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1. Three-dimensional Echocardiography during Percutaneous Mitral Balloon Valvuloplasty

Author

Alev Kiliçgedik and Cevat Kirma

Subjects
interventional echocardiography, mitral stenosis, percutaneous mitral balloon valvuloplasty, three-dimensional echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Percutaneous mitral balloon valvuloplasty (PMBV) has been frequently used as an alternative to open or closed surgical mitral commissurotomy for the treatment of selected patients with symptomatic rheumatic mitral stenosis. PMBV has been proven a safe and effective method, often performed under fluoroscopic guidance. With the advent of three-dimensional echocardiography (3DE), interventional cardiologists have been able to successfully perform complex procedures such as paravalvular leak closure, transcatheter edge-to-edge repair of the mitral valve (MV) using MitraClip, etc. With the expertise derived from these procedures, 3DE has received considerable interests in many other procedures, including PMBV. Pre-, intra-, and postprocedural assessments of the mitral valve (MV) area; commissural splitting; the presence, degree, and location of mitral regurgitation; and other procedure-related complications can be more accurately and readily made using 3DE. In addition, real-time 3D transesophageal echocardiography has been proven to be more accurate than two-dimensional (2D) techniques in identifying specific MV abnormalities associated with complex diseases. Moreover, real-time 3DE offers the advantage of shorter fluoroscopy and radiation times throughout PMBV. This article reviews the use of 3DE during PMBV in light of the most recent literature and based on expertise and discusses the pros and cons of 3DE, with emphasis on its superiority to conventional 2D echocardiography.

Published
2023
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2. The usefulness of morphology‐voltage‐P wave duration ECG score for predicting early left atrial dysfunction in hypertensive patients

Author

Muzaffer Kahyaoglu, Cetin Gecmen, Ozkan Candan, Mehmet Celik, Yusuf Yilmaz, Emrah Bayam, Ender Ozgun Cakmak, Ibrahim Akin Izgi, and Cevat Kirma

Subjects
hypertension, left atrial dysfunction, mvp ecg score, speckle tracking echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective Left atrial (LA) function is an important predictor of adverse cardiovascular outcomes in patients with hypertension (HT). Therefore, recognition of subtle LA dysfunction in the early stages of HT is essential for controlling modifiable variables. Several electrocardiographic and echocardiographic parameters have been studied to show early LA dysfunction. The goal of this study was to investigate the relationship between newly defined morphology‐voltage‐P wave duration electrocardiography (MVP ECG) score and early LA dysfunction in hypertensive patients. Materials and methods Eighty-nine hypertensive patients were included in this study. Based on speckle tracking echocardiography results, the patients were divided into two groups: 67 patients with normal LA function were included in Group 1, and 22 patients with abnormal LA function in Group 2. Results Age, diabetes mellitus history, duration of HT history, left ventricular mass index, E/Em, and MVP ECG score values were statistically significant between the two groups. Based on the results of the multivariate logistic regression test, duration of HT history, E/Em, and MVP ECG score were determined as independent predictive parameters for early LA dysfunction in hypertensive patients. Conclusion In conclusion, MVP ECG score assessment could be a novel approach to detect early LA dysfunction in hypertensive patients.

Published
2021
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3. Evaluation of aortic distensibility in patients with mitral valve prolapse using echocardiography and applanation tonometry

Author

Sedat Kalkan, suleyman Efe, Onur Tasar, Can Yucel Karabay, and Cevat Kirma

Subjects
aortic distensibility, mitral valve prolapse, pulse wave velocity., Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: Mitral valve prolapse (MVP) is a heart valve anomaly that affects a considerable segment of the population. Studies of patients with isolated MVP have shown that aortic distensibility decreased as the aortic diameter increased. The aim of this study was to compare evaluations of aortic distensibility in MVP patients using both applanation tonometry and the conventional echocardiographic examination. Methods: A total of 36 consecutive patients with MVP (16 male and 20 female) and 23 healthy controls (11 male and 12 female) were included in this study. The difference in aortic diameter and distensibility was examined using echocardiography and pulse wave velocity (PWV) was measured with applanation tonometry. Results: According to the echocardiographic measurements, the aortic distensibility was lower in the MVP patients than in the control group (6.2+-4.0 cm².dyn⁻¹.10⁻⁶ vs. 10.0+-5.2 cm². dyn⁻¹.10⁻⁶; p=0.02). The PWV measured with applanation tonometry was significantly higher in the MVP patients than in the control group (9.0+-2.4 m/s vs. 7.2+-1.4 m/s; p=0.006). Conclusion: The results of this study showed that aortic distensibility was reduced in patients with isolated MVP compared with a healthy control group. There was a moderate negative correlation between the results of both methods.

