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Yuksel, Serkan/0000-0001-9501-4568 WOS: 000326458600005 PubMed: 23530911 This study has attempted to evaluate the relationship between aortic stiffness, blood pressure (BP) and serum endothelin-1 (ET-1) levels in patients with essential HT. Totally 152 subjects, consisting of 103 patients diagnosed with HT at least 1 year previously and 49 healthy individuals, were enrolled in this study. They were subdivided, on the basis of BP measurements made at home, into three groups as the hypertensives with dysregulated BP (n = 56), the hypertensives with regulated BP (n = 47) and the normotensive controls (n = 49). Statistically significant differences were observed between the three groups with respect to aortic elasticity parameters (p < 0.01 for aortic strain, aortic distensibility and aortic stiffness). Serum ET-1 levels in the three groups were similar (p = 0.101), but a significant correlation was observed between the ET-1 values and the aortic elasticity parameters (p = 0.004). Alteration of the aortic elasticity parameters in patients with HT not only correlates with the serum ET-1 levels indicating endothelial dysfunction but also gives direct clues about status of BP regulation.

PubMed: 22311878 [No abstract available]

Atrial tachyarrhythmias are a known complication late after Fontan operation. Limited information is available on their prognostic value.All patients with previous Fontan operation followed at our institution since 1999 were identified from the electronic database and included in this study. Demographic and clinical characteristics including history of atrial tachyarrhythmias were recorded at the earliest full clinical assessment and patients were followed thereafter for all-cause mortality and hospitalization.A total of 98 patients, mean age 31.5 ± 8.9 years, 43.8% male, 31.6% with a total cavopulmonary connection (TCPC) were identified. A history of atrial tachyarrhythmia was present at baseline in 60.2% of patients who were older (33.0 ± 8.3 vs 29.1 ± 9.4 years, p=0.002), less likely to have a TCPC (13.5% vs 58.9%, p0.001), and more symptomatic in terms of NYHA class (51.9% vs 26.7%, p=0.007) compared to arrhythmia-free patients. During a median follow-up of 6.7 years 18 patients died and 64 patients were hospitalized. Even after adjustment for baseline clinical characteristics, atrial tachyarrhythmia was an independent predictor of death (propensity score adjusted HR 9.35, 95% CI: 1.10-79.18, p=0.04, c-statistic 0.88) and composite of death or hospitalization (propensity score adjusted HR 5.00, 95% CI: 2.47-10.09, p0.0001).In adult patients with a Fontan-type operation, the presence of atrial tachyarrhythmias is associated with higher morbidity and mortality at mid-term follow-up. Whether early arrhythmia targeting intervention may improve clinical outcome needs to be studied in a prospective manner.

PubMed: 20162733 The single coronary artery is a benign and very rare coronary artery abnormality. Anomalous origin of the right coronary artery originating fromthe left anterior descending artery has been reported previously in just a few cases. In this article, we presented a patient with an anomalous origin of the right coronary artery from the midportion of the left anterior descending artery. The anomalous coronary artery was discovered incidentally during a coronary angiography performed prior to mitral valve surgery. © 2010 Wiley Periodicals, Inc.

Magnetic resonance imaging (MRI) is one of the most advanced diagnostic methods of radiologic imaging. In patients with implanted cardiovascular devices, there can be device malfunction and deterioration in the quality of diagnostic data as a result of MRI-related interferences. This article aimed to review MRI safety in patients with implanted cardiovascular devices.

Yuksel, Serkan/0000-0001-9501-4568 WOS: 000271572500024 PubMed: 19749197 Here we present a huge cardiac cyst hydatid case with wonderful echocardiographic and computed tomographic images, causing cardiac symptoms and electrocardiographic changes.

