EDITORIAL COMMENT | |
1. | How to design studies on premature myocardial infarction? Meral Kayıkçıoğlu PMID: 28902638 doi: 10.5543/tkda.2017.24668 Pages 495 - 497 Abstract | |
ORIGINAL ARTICLE | |
2. | The role of specialized prevention clinics for the short term follow-up of acute coronary syndromes Salih Kılıç, Evrim Şimşek, Hatice Soner Kemal, Elif İlkay Yüce, Cüneyt Türkoğlu, Meral Kayıkçıoğlu PMID: 28902639 doi: 10.5543/tkda.2017.00400 Pages 498 - 505 Objective: This study aimed to investigate the effect of specialized prevention clinics and standard clinics follow-ups on secondary protection after acute coronary syndrome (ACS) on cardiovascular risk factors. Methods: A total of 118 patients who received thrombolytic therapy after being diagnosed with ST-segment elevation myocardial infarction were followed up for 6 months. After ACS, patients in a specialized prevention clinic (Group 1) (n=67) and those in a standard clinic (Group 2) (n=51) were compared in terms of the change in their lifestyle, management of risk factors, and drug compliance. Results: No significant difference was found between groups in terms of baseline clinical and laboratory findings except for triglyceride level (Group 1: median 174 mg/dL; Group 2: median 136 mg/dL; p=0.039). Six months after indexing, smoking cessation (72.4% vs. 50%, p=0.037), diet compliance (43% vs.19.6%, p=0.012), and exercise rates (31% vs. 13.7%, p=0.044) were significantly higher in Group 1. Although the weight control rate was higher in Group 1, no significant difference was noted between the groups (27% vs. 15.6%, p=0.219). The rate of systolic and diastolic blood pressures >140/90 mm Hg was significantly higher in Group 2 (23.5% vs. 9%, p=0.029) at 6 months. The median low-density lipoprotein cholesterol (LDL-C) value was significantly lower in Group 1 patients (Group 1: 91 mg/dL; Group 2: 102 mg/dL; p=0.042). Moreover, the rate of LDL-C ≤70 mg/dL or ≥50% reduction compared with baseline was significantly higher in Group 1 (32.8% vs. 13.7%, p=0.016). Although the recommended treatments were similar in both groups, the statin use rate was significantly higher in Group 1 (95.5% vs. 80.3%, p=0.021) at 6 months. Conclusion: The results of the study showed that specialized prevention clinics were more effective during the management of cardiovascular risk factors after ACS. |
3. | Is neutrophyl to lymphocyte ratio really a useful marker for all grades of degenerative aortic stenosis? Selçuk Küçükseymen, Göksel Çağırcı, Ramazan Güven, Şakir Arslan PMID: 28902640 doi: 10.5543/tkda.2017.32389 Pages 506 - 513 Objective: Inflammatory processes play an important role in cardiac valve calcification and ossification. The aim of this study was to investigate the relationship between the neutrophil-lymphocyte ratio (NLR) and degenerative aortic stenosis (AS). Methods: A total of 220 patients with AS and 158 healthy individuals who were a control group were included in the study. The NLR was calculated by dividing the number of neutrophils by number of lymphocytes in peripheral blood samples. Results: The study group consisted of 220 AS patients (mild/moderate group: n=110; severe group: n=110) and 157 healthy controls. Both the mild/moderate AS group (p<0.001) and the severe AS group (p<0.001) had a significantly higher NLR compared with the control group. The NLR in the severe AS group was significantly higher than that of the mild/moderate AS group (p<0.001). The groups were similar with respect to other baseline characteristics. A receiver operating characteristic curve analysis yielded a strong predictive ability of NLR for the presence of AS (Area under the curve=0.930; 95% CI [confidence interval], 0.898–0.963; p<0.001). A cut-off value of 2.310 for NLR had a sensitivity and specificity of 80.4% and 92.4%, respectively, for the presence of AS. In multivariate logistic regression analysis, NLR (Odds ratio: 43.8; 95% CI, 14.7–130.7) was the only independent predictor of AS. Conclusion: The discriminative performance of NLR for AS is high. NLR is strongly and independently associated with AS. |
