1. | Summaries of Articles Pages 134 - 137 Abstract | |
2. | Daha İlgi Çekici Olmaya Doğru: Arşiv Yayın Kurulu'nun Dergimizle İlgili Önerileri Altan ONATPage 138 Abstract | |
3. | Apolipoprotein C-III Levels and Interrelation with Other Risk Factors in Residents of the Marmara Region Altan ONAT, Köksal CEYHAN, Gülay HERGENÇ, Ömer UYSAL, Beytullah YILDIRIM, Vedat SANSOY, İbrahim KELEŞ, Ali ÇETİNKAYA Pages 139 - 145 In 259 participants of the Turkish Adult Risk Factor Survey, the role of apolipoprotein C-III (apoCIII) in high-dens ity lipoprotein (HDL) and nonHDL apoCIII (nh apoCIII = total minus HDL apoCIII) as markers of triglycerides and HDL-cholesterol and of prevalent coronary heart disease (CHD) risk was studied cross-sectionally in a population sample of the Marmara region. Total and HDL-linked apoCIII were measured by turbidimetric immunoassay. Other ri sk variable measurements and CHD diagnosis were by standard techniques of the main survey. Mean concentrations for nh apoCIII in norınolipidemic men and women were 7.8±3.2 and 7.7±3.6 mg/d!, in hypertriglyceridemic men and women 17.6±6.6 ve 16.3±6.7 mg/dl, respectively. Mean HDL-Iinked apoCIII in normolipidemic subjects were 0. 83±0.5 and 1 .0±0.5 mg/di, in men and women with high triglyceride Jevels 0.94±0.5 mg/d!. Compared to Western populations, nh apoCIII appeared to be by one-half higher, and HDL apoCIII by two-thirds lower, representing an adverse lipoprotein profile, and suggesting a redistribution of apoCIII from HDL to apoB-containing lipoproteins in the fasting state. nh apoCIII was correlated closely notably with triglycerides and apo B, but also with levels of total, LDL-, and HDLcholesterol, anthropometric measures and blood pressures in both genders. In addition, nh apoCIII was significantly correlated with C-reactive protein levels in women. Presumably due to limited size of the cohort, neither nh apoCIII, nor HDL- linked apoCIII proved to be significantly associated with prevalent CHD. It was concluded that Turkish adults probably exhibit a defect in TRL metabolism characterized by a major redistribution of apoCIII from HDL to VLDL and remnants . NonHDL apoCIII concentrations closely reflect plasma triglycerides. Canfirmation of these findings and the assessment of the question as to whether this adverse profile is associated with augmented CHD risk should await further studies. |
4. | Comparison of Vena Contracta Width by Multiplane Transesophageal Echocardiography with Quantitative Doppler and Angiographic Grading to Assess Aortic Regurgitation Bülent MUTLU, Cem ERMEYDAN, Nuri KURTOĞLU, Mustafa KARABULUT, Yelda BAŞARAN Pages 146 - 152 Aortic regurgitation (AR) severity is generally assessed by conventional echo-Doppler methods which are affected by both technica l and hemodynamic variables. Vena contracta (VC) width has been previously shown to be less influenced by hemodynamic vari abtes and correlate wi th angiographic grading of mitral regurgitation. However, el inical application of ve has been limited because of the difficulty in clear imaging the ve by transthoracic echocardiography (TTE) in patients with AR. To our knowledge, there is only one study which evaluates VC method ı n AR by transesophageal echocardiography (TEE) in the literature. This study was designed to co ınp are aortic VC width by multiplane TEE with quanti tative Doppl er echocardiography and angiographic grading. The VC width was measured at the narrowest portion of the AR jet as it emerged through the coaptation of leaflets; it was clearly imaged in 48% of patients by TTE and 88% of patients by TEE. Transesophageal echocardiographic VC width correlated well w ith regurgitation vol u me (r=0.9 J , p |
5. | Relation of Heart Rate Variability with Clinical and Echocardiographic Parameters After Acute Myocardial Infarction Abdi BOZKURT, Ahmet BİRAND, Gulmira Z. KUDAİBERDİEVA Pages 153 - 157 Heart rate variability (HRV) is one of the independent prognostic criteria after acute myocardial infaretion (AMI). The aim of this study is to evaluate the changes in HRV after AMI in patients w ith and without left ventricular (LV) dysfunction and to determine the relation of these HRV changes with elinical and echocardiographic parameters. Twenty patients ( 1 8 males, 2 females; m ean age 49.2±8.2) with preserved LV systolic function after AMI (Group I), twenty patients (I 8 males, 2 females; mean age 5 1.5±7.7) with impaired LV (systolic) function and heart failure (functional class NYHA II-III) (Group II) and 20 healthy subjects (18 males, 2 females; mean age 50.5±7.9) (control group) were studied. In patients