ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology - Turk Kardiyol Dern Ars: 31 (9)
Volume: 31  Issue: 9 - September 2003
1. Effects of Prior Beta-Blocker Therapy on CK-MB Rise After Successful Percutaneous Coronary Interventions
İlyas Atar, Mehmet Emin Korkmaz, İnci Aslı Atar, Öykü Gülmez, Hüseyin Bozbaş, Alparslan Küçük, Bülent Özin, Aylin Yıldırır, Egemen Tayfun, Haldun Müderrisoğlu
Pages 473 - 481
Effects of Prior Beta-Blocker Therapy on CK-MB Rise After Successful Percutaneous Coronary Interventions Creatine kinase (CK)-MB isoenzymes are elevated after 6% to 40% of successful percutaneous coronary interventions (PCI). Except some nonrandomized studies, there are no data regarding the effects of beta-blocker (BB) usage on CK-MB after PCI. We, thus planned to investigate the impact regarding BB usage on CK-MB in patients who underwent successful PCI. We enrolled 300 patients with coronary artery disease in whom PCI was selected as the revascularization modality. Patients were randomized to either BB or control groups at least 1 week before the planned PCI. Patients recieved 50 or 100 mg of metoprolol depending on their blood pressure. Blood samples for cardiac enzymes were obtained immediately, and 6th, 24th and 36th hours after the procedure. Mean age of the study group was 49.4 ± 9.7, and 73.3% of the patients (220/300) were male. Baseline clinical characteristics, medications and laboratory parameters of both groups were similar. CK-MB levels before PCI were normal in all patients. There were no differences between the in-hospital complications of the 2 groups. We did not observe a significant difference in the percentage of patients who had CK-MB elevations between the 2 groups after PCI [BB 18 % (27 patients), control 20 % (30 patients) (p > 0.05)]. The mean CK-MB levels immediately after the PCI and at the 6th, 24th and 36th hours were also similar. In the first randomized, prospective study conducted to evaluate the effect of BB usage on CK-MB levels after PCI, prior BB therapy seemed to have no cardioprotective effect in limiting CK-MB rise after PCI.

2. Atrial Refractoriness Early After Percutaneous Mitral Balloon Commissurotomy in Patients with Mitral Stenosis and Sinus Rhythm
Mustafa Soylu, Ahmet Duran Demir, Özcan Özdemir, Serkan Topaloğlu, Dursun Aras, Erdal Duru, Şule Korkmaz, Ali Şaşmaz
Pages 482 - 488
Atrial Refractoriness Early After Percutaneous Mitral Balloon Commissurotomy in Patients with Mitral Stenosis and Sinus Rhythm Chronic atrial stretch and rheumatic inflammatory activity leads to atrial dilatation, conduction slowing, and this increases the susceptibility to atrial fibrillation (AF). The aim of this study was to examine the effects of changes in the chronic atrial stretch on atrial refractoriness in early period after percutaneous mitral balloon commissurotomy (PMBC) in patients with mitral stenosis and sinus rhythm. We evaluated the changes in pulmonary arterial pressure (PAP), left atrial (LA) pressure, right atrial (RA) pressure, mean mitral diastolic gradient and mitral valve area beside changes in atrial effective refractory periods (AERPs), AERP dispersion, intra- and interatrial conduction times after PBMC in 25 patients. The following hemodynamic parameters were decreased after PBMV mean diastolic gradient (14.5 ±2.6 - 2.8 1.3 mmHg, p<0.001), PAP (53.1 ±12.6 ? 35.7 ±8.9 mmHg, p<0.001), mean RA pressure (6.2 ±1.0 ? 4.9 ±0.4 mmHg; p=0.03), and LA pressure (25.7 ±4.3 ? 12.5 ±2.6 mmHg, p<0.001) and LA diameter (6.2 ±1.0 ? 4.9 ±0.4, p=0.03). High right atrial (HRA), distal coronary sinus (DCS) and right posterolateal (RPL) AERP?s were increased (216 ±15.0 ? 251.1 ±17.1; 266.7 ±17.5 ? 269.5 ±24.8; 207.6 ±20.4 ? 259.2 ±20.7 msec) (p<0.001) and AERP dispersion (55.2 ±5.5 ? 21.5 ±4.7 msec, p<0.001), PAHIS (52.7 ±5.9 ? 39.1 ±4.2 msec, p<0.001) and HRA-DCS interval (65.5 ±14.8 ? 47.5 ±12.9, p<0.001) were significantly decreased. Linear regression and correlation analyses revealed that only the changes in AERP dispersion was correlated with changes in LA pressure. Conclusion: Relief of chronic atrial stretch results in an increase in AERPs and decrease in AERP dispersion suggesting the potential reversibility of the electrophysiological features of chronic atrial dilatation. Beside the hemodynamic changes, the decrease in sympathetic activity after PMBC may also affect the atrial conduction properties and vulnerability.

3. Treatment of Descending Thoracic Aortic Aneurysms and Dissections with Endovascular Stent-Grafts
Harun Arbatlı, Naci Yağan, Ergun Demirsoy, Murat Arpaz, Oğuz Yılmaz, Faruk Tükenmez, Deniz Şener, Fürüzan Numan, Bingür Sönmez
Pages 489 - 497
Treatment of Descending Thoracic Aortic Aneuiysms and Dissections with Endovascular Stent-Grafts The aim of this study was to evaluate the early results of the endovascular treatment for aneurysms and dissections of the deseending thoracic aorta. From August 2001 to June 2003, endovascular procedures were performed for descending thoracic aortic aneurysms and dissections in 6 patients. All patients were male with a mean age of 58.3±18.71 (range 31-73). Two patients were operated due to acute type B dissection; with left heart failure, pulmonary edema and visceral ischemia in one and, intractable hypertension, back pain and radiological signs of evolving rupture in the other. In another patient, there was a false aneurysm and an aorto-bronchial fistula originating from the distal anastomosis of a previously surgically implanted graft within the descending thoracic aorta. One patient had a thoracoabdominal aortic aneurysm, one patient had thoracic aortic aneurysms distal to the left subclavian artery, and the other patient had postraumatic false aneurysm of the thoracic aorta. Endovascular stent-grafts were successfully implanted at the target site in all patients. One patient with acute type B dissection died probably due to massive pulmonary embolism 72 days after the procedure. The remaining patients are leading their normal active life. Treatment of descending thoracic aortic diseases with an endovascular approach has acceptable early mortality and morbidity in high risk patients.

