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Objective: Peripartum cardiomyopathy (PPCM) diagnosis made by excluding identifiable causes of heart failure (HF) and occurs end of the pregnancy or during the postpartum period of five months. It presents a clinical HF spectrum with left ventricular systolic dysfunction. Background: The purpose of this study is to retrospectively evaluate the clinical characteristics, cardiac magnetic resonance (CMR) imaging features, and end-points consisting of left ventricle recovery, left ventricular assist device implantation, heart transplantation, and all-cause mortality. Method: Outpatient HF records between 2008 to 2021 were screened. Thirty-seven patients were defined as PPCM. Twenty-five patients had CMR evaluation at the time of diagnosis, and six patients were re-evaluated with CMR. Results: The mean age was 30.5±5.6 years, and the mean LVEF was 28.2±6.7%. In thirteen(35.7%) patients, LVEF recovered during the follow-up course. The median recovery time was 281(IQR [78-358]) days. LVEF on CMR was 35.3±10.5, and three patients exhibited late gadolinium enhancement(LGE) patterns. Sub-endocardial and mid-wall uptake pattern types were detected. 18(75%) patients met the Petersen left ventricle non-compaction cardiomyopathy(LVNC) criteria. Patients with NC/C ratio lower than 2.3 had lower LVEDVi and LVESVi (124.9±35.4,86.4±7.5, p=0.003;86.8±34.6,52.6±7.6, p=0.006), respectively. The median follow-up time was 2129 (IQR [911-2634]) days. The primary endpoint-free one-year survival was 88.9%(event rate 11.1%), and five-year survival was 75.7%(event rate 24.3%). Conclusion: In a retrospective cohort of PPCM patients, 35.7% of patients’ LVEF recovered, and the primary end-point of free-five-year survival was 75%. Twenty-five patients were assessed with CMR; three of four met the Petersen CMR-derived LVNC at initial evaluation.

Introduction: Renal dysfunction in heart failure (HF) patients is associated with poor outcomes. Reduced cardiac index (CI) and right atrial pressure (RAP) are postulated to be a contributor the renal dysfunction. This study aimed to investigate the relationship between the estimated glomerular filtration rate (eGFR) and the pulmonary artery catheterization (PAC) results. Patients and Method: Hospitalized advanced HF patients, between 2016-2020 PAC performed included in the study. Renal dysfunction was defined as eGFRResults: 181 patients were included in the study, and the mean left ventricular ejection fraction (LVEF) was 20.9±3.7%, the mean eGFR was 79.8±25.4 ml/min/1.73 m , and 22.7% of patients had eGFR lower than 60 ml/min/1.73 m . CI (1.85±0.72; 1.84±0.64; p=0.47, respectively) and RAP (13.1±6.6; 13.7±6.8; p=0.61,respectively) was not significantly associated with renal dysfunction in HF patients. In the multivariable model, smoking history, AF, body mass index (BMI) revealed negative relation with eGFR, continuing ACEi or ARB therapy, and pulmonary artery capacitance index(PAC-i) were positively related variables with eGFR (pConclusion: These results indicate that CI or RAP is not the primary driver for eGFR. PAC-i and continuing ACEi or ARB positively, AF, smoking history, and BMI were negatively related factors for reduced eGFR.

Ege Üniversitesi Tıp Fakültesi’nde salgın döneminde uzaktan öğretim sürecinde kararlar, öğretim üyeleri ve öğrencilerin katılımı ile kurul ve komisyonlarca alınmıştır. Alt komisyon ve kurullarda alınan kararlar, Eğitim Komisyonunda görüşülüp kabul edildikten sonra fakültenin ve üniversitenin ilgili kurullarının onayı ile yürürlüğe girmiştir. Salgının gidişatına göre eğitimle ilgili tüm değişiklikler iç paydaşlarla dinamik bir şekilde paylaşılarak yürürlüğe konmuştur. Tüm kararlar, Fakülte ve Dönem Temsilcileri, Ege Tıp Öğrenci Kurulu ile yapılan toplantılar, öğrenci ve öğretim üyelerinin geri bildirimleri doğrultusunda “öğrenen merkezli” olacak şekilde alınmış ve yürütülmüştür. Uzaktan öğretim kapsamında, öğrenme materyalleri Fakültemizin Öğrenme Kaynakları Merkezi (ÖKM) sunucusuna yüklenmiş; senkron dersler ise Üniversitemizin sağlamış olduğu çevrimiçi alt yapı ile gerçekleştirilmiştir. Eğitim programımızda yatay ve dikey entegrasyonu güçlendiren multidisipliner entegre oturum/panellerin tamamı ve bazı teorik dersler blok yürütme kurullarının organizasyonuyla senkron olarak yapılmıştır. Çevrimiçi Ölçme Değerlendirme Usul ve Esasları oluşturulmuş, sınavlar ödev şeklinde planlanarak ÖKM üzerinden uygulanmıştır. Mezuniyet sonrası uzmanlık eğitiminin sürekliliği çevrimiçi ortamda yapılan seminer, olgu tartışmaları, konseyler ve devam eden sağlık hizmeti ile sağlanmıştır. Öğretim elemanlarına yönelik sürekli mesleksel gelişim etkinlikleri çevrimiçi ortamda sürdürülmüştür. Sonuç olarak, salgın döneminde Ege Üniversitesi Tıp Fakültesi’nde “tıp eğitimi”, tüm paydaşların katılımıyla, eğitim programının kazanımları doğrultusunda, “öğrenen merkezli” ve dinamik bir çalışma süreci ile yürütülmüştür., During the epidemic period in the Ege University Faculty of Medicine, decisions were taken by the boards and commissions with the participation of faculty members and students. The decisions taken in the sub-commissions and boards, after being discussed and accepted by the Education Commission, entered into force with the approval of the relevant boards of the faculty and the university. All educational changes have been dynamically shared with internal stakeholders. All decisions were taken and carried out in a “learner-centered” manner in line with the meetings held with the Faculty and Term Representatives, Medical Student Council, and the feedback of the students and faculty members. Within the scope of distance education, learning materials were uploaded to the server of our Faculty's Learning Resources Center (OKM); Synchronous lessons were carried out with the online infrastructure provided by our university. In our education program, all of the multidisciplinary integrated sessions/panels that strengthen horizontal and vertical integration and some theoretical courses were held synchronously with the organization of the block executive committees. Online Measurement and Evaluation Procedures and Principles were established; exams were planned as homework and applied over the OKM. Continuity of postgraduate residency training was provided by online seminars, case discussions, councils, and ongoing healthcare services. Continuous professional development activities for lecturers continued online

