ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology - Turk Kardiyol Dern Ars: 32 (1)
Volume: 32  Issue: 1 - January 2004
DERLEME
1. Value of Serum Gamma Glutamyltransferase as a Cardiovascular Risk Factor in Turkish Adults: A Good Marker of Metabolic Syndrome and its Components and of Coronary Disease Likelihood
Altan ONAT, İbrahim SARI, Gülay HERGENÇ, Serdar TÜRKMEN, Bülent UZUNLAR, Hüseyin UYAREL, Mehmet YAZICI, İbrahim KELEŞ, Günay CAN, Vedat SANSOY
Pages 1 - 9
Value of Serum Gamma Glutamyltransferase as a Cardiovascular Risk Factor in Turkish Adults: A Good Marker of Metabolic Syndrome and its Components and of Coronary Disease Likelihood Purpose of the study was to investigate the value of serum gamma glutamyltransferase (GGT) activity as a cardiovascular risk factor in a population sample of 868 men and women among the cohort of the Turkish Adult Risk Factor Study, surveyed in 2003. Metabolic syndrome (MS) was diagnosed based on criteria of the ATP-III, and coronary heart disease (CHD) on the presence of angina and Minnesota coding of the resting ECGs. MS was observed in 37%, CHD in 10.5% of the study sample. GGT activity was measured by the Elecsys method, and values were log-transformed due to the skewed distribution. In 421 men and 447 women (mean age 52.7±11 years), geometric means of GGT were 28.7±1.8 U/L and 20,8±1.8 U/L, respectively (p<0.001). Concentrations rose mildly with age (r =0.11). Strongest correlations existed with serum uric acid, fasting triglycerides and insulin, complement C3, waist circumference and with the diagnosis of metabolic syndrome (r = 0.3 to 0.4). Moreover, significant correlations were found between GGT and BMI, total cholesterol and physical inactivity in both genders, and systolic pressure and impaired fasting glucose (r 0.16 to 0.25) in women alone. Alcohol intake and waist circumference, followed by body mass index, levels of uric acid, fasting insulin and complement C3 were the significant independent determinants of serum GGT activity among 13 variables included in a multiple linear regression analysis. A 2-fold increase in serum GGT levels was associated by logistic regression analysis with a rise of 36% in MS likelihood - independent of age and sex (p<0.001). Optimal cutoff points of GGT for CHD likelihood were selected as 50 U/L and 35 U/L in men and women, respectively. As opposed to individuals below the cutoff, those above the cutoff exhibited an odds ratio for CHD likelihood of 2.17 (95%CI 1.23; 3.82) - independent of age, sex and alcohol usage - indicating that, a 2-fold elevation in serum GGT activity corresponded to a 58% excess in CHD likelihood. This population-based study among Turkish adults confirmed that serum GGT activity is closely linked to the metabolic syndrome and its components. GGT proved to be a good marker of CHD likelihood, and moderate elevations of its activity significantly reflected a rise in this likelihood. Cutoff values suitable for use in clinical practice were proposed. (Türk Kardiyol Dern Arş 2004; 32: 1-9)

2. Heart Rate Variability and QT Dispersion in Patients with Slow Coronary Flow
Adnan KÖŞÜŞ, Olcay SAĞKAN, İhsan DURSUN, Mehmet ELÇİK, Y.Mustafa YAZICI, Mahmut ŞAHİN, Osman YEŞİLDAĞ
Pages 10 - 15
Slow coronary flow is a very rare finding in normal coronary arteries. Reserve abnormality of the coronary microvasculature and increased activity of adrenergic system are accused for slow flow. We could not find any study investigating the effects of slow coronary flow on heart rate variability(HRV) and repolarisation of the myocardium. Therefore, we decided to make this trial. Twenty-nine patients with slow coronary flow and normal coronary arteries were included in the study. Twenty-two healthy subjects were accepted as control group. In the slow coronary flow group, TIMI frame counts from coronary angiography, QTc dispersion from 12 lead ECG, HRV from 24 hour ambulatory ECG monitoring were determined. In healthy subjects, HRV and QTc were determined by the same methods. Mean SDNN (109±29), pNN50 (11±7) and triangular index (462±119) of the slow coronary flow group were more depressed than the mean SDNN (146±44), pNN50 (20±16) and triangular index (584±142) of the control group (p values were 0.019, 0.037 and 0.008, respectively). There was no direct correlation between TIMI frame count and HRV indices in the slow coronary flow group. As a result, we suggested that HRV and QTc parameters are changed in the coronary slow flow patients in order to support the theory of increased adrenergic activity may be cause of abnormal coronary flow reserve at the microvascular level and slow coronary flow. Decreased HRV and increased heterogenity of repolarisation of myocardium may be cause of sudden cardiac death in some patients. For this purpose, larger and longer follow-up trials must be conducted in this patient group. (Türk Kardiyol Dern Arş 2004; 32: 10-15)