4. Comparison of Mid-term Angiographic Results in Diabetic and Non- diabetic Patients After Coronary Artery Bypass Grafting
Hilmi TOKMAKOĞLU, Bora FARSAK, Serdar GÜNAYDIN, Özer KANDEMİR, Cem YORGANCIOĞLU, Tevfik TEZCANER, Kaya SÜZER, Yaman ZORLUTUNA, Can ÖZER
Pages 498 - 503
Diabetes mellitus is an established independent risk factor for significant morbidity and mortality for coronary artery bypass grafting. The impact of diabetes on bypass graft patency, development of new lesions and the rates of re-operation, re-intervention were assessed angiographically in 101 diabetic and 309 non-diabetic patients who had been operated between 1992-2001. The mean period of control angiography was 53.4 ±21.±2 vs 54.0 ±22.6 months. Compared with nondiabetic patients, the group with diabetes was older (61.3 ±10.7 years versus 59.4 ±11.2 years), comprised more women (26.7% versus 11.7% p=0,001), had more common triple-vessel disease (55.4 % versus 41.7%, p=0,02) and had lower ejection fractions (54.5 ±8.9 versus 56.6 ±8.5, p=0.03). A total of 309 (3.0 ±1.1) vs 902 (2.9 ±1.1) anastomosis was performed in 101 diabetic and 309 non-diabetic patients. The patency of left internal mammary artery -left anterior descending artery anastomosis were 95.9% vs 94.6% and 79.6% vs 73.7% in saphenous vein graft anastomosis. Development of new lesions were 37 (36.6 %) vs 79 (25.6% ), (p =0.041); reintervention rates were 33 (32.7%) vs 85 ( 27.5%)(p =0.3). The reoperation rate was 0 % vs 0.6% , in diabetic and non-diabetic patients, respectively. Freedom from reintervention and reoperation were 67.3% vs 72.7% (p=0.3) in group I and group II. Although diabetes appeared to be an independent risk factor for development of new lesions, no correlation was found on graft patency and in reinterventions between diabetics and non-diabetics.

5. Magnetic Resonance Imaging Technique in Evaluation of Myocardial Ischemia and Role in Routine Clinical Practice
Barış Diren, Ümit Belet
Pages 516 - 525
Magnetic Resonance Imaging Technique in Evaluation of Myocardial Ischemia and Role in Routine Clinical Pratice Several imaging methods such as perfusion scintigraphy (SPECT), positron emission tomography (PET) and dobutamine echocardiography are used routinely in the evaluation of myocardial ischemia for clinical practice. These examination techniques are also used to depict the chronic transmural scar tissue and viable residual myocardium at the infarcted area and to showing the thinned akinetic ventricular wall. This information is important for the evaluation of chronic myocardial infarction and in choosing the treatment protocol. Magnetic resonance imaging, with its increasing use parallel to the recent technologic advances in evaluation of cardiac pathologies, has also been used to show viable myocardium and to differentiate it from myocardial necrosis and scar tissue. The use of MRI for this purpose an opportunity of evaluating the cardiac pathologies with a single and non-invasive method. In this review, the role and routine clinical practice of MRI in diagnosis of myocardial ischemia and evaluation of myocardial viability are presented with relevant literature review.

6. Iodine-induced Sialadenitis After Primary Transluminal Coronary Intervention in a Patient with Acute Myocardial Infarction
İlyas Atar, Bülent Özin, Aylin Yıldırır, Haldun Müderrisoğlu
Pages 526 - 528
Iodine-induced Sialadenitis After Primary Percutaneous Transluminal Coronary Intervention in a Patient with Acute Myocardial Infarction Sialadenitis (iodide mumps) is an infrequent reaction to iodine administration. The mechanism for iodide-induced sialadenitis is poorly understood and may be either idiosyncratic or related to toxic accumulation of iodide in salivary glands. A total of 36 subsequent reported cases were found in literature. We report a case with acute myocardial infarction who developed iodide-induced sialadenitis following primary percutaneous transluminal coronary intervention

7. 19th National Congress of Cardiology Abstracts

Pages 529 - 616
Arterial Pulse Wave Velocity The pulse wave generated by the left ventricular myocardium contraction and blood ejection is propagated throughout the arterial tree at a speed determined by the elastic and geometric properties of arterial wall and the blood density. This velocity along the aorta or along the arteries of the forearm can be measured by using two ultrasound or strain-gauge transducers fixed transcutaneously over the course of a pair of arteries separeted by a known distance: the carotid and femoral arteries and the radial and brachial arteries, respectively. The measured pulse wave velocity is an index of arterial wall stiffness. It is also inversely related to the arterial distensibility or relative arterial compliance. In major studies, pulse pressure and pulse wave velocity are predicting cardiovascular events. In this review, by the help of our study findings, arterial pulse wave velocity and the factors contributing in its mechanism was evaluated.



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Journal Citation Indicator: 0.18
CiteScore: 1.1
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SCImago Journal Rank: 0.348

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