Hashimoto’s Thyroiditis (HsT) is one of the most frequently occurring autoimmune diseases, characterized by lymphocytic infiltration, destruction and fibrosis of thyroid tissue and the presence of antibodies to thyroid peroxidase and thyroglobulin. The effects of euthyroid Hashimoto’s thyroiditis (eHsT) on cardiovascular system are unclear. We aimed to identify if any deteriorations in LA and LV myocardial functions in patients with eHsT by 3D-STE in the current study. Fifty eight patients with eHsT and 60 age- and gender-matched controls were enrolled into the study. All participants underwent laboratory analyses which included thyroid hormones and thyroid autoantibody levels; and conventional 2D echocardiographic and 3D-STE analyses were performed. The mean age of the study patients was 34.5 ± 9 years, and 68.6% were female. Left ventricular global longitudinal strain (LV-GLS) was significantly depressed in the eHsT (+) group than in the control group (? 15.3 ± 3.6 vs. ? 22.8 ± 3.8, p

Coronary artery tortuosity (CAT) is a common finding in coronary angiography, and is defined as three fixed bends during both systole and diastole in at least one epicardial coronary artery, with each bend showing a 45° change in vessel direction. The impact of CAT on the myocardial deformation has not been completely evaluated using 3D-STE. As a result of this, we aimed to assess the effects of CAT on LV functions using 3D-STE in the present study. Eighty-two patients with CAT and 80 age- and gender-matched controls who proved to have normal coronary angiograms were enrolled into the study. 3D-STE was performed and LV-GLS, LV-GCS, LV-GAS, and LV-GRS were obtained for every patient after coronary angiography. The LV-GLS was significantly depressed in the CAT (+) group than in the control group (p = 0.001). ROC analysis was performed to find out ideal LV-GLS cut off value to predict the presence of CAT. A LV-GLS value of > ? 17 has 81.3% sensitivity, 56.7% specificity to detect the presence of CAT. The present study is the first to focus on the assessing LV myocardial functions in patients with CAT by 3D-STE. CAT has a considerable negative effect on LV myocardial longitudinal deformation as evaluated by 3D strain parameters. Our results support that patients with CAT may have subclinical LV longitudinal deformation abnormalities even though they are apparently healthy. © 2020, Springer Nature B.V.

This study evaluated whether subclinical myocardial dysfunction occurs in first-degree relatives of patients with idiopathic dilated cardiomyopathy (IDCM), using strain echocardiographic imaging, before apparent left ventricular (LV) failure is observed. The study comprised 77 subjects aged 16–63 years who had first-degree relatives with a previous or new diagnosis of IDCM. LV myocardial deformation parameters of the first-degree relatives with normal LVEF (≥55%) values, as assessed using 2D echocardiography, were evaluated. The findings of the first-degree relatives were compared with an age- and sex-matched control group (n = 86). No difference in terms of age, gender, and body surface area was detected between first-degree relatives and controls. First-degree relatives of IDCM patients had significantly lower LVEF (62.04 ± 5.8% vs. 65.65 ± 6.3%, p

Introduction Ege University is a pioneering university at Ege region with its 70 000 students and approximately 3000 academic staff. Tobacco control policies, parallel to the current regulations in the country, are an important issue for Ege University too, yet it bares important opportunities as well as barriers for an integrative approach for tobacco control on University Campus. Aim This study aims to explain the construction of Smoke-Free Ege Working Group, its formal initiation at the World No Tobacco Day (May 31st) and its subsequent action plan structured in the light of MPOWER. Methods Since 1999, smoking cessation outpatient service delivery points have been the main units of motivation for tobacco control policies at Ege University. Although Turkey is moving well about tobacco regulations, adherence to regulations is deficient and high prevalence of smoking among university staff and students remains as a major concern throughout the years. In March 2018, the administrative bodies of Medical School, have dealt their concerns to the units serving care for cessation and have gathered them at a first meeting. The Dean and Medical Manager of Medical Faculty, with a non-smoker administrative team, mentored and facilitated these efforts. Starting at this point, with regular meetings, the representatives determined their objectives, current barriers and opportunities. The construction of Smoke-Free Ege Working Group has rooted from these consecutive meetings. In the light of MPOWER, specific objectives at University Campus were listed. The major aim of the group was recognized as “changing the norms and culture for smoking”. This needed a good promotion strategy as well as collaboration with staff, students and administrative units. The efforts were collaborated with the Communications Unit of the University. A logo was created, brochures to raise awareness for the Smoke Free issue and the Working group, were prepared. The formal presentation of the Working Group was planned as a colorful activity on World No Tobacco Day, May 31st. To gather more visibility at the social media and press, representatives from three major opponent sports teams of Izmir city were invited. Results The Working Group was introduced to the media in the presence of the Rector, Dean, Medical managerl and all administrative units of the Medical School. Staff who succeeded to stop smoking, at the cessation service of the University, were awarded with certificates. The media showed great interest in the activity as it was put as “the famous sportsmen are supporting the efforts for a Smoke-free university”. Students and staff attended and shared the activity in social media as the entrance of the meeting was also colorfully designed for such promotion. Conclusions The Working Group has achieved to attract attention of staff, students and responsible bodies of the University and now moving forward for Smoke –Free Councils with students and staff representatives. Barriers and opportunities will be discussed, actions in the light of MPOWER, will be planned at these Councils. Smoke –Free Unit certifications and awards, designing smoking points outside of education and hospital settings and changing the “norm” are targeted.