Published
2020
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4. Serum lactate level may predict the development of acute kidney injury in acute decompensated heart failure

Author

Muzaffer Kahyaoglu, Ahmet Karaduman, Çetin Geçmen, Özkan Candan, Ahmet Güner, Ender Ozgün Cakmak, Emrah Bayam, Yusuf Yılmaz, Mehmet Çelik, Ibrahim Akin Izgi, and Cevat Kirma

Subjects
acute decompensated heart failure, acute kidney injury, lactate., Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Objective: Acute decompensated heart failure (ADHF) is a life-threatening medical condition and more than 30% of patients hospitalized for ADHF develop acute kidney injury (AKI), which increases the rate of both mortality and morbidity. Previous research has indicated that several biomar- kers may help to predict the development of AKI. The aim of this study was to investigate the relationship between lactate level at the time of admission and AKI in ADHF patients. Methods: A total of 154 consecutive ADHF patients were prospectively enrolled from June 2018 to December 2018, and after applying the exclusion criteria, a total of 91 patients were included in the study. The patients were divided into 2 groups: those with and without AKI. Results: There were 63 patients in the group without AKI and 28 patients in the group with AKI. The AKI group had a higher percentage of a history of chronic kidney disease (CKD), a higher creatinine level, lower glomerular filtration rate level, lower bicarbonate level, higher lactate level, and a lower left ventricular ejection fraction compared with the non-AKI group (p

Published
2020
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6. Closure of mitral paravalvular defects without performing an arteriovenous loop: a case series of fourteen patients

Author

Alev Kilicgedik, Sabahattin Gunduz, Ali Fedakar, Hasan Sunar, Akin Izgi, Muhsin Türkmen, Mehmet Ozkan, and Cevat Kirma

Subjects
mitral regurgitation, paravalvular leak, percutaneous mitral valvuloplasty, Medicine
Abstract

Introduction: The arteriovenous (AV) loop is recommended when further support is needed during paravalvular leak (PVL) closure. Aim: We report the feasibility and safety of mitral PVL closure without constructing an AV loop, based on a single-centre experience. Material and methods: Fourteen patients with mitral valve replacement (MVR) who had New York Heart Association (NYHA) class III–IV dyspnoea or NYHA class II symptoms with significant haemolytic anaemia caused by severe or moderate-to-severe paravalvular regurgitation and who underwent transcatheter PVL closure (TPVLC) between May 2014 and February 2017 were enrolled. Results : In total, 15 PVL procedures and 19 device deployments were performed. The patients had one (n = 10), three (n = 1) or four (n = 1) devices for closure at the time of the procedure; one patient had two devices from two procedures at different times with different access ways. Nineteen devices (10 (66.6%) via transseptal access; 4 (26.6%), transapical access; and 1 (6.6%), retrograde access) were deployed successfully without making an AV loop. Conclusions : The TPVLC is a less invasive and effective alternative to surgery in symptomatic patients with significant PVLs and high operational risks. The success rates are satisfactory, with improving techniques and devices. Procedural success without using an AV loop can be achieved with reduced costs, fluoroscopic times and complications.

Published
2017
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7. Left Atrial Mechanical Function and Aortic Stiffness in Middle-aged Patients with the First Episode of Atrial Fibrillation

Author

Alev Kilicgedik, Suleyman Ç Efe, Ahmet S Gürbüz, Emrah Acar, Mehmet F Yılmaz, Aslan Erdoğan, Gökhan Kahveci, Ibrahim A Izgi, and Cevat Kirma

