baysal-Kirac
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Nail Güven Serbest
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Fatih, 34093 Istanbul, Turkey.
| | - Erdi Şahin
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Hava Özlem Dede
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Candan Gürses
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Ayşen Gökyiğit
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Nerses Bebek
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
| | - Ahmet Kaya Bilge
- Istanbul University, Istanbul Faculty of Medicine, Department of Cardiology, Fatih, 34093 Istanbul, Turkey.
| | - Betül Baykan
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology and Clinical Neurophysiology, Fatih, 34093 Istanbul, Turkey.
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Akbay NO, Bingol Z, Kiyan E, Karaayvaz EB, Bilge AK, Issever H, Okumus G. Fractional Exhaled Nitric Oxide Measurement in Pulmonary Hypertension: A Follow-Up Study. Clin Appl Thromb Hemost 2017; 24:483-488. [PMID: 28393619 DOI: 10.1177/1076029617702243] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Pulmonary hypertension (PH) is a fatal disease although significant improvements in treatment are achieved. Easily implemented and noninvasive prognostic techniques are needed while following-up these patients. The aim was to investigate the role of fractional exhaled nitric oxide (FeNO) in follow-up for patients with PH. In this longitudinal study, patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic PH (CTEPH) who were seen in PH Outpatient Clinic, Istanbul Faculty of Medicine, Istanbul University, were enrolled in the study. Echocardiography, 6-minute walking test, brain natriuretic peptide, and FeNO measurements were performed, and World Health Organization functional class was evaluated to all patients at baseline, and third, and sixth months. Right-heart catheterization and pulmonary function tests at the time of diagnosis were recorded. The study comprised 31 patients (23 women, 8 men; mean age: 53.4 ± 17.1 years) with PAH (n = 19) and CTEPH (n = 12) and 80 healthy controls. Patients with PH had lower FeNO values than the control group (16.5 ppb vs 19.8 ppb; P < .05). Fractional exhaled nitric oxide values did not change during follow-up and did not correlate with other follow-up measures except tricuspid annular plane systolic excursion values. Fractional exhaled nitric oxide was higher in the idiopathic PAH subgroup at baseline and at third month than patients with PAH associated with other diseases. Fractional exhaled nitric oxide did not change in patients who had clinical deterioration. As a conclusion; Patients with PH had lower FeNO values than healthy controls, but FeNO did not change significantly during follow-up. Large-scale studies with prolonged follow-up periods are needed to understand the role of FeNO in the follow-up of the patients with PH.
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Affiliation(s)
- Nilay Orak Akbay
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | - Zuleyha Bingol
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | - Esen Kiyan
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
| | | | - Ahmet Kaya Bilge
- 2 Istanbul Medical Faculty, Cardiology, Istanbul University, Istanbul, Turkey
| | - Halim Issever
- 3 Istanbul Medical Faculty, Public Health, Istanbul University, Istanbul, Turkey
| | - Gulfer Okumus
- 1 Istanbul Medical Faculty, Pulmonary Medicine, Istanbul University, Istanbul, Turkey
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Dursunoğlu N, Köktürk N, Baha A, Bilge AK, Börekçi Ş, Çiftçi F, Gezmen Karadağ M, Çalık Kütükçü E, Noyan A, Polatlı M, Önen ZP, Sarınç S, Umut S, Uzaslan E, Kubat Üzüm A, Akkoca Yıldız Ö. Comorbidities and their impact on chronic obstructive pulmonary disease. Tuberk Toraks 2016; 64:289-298. [PMID: 28393718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a complex disease that is associated with devastating outcomes resulting from lung involvement and several comorbidities. Comorbidities could impact on symptomology, quality of life, the complications, the management, economic burden and the mortality of the disease. The importance of comorbidities originates from their impact on the outcome of COPD. The most frequent comorbidities in COPD are cardiovascular, endocrinological, musculoskeletal, phycological disorders and lung cancer. Almost 50% of the COPD patients have 3 or more comorbidities. The recent Global Initiative of Obstructive Lung Disease (GOLD) Guideline suggested proactive search and the treatment of the comorbidities. However, there is no certain evidence demonstrating that active treatment of comorbidities improve the outcomes of COPD. However, it is well known that several comorbidities such as cardiovascular disease and lung cancer have greater impact on mortality caused by COPD. Several studies have shown that Charlson Comorbidity index or more recenty COPD Specific Comorbidity Index (COTE) has been found to be related with mortality of COPD. This concise review intended to summarize the most frequent comorbidities in association with their impact on COPD.