Yuksel, Serkan/0000-0001-9501-4568 WOS: 000264334000005 PubMed: 19109761 Evaluation of atrial function has received less attention than that of the ventricle although normal atrial function is required for optimal overall cardiac function. Obesity is associated with increased cardiovascular morbidity and mortality. In this study, we compared left atrial functions in obese adults (body mass index = BMI a parts per thousand yen30 kg/m(2)) with those in non-obese adults (BMI < 30 kg/m(2)) by color tissue Doppler parameters. There were 37 adults with BMI a parts per thousand yen30 kg/m(2) (mean age 36 +/- A 11 years) and 26 adults with BMI < 30 kg/m(2) (mean age 35 +/- A 5 years). Mean BMI was 38 +/- A 6 kg/m(2) in the obese group whereas that was 24 +/- A 2 kg/m(2) in the non-obese group. For color tissue Doppler imaging, sample volumes were placed on the mid left atrium at the septum, lateral, inferior, and anterior walls. The peak systolic strain (S (s)), peak systolic strain rate (SRs), peak early diastolic SR (SRe), peak late diastolic SR (SRa), peak systolic tissue velocity (TVs), peak early diastolic TV (TVe) and peak late diastolic TV (TVa) values were measured. For each measurement, values in three consecutive cardiac cycles were measured and then averaged. To simplify the analysis, the values at each wall were combined and averaged to obtain mean values. All left atrial systolic function parameters (S (s), SRs, TVs) were similar between the groups. In addition, there was no statistically significant difference at left atrial diastolic function parameters (SRe, SRa, TVe, TVa). We could not find any significant difference between obese and non-obese adults at left atrial functions assessed by color tissue Doppler parameters.

Coarctation of abdominal aorta is a very rare vascular disease. In etiology; congenital, acquired, inflammatory and infectious mechanisms have been proposed. Patients typically present with severe hypertension.We report an atypical case of infrarenal abdominal aortic coarctation without any complication diagnosed during a cardiac catheterization study and demonstrated by multislice computed tomography.

In this study, we investigated the association of two genetic variants of the endothelial nitric oxide synthase (eNOS), T786C and G894T, with CAD. Polymerase chain reaction and restriction fragment length polymorphism analyses were performed to detect the variants of eNOS gene in 102 patients with coronary artery disease and 103 healthy controls under the age 55. The statistical analysis was done by Chi square. The genotype and allele frequencies of CAD patients and controls were compared for the T786C genetic variant of eNOS. No evidence of significant difference was found between the two groups in the frequencies of the genotype [p = 0.810, OR = 0.77(0.25-2.15)] and allele [p = 0.173, OR = 0.72(0.47-1.11)]. In addition, the genotype and allele frequencies of CAD patients and controls were compared for the G894T genetic variant of eNOS. Similarly, no evidence of significant difference were found between the frequencies of genotype [p = 0.627, OR = 0.69 (0.25-1.88)] and allele [p = 0.610, OR = 0.87 (0.56-1.36)]. The present study provides evidence that the T786C and G894T polymorphism of the eNOS gene are not associated with the early-onset coronary artery disease in our population. © 2007 Asian Network for Scientific Information.

Familial hypercholesterolaemia is a genetic disease that provides the best evidence for the causal role of low-density lipoprotein cholesterol in human atherosclerosis. The disease was first described by Muller in 1939 and is characterised by high cholesterol levels from birth, and the subsequent development of tendon and cutaneous xanthomas and premature atherosclerosis. In this case report, we described an 18-year-old female patient who was admitted to the out-patient clinic with swellings on various parts of her body. Her family history, physical examination and laboratory evaluation revealed that these swellings were giant tendon xanthomas caused by familial hypercholesterolaemia. In this report we also discuss the pathogenesis, clinical manifestations, complications and treatment of familial hypercholesterolaemia.

PP-302 Although there have been a number of studies about coronary slow flow (CSF), the pathophysiologic mechanism still has not been fully understood. There are many proposed mechanisms such as; microvascular vasomotor dysfunction, diffuse atherosclerosis, inflammation, small vessel occlusion

High baseline insulin and glucose levels and presence of accompanying dyslipidemia, which are considered in the pathogenesis of metabolic syndrome X, were also observed in patients with cardiac syndrome X, which is similar to metabolic syndrome X in many aspects. In this study we aimed to compare serum insulin, glucose and lipid levels in patients with coronary slow flow which is hypothesized as a subgroup of cardiac syndrome X with those of healthy subjects and determine the relation of corrected TIMI frame count (cTFC) with these levels.Forty-six patients with normal epicardial coronary arteries but determined as coronary slow flow in coronary angiography performed because of chest pain and 16 healthy subjects having normal coronary arteries but without coronary slow flow were included in this study. Maximal exercise stress test according to Bruce protocol was performed in all patients. Baseline serum insulin, glucose and lipid levels were measured from venous blood samples of patients in both groups. TIMI 'frame count' method was used for diagnosis of coronary slow flow. The relationship between the degree of coronary slow flow and serum insulin, glucose and lipid levels was investigated.Exercise stress test results of both groups were considered as negative regarding ischemia. There were no differences between 2 groups in serum insulin, glucose and lipid levels. (p0.05). No relationship were determined by correlations analysis between serum insulin, glucose and lipid levels and corrected TIMI frame count.Normal values of insulin, glucose and lipid levels in patients with coronary slow flow and lack of their relation with cTFC support the opinion that coronary slow flow is a separate from the cardiac syndrome X clinical entity.