Subjects
Aortic Stiffness, Atrial Fibrillation, Atrial Strain, Medicine
Abstract

Background: In the early stages of atrial remodeling, aortic stiffness might be an indication of an atrial myopathy, in particular, atrial fibrosis. This study aimed to investigate the association between left atrial (LA) mechanical function, assessed by two-dimensional speckle tracking echocardiography, and aortic stiffness in middle-aged patients with the first episode of nonvalvular atrial fibrillation (AF). Methods: This prospective study included 34 consecutive patients with the first episode of AF, who were admitted to Kartal Koşuyolu Research and Training Hospital between May 2013 and October 2015, and 31 age- and gender-matched healthy controls. During the 1 st month (mostly in the first 2 weeks) following their first admission, 34 patients underwent the first pulse wave measurements. Then, 21 patients were recalled for their second pulse wave measurement at 11.8 ± 6.0 months following their initial admission. Echocardiographic and pulse wave findings were compared between these 34 patients and 31 healthy controls. We also compared the pulse wave and echocardiographic findings between the first and second measurements in 21 patients. Results: Pulse wave analysis showed no significant differences between the AF patients and healthy controls with respect to PWV (10.2 ± 2.5 m/s vs. 9.7 ± 2.1 m/s; P = 0.370), augmentation pressure (9.6 ± 7.4 mmHg vs. 9.1 ± 5.7 mmHg; P = 0.740), and aortic pulse pressure (AoPP; 40.4 ± 14.0 mmHg vs. 42.1 ± 7.6 mmHg, P = 0.550). The first LA positive peak of strain was inversely related to the augmentation pressure (r = −0.30; P = 0.02) and aortic systolic pressure (r = −0.26, P = 0.04). Comparison between the two consecutive pulse wave measurements in 21 patients showed similar results, except for AoPP. In 21 patients, the AoPP at the second measurement (45.1 ± 14.1 mmHg) showed a significant increase compared with AoPP at the first measurement (39.0 ± 10.6 mmHg, P = 0.028), which was also higher than that of healthy controls (42.1 ± 7.6 mmHg, P = 0.000). Conclusion: The association between aortic stiffness with reduced atrial strain and the key role of AoPP in the development of AF should be considered when treating nonvalvular AF patients with normal LA sizes.

Published
2017
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8. Saphenous vein graft aneurysm: A case report

Author

Ahmet Seyfeddin Gurbuz, Semi Ozturk, Emrah Acar, Suleyman Cagan Efe, Alev Kilicgedik, and Cevat Kirma

Subjects
Coronary Aneurysm, Saphenous Vein, Stents, Computed Tomography, Coronary Artery Bypass Grafting, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

BACKGROUND: Saphenous vein graft aneurysms (SVGAs) are rare seen issues after coronary artery bypass graft operation which may lead to major complications including compression of adjacent structure, myocardial ischemia, rupture, and even death. CASE REPORT: We report a patient with recurrent SVGA and its treatment by percutaneous intervention with a covered stent, the diagnostic and treatment procedure were based on contrast enhanced computed tomography and myocardial perfusion scintigraphy. DISCUSSION: Multimodality imaging is required to demonstrate the true size and complications of the SVGA, the relationship among the adjacent structure, and to assess ischemia and size of myocardial territory supplied by the aneurysmal graft to decide treatment strategy.

Published
2016

9. Acquired long QT syndrome and Torsades de Poin

Author

Ahmet Seyfeddin Gurbuz, Semi Ozturk, Emrah Acar, Süleyman Çagan Efe, Taylan Akgun, Alev Kilicgedik, Ahmet Guler, and Cevat Kirma

Subjects
Donepezil, AChIs, Torsades de Pointes, QT prolongation, Syncope, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Acetylcholinesterase inhibitors are group of drugs commonly used in Alzheimer disease and have beneficial effects on treatment. Although they have many known side effects, cardiovascular side effects are rarely seen. We present a 84 year old female who was admitted to emergency service due to repetitive syncope episodes while taking donepezil. Her electrocardiogram showed QT prolongation and on follow-up a Torsades de Pointes episode occurred. Patient was discharged with normal corrected QT time after removal of donepezil.

Published
2016
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10. Perforation of anterior mitral leaflet aneurysm: A rare cause of severe mitral regurgitation

Author

Ahmet Seyfeddin Gurbuz, Semi Ozturk, Suleyman Cagan Efe, Alev Kilicgedik, Emrah Acar, Can Yucel Karabay, Ahmet Guler, and Cevat Kirma

Subjects
Mitral regurgitation, Aortic regurgitation, Endocarditis, Perforation, Three dimensional echocardiography, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Mitral valve perforation is a rare cause of severe mitral regurgitation. Infective endocarditis, connective tissue disease, cardiac surgery and aortic regurgitation jet are blaming causes of mitral valve perforation. We present a case of anterior mitral leaflet perforation accompanied with mitral valve prolapse identified by real-time three-dimensional transesophageal echocardiography.