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Affiliation(s)
| | - Nurdan Köktürk
- Department of Chest Diseases, Faculty of Medicine, Gazi University, Ankara, Turkey.
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Golcuk E, Yalin K, Aksu T, Tiryakioglu SK, Bilge AK, Adalet K. Peri-Infarction Zone as a Risk Marker for Patients With Postmyocardial Infarction. Am J Med Sci 2016; 351:452-8. [DOI: 10.1016/j.amjms.2016.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/03/2015] [Indexed: 11/24/2022]
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Altun İ, Akın F, Biteker M, Köse N, Güz G, Öz F, Önür İ, Bilge AK, Adalet K. Mean Platelet Volume in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia. Haseki 2015. [DOI: 10.4274/haseki.2631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Altun I, Pamukcu B, Yildiz CE, Arkaya SC, Guz G, Yilmaz A, Bilge AK, Turkoglu UM, Adalet K. Cardiotrophin-1: A new predictor of atrial fibrillation relapses after successful cardioversion. Bosn J Basic Med Sci 2015; 15:68-73. [PMID: 26295297 DOI: 10.17305/bjbms.2015.503] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Revised: 06/16/2015] [Accepted: 06/19/2015] [Indexed: 01/19/2023] Open
Abstract
We aimed to investigate whether or not cardiotrophin-1 (CT-1) can be used as a predictor of sinus rhythm constancy in patients with atrial fibrillation (AF) converted to sinus rhythm. Thirty two patients with AF (48-78 years), without any structural heart disease were enrolled for the study. The control group consisted of 32, age and gender matched healthy persons. Measurements of CT-1 were made after transthoracic and transesophageal echocardiography prior to cardioversion (CV). Relapses of AF were investigated by monthly electrocardiograms (ECGs) and ambulatory ECGs at 1st, 3rd, and 6th month. At the end of 6th month, measurements of CT-1 were repeated. At the beginning patients with AF had increased CT-1 levels when compared to controls (0.94 ± 0.32 pg/mL vs. 0.30 ± 0.12 pg/mL, [p < 0.001]). At the end of follow-up of the 32 patients, 17 (53%) had AF relapse. Age, initial duration of AF, left ventricle diameters, ejection fraction, left atrium appendix flow rates were similar among patients with and without AF relapse. However, basal left atrium diameter (4.24 ± 0.14 cm vs. 4.04 ± 0.22 cm, p = 0.005), pulmonary artery pressure (32.82 ± 5 vs. 28.60 ± 6.23 mmHg, p = 0.004) and CT-1 values (1.08 ± 0.37 vs. 0.82 ± 0.16 pg/mL, p = 0.02) were significantly increased in patients with AF relapse. Furthermore, patients with relapsed AF had higher CT-1 levels at 6th month when compared to those in sinus rhythm (1.00 ± 0.40 vs. 0.71 ± 0.23 pg/mL). We conclude that post-CV, AF relapses are more frequent among patients with increased baseline CT-1 levels, and CT-1 may be a potential predictor of AF relapse.
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Affiliation(s)
- Ibrahim Altun
- Mugla Sitki Kocman University, Faculty of Medicine, Department of Cardiology.