4. | Assessment of the association between the personality traits of young patients with acute coronary syndrome and the severity of coronary artery disease Nermin Bayar, Ramazan Güven, Zehra Erkal, Kamil Can Akyol, Mustafa Ilker Edebali, Selçuk Küçükseymen, Şakir Arslan PMID: 28902641 doi: 10.5543/tkda.2017.32379 Pages 514 - 519 Objective: The role of psychosocial risk factors is becoming increasingly important in the etiology of acute coronary syndrome (ACS). The purpose of this study was to assess an association between the personality types of young patients with ACS and the prevalence and severity of coronary artery disease (CAD). Methods: Patients younger than 45 years of age who presented with ACS and who underwent coronary angiography in the period from 2012 to 2016 were included in the study. The coronary angiography records of the patients were examined and their Gensini score (GS) was calculated; GS ≥20 was considered to be severe CAD. The Eysenck Personality Questionnaire-Revised Short Form scales were used to measure psychoticism, extraversion, lying, and neuroticism. Results: A total of 139 patients were included in the study. The median psychoticism score of patients with GS <20 was found to be significantly higher than that of patients with GS ≥20 [1.0 (25th and 75th percentile: 0.0–2.0) vs. 1.0 (25th and 75th percentile: 0.0–1.0); p=0.015]. The median psychoticism score was 1.0 (25th and 75th percentile: 1.0–2.0) in the unstable angina pectoris group, 0.5 (25th and 75th percentile: 0.0–1.0) in the ST segment elevation myocardial infarction group, and 1.0 (25th and 75th percentile: 0.0–1.0) in the non-ST segment elevation myocardial infarction group (p=0.004). Conclusion: The presence of psychoticism characteristics in patients who present with ACS is associated with less severe CAD. |
5. | The association between apelin gene polymorphism and coronary artery disease in young patients with acute obstructive coronary syndrome Ramazan Güven, Kamil Can Akyol, Nermin Bayar, Mustafa Keşaplı, Muhammed İkbal Şaşmaz, Asım Arı, Şakir Arslan PMID: 28902642 doi: 10.5543/tkda.2017.95849 Pages 520 - 526 Objective: The purpose of this study was to evaluate the association between V103V, 6140AG, TGA-Stop-TAA Stop, and 6016CA polymorphisms of the apelin (APLN) gene detected for the first time among young patients with acute coronary syndrome (ACS) and coronary artery disease (CAD). Methods: This was a prospective cross-sectional study. The study population was divided into 2 groups. The first group included 132 patients who were found to have critical lesions in their coronary arteries, while the control group consisted of 41 patients who were found to have normal coronary arteries or non-critical atherosclerotic lesions. Results: Among the gene polymorphisms, V103V was found to be more common in the critical CAD patients with the GG genotype compared with the control group (67.4% vs. 46.3%). On the other hand, the GT genotype was more common in the control group (53.7% vs. 32.6%). Univariate and multivariate logistic regression analysis revealed that the GG genotype of V103V was an independent predictor for the presence of critical CAD (odds ratio: 2.397; 95% confidence interval, 1.174–4.892; p=0.016). Conclusion: In cases of V103V polymorphism of the APLN gene, patients with the GG genotype were at a greater risk for the presence of atherosclerotic critical lesions compared with the control group. |