with and without LV dys function high frequency power (HFP), low frequency power (LFP), very low frequency power (VLFP) and LFP/HFP ratio which reflects sympathetic activity increased when compared with the control group (p<0.05). In patients with LV sys tolic dysfun ction, HFP/LFP ratio was s ignificantly higher than in patients without systolic dysfunction. In the latter group, HFP was found to be negatively correlated with end-diastolic volume and, pos itively correlated with stroke volume whereas VLFP was negatively correlated with heart rate and NYHA stage. We concluded that, parasympathetic activity which is a elinical and prognostic parameter after AMI is decreased, the other parameter sympathetic activity is increased, and HRV is depressed. These changes are fo und to be mo re prominent in patients w ith LV systolic dysfunction. HFP, reflecting parasympathetic activ ity of HRV parameter, is rel ated significantly to LV systolic functions. |
6. | Response of In-vitro Platelet Aggregation Induced by Adenosine Diphosphate and Epinephrine in Stable Angina Pectoris with Essential Hypertension Abdi SAĞCAN, Meral KAYIKÇIOĞLU, Serdar Bedii OMAY, Mustafa AKIN Pages 158 - 163 Hypertension is an independent risk factor for coronary artery di sease (CAD) in both males and females. Platelet activation is seen in the progress of hypertension and CAD. In th is study, the effect of controlled class I-II hypertension on in-vitro platelet aggregation was investigated in patients with stable angina pectoris (SAP). One-lıundre d and three patients were included in the study after canfirmati on of an g ina pectori s c lin ically and angiographically. Patients were divided into two groups: Group I consisted of 45 CAD patients (3 1 male, 14 female, mean age:57±10) with essential hypertension, and 58 normotensive CAD parients (53 male, 5 female, mean age:54±9) made up Group II. Platelet-rich plasma (PRP) samples were prepared from the patients' venous blood taken befo re breakfast at room temperature. PRP was treated with adenesine diphosphate (ADP) and epinephrine and platelet aggregation slopes were obtained by use of turbidometric method of Bohr. These slopes were recorded on special millimetric papers and activation time (second) and activation ratios (amplitude %) of primary and secondary waves were calculated from the slopes. Student's t test was used for statistical analyses. Activation ratios of in-vitro platelet aggregation induced by ADP and epinephrine was significantly increased in group I than group II for borh primary and secondary waves. No difference was found between groups when activation time of primary waves were compared (p>0.05) but activation time of secondary waves were significantly increased in groups I (p<0.05). It was found that use of antihypertensive agents like converting enzyme inhibitors, calcium channel and beta blackers did not cause significant changes in response to platelet aggregation (p>0.05). Hypertensive SAP patients even having been treated by antihypertensive drugs have signi ficantly increased platelet aggregation response w:hen compaı·ed to normotensive SAP patients. But, in vivo prospective studies in wider and more homogeneous hypertensive patients population are necessary to conclude the need for more potent antiaggregant treatment with use of antihypertensive drugs having antiaggregant properties. |
7. | Comparison of Results of Radiofrequency Catheter Ablation in Patients with Idiopathic and Secondary Ventricular Tachycardia Kamil ADALET, Fehmi MERCANOĞLU, Mehmet MERİÇ, Murat SEZER, Önal ÖZSARUHAN, Faruk ERZENGİN Pages 164 - 172 The aim of this study was to compare the results of radiofrequency catheter ablation (RFA) in patients (pts) with idiopathic and secondary ventricu lar tachycardia (VT). Sixty-six pts with monomorphic VT (1 I female, 55 m ale; m ean age 35.5± I 5.6 years, range I 0-75 years) were included. Forty-one pts presented with idiopathic (21 right ventricular outflow tract, 20 left ventricular VT) and 25 pts presented w ith secondary VT ( I 2 ischaemic, 5 arrythmogenic right ventricular dysplas ia, 3 dilated cardiomyopathy, I hypertrophic cardiomyopathy, 2 bundle branch reentrant tachycardia, I mitral valve prolapse, 1 post-operative). The mean duration of symptoms w as 73.1 ±77 months in idiopathic VT group and 37±38 months in secondary VT group (p<0,03). The pts in idiopathic VT group had prev iously received a mean of 2.79± 1.5 antiarrhythmic drugs, and a mean of 3.63±1.6 antiarrhythmic drugs were adınİnistered to the pts in secondary VT group. The mean number of RF pulses delivered to the 40 pts in idiopathic VT group (5.7±5) was significantly lower (p<0.05) than pls in secondary VT group (12.2+10). Primary success rate was 80% (20 of 25 pts) in secondary VT group and 92.6% in idiopathic VT group (38 of 4 ı pts). The m ean total d uration of the procedure w as ı ı 4±43 minules in idiopathic VT group and 144±75 minutes in secondary VT group. No serious complications occurred in both groups. Pts were followed for a m ean of 28.3± I 9 months in idiopathic VT group and 50.3±20.7 months in secondary VT group (p |