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Yalin K, Golcuk E, Bilge AK, Aksu T, Buyukbayrak H, Tiryakioglu SK, Emet S, Adalet K. Combined analysis of unipolar and bipolar voltage mapping identifies recurrences after unmappable scar-related ventricular tachycardia ablation. Europace 2015; 17:1580-6. [PMID: 25750215 DOI: 10.1093/europace/euv013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 01/19/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS Scars causing ventricular tachycardia can extend deep to and beyond bipolar low-voltage areas (LVAs) and they may be a reason for endocardial ablation failure. Analysis of endocardial unipolar voltage maps has been used to detect scar transmurality and epicardial scar. We hypothesized that endocardial unipolar LVA around the overlying bipolar LVA may predict endocardial ablation recurrence in patients with structural heart disease undergoing substrate modification. METHODS AND RESULTS Twenty consecutive patients with structural heart disease (11 ischaemic and 9 non-ischaemic cardiomyopathy) and undergoing substrate modification due to unmappable ventricular tachycardia (VT) (18 males, 51 ± 11 age, LVEF: 36 ± 7%) were retrospectively reviewed. Bipolar LVA defined as <1.5 mV and unipolar LVA defined as <8.3 mV, respectively, on electro-anatomic mapping system. Peripheral unipolar LVA (pUni-LVA) surrounding bipolar LVA was measured and compared patients with and without VT recurrence at 6-month follow-up period. : Mean unipolar voltage and mean bipolar voltage was 6.26 ± 4.99 and 1.90 ± 2.30 mV, respectively. Bipolar voltage and unipolar voltage in corresponding points were correlated (r = 0.652, P = 0.0001). In all patients, unipolar LVAs were larger than the bipolar LVAs. Bipolar LVA (91.1 ± 93.5 vs. 87.5 ± 47.5 cm(2), P = 0.91) and unipolar LVA (148.1 ± 96.3 vs. 104.7 ± 44.2 cm(2), P = 0.21) were similar in patients with and without VT recurrence, respectively. Peripheral unipolar LVA was significantly larger in patients with VT recurrence than without (57.0 ± 40.4 vs. 17.2 ± 12.9 cm(2), P = 0.01). CONCLUSION In patients with structural heart disease and unmappable VT, pUni-LVA surrounding bipolar scar predicts recurrence of VT ablation. The results of this pilot study highlight the importance of intramural/epicardial substrate on endocardial VT ablation outcome.
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Affiliation(s)
- Kivanc Yalin
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul Tıp Fakültesi-Fatih, Fatih, Istanbul 34104, Turkey Cardiology Clinic, Bursa State Hospital, Kliniği Osmangazi, Alaaddin Mh., Bursa 16040, Turkey
| | - Ebru Golcuk
- Department of Cardiology, School of Medicine, Koc University, Davutpaşa Cd. No:4 Topkapı, İstanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul Tıp Fakültesi-Fatih, Fatih, Istanbul 34104, Turkey
| | - Tolga Aksu
- Department of Cardiology, Kocaeli Derice Research and Training Hospital, İbnisina Mh. Lojman Sk. Derince, Kocaeli, Turkey
| | | | - Selma Kenar Tiryakioglu
- Cardiology Clinic, Bursa State Hospital, Kliniği Osmangazi, Alaaddin Mh., Bursa 16040, Turkey
| | - Samim Emet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul Tıp Fakültesi-Fatih, Fatih, Istanbul 34104, Turkey
| | - Kamil Adalet
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul Tıp Fakültesi-Fatih, Fatih, Istanbul 34104, Turkey
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Elitok A, Ikitimur B, Onur I, Oz F, Emet S, Karaayvaz EB, Serbest NG, Sarikaya R, Kasali K, Bilge AK, Kaya MG, Mercanoglu F, Oflaz H. The relationship between T-wave peak-to end interval and ST segment recovery on intracoronary ECG during primary PCI. Eur Rev Med Pharmacol Sci 2015; 19:1086-1091. [PMID: 25855936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE T-wave peak to end interval (TPE) is a measure of repolarization dispersion, which has been reported as a major arrhythmogenic factor post acute myocardial infarction. The aim of our study was to investigate the changes in TPE in this patient population with regard to peri-procedural intracoronary ECG findings. PATIENTS AND METHODS Forty-four patients (34 male and mean age of 54.9 ± 10.9 years) with acute STEMI were included. Intracoronary ECG was performed during primary PCI. TPE indices were calculated before and after the procedure. Measurement of the intracoronary ST-segment was carried out before and just after coronary blood flow was established in the infarct related artery. Intracoronary ST-segment resolution (IC-STR) was defined as ≥ 1 mm compared to baseline. RESULTS There was no difference with respect to baseline characteristics when patients with IC-STR were compared with patients without IC-STR. TPE values decreased significantly after primary PCI in patients with IC-STR (80.9 ± 22.8 ms vs. 65.8 ± 14.4 ms; p < 0.001) whereas they did not change significantly after PCI in patients without IC-STR (79.2 ± 20.9 ms vs. 68.5 ± 16.3 ms; p = 0.18). CONCLUSIONS TPE measured from surface ECG recordings is significantly reduced in STEMI patients with successful reperfusion after primary PCI, as determined by IC-ECG recordings.