Published
2016
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11. Resistin, A Potential Actor in Coronary Artery Disease

Author

Elif KILIC, Nezaket EREN, Cevat KIRMA, Şebnem CIGERLI, Fatma TURGAY, Saban YAYLA, and Abdurrahim KOCYIGIT

Subjects
Resistin, coronary artery disease, hsCRP, inflammation, Medicine (General), R5-920
Abstract

Objective:Biochemical observations of the decrease in mortality rate and prediction of the degree of coronary artery stenosis before symptomatic improvement are gaining importance. In our study, we aimed to evaluate the etiological value of the recently discovered resistin biomolecule in coronary atherosclerosis pathogenesis.Methods:In this study, we evaluated and compared serum resistin levels in patients with angiographically proven coronary artery disease (stenosis ratio >25%) (n=43) and in the control group with angiographically proven normal coronary artery diameter (stenosis ratio 0.05). While considering both patient and control group correlations, we determined a positive correlation between resistin and fasting insulin (p=0.012, r=0.304), HOMA-IR (p=0.046, r=0.243), homocysteine (p=0.05; r 0.239), and hsCRP (p=0.029, r=0.265).Conclusion:Resistin values differ between patients and control subjects but were not statistically significant. The modifying effect of anti-hyperlipidemic agents over serum resistin levels may have a preventive role in the process of atherosclerosis. We think that effective results will be obtained in raising the selected threshold level of atherosclerosis diagnosis and increasing the number of patients.

Published
2014
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12. Complete aortic prosthetic valve dehiscence after modified Bentall-De Bono procedure

Author

Onur Tasar, Arzu Kalayci, Can Yucel Karabay, and Cevat Kirma

Subjects
Complete dehiscence, endocarditis, prosthetic valve, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

A 56-year-old male patient was admitted to our clinic due to persistent fever despite the use of antibiotics for 2 weeks, chest pain, and presyncope. His medical history revealed that the patient underwent modified Bentall-De Bono procedure 2 months ago due to ascending aortic aneurysm and severe aortic insufficiency. Transthoracic apical 5 chamber view showed that mobile vegetation prolapsed into the left ventricular outflow tract during ventricular diastole and that mechanical prosthetic valve was superior to the aortic annulus. Transesophageal echocardiography revealed normal aortic mechanical prosthetic valve function; however, the valve was positioned more superior to the annular plane and a dense vegetation was observed. Moreover, a complete dehiscence of the prosthetic valve was attached to aortic annulus with a single stitch in an area between noncoronary sinus and left coronary sinus. Dense thrombus formation was observed in the perivalvular region. Many cases with prosthetic valve endocarditis and partial dehiscence as its complication have been reported in the literature. However, to the best of our knowledge, there is no reported case of complete dehiscence secondary to infective endocarditis following complete ascending aortic graft and prosthetic aortic valve replacement (modified Bentall-De Bono procedure).

Published
2018
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13. An unexpected complication of the MitraClip device: one of the arms gets stuck inside the guide catheter in the left atrium

Author

Cüneyt Toprak, Gokhan Kahveci, Anil Avci, Cevat Kirma, and Ali M Esen

Subjects
mitral valve regurgitation, mitraclip device, Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Percutaneous edge-to-edge mitral valve repair using the MitraClip (Abbot Vascular, USA) system is a promising technique for mitral regurgitation treatment in select high-risk surgical patients. Although the safety and efficacy of the technique have been demonstrated, a few complications of the MitraClip device have been reported. In this report, we present a rare complication that recently occurred during the performance of a MitraClip procedure in a patient with severe functional mitral regurgitation. One MitraClip arm got stuck inside the guide catheter in the left atrium and a decision was made to discontinue percutaneous intervention because the problem could not be resolved.

Published
2015
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14. New technique for withdrawing broken sheath

Author

Süleyman Cagan Efe, Ahmet Seyfettin Gurbuz, Emrah Acar, Ayhan Kup, Mehmet Fatih Yilmaz, Alev Kilicgedik, Taylan Akgun, Semi Ozturk, and Cevat Kirma

Subjects
Balloon catheter, Retrieving broken sheath, Withdrawing technique, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

A sheath that is broken inside vessel is a rare complication, and intravascular fragments from broken sheaths are retrieving transcutaneously by techniques including the loop snare catheter, basket catheter, and grasping/biopsy forceps. We reported a less common type of broken central venous sheath in location and a successful unique technique for retrieving it from subclavian vein by using noncompliant balloon from 40 year old female patient.