6. | Prevalence and characteristics of coronary artery anomalies in children with congenital heart disease diagnosed with coronary angiography Münevver Tuğba Temel, Mehmet Enes Coşkun, Osman Başpınar, Abdullah Tuncay Demiryürek PMID: 28902643 doi: 10.5543/tkda.2017.24162 Pages 527 - 532 Objective: Aim of the present study was to determine the prevalence of coronary artery anomalies in children with congenital heart disease. Methods: Data of 1138 consecutive patients who were referred for cardiac catheterization and angiography for assessment of coronary anomaly between January 2005 and December 2009 were retrospectively analyzed. Total of 515 patients whose coronary arteries could be examined through left ventricle and aortic root injection were included in the study. Results: Of 515 angiograms with visible coronaries, 42 patients (20 males, 22 females; mean age: 5.3±2.0 years) were found to have final diagnosis of coronary anomaly. Prevalence of coronary artery anomalies was 8.16% in this study. It was determined that 38 (90.4%) were anomalies of origination, 2 (4.8%) were anomalies of intrinsic coronary arterial anatomy, and 2 (4.8%) were anomalies of coronary termination. Most common coronary artery abnormality was anomalous origin of the right coronary artery from the left aortic sinus (16 patients; 38.1%), and the most common congenital heart disease was tetralogy of Fallot (18 patients; 42.9%). Conclusion: Recognizing variability of coronary artery anomalies is critical when considering surgical or interventional therapies in children with congenital heart disease. |
7. | Serum oxidized low-density lipoprotein level as a marker of oxidative stress in patients undergoing hyperbaric oxygen therapy Kudret Keskin, Hakan Kilci, Gökhan Aksan, Gökhan Çetinkal, Süleyman Sezai Yıldız, Füsun Kocaman Türk, Gülsüm Bingöl PMID: 28902644 doi: 10.5543/tkda.2017.28302 Pages 533 - 537 Objective: Oxidative stress (OS) is involved in the pathogenesis of atherosclerosis. Hyperbaric oxygen therapy (HBOT), in which 100% oxygen is inhaled under hyperbaric pressure, may create OS. Therefore, the aim of this research was to measure the serum oxidized low-density lipoprotein (oxLDL) level in patients undergoing HBOT. Methods: Twenty-nine patients who underwent HBOT to treat various diseases were enrolled in this study. The serum oxLDL level was measured at the beginning of the first and after the 10th therapy session. Results: There was no significant difference between the oxLDL level of patients before and after HBOT (4.96±0.1 vs. 4.94±0.1 U/mL; p=0.36). Conclusion: HBOT seems to be safe in terms of oxLDL production up to 10 sessions. However, further large-scale studies investigating longer duration of HBOT treatment are required to understand the role of OS. |
CASE REPORT | |
8. | A rare cause of cyanosis in childhood: Pulmonary arteriovenous malformation Osman Güvenç, Murat Saygı, İbrahim Halil Demir, Ender Ödemiş PMID: 28902645 doi: 10.5543/tkda.2016.57262 Pages 538 - 540 Pulmonary arteriovenous malformation, which is defined as the presence of an ab-normal connection between the pulmonary artery and pulmonary vein, is rarely seen. Although it generally presents as a congenital condition, it may be accompanied by hereditary hemorrhagic telangiectasia. Clinical signs vary according to the amount of shunt in proportion to the number and size of the fistulae. Patients may present with cyanosis and respiratory trouble. If the disease remains untreated, it may result in cardiac failure and ineffective endocarditis, thereby leading to the rupture of the an-eurysmal fistula. Transcatheter embolization of abnormal vascular connection is the current treatment method in this disease. This article describes the case of an 8½-year-old child. He was presented with the symptom of getting tired quickly. Transcutaneous oxygen saturation of 75%, and pulmonary arteriovenous malfor-mation was detected in his examination. Successful transcatheter fistula embolization was performed. |