Introduction We aimed to determine the smoking prevalence and related factors among 1,2,3 and 6th grade students at Ege University Faculty of Medicine. Methods This cross-sectional survey was a part of a multi-centre study throughout Turkey and the data were collected in May-June 2018. The target group of this study was 1537 medical students studying in the first, second, third and sixth grades. Questionnaires were applied to 1040 students (67.7%) who agreed to participate in the study. The coverage was 94.5%, 78.6%, 57.4%, 36.7% for the first, second, third and sixth grades, respectively. Results The overall prevalence of smoking was 18.4%, with 18.1%, 18.6%, 17.0% and 22.1% in the first, second, third and sixth grades, respectively. The mean age at starting to smoke was 16.5±2.3 yrs (min.8, max.23). Current smoking was more prevalent in males compared to females (24.3% vs. 11.7%, p

Hipertrofik kardiyomiyopati (HKM) genetik gecisli bir kalp hastaligidir. Genc sporcularda ani kardiyak olumun (AKO) en sik nedenidir. Bu olumlerin onlenebilmesi icin hekimler buyuk ozen gostermektedir. Ani kardiyak olum acisindan yuksek riskli hastalar implante edilebilen kardiyoverter defibrilator tedavisi icin adaydirlar. Ani kardiyak olum acisindan yuksek riskli bu bireylerin saptanabilmesi icin yapilan risk siniflandirmasinda kardiyak goruntuleme yontemleri onemli bilgiler saglamaktadir. Goruntuleme yontemleri ile elde edilen bilgilerin dogru yorumlanmasi ve onlemlerin alinmasi bu hastalar icin hayat kurtarici olmasi nedeniyle buyuk onem tasimaktadir. Teknolojideki gelismeler yuksek riskli hastalarin erken tespitine onemli katkilar saglamaktadir. Bu derlemede biz HKM'li hastalarin risk siniflandirmasinda goruntuleme yontemlerinin yeri ve onemini degerlendirdik.

Overnight rostral leg fluid displacement in heart failure (HF) patients is related to the high prevalence and severity of obstructive sleep apnea syndrome (OSAS). We hypothesized that rostral fluid shift would decrease in a semirecumbent (45-degree elevated) position, and evaluated the effect of semirecumbent sleeping on severity of sleep apnea in HF patients with OSAS.Demographic, anthropometric characteristics, and medical history of 30 consecutive patients with HF and OSAS were recorded. The patients underwent 2 polysomnographic procedures within 1 week: 1 while lying flat and the other in a semirecumbent position. Out of 30 patients (mean age 54.7 ± 10.2, 26 men), 16 (53.3%) were obese and 29 (96.7%) had comorbidities other than HF. Mean apnea-hypopnea index was 30.8 ± 20.7 events/h while lying flat which decreased to 17.8 ± 12.1 events/h in semirecumbent position (P.0001). Similarly, oxygen desaturation index decreased from 22.3 ± 19.8 to 12.7 ± 11.5 events/h (P.0001), and the percentage of sleep time with oxygen saturation (SpO2)90% (P = .036) and lowest SpO2 (P = .004) were improved in the semirecumbent position. Furthermore, the percentage of stage N2 sleep decreased from 47.0% while lying flat to 39.6% (P = .014).The present findings support that the severity of OSAS decreased significantly in a semirecumbent sleep position in patients with HF. Therefore, semirecumbent sleeping may be a promising therapeutic option in the management of HF-related sleep apnea.

WOS: 000351491700014, PubMed ID: 24671901, Background: We evaluated the associations among the well-known atrial fibrillation (AF) predictors including P-wave dispersion (PWD), intra- and inter-atrial electromechanical dyssynchrony (EMD), left atrial (LA) phasic functions, and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels, in patients with hypertrophic cardiomyopathy (HCM). Methods: Seventy patients with HCM and age and sex matched 70 subjects were enrolled. PWD, LA total emptying fraction (LATEFr), active emptying fraction (LAAEFr), passive emptying fraction (LAPEFr), expansion index (LAEI) intra-and inter-atrial EMD were calculated. Levels of NT-proBNP of all subjects were determined. Results: Higher PWD (p = 0.006), significantly decreased LAEI (p < 0.001), LATEFr, and LAPEFr (both p values < 0.001) values and significantly increased inter-atrial (p < 0.001), LA (p = 0.001), and right atrial dyssynchrony (p < 0.001) were observed in the HCM group compared to controls. PWD was negatively correlated with LAEI (r = -0.236, p = 0.005) and LATEFr (r = -0.242, p = 0.04), however not with LAPEFr (p = 0.7), or LAAEFr (p = 0.3). Except for the LA lateral wall PA' (r = 0.283, p = 0.02), PWD was not correlated with any atrial EMD parameter. Inter-atrial dyssynchrony was related to LAEI (r = -0.272, p = 0.001), LATEFr (r = -0.256, p = 0.03), and LAPEFr (r = -0.332, p = 0.006), but not, however, to LAAEFr (p = 0.4). The plasma NT-proBNP levels of patients were not correlated with either PWD (p = 0.927) or inter-atrial dyssynchrony (p = 0.102). Conclusions: PWD and inter-atrial dysynchrony seem to independently promote AF, although both are associated with LA reservoir function in HCM populations. The NT-proBNP level is not associated with these two AF predictors in patients with HCM. NT-proBNP seems to be a poor marker of atrial electrical remodeling in HCM patients., Ege UniversityEge University [11-TIP-044], This study was supported by a grant from Ege University (11-TIP-044) and we would like to thank to Dr Raika Durusoy for her guidance in statistical analysis.

WOS: 000417875700007, PubMed ID: 29145216, Objective: This study compared the efficacy and safety of warfarin in specialized international normalized ratio (INR) outpatient clinic (INR-C) and in general cardiology outpatient clinic (General-C). Methods: Herein, 381 consecutive patients with a regular follow-up at INR-C (n=233) or General-C (n=148) for at least 1 year were retrospectively included. While INR-C patients were followed by a single experienced trained nurse, General-C patients were followed by a different cardiologist who worked in a rotational principle every month. During controls, demographic characteristics, INR levels, bleeding events, ischemic stroke, and transient ischemic attacks in the last 1 year were recorded. Primary endpoint was defined as the evaluation of the combined major bleeding and ischemic event, and secondary endpoint was defined as the evaluation of them separately. Results: The mean age of the patients was 62 +/- 12.86 and 43.8% were male. Mean time in therapeutic range (TTR) level was statistically higher in INR-C than that in General-C (68.8%+/- 15.88 and 51.6%+/- 23.04, respectively; p

An increase in intraocular pressure following cataract surgery is very common. The main reason for this condition is viscoelastic agent remaining in the eye, which leads to mechanical obstruction of the trabecular meshwork. Prophylaxis with oral acetazolamide is frequently practised to prevent this early rise in intraocular pressure in the preoperative and postoperative periods. We report a case of an 81-year-old man with acute pulmonary oedema due to prophylactic acetazolamide intake after cataract surgery. The case is presented in order to draw attention to this serious complication.