Published
2016
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15. Reverse type IV dual left anterior descending coronary artery accompanying with anomalous origin of circumflex artery from right coronary sinus

Author

Ahmet Seyfeddin Gurbuz, Mehmet Inanir, Suleyman Cagan Efe, Semi Ozturk, Ahmet Guler, Ibrahim Akin Izgi, and Cevat Kirma

Subjects
Dual left anterior descending artery, Coronary anomaly, Anomalous origin of circumflex artery, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Dual left anterior descending (LAD) artery is an infrequent coronary anomaly classified into six types. Short LAD arising from left main coronary artery (LMCA) and long LAD sourcing from proximal right coronary artery comprise Type IV dual LAD. We reported anomalous origin of circumflex artery (Cx) with reverse Type IV LAD including short LAD arising from right coronary sinus and long LAD originated form LMCA.

Published
2016
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16. An unusual presentation of peripartum cardiomyopathy: Recurrent transient ischemic attacks

Author

Regayip Zehir, Can Yucel Karabay, Gonenc Kocabay, Arzu Kalayci, Taylan Akgun, and Cevat Kirma

Subjects
Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Peripartum cardiomyopathy (PPCM) is a rare form of dilated cardiomyopathy that is associated with high maternal morbidity and mortality. Onset is usually between the last month of pregnancy and up to the fifth month postpartum. PPCM usually presents with signs and symptoms of heart failure and rarely with thromboembolic complications. The true incidence of thromboemboli in PPCM is unknown. Herein we report an unusual case of PPCM in a previously healthy woman who presented with recurrent transient ischemic attacks due to thrombus in the left ventricle. Resumo: A miocardiopatia periparto (MPP) é uma forma rara de miocardiopatia dilatada, associada a elevada mortalidade e morbilidade materna. A doença manifesta-se habitualmente entre o último mês de gravidez até ao 5.° mês depois do parto. A MPP apresenta-se habitualmente com sinais e sintomas de insuficiência cardíaca e, raramente, com complicações tromboembólicas. A verdadeira incidência de tromboembolismo na MPP não é conhecida. Apresentamos um caso, pouco habitual, de MPP em mulher previamente saudável que se apresentou com acidentes isquémicos transitórios recorrentes, devido à presença de trombo no ventrículo esquerdo. Keywords: Peripartum cardiomyopathy, Transient ischemic attacks, Transthoracic echocardiography, Palavras-chave: Miocardiopartia periparto, Acidente isquémico transitório, Ecocardiografia transtorácica

Published
2014
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17. One of the most urgent vascular circumstances: Acute limb ischemia

Author

Rezzan D Acar, Muslum Sahin, and Cevat Kirma

Subjects
Medicine (General), R5-920
Abstract

Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability and requires urgent evaluation and management. Most of the causes of acute limb ischemia are thrombosis of a limb artery or bypass graft, embolism from the heart or a disease artery, dissection, and trauma. Assessment determines whether the limb is viable or irreversibly damaged. Prompt diagnosis and revascularization by means of catheter-based thrombolysis or thrombectomy and by surgery reduce the risk of limb loss and mortality. Amputation is performed in patients with irreversible damage. Despite urgent revascularization, amputation rate is 10%–15% in patients during hospitalization, mostly above the knee, and mortality within 1 year is 10%–15% due to the coexisting conditions.

Published
2013
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18. Mitral valve perforation mimicking chordal rupture

Author

Vefik M Yazicioglu, Yeliz Guler, Gokhan Kahveci, and Cevat Kirma

Subjects
mitral valve perforation, chordal rupture, 3d transesophageal echocardiography, Medicine, Internal medicine, RC31-1245, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published
2014
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19. Papillary Muscle Free Strain in Patients with Severe Degenerative and Functional Mitral Regurgitation

Author

Alev Kılıcgedik, Gokhan Kahveci, Ahmet Seyfeddin Gurbuz, Can Yucel Karabay, Ahmet Guler, Suleyman Cagan Efe, Soe Moe Aung, Ugur Arslantas, Serdar Demir, Ibrahim Akin Izgi, and Cevat Kirma