9. | A massive left-to-right shunt due to delayed spontaneous perforation of polyvinyl alcohol membrane of atrial septal occluder Serdar Bozyel, Tayfun Şahin, Emir Dervis, Müjdat Aktaş, Hüseyin Şaşkın PMID: 28902646 doi: 10.5543/tkda.2017.04640 Pages 541 - 544 Percutaneous closure of an atrial septal defect (ASD) has emerged as an alternative to surgery. A 54-year-old woman with a history of percutaneous ASD closure with a 30-mm Cardia Ultrasept septal occluder (Cardia Inc., Eagan, MN, USA) comprising 2 discs made of Nitinol wire mesh covered with polyvinyl alcohol (PVA) membrane, was admitted to the hospital with unstable angina pectoris. In a routine examination, transthoracic echocardiography revealed a left-to-right shunt through the device. Transesophageal echocardiography (TEE) also demonstrated significant left-to-right shunt through the central portion of the prosthesis. Coronary angiography was performed, which disclosed severe stenosis in the right and left anterior descending coronary arteries. Three-dimensional TEE showed multiple perforations of the PVA membrane with intact nitinol frame. Surgical removal of failing device and closure of the ASD with a pericardial patch was performed together with coronary artery bypass graft surgery. On perioperative view, the device appeared to have been correctly implanted, and the device frame was completely intact; however, the PVA membrane of both the right and left discs had almost completely disappeared and there was incomplete endothelialization around the frame. Surgeons must be aware of this rarely seen complication and they should re-examine all patients implanted with Cardia devices in regular follow-up examinations for a long period of time. |
10. | Isolated left-sided partial anomalous pulmonary venous connection in a child İsmihan Selen Onan, Onur Sen, Selman Gokalp, Burak Onan PMID: 28902647 doi: 10.5543/tkda.2017.68745 Pages 545 - 548 Isolated left-sided partial anomalous pulmonary venous connection with intact interatrial septum is a rare diagnosis in childhood. In these cases, a vertical vein drains the left upper pulmonary lobe into the brachiocephalic vein and finally to the right atrium. Surgical treatment is performed to prevent right ventricular failure and pulmonary artery disease in advanced age. In this report, the rare entity of isolated left-sided anomalous pulmonary venous connection in a 14-year-old girl and successful minimally invasive surgery without cardiopulmonary bypass are described. |
11. | Fabry disease: An overlooked diagnosis in adult cardiac patients Meral Kayıkçıoğlu, Evrim Şimşek, Sema Kalkan Uçar, Selen Bayraktaroğlu, Hüseyin Onay, Eser Sözmen, Mahmut Çoker PMID: 28902648 doi: 10.5543/tkda.2017.68709 Pages 549 - 555 Fabry disease is a rare, X-linked, lysosomal glycosphingolipid storage disorder. A deficiency of the enzyme alpha-galactosidase results in intracellular accumulation of globotriaosylceramide in multiple cell types, such as those of the nerves, kidneys, cardiac, and cutaneous tissues, leading to a multisystem disease. Male patients are more severely affected; however, heterozygous female patients may also be afflicted, though often the symptoms develop later. Cardiac involvement can include left ventricular hypertrophy, conduction abnormalities, arrhythmias, valvular abnormalities, and heart failure. A variant of the disease affects only cardiac tissue and mostly manifests as unexplained ventricular hypertrophy. Presently described are 2 cases of Fabry disease and the signs and symptoms of cardiac involvement, as well as the importance of early diagnosis to start enzyme replacement therapy before the development of irreversible tissue damage. |
12. | Percutaneous treatment of a superior mesenteric artery pseudoaneurysm and arteriovenous fistula with coil embolization: a case report Alparslan Kılıç, Mikail Yarlıoğlueş, Elif Ergün, Yılmaz Ünal, Sani Namık Murat PMID: 28902649 doi: 10.5543/tkda.2017.56346 Pages 556 - 559 Visceral artery pseudoaneurysm and arteriovenous fistula following penetrating abdominal injuries is a rarely observed complication. Presently described is the case of a 44-year-old male admitted to the hospital after having previously experienced penetrating abdominal trauma. The patient had developed a pseudoaneurysm in the superior mesenteric artery and an arteriovenous fistula between the superior mesenteric artery and vein following surgery. The patient underwent successful coil embolization procedure and he was discharged 1 day after intervention. |