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac disorder. It is the most common reason of sudden cardiac death (SCD) in young athletes. Prevention of these deaths is of high concern among physicians. Patients with high risk of SCD are canditates for implantable cardioverter device therapy. Cardiac imaging modalities provide important data in risk stratification for identifying HCM patients with high risk of SCD and interpreting the data obtained by different imaging modalities is important for prevention of SCD in this population. In this review, we evaluated the role of imaging modalities and their values in risk stratification of patients with HCM., Hipertrofik kardiyomiyopati (HKM) genetik geçişli bir kalp hastalığıdır. Genç sporcularda ani kardiyak ölümün (AKÖ) en sık nedenidir. Bu ölümlerin önlenebilmesi için hekimler büyük özen göstermektedir. Ani kardiyak ölüm açısından yüksek riskli hastalar implante edilebilen kardiyoverter defibrilatör tedavisi için adaydırlar. Ani kardiyak ölüm açısından yüksek riskli bu bireylerin saptanabilmesi için yapılan risk sınıflandırmasında kardiyak görüntüleme yöntemleri önemli bilgiler sağlamaktadır. Görüntüleme yöntemleri ile elde edilen bilgilerin doğru yorumlanması ve önlemlerin alınması bu hastalar için hayat kurtarıcı olması nedeniyle büyük önem taşımaktadır. Teknolojideki gelişmeler yüksek riskli hastaların erken tespitine önemli katkılar sağlamaktadır. Bu derlemede biz HKM'li hastaların risk sınıflandırmasında görüntüleme yöntemlerinin yeri ve önemini değerlendirdik.

In this study, efficacy of the angiotensin II type 1 receptor blocker telmisartan given as monotherapy was compared with that of perindopril monotherapy in patients with mild-to-moderate hypertension. After a 2-week, single-blind, placebo run-in period, 60 patients were randomised to double-blind, once-daily treatment with telmisartan 80 mg or perindopril 4 mg for 6 weeks. Clinic and ambulatory blood pressure measurements and clinical laboratory evaluation were performed at the end of the placebo run-in and active treatment phases. Both telmisartan and perindopril significantly (p < 0.0001) reduced clinic systolic blood pressure (SBP) and diastolic blood pressure (DBP) compared with baseline values. Also, both drugs significantly (p < 0.0001) reduced 24-h mean ambulatory SBP and DBP compared with baseline. Comparison of the mean hourly antihypertensive activities showed that the reduction in mean ambulatory DBP for the last 8 h of the dosing interval was significantly greater (p < 0.05) in telmisartan-treated patients. A 24-h mean DBP of

Background: Secondary pulmonary hypertension (PH) and cor pulmonale are the major clinical cardiovascular complications affecting prognosis in patients with chronic obstructive pulmonary disease (COPD). It is also known that endothelin-1 (ET-1) is a potent vasoconstrictor peptide produced by the pulmonary vascular endothelium, and ET-1 may be implicated in the pathogenesis of PH. Objectives: The purpose of this study was to investigate the presence of ET-1 in patients with COPD and to assess the correlation of ET-1 levels in the plasma and bronchoalveolar lavage (BAL) fluid (BALF) in COPD patients with or without PH. Methods: Twenty-two patients with COPD and 15 healthy controls were enrolled in the study. Peripheral venous blood samples were collected in all patients and controls. BAL was obtained in COPD patients, and ET-1 levels were measured by radioimmunoassay in all plasma and BALF samples. Results: Plasma ET-1 levels were 2.46 ± 0.55 and 1.70 ± 0.42 pmol/dl in patients with COPD and controls, respectively (p < 0.0001). Sixteen of the 22 patients with COPD (73%) had PH established by echocardiography. The ET-1 level in these patients amounted to 2.59 ± 0.50 pmol/dl, and it was 2.10 ± 0.54 pmol/dl in 6 patients with COPD without PH. In COPD patients with and without PH, BALF ET-1 levels were 0.19 ± 0.08 and 0.24 ± 0.01 pmol/dl, respectively (p > 0.05). Conclusions: These results suggest that ET-1 is detectable in both the peripheral blood and BALF of COPD patients, but the levels do not statistically differ between patients with and without PH.

Left ventricular hypertrophy (LVH) increases the risk of ventricular arrhythmias and sudden death and has a significant effect on total cardiovascular mortality. QT dispersion (QTd) is a measure of inhomogeneous repolarization and is used as an indicator of arrhythmogenicity. In this study we detected QTd in patients with different etiologies of left ventricular hypertrophy and the effect of LVH in QTd on endurance athletes. The study group consisted of 147 white male subjects with 3 different etiologies of LVH and 30 healthy male individuals. The underlying etiologies of LVH were essential hypertension, valvular aortic stenosis and long-term training (athletic heart). QTd was measured by surface electrocardiogram and Bazett's formula was used to correct QTd for heart rate (QTcd). Left ventricular mass was determined by transthoracic echocardiography and left ventricular mass index was calculated in relation to body surface area. The QTcd was significantly higher in patients with pathological LVH (due to hypertension and aortic stenosis) than in the athletes' group (physiological LVH) and healthy subjects (P0.05). The magnitude of QTcd was similar between athletes and the control group (P=0.6). The difference of QTcd between the groups with pathological LVH was not statistically significant (P=0.1). In conclusion; the increasing of QT dispersion is associated with only pathological conditions of LVH. The left ventricular hypertrophy has not a negative effect in QT dispersion on endurance athletes. The measurement of QT dispersion may be a non-invasive useful method for screening additional pathological conditions in endurance athletes.

Background: The high incidence of ventricular arrhythmias in patients with hypertension and left ventricular hypertrophy (LVH) is well documented. However, few studies have been conducted on the prevalence of ventricular arrhythmias in patients with isolated systolic hypertension without LVH. Objectives: The objectives of this study were to (1) determine the prevalence of ventricular arrhythmias in patients with systolic hypertension without LVH and (2) estimate the effect of a perindopril/indapamide combination, which does not have an antiarrhythmic effect, on the incidence of ventricular arrhythmias. Methods: Patients with newly diagnosed isolated systolic hypertension (systolic blood pressure [SBP] >160 mm Hg) and a control group of normotensive patients were enrolled. During the 2-week washout period, patients underwent physical examination (including blood pressure measurements), ambulatory electrocardiography monitoring, echocardiography, and laboratory urine and blood tests. Absence of LVH was confirmed by echocardiographic examination. The group of hypertensive patients received 1 tablet of 2 mg perindopril/0.625 mg indapamide per day for a total of 4 weeks. Physical examinations and ambulatory electrocardiographic monitoring were repeated after treatment. Results: A total of 60 hypertensive (mean age, 63.1 years; mean SBP, 176.8 ± 3.1 mm Hg; mean diastolic blood pressure, 82.6 ± 2.9 mm Hg) and 60 normotensive patients were enrolled. Ambulatory electrocardiographic monitoring indicated that 18 of the 60 hypertensive patients (30%) had ventricular arrhythmias: 17 had ventricular premature contractions (>100/24 h) and 1 had ventricular tachycardia plus ventricular premature contractions. In the control group, 7 of 60 subjects (11.7%) had ventricular premature contractions. The difference between the 2 groups in incidence of ventricular arrhythmias was significant ( P P Conclusions: The results of this study suggest that in patients with isolated systolic hypertension without LVH, (1) the prevalence of ventricular arrhythmia is higher than in normotensive patients and (2) treatment with perindopril/indapamide decreases the incidence of ventricular arrhythmias.