3. Evaluation of Elastic Properties of Aorta in Patients with Impaired Glucose Tolerance by Conventional and Color-Doppler Tissue Echocardiography
Y.Ramazan TOPSAKAL, Fahri BAYRAM, Mustafa ÇALIŞKAN, İbrahim ÖZDOĞRU, Namık Kemal ERYOL, Cumali GÖKÇE, Mustafa GÜR, Ali ERGİN
Pages 16 - 22
Increased arterial stiffness is a risk factor for cardiovascular disease. In our study we aimed to evaluate the elastic properties of the aorta with conventional and color Doppler tissue imaging (CDTI) in patients with impaired glucose tolerance (IGT) who had no hypertension or coronary artery disease. The study group consisted of 47 IGT patients having without hypertension or coronary artery disease (mean age 37±8), and the control group of 32 healthy subjects (mean age 34±8). To evaluate the elastic properties of the aorta, diastolic and systolic diameters of the aorta were measured by M-mode echocardiography and tissue Doppler velocities of the superior wall of aorta were measured by CDTI (S, E, A m/sn) and heart rate and blood pressure were measured during echocardiographic evaluation. Aortic stiffness index and aortic distensibility were calculated using the formulas (aortic stiffness index=ln(SKB/DKB)/(AoS-AoD)/AoD cm2 dynes-1, aortic distensibility=2x(AoS-AoD)/NBxAoD). Aortic stiffness index, aortic distensibility and S velocities (m/sn) of superior aortic wall were significantly different the in study group compared with the controls. (1.39±1.52 vs 0.54±32, p=0.002, 2.64±1.83 vs 7.11±4.33, p<0.001, 0.057±0.022 vs 0.069±0.027, p=0.029, respectively). Aortic stiffness index was negatively correlated with superior aortic wall S velocity (r=-30, p=0.007) and with E velocity (r=-0.34, p=0.002). Aortic distensibility was positively correlated with superior aortic wall S velocity (r=0.34, p=0.002) and with E velocity (r =0.37, p=0.001). Conclusion: In patients with IGT, aortic stiffness index was higher and aortic distensibility lower than in normal controls. S velocity of superior wall of the aorta measured by CDTI decreased as aortic stiffness increased. (Türk Kardiyol Dern Arş 2004; 32: 16-22)

4. The Role of Angiotensin Converting Enzyme Gene Polymorphism in the Development of Premature Coronary Artery Disease
Tamer AKBULUT, Tuba BİLSEL, Hüseyin UYAREL, Sait TERZİ, Nurten SAYAR, Alper AYDIN, Şennur Ünal DAYİ, Figen ÇİLOĞLU, Bayram BAĞIRTAN, İsmail PEKER, Kemal YEŞİLÇİMEN
Pages 23 - 27
Angiotensin-converting enzyme (ACE) gene polymorphism has been associated with many cardiovascular pathologies. The goal of our study was to assess the association of ACE gene polymorphism with premature coronary artery disease in Turkish population sample. A total of 139 young patients (?50 years) with coronary artery disease were evaluated in regard to ACE gene polymorphism and conventional coronary risk factors. The findings were analyzed and compared with those of 67 healthy young persons. Both allele frequencies and ACE genotype distribution did not differ substantially between groups (ACE I/I: %13.7; ACE I/D: %59; ACE D/D: %27.3 in the study group and; ACE I/I: %17.9, ACE I/D: %57.2, ACE D/D: %27.9 and in the control group). The odds ratios were 0.88 for D homozygotes (p > 0.05) and 1.03 for the D allele (p > 0.05). On the other hand, the other variables (smoking, plasma cholesterol level, obesity, and diabetes mellitus) were found to be related to the development of premature coronary artery disease. Conclusion: ACE gene polymorphism does not seem to be associated with premature coronary artery disease in the studied, limited-sized Turkish sample population. (Türk Kardiyol Dern Arş 2004; 32: 23-27)