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Affiliation(s)
- A Elitok
- Department of Cardiology, Istanbul University, School of Medicine, Istanbul, Turkey.
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Altun I, Oz F, Arkaya SC, Altun I, Bilge AK, Umman B, Turkoglu UM. Effect of statins on endothelial function in patients with acute coronary syndrome: a prospective study using adhesion molecules and flow-mediated dilatation. J Clin Med Res 2014; 6:354-61. [PMID: 25110539 PMCID: PMC4125330 DOI: 10.14740/jocmr1863w] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2014] [Indexed: 12/03/2022] Open
Abstract
Background Accumulating evidence suggests that inflammatory mechanisms play a central role in the development, progression and outcome of atherosclerosis. Recent evidence suggests that statins improve anti-inflammatory, anti-thrombotic and endothelial functions, along with their lipid-decreasing effects. We examined the effect of statins on endothelial function using biochemical markers of endothelial dysfunction and brachial artery flow-mediated dilatation (FMD). Methods Thirty male patients presenting with acute coronary syndrome (ACS) and 26 age-matched healthy control subjects aged 40 - 60 years who were not on any medication were enrolled in the study. The patient group was started on atorvastatin (40 mg/day) without consideration of their low-density lipoprotein (LDL)-cholesterol levels. Endothelin, sICAM and E-selectin from stored serum samples were measured using commercially available enzyme-linked immunosorbant assays (ELISAs). Endothelial function was assessed using brachial artery FMD. Results Prior to statin treatment, E-selectin, sICAM and endothelin levels, endothelial dysfunction markers, were 99.74 ± 34.67 ng/mL, 568.8 ± 149.0 ng/mL and 0.62 ± 0.33 fmol/mL, respectively in the patient group. E-selectin and sICAM levels were significantly higher in the patients than in the control subjects (P < 0.001); however, endothelin levels were not significantly different between groups. Statin treatment significantly reduced E-selectin and sICAM levels (P < 0.001); however, the decrease in endothelin levels was not statistically significant. %FMD values were significantly increased after statin treatment (P = 0.005), and levels of C-reactive protein (CRP), an inflammation marker, were significantly reduced. Conclusion Our results indicate that statins play an important role in treatment endothelial dysfunction by reducing adhesion of inflammatory cells.
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Affiliation(s)
- Ibrahim Altun
- Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Fahrettin Oz
- Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Selda Can Arkaya
- Department of Biochemistry, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Ilknur Altun
- Department of Radiology, Sisli Etfal Training and Research Hospital, Sisli-Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Berrin Umman
- Department of Cardiology, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
| | - Umit Mutlu Turkoglu
- Department of Biochemistry, Istanbul School of Medicine, Istanbul University, Istanbul, Turkey
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Yalin K, Golcuk E, Teker E, Yilmaz R, Dursun M, Bilge AK, Adalet K. No association between scar size and characteristics on T-wave alternans in post-myocardial infarction patients with relatively preserved ventricular function presented with nonsustained ventricular tachycardia. ACTA ACUST UNITED AC 2014; 14:442-7. [DOI: 10.5152/akd.2014.4918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Golcuk E, Yalin K, Kaya Bilge A, Elitok A, Aksu T, Akgun T, Bilal Karaayvaz E, Emet S, Adalet K. Usefulness of T(peak) -T(end) interval to distinguish arrhythmogenic right ventricular cardiomyopathy from idiopathic right ventricular outflow tract tachycardia. Pacing Clin Electrophysiol 2014; 37:1665-70. [PMID: 25041179 DOI: 10.1111/pace.12464] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 04/28/2014] [Accepted: 05/31/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND The two predominant etiologies of right ventricular tachycardia (VT) are arrhythmogenic right ventricular cardiomyopathy (ARVC) and idiopathic VT arising from the right ventricular outflow tract (RVOT). Discrimination between these two entities is critical, as their prognoses and therapeutic options differ. The Tpeak -Tend (Tpe) interval reflects the transmural repolarization dispersion and its prolongation is associated with high mortality. METHODS We compared the sinus rhythm electrocardiogram (ECG) of 43 patients (24 male, 43 ± 16 years) with VT originating from right ventricle. Five patients under antiarrhythmic drug therapy were excluded. Tpe interval was measured in each precordial leads and compared among patients with ARVC and RVOT-VT. RESULTS Twenty-five patients (16 male, 42 ± 16 years) met the Task Force criteria for the diagnosis of ARVC, and 13 patients (seven male, 45 ± 14 years) had idiopathic RVOT tachycardia. Patients with ARVC had significantly prolonged Tpe intervals in all precordial leads compared to patients with idiopathic RVOT VT (137.1 ± 32.6 ms vs 93.8 ± 16.9 ms; P < 0.001 in V1, 133.2 ± 35.5 ms vs 104.7 ± 16.9 ms; P = 0.01 in V2, 125.7 ± 31.5 ms vs 99.1 ± 19.6 ms; P = 0.09 in V3, 121.9 ± 26.5 ms vs 92.3 ± 19.7 ms; P = 0.001 in V4, 123.1 ± 26.5 ms vs 99.5 ± 20:1 ms; P = 0.04 in V5 and 126.9 ± 32.2 ms vs 89 ± 11.3 ms; P < 0.001 in V6, respectively). For the diagnosis of ARVC, Tpe cut-off value of 97 ms in V1 had 84% sensitivity and 62% specificity (area under curve = 0.880). CONCLUSION In patients with VT of RV origin, the prolonged Tpe interval in sinus rhythm electrocardiogram supports the diagnosis of ARVC.
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Affiliation(s)
- Ebru Golcuk
- Department of Cardiology, Kocaeli Derince Research and Training Hospital, Kocaeli, Turkey
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Onur I, Ikitimur B, Oz F, Ekmekci A, Elitok A, Cagatay AA, Adalet K, Bilge AK, Kaya MG. Evaluation of Human Immunodeficiency Virus Infection-Related Left Ventricular Systolic Dysfunction by Tissue Doppler Strain Echocardiography. Echocardiography 2014; 31:1199-204. [DOI: 10.1111/echo.12569] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Imran Onur
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Baris Ikitimur
- Department of Cardiology; Cerrahpasa School of Medicine; Istanbul University; Istanbul Turkey
| | - Fahrettin Oz
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ahmet Ekmekci
- Department of Internal Medicine; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ali Elitok
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Arif Atahan Cagatay
- Department of Infectious Diseases and Clinical Microbiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Kamil Adalet
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology; Istanbul School of Medicine; Istanbul University; Istanbul Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology; Erciyes University School of Medicine Kayseri; Istanbul Turkey
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Yalın K, Gölcük E, Bilge AK. Author's reply. Anadolu Kardiyol Derg 2014; 14:96-97. [PMID: 24745042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Yalın K, Gölcük E, Bilge AK, Adalet K. Ablation of heterogeneous zone eliminates ventricular tachycardia: Can cardiac MR be a criterion for successful ablation? ACTA ACUST UNITED AC 2013; 13:710-2. [PMID: 24084151 DOI: 10.5152/akd.2013.231] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kıvanç Yalın
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul-Turkey.
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Yalin K, Golcuk E, Buyukbayrak H, Karaayvaz EB, Akdeniz CS, Yilmaz R, Dursun M, Bilge AK, Adalet K. Relationship between Scar Size and Characteristics by ce-CMR and Tpeak-Tend Interval in Post-MI Patients with Relatively Preserved LV Functions and Nonsustained Ventricular Tachycardia. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Yalın K, Gölcük E, Dindar A, Bilge AK. Successful ablation of cavo-tricuspid isthmus dependent atrial flutter in a patient with Senning operation. Anadolu Kardiyol Derg 2013; 13:597-9. [PMID: 24064082 DOI: 10.5152/akd.2013.200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kıvanç Yalın
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul-Turkey.
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Yalın K, Gölcük E, Teker E, Bilge AK, Adalet K. Is there a role of MMA T wave alternans test for risk assessment in Brugada syndrome? ACTA ACUST UNITED AC 2013; 13:702-4. [PMID: 24084148 DOI: 10.5152/akd.2013.228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Kıvanç Yalın
- Department of Cardiology, İstanbul Faculty of Medicine, İstanbul University, İstanbul-Turkey.