Behcet's disease is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Cardiac involvement is an extremely rare manifestation of this disorder. We report an unusual case of Behcet's disease characterized by a mural cardiac thrombi in the right atrium and right ventricle along with transient protein C and S deficiency.

We retrospectively analyzed the blood pressure (BP) and cardiothoracic index (CTi) of 67 hemodialysis patients with hypertension who could be followed up for at least 8 months. A new treatment policy was adopted, aimed at strict volume control. Dietary salt restriction was strongly emphasized. Ultrafiltration (UF) was applied during regular dialysis sessions and sometimes in additional sessions, as long as BP and CTi remained at greater than normal values. All antihypertensive drugs were discontinued at the beginning of treatment. Average BP decreased from 173 ± 17/102 ± 9 to 139 ± 18/86 ± 11 mm Hg after 6 months and to 118 ± 12/73 ± 6 mm Hg after 36 months. Corresponding values for CTi were 52% ± 4%, 47% ± 3%, and 42% ± 4%, respectively. Conventional relatively short dialysis (three times weekly for at least 4 hours) can achieve normal BPs with prolonged effort in most patients, whereas improvement in heart condition facilitates this.

Spontaneous echo contrast (SEC) may be detected by ultrasonography in environments favoring blood stasis. It is most commonly seen through the use of transesophageal echocardiography in the left atrium of patients with rheumatic mitral valve disease especially in the presence of atrial fibrillation. We studied the predictors of SEC, such as cardiac rhythm, left atrium and left atrial appendage functions, and mitral and pulmonary vein flow parameters, in patients with rheumatic mitral valve disease. The relationship between these parameters and the severity of SEC and appearance of thrombus was evaluated.

A 56-year-old man with history of coronary bypass 6 years ago and ICD implantation 5 months ago was admitted to hospital after hearing a beeping from the ICD. On chest x-ray, the tip of the lead had migrated out of the heart silhouette. Percutaneous lead extraction was performed under close monitoring and fully equipped for pericardiosynthesis and resuscitation with on standby surgical backup. Although right ventricle perforation is a rare complication of pacemaker implants, regardless of the lead fixation mechanism, the possibility of perforation should always be considered.

Renal enfarktüs, literatürde nadiren karşılaşılan bir klinik durum olup, bir çalışmada, tüm acil servis başvurularının yaklaşık % 0,01’ini oluşturduğu belirtilmiştir. Renal enfarktüse ait özgün klinik bulgu ve belirtinin olmaması, benzer klinik tabloya sahip ve daha sık olarak görülen üriner sistem veya diğer karın içi patolojilerle karışmasından dolayı ayırıcı tanıda ilk sıralarda düşünülmemesi düşük insidansın önemli bir nedenidir. Atriyal fibrilasyon, böbreğin de tutulabildiği sistemik (miyokard, beyin veya diğer iç organlarda) arteryel embolizasyona yol açabilmektedir. Yazımızda, mitral darlığı ve kronik atriyal fibrilasyon zemininde bilateral renal enfarktüs gelişen 53 yaşında kadın olgu sunulmuştur., Renal infarction is an uncommon diagnosis with an incidence of about 0.01% of emergency department admissions. It is often mimicked by other more common diseases such as urinary system or other abdominal lesions at clinical presentation. Atrial fibrillation can result in systemic arterial embolism, involving the kidney. With atrial fibrillation, this complication risks are increased. In this report, a 53 year old woman who has bilateral renal infarction diagnosis due to atrial fibrillation is presented.

Pentalogy of Cantrell is a rare syndrome characterized by defects involving the abdominal wall, lower sternum, diaphragm, pericardium, as well as congenital cardiac anomalies. Tetralogy of Fallot is a cardiac anomaly consisting of a ventricular septal defect (VSD), dextroposition of the aorta, obstruction to the pulmonary blood flow, and right ventricular (RV) hypertrophy. Addition of atrial septal defect (ASD) to these anomalies is called pentalogy …