13. | A rare cause of cyanosis and hypoxia that should not be forgotten after implantable cardioverter defibrillator implantation Uğur Canpolat, Nihan Bahadır, Levent Şahiner, Kudret Aytemir PMID: 28902650 doi: 10.5543/tkda.2017.34801 Pages 560 - 562 Transvenous pacemaker or implantable cardioverter defibrillator (ICD) implantation procedures are usually performed under local anesthetic, and prilocaine is the most common agent to be used. The data regarding methemoglobinemia after cardiac device implantation are scarce. Thus, presently described is the case of a 47-year-old female patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia who underwent ICD implantation for secondary prophylaxis and developed cyanosis as a result of prilocaine-associated methemoglobinemia. Prilocaine was administered during the procedure. To our knowledge, this is the second case in the literature presenting methemoglobinemia due to local anesthetic after transvenous cardiac device implantation. |
REVIEW | |
14. | Anticoagulant therapy for acute venous thromboembolism Hilal Ermiş, Necip Ermiş PMID: 28902651 doi: 10.5543/tkda.2017.94838 Pages 563 - 571 Deep vein thrombosis (DVT) and pulmonary embolism (PE) are currently defined as venous thromboembolism (VTE) since they share pathophysiological features and the treatment is similar in many respects. It has been determined that more than 90% of PE cases originate from DVT in the legs. PE, which is difficult to diagnose, has a mortality rate of 12% when untreated. The worldwide increase in obesity, cancer diseases, and average survival time also contribute to the increase in the incidence of VTE. Traditional treatment of VTE includes heparin, low-molecular-weight heparin, and warfarin. Despite availability for oral use, warfarin has a narrow therapeutic range and a wide range of food interactions. After many years of research, new oral anticoagulant agents (NOACs) are expected to overcome these handicaps in treatment. In this review, the use of NOACs in the treatment of VTE is investigated in the light of current guidelines. |
CASE IMAGE | |
15. | Occurrence of atrial fibrillation while isolating the left atrial appendage due to vasospasm at the sinoatrial node artery Uğur Canpolat, Banu Evranos, Hikmet Yorgun, Tuncay Hazırolan, Kudret Aytemir PMID: 28902652 doi: 10.5543/tkda.2017.37485 Page 572 |
16. | Inferior and anterior ST-segment elevation and successful percutaneous coronary intervention in a patient with anomalous right coronary artery originating from the mid-left anterior descending artery Özgür Kaplan, Sabri Demircan PMID: 28902653 doi: 10.5543/tkda.2017.74004 Page 573 |
17. | Acquired pseudoaneurysm of the sinus of Valsalva Ali Çoner, Sinan Akıncı, Davran Çiçek, Tonguç Saba, Haldun Müderrisoğlu PMID: 28902654 doi: 10.5543/tkda.2017.99045 Page 574 |
18. | Conservative treatment of localized periatrial hematoma associated with functional mitral stenosis, a complication of percutaneous coronary intervention Murat Akçay, Korhan Soylu, Mustafa Yenerçağ PMID: 28902655 doi: 10.5543/tkda.2017.39126 Page 575 |
LETTER TO EDITOR | |
19. | Association of neutrophil/lymphocyte ratio and CHA2DS2-VASc score with left atrial thrombus in patients who are candidates for percutaneous mitral balloon valvuloplasty Fatih Kahraman PMID: 28902656 doi: 10.5543/tkda.2017.91535 Page 576 Abstract | |
20. | Authors' reply Orhan Maden, Kevser G. Balci, Mustafa M. Balci, Serdar Kuyumcu, Hatice Selçuk, Mehmet T. Selçuk PMID: 28902657 Page 577 Abstract | |
OTHER ARTICLES | |
21. | Kardiyoloji yayınlarında gündem ve yorumlar Ertan Ural Page 578 Abstract | |
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