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Ozer HT, Ozer O, Coteli C, Kivrak A, Sahiner ML, Ozer N. P14893D strain echocardiography in assessing left ventricular diastolic dysfunction. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0254] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Diastolic dysfunction is an important factor in the development of heart failure with preserved ejection fraction (HFpEF). As the ejection fraction is preserved in HFpEF, the diagnosis of this disease with non-invasive methods is difficult.
Purpose
In this study, the relationship of BNP, NT-proBNP, Ghrelin, and echocardiographic 3D strain findings with diastolic dysfunction was investigated in patients undergoing left heart catheterization.
Methods
Our study is a cross-sectional study and included 78 patients in whom echocardiography was performed, and who underwent left heart catheterization based on relevant indications. The patient data recorded for evaluation included the findings from left heart catheterization, follow-up 3D echocardiography; and the levels of blood NT-proBNP, and Ghrelin.
Results
The rate of diastolic dysfunction was 42.3%. Longitudinal 2D and 3D mean strain as absolute values were observed to decrease more in patients with diastolic dysfunction. The median levels of BNP, NT-proBNP, and Ghrelin levels were higher in patients with diastolic dysfunction. The independent predictors of diastolic dysfunction were determined to be the left atrial volume index (LAVI) (OR=1.17; p=0.018), longitudinal 3D strain values (OR=1.88; p<0.001), NT-proBNP (OR=1.11; p=0.001), and Ghrelin (OR=1.40; p=0.001), respectively.
Relationship Between LV EDP and LV Longitudinal Strain LV EDP 2D Strain 3D Strain r p r p r p BNP, pg/ml 0.429 <0.001* 0.115 0.316 0.178 0.118 NT-proBNP, pg/ml 0.484 <0.001* 0.155 0.177 0.186 0.104 Ghrelin, pg/ml 0.478 <0.001* 0.086 0.455 0.157 0.169 SolV DB – – 0.481 <0.001* 0.591 <0.001* dP/dT −0.389 <0.001* −0.283 0.012* −0.307 0.006* Negative dP/dT −0.747 <0.001* −0.337 0.003* −0.458 <0.001* 2D. % 0.481 <0.001* – – 0.852 <0.001* 3D. % 0.591 <0.001* 0.852 <0.001* – – If p value is less than 0.05 shows statistical significance.
Measurement of longitudinal strain
Conclusion
In conclusion, our study found out that the reduced 3D strain absolute values and increased levels of NT-proBNP and Ghrelin biomarkers predicted diastolic dysfunction. If further large-scale studies prove the efficiency of these practical, they may not only allow for making a diagnosis of HFpEF more readily but may also eliminate the confusion in diagnostic algorithms.
Acknowledgement/Funding
None
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Affiliation(s)
- H T Ozer
- Hacettepe University, Cardiology, Ankara, Turkey
| | - O Ozer
- Hacettepe University, Cardiology, Ankara, Turkey
| | - C Coteli
- Hacettepe University, Cardiology, Ankara, Turkey
| | - A Kivrak
- Hacettepe University, Cardiology, Ankara, Turkey
| | - M L Sahiner
- Hacettepe University, Cardiology, Ankara, Turkey
| | - N Ozer
- Hacettepe University, Cardiology, Ankara, Turkey
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Canpolat U, Kocyigit D, Yalcin MU, Coteli C, Sener YZ, Oksul M, Gurses KM, Evranos B, Yorgun H, Aytemir K. P1920Long-term outcomes of pulmonary vein isolation using second-generation cryoballoon during atrial fibrillation ablation: A single-center large-scale study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0667] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Currently available second-generation cryoballoon (CB2) is accepted as an effective and safe tool for pulmonary vein isolation (PVI). Although much more data exists about 1-year outcomes of CB2 ablation, data on long-term outcomes are scarce. Objective: We aimed to assess the long-term outcomes of PVI using CB2 in a large-scale symptomatic AF population at our tertiary referral center.
Methods
In this non-randomized prospective observational study, a total of 486 patients with paroxysmal (71%) or persistent (29%) AF who underwent index PVI using CB2 at our hospital between January 2013 and June 2017 were enrolled. Atrial tachyarrhythmia (ATa) free survival was defined as absence of AF, atrial flutter or atrial tachycardia recurrence >30 s following 3-months blanking period. Predictors of recurrence were evaluated by univariate and multivariate Cox proportional hazards regression models.
Results
Acute procedural success rate was 99.8% (1898/1902 PVs). Mean procedural and fluoroscopy time were 64.9±9.2 and 12.1±2.6, respectively. At median 39 (IQR: 26–56) months follow-up, ATa free survival was 78.6% after a single procedure (280/345 [81.2%] for paroxysmal AF vs 102/141 [72.3%] for persistent AF, p=0.019) and 84.4% after a mean 1.48±0.42 ablations.Cox regression analysis showed that left atrium diameter, duration of AF history and early ATa recurrence were found as the independent predictors of late recurrence. PNP was observed in 17 (3.5%) patients.
Figure 1
Conclusions
Second-generation CB based PVI is effective to maintain sinus rhythm in a significant proportion of paroxysmal and early persistent AF patients with an acceptable complication rates at long-term follow-up.
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Affiliation(s)
- U Canpolat
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - D Kocyigit
- Dinar State Hospital, Cardiology Clinics, Afyonkarahisar, Turkey
| | - M U Yalcin
- Selcuk University Meram, Cardiology, Konya, Turkey
| | - C Coteli
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - Y Z Sener
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - M Oksul
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - K M Gurses
- Adnan Menderes University, Basic Medical Sciences, Aydin, Turkey
| | - B Evranos
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - H Yorgun
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
| | - K Aytemir
- Hacettepe University, Faculty of Medicine, Ankara, Turkey
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Sener YZ, Oksul M, Coteli C, Sahiner ML, Kaya EB, Canpolat U, Yorgun H, Ozer N, Aytemir K. P3880Assessment of patients with lead extraction due to cardiac implantable electronic device infections. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3880] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
- Y Z Sener
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - M Oksul
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - C Coteli
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - M L Sahiner
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - E B Kaya
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - U Canpolat
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - H Yorgun
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - N Ozer
- Hacettepe University, Department of Cardiology, Ankara, Turkey
| | - K Aytemir
- Hacettepe University, Department of Cardiology, Ankara, Turkey
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