8. | Evaluation of Relationship Between Left Ventricular Hypertrophy and Diastolic Functions by New Echocardiographic Methods Sinan DAĞDELEN, Nevnihal EREN, Hasan KARABULUT, İlyas AKDEMİR, Mehmet ERGELEN, Murat AKÇAY, Cem ALHAN, Nuri ÇAĞLAR Pages 173 - 180 The aim of this study was to investigate the relationship between left ventricular hypertrophy (LVH) and diastolic func tions by new echocardiographic methods. By this aim 35 (28 hypertensive, 7 normotensive) patients (19 M, 16 F, mean age± SD: 55.9 ± ı 1.7 years) w ith L VH who had left ventricle mass index (LVMI) > 134 g/m2 in men and > ı 10 g!m2 in women and angiographically proven to be free of significant coronary artery lesi o n s ( < 40 % stenosis) were studied. The mean (±SD) LVMI was ı58.4 ± 28.9 glm2. Using an Aloka SSD 2200 echocardiography device, mitral E and A velocities and time integrals (E and Avti), i sovoıumetri c relaxation time (IVRT), E deceleration time (EDT), A flow time (A-t), and pulmonary vein reversal flow time (PA-t) were measured in every patient. Lateral mitral annulus early and Iate diastolic velocities (Em, Am), Em deceleration time (EmDT), Am flow time (Am-t) were evaluated by tissue Doppler imaging. Color M-mode imagings of the mitral valve in apical 4-chamber view were obtained to ıneasure propagation velocity (Yp) and Yp acceleration time (Yp-at). No significant correlation w as fo und between L YMI and EDT, A-t, E/A, PA-t, and Aın-t (r=0.22, 0.23, - O.ı6, 0.28, and 0.31 , respectively). LYMI was weakly correlated with IYRT and Evti/Avti (r=0.45, -0.39, respectively) and had a good correlation with Em/Am, EınDT, Yp, and Yp-at (r= -0.66, 0.54, - 0.65, and 0.57 , respectively). Comparing the subgroups with and without hypertension, lower Em/Am, longer EınDT, lower Yp, and longer Yp-at were found in patients with hypertension. In evaluating of left ventricular diastolic functions, ıneasureınents obtained by tissue Doppler imaging and color M-ınode have better correlations with L YMI, coınpared to conventional ıneasureınents . |
9. | Homocysteine and Cardiovascular Disease Murat SUCU, A. Aziz KARADEDE, Nizamettin TOPRAK Pages 181 - 190 Homocysteine is a sulphur-containing aınino acid formed during the ınetabolisın of ınethionine . It is ınetabolised by reınethy lation or transsulphuration. Fasting normal ranges are 5- ı 5 ııınoi/L in the general population. Plasma hoınoc yste ine ı eve l s are strongly influenced by diet, as well as genetic factors. It is suggested that atherogenic propensity associated with h yperhoınocysteineın i a results from endothelial dysfunction and injury. Although there is considerable epideın i ologica l evidence for a relation between plasına hoınocyste ine and cardiovascular disease, not all prospective studies have supported such a relationship. Moreover, despite the potential for reducing hoınocysteine levels with increased intake of folic acid, it is not known whether reduction of plasına hoınocyste ine by diet and/or vitamin therapy wi ll reduce cardiovascular disease risk. Hoınocysteine leveıs of mo re than ı 5 ıım oi/L ınay be ınanaged with 400 ııg folate with or without other B vitamins. |
10. | Takayasu Arteritis Presenting as Anterior Myocardial Infarction Sait ALAN, Mehmet Sıddık ÜLGEN, A. Aziz KARADEDE, Bircan ALAN, Nizamettin TOPRAK Pages 191 - 194 Takayasu arteritis is a rarely encountered arteritis that involves aorta, Jeads to the its ınajor branches and pulınonary arteries. The disease ınay frequently occlusion or aneurysnı atic dilatation of the involved segment. In spite of frequent i n volveınen t of renal arteries, coronary in vol veınent is rare, but ınay lead to serious co ınplica ti o n s . A fo rty-year old patient with Takayasu arteritis admitted to our clinic due to acute anterior myocardial infarct ion, accompanied by severe hypertension that was taken into control fo llowing renal angioplasty. We present this case to emphasize that Takayasu arteritis is ararely encountered disease which may lead to acute myocard ial infarction |
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