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Ergul Y, Nisli K, Bilge AK, Dindar A. Aborted sudden cardiac death in a child with left ventricular non-compaction. Pediatr Int 2013; 55:388-91. [PMID: 23782373 DOI: 10.1111/ped.12013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Revised: 06/25/2012] [Accepted: 09/26/2012] [Indexed: 11/28/2022]
Abstract
Left ventricular non-compaction is a rare form of cardiomyopathy believed to be the result of intrauterine arrest of compaction of the endomyocardial morphogenesis, leading to persistence of the embryonic myocardium. Clinical manifestations are highly variable, ranging from no symptoms to a progressive deterioration in cardiac function that results in congestive heart failure, systemic thromboemboli, arrhythmias, and sudden cardiac death. Presented here is the case of a 4-year-old child with a history of aborted sudden cardiac death. Following resuscitation, he was admitted to the intensive care unit with neurologic sequelae that regressed later on. Transthoracic echocardiography and magnetic resonance imaging showed numerous prominent trabeculations and deep intertrabecular recesses at the apical and anterolateral region of the left ventricle. Electrophysiologic study showed polymorphic ventricular tachycardia. An implantable cardioverter-defibrillator (ICD) was implanted following clinical recovery. Five months after implantation, appropriate ICD shock due to ventricular fibrillation was documented.
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Affiliation(s)
- Yakup Ergul
- Department of Pediatric Cardiology, Istanbul University, Istanbul, Turkey.
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Gölcük E, Yalın K, Bilge AK, Adalet K. Atrioventricular complete block occurring 12 years after successful ablation of slow-slow atrioventricular nodal reentrant tachycardia. Turk Kardiyol Dern Ars 2013; 41:233-7. [PMID: 23703560 DOI: 10.5543/tkda.2013.74419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Atrioventricular nodal reentrant tachycardia (AVNRT) is the most frequent form of paroxysmal supraventricular tachycardia. Selective radiofrequency (RF) catheter ablation of the slow pathway is an ideal method for treatment of patients with AVNRT. Complete atrioventricular block is a rare but serious complication of RF ablation, and primarily occurs during or immediately after the procedure. We report on a 45-year-old woman who underwent successful ablation for symptomatic AVNRT at the age of 33. She presented with paroxysmal complete AV block, which developed twelve years after RF ablation of the slow pathway and a permanent DDD pacemaker was implanted. As seen in the case we report, complete AV block complicating RF ablation can occur years after the procedure.
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Affiliation(s)
- Ebru Gölcük
- Department of Cardiology, İstanbul University, İstanbul Faculty of Medicine, İstanbul, Turkey.
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Yalin K, Golcuk E, Ozer CS, Buyukbayrak H, Yilmaz R, Dursun M, Bilge AK, Adalet K. 964Identification of Arrhythmogenic Substrate by ce-CMR in
post-MI patients with relatively preserved left ventricular ejection fraction
nonsustained ventricular tachycardia. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet070r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yalin K, Golcuk E, Ozer CS, Buyukbayrak H, Yilmaz R, Dursun M, Bilge AK, Adalet K. 965Relationship between scar size and characteristics by
ce-CMR and Tpeak-Tend interval in post-MI patients. Eur Heart J Cardiovasc Imaging 2013. [DOI: 10.1093/ehjci/jet070aq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Yalin K, Golcuk E, Bilge AK, Adalet K. USEFULNESS OF TPEAK-TEND INTERVAL TO DISTINGUISH ARRHYTHMOGENIC RIGHT VENTRICULAR CARDIOMYOPATHY FROM IDIOPATHIC RIGHT VENTRICULAR OUTFLOW TACHYCARDIA. J Am Coll Cardiol 2013. [DOI: 10.1016/s0735-1097(13)60252-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Oz F, Elitok A, Bilge AK, Mercanoglu F, Oflaz H. Relationship Between Brachial Artery Flow-Mediated Dilation, Carotid Artery Intima-Media Thickness and Coronary Flow Reserve in Patients With Coronary Artery Disease. Cardiol Res 2012; 3:214-221. [PMID: 28348690 PMCID: PMC5358134 DOI: 10.4021/cr219w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2012] [Indexed: 12/17/2022] Open
Abstract
Background The aim of this study was to assess the relationship between brachial artery flow mediated dilation (FMD), carotid artery intima-media thickness (IMT) and coronary flow reserve (CFR) in patients with coronary artery disease (CAD). Methods Fifty patients with coronary artery disease, except left anterior descending artery (LAD), who showed no cardiac symptoms and 45 control subjects underwent assessment of brachial artery FMD, carotid artery intima-media thickness by high-resolution ultrasound. In addition, transthoracic second harmonic Doppler echocardiography was used to measure CFR. Results All of the parameters were found to be correlated with each other. CFR correlated with brachial artery FMD (r = 0.232, P < 0.05) and with carotid IMT (r = -0.403, P < 0.001). Carotid IMT correlated with brachial artery FMD (r = -0.211, P < 0.05). Conclusion Transthoracic CFR correlated with well-established noninvasive predictors of atherosclerosis and we suggest that it can be used as a surrogate for coronary atherosclerosis.