Amaç: Bu çalışmada semptomatik hipertrofik obstrüktif kardiyomiyopati (HOKM) nedeniyle septal alkol ablasyonu (SAA) uygulanan olguların erken ve geç dönem sonuçları değerlendirildi. Çalışma planı: Ocak 2005 - Kasım 2011 tarihleri arasında kliniğimizde medikal tedaviye dirençli semptomatik HOKM nedeniyle SAA uygulanan 15 hasta (9 erkek, 6 kadın; ort. yaş 53±14 yıl; dağılım 23-81 years) retrospektif olarak incelendi. Tüm olgulara perkütan olarak sol koroner arter içerisinden septal arter kateterize edilerek kontrast ekokardiyografi kılavuzluğunda uygun hedef bölgeye etil alkol enjeksiyonu yapıldı. Bulgular: İşlem öncesi ortalama fonksiyonel sınıf 3.5±0.5, maksimal sol ventrikül çıkış yolu (SVÇY) gradiyentleri ekokardiyografik olarak 104±25 mmHg, kateterizasyonda 97±25 mmHg ve bazal interventriküler septum kalınlığı 2.3±0.4 cm idi. İşlemin sonrasında SVÇY gradiyentleri ekokardiyografik olarak 35±15 mmHg’ye, kateterizasyonda ise 25±14 mmHg’ye düştü. Bir olguda geçici süreli Wenckebach periyodu bir olguda ise akut atriyal fibrilasyon izlendi. Septal alkol ablasyonundan sonra geçen süre ortalama 1196±675 gündü. Hastaların 6. aydaki ortalama fonksiyonel sınıfları 1.2±0.6 idi. Bir olguya üçüncü yılda tekrarlayan yakınmalar nedeniyle tekrar SAA işlemi yapıldı. İzlem süresi içerisinde bir olgunun işlemden yaklaşık bir yıl sonra kaybedildiği öğrenildi. Başlangıçta üç olguda kardiyak defibrilatör ve bir olguda kalıcı kalp pili mevcut iken, izlem boyunca hiçbir olguya yeni kalp pili takılması gerekmedi. Sonuç: Medikal tedaviye dirençli, semptomatik ve uygun seçilmiş HOKM olgularında, SAA kabul edilebilir bir başarı ve güvenilirlikle uygulanabilir., Background: This study aims to evaluate early- and late outcomes of alcohol septal ablation (ASS) in symptomatic patients with hypertrophic obstructive cardiomyopathy (HOCM). Methods: Between January 2005 and November 2011, 15 patients (9 males, 6 females; mean age 53±14 years; range 23 to 81 years) who underwent ASS in our clinic due to medically refractory symptomatic HOCM were retrospectively analyzed. In all cases, septal artery was catheterized percutaneously through the left coronary artery and ethyl alcohol was injected to appropriate target site with contrast echocardiographic guidance. Results: The mean preoperative functional class was 3.5±0.5, maximum left ventricular outflow tract (LVOT) gradients were echocardiographically 104±25 mmHg, in catheterization 97±25 mmHg and basal interventricular septal thickness was 2.3±0.4 cm. Following the procedure, LVOT gradients echocardiographically decreased to 35±15 mmHg and in catheterization to 25±14 mmHg. A temporary Wenckebach episode in one case and acute atrial fibrillation in one case were observed. The mean time from ASS was 1196±675 days. At six months, the mean functional class of the patients was 1.2±0.6. One case underwent re-SAA due to recurrent complaints at three years. During the follow-up, one case died within a year following the procedure. At baseline, three cases had cardiac defibrillators and one case had a pacemaker, no case required new pacemaker during the follow-up period. Conclusion: In appropriately selected patients with medically refractory and symptomatic HOCM, ASS can be applied with an acceptable success and reliability.

Cardiac cyst hydatic is a rare disease. Two cases with left and right ventricular involvement are presented that demonstrate the use of echocardiography in the diagnosis and during follow up of the disease.

WOS: 000285431300010, PubMed ID: 20952354, Objective: Any disease specific Health Related Quality of Life Instrument for Chronic Heart Failure (CHF) is lacking in Turkey. The aim of this study is to adapt the Chronic Heart Failure Questionnaire (CHQ) into Turkish and probe the reliability and validity of this questionnaire. Methods: There are four dimensions of this 20 items scale. These dimensions are: dyspnea (5 items), fatigue (4 items), emotional status (7 items) and mastery (4 items). Response options were evaluated using a 7 -point Liken type scale. Quality of life (QOL) improves as the score increases. A total of 205 CHF patients hospitalized in the Department of Cardiology of Ege University hospital were enrolled in this study. The CHQ was applied to the patients twice with a wash-out period of 15 days. Confirmatory approach was used during the reliability and validity analysis. Cronbach alpha test was used for the reliability analysis. Confirmatory factor analysis (CFA) was used for the construct validity testing. NYHA classification for testing the criterion validity; SF-36 and WHOQOL-100 General Health and QOL facet for convergent validity testing of the Turkish version of the CHQ were used. Responsiveness to change was evaluated by Effect Size analysis by using test-retest data. Results: The range of Cronbach alpha values is 0.72-0.94. A considerable ceiling and floor effects were observed for the dyspnea dimension of the scale but no problematic items were observed for the entire scale. The CFA results supported the original four factors scale structure. Criterion and construct validity rebuts were satisfactory. Effect sizes obtained among dimensions of the CHQ were between 0.13 and 0.56. Conclusion: Overall results revealed that Turkish version of the CHQ is a reliable and valid instrument to be used for the evaluation of CHF patients. (Anadolu Kardiyol Derg 2010; 10: 526-38)

WOS: 000282730600001, PubMed ID: 20704764, Background: Early surgery is recommended for asymptomatic severe mitral regurgitation (MR), because of increased postoperative left ventricular (LV) dysfunction in patients with late surgery. On the other hand, recent reports emphasized a "watchful waiting" process for the determination of the proper time of mitral valve surgery. In our study, we compared magnetic resonance imaging (MRI) and transthoracic echocardiography to evaluate the LV and left atrial (LA) remodeling; for better definitions of patients that may benefit from early valve surgery. Methods: Twenty-one patients with moderate to severe asymptomatic MR were evaluated by echocardiography and MRI. LA and LV ejection fractions (EFs) were calculated by echocardiography and MRI. Pulmonary veins (PVs) were measured from vein orifices in diastole and systole from the tangential of an imaginary circle that completed LA wall. Right upper PV indices were calculated with the formula; (Right upper PV diastolic diameter-Right upper PV systolic diameter)/Right upper PV diastolic diameter. Results: In 9 patients there were mismatches between echocardiography and MRI measurements of LV EF. LV EFs were calculated >= 60% by echocardiography, meanwhile < 60% by MRI in these 9 patients. Severity of MR evaluated by effective regurgitant orifice area (EROA) didn't differ with preserved and depressed EFs by MRI (p > 0.05). However, both right upper PV indices (0.16 +/- 0.06 vs. 0.24 +/- 0.08, p: 0.024) and LA EFs (0.19 +/- 0.09 vs. 0.33 +/- 0.14, p: 0.025) were significantly decreased in patients with depressed EFs when compared to patients with normal EFs. Conclusions: MRI might be preferred when small changes in functional parameters like LV EF, LA EF, and PV index are of clinical importance to disease management like asymptomatic MR patients that we follow up for appropriate surgery timing.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide killing nearly 3 million people annually. Even the most optimistic estimates suggest that COPD mortality rates will increase by 50% over the next 15 years. Individuals with COPD are at increased risk of cardiovascular diseases (CVD), lung cancer, osteoporosis and muscle wasting. Smoking is a well-described risk factor for both COPD and CVD, but CVD in patients with COPD is likely to be due to other factors in addition to smoking. Systemic inflammation may be an important common etiological cause between COPD and CVD, being well described in both diseases. This paper reviews the close relationship between COPD and cardiovascular diseases, principally atherosclerosis. The common pathogenetic mechanisms, relation between cardiovascular comorbidities and pulmonary function parameters, the treatment of pulmonary and systemic inflammation, the role medications in the treatment of both disorders, the effect of cardiovascular comorbidities on the prognosis of COPD and prediction of mortality is discussed. The anti-inflammatory effects of inhaled corticosteroids and statins, their effects on cardiovascular endpoints, all-cause mortality, and survival of COPD patients are reviewed as a new perspective to the treatment.