5. Role of Complement System in Atherosclerosis
Gülay HERGENÇ
Pages 28 - 37
It is not unexpected that complement system has a role in atherosclerosis which is a chronic inflammatory disease. Complement system is a pathway in which inflammatory peptides, opsonins and membrane attack complex are produced by stepwise activation of inactive plasma proteins. Complement system, coagulation, kinin and fibrinolytic pathways are in close inter-action. Immuncomplexes bound to complement cause platelet aggregation and thrombosis. Many proteins of the hemostatic system and their receptors are affected by complement activation, immune response and cytokine release. Activation of the complement system like coagulation system, fibrinolysis, kininogenesis and angiogenesis, is triggered by the contact system. Serum complement C3 (C3) levels show significant associations with several lipid parameters. Acylation stimulating protein formed from three different complement factors in adipose tissue has been shown to play a very important role in lipoprotein and triglyceride metabolism and glucose transport. Suppression of the complement activation is among the antiatherogenetic functions of HDL. Apo AI, the major apolipoprotein of HDL, inhibits the formation of the terminal complement complex and has effects on the regulatory proteins of the complement system. Modified and oxidized lipoproteins have been shown to induce production and oxidation of complement factors. C5a, the major inflammatory factor released by the complement system, is a very powerful chemoattractant for neutrophils. Complement system has a role in the conversion of foam cells to atherosclerotic lesions. C3 level was found to be an independent predictor of myocardial infraction in men with no previous ischemic event. Measurement of various components of the complement system may be promising in prediction of atherosclerosis, differentiation of an early MI from a reversible ischemic event and in the control of an inflammatory response in post-MI reperfusion. (Türk Kardiyol Dern Arş 2004; 32: 28-37)

6. MR Imaging Technique in Cardiovascular Diseases
H.Barış DİREN, Y.Ümit BELET
Pages 38 - 43
Magnetic resonance imaging (MRI) is an advanced medical imaging method developed in the 1980s. In variance from the known classical imaging methods (such as X-rays and ultrasound) MRI renders real images of organs by using physiological parameters. MRI is privileged of being used in imaging all organs of human body because of the data it offers. MRI has been widely used in the diagnosis of cardiovascular diseases as a non-invasive imaging method in an increasing manner. The anatomy of all cardiac chambers, atrio-ventricular mor-phology, great vessels and their relations with the cardiac chambers can be evaluated in detail with MRI in congenital cardiac pathologies. MRI, with its increasing use parallel to the recent technologic advances both in software and hardware, has also been used to evaluate myocardial ischemia. Diffusion- and perfusion-weighted MRI applications are effective to evaluate acute myocardial ischemia and differentiate it from myocardial necrosis and scar tissue in the chronic stage. MR-angiography is another advantage of this technique and can also show the flow in vessels nonivasively and coronary arteries can thus be evaluated morphologically. The use of MRI in the evaluation of cardiovascular diseases provides the chance of evaluating morphology, physiology and histology of this organ with a single and non-invasive method getting an increasing importance in this field. The contributions that MRI may provide in the diagnosis of cardiovascular diseases were herein reviewed in the light of recent advances MR technology reached. (Türk Kardiyol Dern Arş 2004; 32: 38-43)

OLGU
7. A Case Who Benefited From Cardiac Resynchronization Therapy
Erdem DİKER, Deniz ŞAHİN, Telat KELEŞ, Hülya ÇİÇEKÇİOĞLU, Kadir POLAT, Alper CANBAY, Sinan AYDOĞDU
Pages 44 - 51
Cardiac resynchronization therapy is a novel non-pharmacological treatment approach in the treatment of heart failure. Previous studies proved the safety and efficacy of this treatment. The selection of the most suitable candidate for cardiac resynchronization therapy is a crucial issue and still a matter of debate. Variable clinical, electrocardiographic and echocardiographic criteria have been proposed for appropriately selecting candidates for this therapy. Unfortunately, we still do not have satisfactory selection criteria set, which determines patients who will mostly benefit from this therapy. In this case report, we present a 60-year-old woman with dilated cardiomyopathy, who underwent atriobiventricular pacemaker implantation for cardiac resynchronization therapy. This patient would presumebly benefit from this therapy due to long (180 ms) QRS duration, long (170 ms) PQ duration, long ( 380 ms) mitral regurgitation duration and reltively long (> 130 ms) septum-posterior wall motion delay. As expected, symptoms, functional class and exercise capacity improved dramatically after therapy and it is shown that this improvement is not a placebo effect. We discussed which patient will benefit mostly from cardiac resynchronization therapy. (Türk Kardiyol Dern Arş 2004; 32: 44-51)

8. Aortic Graft With Kink Formation
İstemihan TENGİZ, Ertuğrul ERCAN, Emil ALİYEV, Reşat MAHMUDOV
Page 52
Abstract |Full Text PDF

OTHER ARTICLES
9. Practice Guidelines of Methods of Nuclear Cardiology in Turkish Society of Cardiology Heart Disease

Pages 53 - 69
Abstract |Full Text PDF



Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
per Paper:
0.22
SCImago Journal Rank: 0.348

Quick Search



Copyright © 2025 Archives of the Turkish Society of Cardiology



Kare Publishing is a subsidiary of Kare Media.