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Affiliation(s)
- Fahrettin Oz
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ali Elitok
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Ahmet Kaya Bilge
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Fehmi Mercanoglu
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Huseyin Oflaz
- Department of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Abstract
Brugada syndrome is a genetic disease characterized by persistent or transient ST elevation in the right precordial electrocardiogram (ECG) leads with or without right bundle branch block. It represents an increased risk for sudden cardiac death despite a structurally normal heart. Brugada-type ECG can be unmasked and induced by several circumstances. We report on a 24-year-old male patient who experienced a syncopal episode and manifested Brugada type 1 ECG during a febrile state. His ECG changed to normal after treatment of fever. A single-chamber ICD was implanted to the patient because of syncope, fever-induced type I Brugada ECG pattern, and ventricular fibrillation during ajmaline challenge.
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Affiliation(s)
- Kivanç Yalin
- Department of Cardiology, Medicine Faculty of İstanbul University, İstanbul, Turkey.
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Yilmaz E, Kaya Bilge A, Umman B, Mercanoglu F, Oncul A, Nisanci Y. Acute anterior myocardial infarction in a young man with essential thrombocythemia: A case report. Int J Angiol 2011. [DOI: 10.1007/s00547-003-0948-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Atilgan D, Bilge AK, Onur I, Pamukçu B, Ozcan M, Adalet K. Assessment of longitudinal left ventricular systolic function by different echocardiographic modalities in patients with newly diagnosed mild-to-moderate hypertension. ACTA ACUST UNITED AC 2010; 10:247-52. [PMID: 20538560 DOI: 10.5152/akd.2010.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Standard echocardiographic methods reflect chamber dynamics and do not provide a direct measure of myocardial fiber shortening. Therefore we evaluated longitudinal left ventricular myocardial function by tissue Doppler echocardiography; strain (S), strain rate (SR), tissue Doppler velocity (TDV) in newly diagnosed mild to moderate hypertensive patients. METHODS Our cross-sectional and observational study population consisted of 57 patients and 48 normotensive control subjects. Patients with obesity, diabetes mellitus, regional wall motion abnormality, secondary hypertension and a history or clinical evidence of cardiovascular disease, arrhythmias or conduction abnormalities were excluded from the study. Ejection fraction, endocardial fractional shortening (eFS), meridional end-systolic stress (mESS), stress-adjusted eFS (observed /predicted eFS) were measured by M-mode echocardiography. Relationship between the left ventricular mass index and mESS was assessed by Pearson's linear regression model. RESULTS Hypertensive patients had significantly decreased longitudinal myocardial function compared to control subjects determined by septal (-1.25+/-0.30 vs. -1.02+/-0.33, p<0.001) and lateral (-1.20+/-0.28 vs. 1.02+/-0.41, p<0.01) SR (1/s) measurements. However, there was no significant correlation between the mESS and strain-strain rate measurements in both normal and hypertensive subjects. CONCLUSIONS Early impairment in longitudinal left ventricular systolic function can be expected despite normal endocardial left ventricular function indicated by M-mode echocardiography in patients with newly diagnosed and never treated mild to moderate hypertension.
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Affiliation(s)
- Dursun Atilgan
- Department of Cardiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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