The study aimed to evaluate the effects of putting a sandbag on femoral access site after cardiac invasive procedure and changing patients' position in bed on vascular complications rate and the severity of back pain related to the duration of bed rest after procedure.This randomized controlled study included 169 patients divided into five different groups assigned randomly. Group 1 patients were applied 4.5 kg sandbag for 30 minutes and Group 2 patients were applied 2.3 kg sandbag for 2 hours on femoral access site after procedure. Group 1 and 2 patients' body positions were changed every hour beginning from the second hour. Group 3 patients received application of 4.5 kg sandbag for 30 minutes and Group 4 patients were applied 2.3 kg sandbag for 2 hours on femoral access site after procedure and these patients' body positions were not changed after catheterization. Group 5 patients remained in supine position without changing position and had no application of a sandbag.The incidence of vascular complications was not significantly different in the group with application of sandbag when compared with the group without application of sandbag. Back pain was reported more often in the patients whose positions were not changed and whose heads of beds were not raised (p0.05).Sandbag was not effective in decreasing the incidence of the vascular complications after procedure. To increase the comfort and to decrease the back pain of the patient, the patient's position should be changed and the head of the bed should be raised about 30 or 45 degrees.

Amaç: Epidemiyolojik çalışmalar yüksek trigliserid düzeylerinin koroner arter hastalığı (KAH) riskini artırdığını göstermiştir. Bu çalışmada, bir üçüncü basamak sağlık merkezinin, koroner arter hastalarında trigliserid düzeylerine yaklaşımı değerlendirildi. Çalışma planı: Çalışmaya, bir üniversite hastanesi kardiyoloji kliniğine son bir ay içinde angina pektoris yakınmasıyla başvuran ve elektif koroner anjiyografi amacıyla yatırılarak KAH saptanan ardışık 100 hasta (79 erkek, 21 kadın; ort. yaş 58±10) alındı. Çalışma verileri olguların hastane dosya kayıtlarından elde edildi. Hastaların lipid profilleri ve uygulanan tedaviler incelendi. Bulgular: Hastaların %66’sı hiperlipidemikti. Ortalama lipid düzeyleri şu şekildeydi: Total kolesterol 203±44 mg/dl; trigliserid 195±106 mg/dl; yüksek yoğunluklu lipoprotein 43±11 mg/dl, düşük yoğunluklu lipoprotein 124±38 mg/dl. Olguların %31’i yatışta statin kullanıyordu ve taburcu olurken %65’ine statin önerilmişti. Hiçbir hasta yatışta fibrat türevi kullanmıyordu. On hastada trigliserid düzeyine hiç bakılmamıştı. Trigliserid düzeyinin ölçüldüğü hastaların sadece 29'unda (%32.2) trigliserid düzeyi ATP III kılavuzuna göre normal sınırlardaydı (, Objectives: Epidemiological studies have demonstrated that elevated triglyceride levels increase the risk for coronary artery disease (CAD). This study sought to evaluate the approach to triglyceride levels in patients with CAD in the cardiology department of a tertiary medical center. Study design: The study consisted of 100 consecutive patients (79 males, 21 females; mean age 58±10 years) who were admitted to the cardiology department of a university hospital with angina pectoris and were found to have CAD by elective coronary angiography. Data were obtained from hospital records. Lipid profiles of the patients and management strategies were assessed. Results: Hyperlipidemia was detected in 66%. The mean total cholesterol, triglyceride, high- and low-density lipoprotein cholesterol levels were 203±44 mg/dl, 195±106 mg/dl, 43±11 mg/dl, and 124±38 mg/dl, respectively. On admission, none of the patients were receiving fibrates, and 31% were on statin treatment, which increased to 65% on discharge. In 10 patients, triglyceride levels were not determined at all. According to the Adult Treatment Panel III (ATP III), triglyceride levels were normal (

A left ventricular aneurysm (LVA) is most commonly the result of myocardial infarction, usually involving the anterior wall. A left ventricular pseudoaneurysm (LVPSA) or false aneurysm forms when cardiac rupture is contained by adherent pericardium or scar tissue. The accurate diagnosis, although difficult to establish, is an important one to make because these aneurysms are prone to rupture. In this article, we report a challenging case of a cardiac aneurysm a year after a coronary bypass operation which could not be definitively diagnosed despite of imaging with different techniques including echocardiography, coronary angiography, left ventriculography and magnetic resonance imaging (MRI). The patient underwent a second cardiac surgery, the aneurysm was resected, the mitral valve was replaced and the defect in the ventricular wall was repaired. Because of the combined diagnostic capabilities like detailed and functional pathoanatomy and aneurysmal wall characterization, MRI seems to have multiple advantages in differential diagnosis.

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Perkütan koroner girişimler (PKG) sırasında meydana gelen endotel hasarı, miyokard iskemisi/hasarı ve hemodinamik değişikliklerin sempato-adrenerjik ve nörohumoral sistem aktivasyonuna neden olabildiği gösterilmiştir. Bu çalışmada, PKG.esnasında ortaya çıkan plazma Anjiotensin-ll değişikliklerinin incelenmesi ve takip dönemindeki restenozla ilişkisinin incelenmesi hedeflenmiştir. Çalışmaya nativ koroner artere elektif PKG endikasyonu konan ve başarılı olarak işlem uygulanan toplam 76 olgu ve özellikleri benzer 15 sağlıklı olgu kontrol grubu olarak alındı. Olguların bazal, işlem sonrası ve 24.saatte venöz plazma Ang-ll düzeyleri için kan örnekleri alındıktan sonra,ortalama 5,8±1 ay süre ile izlendiler. Bazal plazma Ang-ll düzeyleri, çalışma olgularında kontrol grubuna göre daha yüksek saptanmakla birlikte bu fark anlamlı değildi (15±6pm/L'ye karşın 14±5pm/L, p=0.299). PKG sonrasında ise hemen yapılan ölçümlerde Ang-ll düzeylerinde ve 24. saat ölçümlerinde bir artış izlenmekteydi (Bazal Ang ll'ye göre hemen sonrasında 25±15pm/L, p, It has been shown that during percutaneous coronary intervention (PCI), sympatho-adrenergic and neuro-humoral system activation can occur due to endothelial injury, myocardial ischemia/injury and hemodynamic changes. In this article, we aimed to investigate the changes öf plasma Anjiotensin - II levels during PCI and its relationship between restenosis at the follow-up. We enrolled 76 cases which was performed elective and succesful PCI to a native coronary artery and 15 healthy controls. Blood samples were withdrawn before, after PCI and at the 24. hour of PCI for venous plasma Ang-ll and they were followed-up 5,8+1 months. Basal plasma Ang-ll levels were insignificantly higher in the PCI group (15±6 pm/L vs 14±5 pm/L, p=0.299). Post-PCI and 24.hour measurements were significantly higher ( Basal 15±6 pm/L vs Post-PCI 25±15pm/L, p