We report the case of a female patient under oral prednisolone therapy due to a diagnosis of idiopathic intracranial hypertension with papilledema. Unfortunately, short-term treatment with prednisolone caused an unusual complication in the patient, i.e., recurrent myocardial ischemia. Possible mechanisms leading to this complication were evaluated in the light of current knowledge. Resumo: Descrevemos o caso clínico de um paciente sob terapia prednisolona oral devido a um diagnóstico de hipertensão intracraniana idiopática com papiledema. Infelizmente, o tratamento a curto prazo com prednisolona causou uma complicação incomum no paciente, isto é, isquemia miocárdica recorrente. Os possíveis mecanismos que conduzem a esta complicação foram avaliados em função das literaturas correntes. Keywords: Steroid, Prednisolone, Myocardial ischemia, Myocardial infarction, Coronary slow flow, Palavras-chave: Esteróides, Prednisolona, Isquemia miocárdica, Enfarte agudo do miocárdio, Fluxo lento coronário

The coronary slow flow phenomenon (CSFP) is the delayed opacification of coronary arteries in the absence of significant stenosis. The pathogenesis of CSFP has not been completely understood yet. There are several proposed mechanisms such as the structural and functional abnormalities in coronary microcirculation. Nail fold capillaroscopy is a simple, noninvasive examination of the microvasculature and suggested to be a useful technique for analysis in various inflammatory and autoimmune diseases. In this study; we hypothesized that; CSFP is a part of systemic vascular entity rather than a problem confined to coronary vasculature and our aim was to investigate the nail fold capillaries of the patients with CSFP and compare to those with normal coronary flow (NCF). The study was designed as a case-control study and total 25 patients (10 male, mean age 55 ± 9 years) with documented CSFP, and 24 patients (15 male, mean age 55 ± 11 years) with NCF were recruited. Nail fold capillaroscopy examinations were performed by video dermatoscopy in all patients and results were compared between two groups. The demographic and clinical characteristics were similar between patients of CSFP and NCF groups. Nail fold capillary abnormalities including dilatation, tortuosity and microhemorrhage were present in 15 (60%) patients in CSFP group and 5 (21%) patients in NCF group (p < 0.05 OR: 5.7 95% C.I 1.602-20.279). In this study, we found that the abnormalities in nail fold capillaries suggesting the presence of inflammation and anatomical changes were significantly higher in patients with CSFP.

Purpose: The myocardial performance index (Tei index) reflects both systolic and diastolic function of the heart and it's easily applied in the practice. In this study; we aimed to determine the relationship between Tei index and invasive hemodynamic parameters in heart failure patients. Methods: 126 patients (pts) with heart failure were selected for the study. Diagnostic cardiac catheterizations were performed in all patients. The pts were divided into 2 groups. Group I consisted of 59 pts (32 men, mean age 61±10, Functional capacity NYHA Class I and LVEDP0.05).Group II pts had longer IVCT and ET (p

After a presyncopal attack, echocardiography of a 79-year old man with atrial fibrillation and rheumatic mitral valve stenosis revealed a giant mobile ball thrombus transiently obstructing the mitral valve orifice, with another giant immobile thrombus filling the left atrial appendage (Supplementary Videos 1 and 2). Both thrombi, with dimensions of 40 × 30 and 60 × 30 mm, were removed successfully with the implantation of a prosthetic mitral valve (Figs 1 and 2). Supplementary material (Videos 1 and 2) is available at EJCTS online. Video 1: Echocardiographic apical four-chamber view of the free-floating giant ball thrombus transiently obstructing stenotic mitral valve orifice during diastole. Video 2: Echocardiographic parasternal short-axis view of the two thrombi in the left atrium.