PP-228 In this study, we investigated the effect of percutaneous closure of ASD on the right ventricular global and segmental strain (S)strain rate (SR) values. Our study consisted of 22 patients with secundum ASD and 22 healthy subjects of similar age distribution and characteristics as control

In this study we aimed to investigate whether serum C- reactive protein (CRP) levels are related with the incidence of coronary artery disease (CAD) and selection of management approaches in stable angina pectoris (SAP).Overall 134 patients (pts) with SAP and positive exercise stress test were investigated. All pts were divided into two groups according to the baseline levels of CRP. In group 1 (mean age 57.8+/-10.3 years) there were 41 pts with the level of CRP0.50mg/dl (high levels of CRP) and group 2 consisted of 93 pts (mean age 56.0+/-11.7 years) with the CRP levels0.50mg/dl (normal levels of CRP). We investigated the relationship between CRP levels with coronary artery disease and treatment strategies.There were no significant differences in age, sex, hypertension and hyperlipidemia between groups. In group 1 (n=41) 36 pts, and in group 2 (n=93) 58 pts had CAD (p= 0.004). We found statistically significant relationship between high levels of CRP and smoking and diabetes mellitus. After adjustment of these risk factors by multivariate regression analyses the CRP association with CAD become attenuated but was still statistically significant (p=0.03).In this study we found that high level CRP is an independent strong marker of CAD in middle-aged patients with stable angina and positive treadmill exercise test. There was no correlation between CRP levels and interventional procedures.

Amaç: Bu çalışmada, kararlı anjina pektoris tanımlayan ve efor testi pozitif bulunan ayaktan hastalardaki serum C-reaktif protein (CRP) düzeyiyle koroner arter hastalığının (KAH) sıklığı ve tedavi seçimi arasındaki ilişkiyi araştırdık. Yöntem: Kararlı anjinası olan ve efor testi pozitif bulunan 134 hasta çalışmaya alındı. Tüm hastalar CRP düzeylerine göre iki gruba ayrıldılar. Birinci grup (Grup 1I), CRP düzeyi >0.50 mg/dl (yüksek CRP düzeyi) olan ve ortalama yaşları 57.8±10.3 yıl olan 41 hastadan oluşmaktaydı. İkinci grupta (Grup 2) ise CRP düzeyi, Objective: In this study we aimed to investigate whether serum C- reactive protein (CRP) levels are related with the incidence of coronary artery disease (CAD) and selection of management approaches in stable angina pectoris (SAP). Methods: Overall 134 patients (pts) with SAP and positive exercise stress test were investigated. All pts were divided into two groups according to the baseline levels of CRP. In group 1 (mean age 57.8±10.3 years) there were 41 pts with the level of CRP >0.50mg/dl (high levels of CRP) and group 2 consisted of 93 pts (mean age 56.0±11.7 years) with the CRP levels

Erectile dysfunction (ED) commonly coexists with coronary artery disease (CAD) and/or risk factors for atherosclerosis. Because the silent or documented atherosclerosis or vascular risk factors are very frequent, the possibility of endothelial dysfunction in ED patients is expected to be increased. Our aim was to evaluate the endothelial functions in patients with vasculogenic ED with vascular risk factors and compare them with age-matched non-ED patients or healthy controls.We studied 36 patients with presumed vasculogenic ED, 39 age-matched patients with similar risk factors without ED and 25 age-matched healthy controls without ED, known cardiovascular disease or risk factors. Erectile function was evaluated by the International Index of Erectile Dysfunction (IIEF) scores. Brachial artery flow-mediated dilatation (FMD) and nitroglycerine-mediated dilatation (NMD) were measured.Baseline demographics were similar except the IIEF score and duration of diabetes in patients with ED. Brachial artery FMD and NMD were significantly reduced in patients with ED (3.2+/-3. vs. 6+/-4, p0.0001 for FMD, 12.2+/-6 vs. 15.4+/-6 p=0.032 for NMD). In patients with similar risk factors but without ED, FMD was significantly lower but NMD were not different compared with healthy controls (6+/-4 vs. 10.2+/-3, p0.0001 for FMD and 15.4+/-8 vs. 16.4+/-6, p=0.81). IIEF scores were weakly correlated with FMD (r=0.25, p=0.028) in patients with ED. There were significant correlations between FMD and NMD in patients with ED (r=0.46, p=0.05) and with risk factors (r=0.72, p0.0001) but not in healthy controls (r=0.54, p=0.792). Vasculogenic ED patients have more markedly impaired endothelial and smooth muscle functions compared with patients with similar risk factors but no ED.

WOS: 000178272900008, PubMed ID: 12227714, The incidence and nature of cardiac involvement in Behcet's disease are not yet clearly documented. We first used transesophageal echocardiography in combination with resting and signal averaged electrocardiography to define cardiac involvement in Behcets patients. Transthoracic and multiplane transesophageal echocardiography, and resting and signal averaged electrocardiography were performed in 35 Beh et's disease patients (9 women and 26 men, mean age: 38 12 years) and 30 normal subjects. Higher incidences of interatrial septum aneurysm (31% to 6%), mitral valve prolapse (25% to 3%), mitral regurgitation (40% to 6%) and aneurysmal dilatations of sinus valsalva and ascendan aorta were observed in the Beliget's disease patients than in the normal subjects. Mean QT dispersion and mean corrected QT dispersion values were significantly greater in the patients with Beliget's disease. Patients with interatrial septum aneurysm (and/or PFO), valvular dysfunction or proximal aorta dilatation had greater QT dispersion values than thase without these pathologies in the Behqet's group (63+/-11 vs 44+/-19 ms, 58+/-23 vs 41+/-24 and 60 27 vs 42 23 ms respectively, P