Subjects
Insuficiência da Valva Mitral / diagnóstico, Insuficiência da Valva Mitral / fisiopatologia, Músculos Papilares / fisiopatologia, Diagnóstico por Imagem, Ecocardiografia / métodos, Função Ventricular, Remodelação Ventricular, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Abstract Fundamento: The role of papillary muscle function in severe mitral regurgitation with preserved and reduced left ventricular ejection fraction and the method of choice to evaluate PM have still been the subjects of controversy. Objectives: To evaluate and compare papillary muscle function in and between patients with severe degenerative and functional mitral regurgitation by using the free strain method. Methods: 64 patients with severe mitral regurgitation - 39 patients with degenerative mitral regurgitation (DMR group) and 25 patients with severe functional mitral regurgitation (FMR group) - and 30 control subjects (control group) were included in the study. Papillary muscle function was evaluated through the free strain method from apical four chamber images of the anterolateral papillary muscle (APM) and from apical three chamber images of the posteromedial papillary muscle (PPM). Global left ventricular longitudinal and circumferential strains were evaluated by applying 2D speckle tracking imaging. Results: Global left ventricular longitudinal strain (DMR group, -17 [-14.2/-20]; FMR group, -9 [-7/-10.7]; control group, -20 [-18/-21] p < 0.001), global left ventricular circumferential strain (DMR group, -20 [-14.5/-22.7]; FMR group, -10 [-7/-12]; control group, -23 [-21/-27.5] p < 0.001) and papillary musle strains (PPMS; DMR group, -30.5 [-24/-46.7]; FMR group, -18 [-12/-30]; control group; -43 [-34.5/-39.5] p < 0.001; APMS; DMR group, (-35 [-23.5/-43]; FMR group, -20 [-13.5/-26]; control group, -40 [-32.5/-48] p < 0.001) were significantly different among all groups. APMS and PPMS were highly correlated with LVEF (p < 0.001, p < 0.001; respectively), GLS (p < 0.001, p < 0.001; respectively) and GCS (p < 0.001, p < 0.00; respectively) of LV among all groups. No correlation was found between papillary muscle strains and effective orifice area (EOA) in both groups of severe mitral regurgitation. Conclusions: Measuring papillary muscle longitudinal strain by the free strain method is practical and applicable. Papillary muscle dysfunction plays a small role in severe MR due to degenerative or functional causes and papillary muscle functions in general seems to follow left ventricular function. PPM is the most affected PM in severe mitral regurgitation in both groups of DMR and FMR.

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20. The right ventricle systolic force ratio could predict the severity of the tricuspid regurgitation‐RIVIERA ratio.

Author

Emrah, Acar, Servet, Izci, Ibrahim, Donmez, Fatih, Yilmaz Mehmet, Neryan, Ozgul, Hande, Seymen, Eda, Ozcan, Tuba, Kaygusuz, Oguz, Kayabası, Mustafa, Gokce, Yilmaz, Güneş, Akin, Izgi Ibrahim, and Cevat, Kirma

Abstract

Purpose: For assessing the severity of tricuspid regurgitation (TR), there is no gold standard. We developed a parameter, the right ventricular systolic force ratio—RIVIERA, using the continious wave Doppler analysis of TR and pulsed‐wave analysis of the right ventricle outflow tract. We hypothesized that the RIVIERA would facilitate the ability to identify severe TR in clinical settings. Materials and Methods: We obtained data from routine transthoracic echocardiograms. All records reporting no or mild TR (n = 732), moderate TR (n = 584), and severe TR (n = 519) TR were reanalyzed to measure vena contracta (VC) width, TR jet area, effective regurgitant orifice (EROA) derived with the proximal isovelocity surface area method, the RIVIERA, and right‐sided chamber volumes. Results: Significant linear trends were demonstrated for right atrial volume index, end‐diastolic volume index, RVOT velocity time integral, TR jet area, TR‐Vmax, TR‐VTI, TR acceleration, VC width, EROA with increasing TR severity. Independent predictors of severe RT included RIVIERA <4.8, VC width ≥0.7 cm, TR jet area > 10 cm2, and EROA ≥0.4 cm2. Conclusion: The RIVIERA is a feasible, effective, and independent predictor of severe TR that enhances established techniques for estimating TR severity. For clinical decision‐making and management, accurate measurement and classification of TR severity are essential. Therefore, it should be thought about include the RIVIERA in the integrative method to assessing TR severity. [ABSTRACT FROM AUTHOR]

Published
2023
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21. Serum lactate level may predict the development of acute kidney injury in acute decompensated heart failure

Author

Özkan Candan, Muzaffer Kahyaoglu, İbrahim Akın İzgi, Çetin Geçmen, Ahmet Karaduman, Cevat Kirma, Emrah Bayam, Yusuf Yilmaz, Ahmet Güner, Mehmet Celik, and Ender Özgün Çakmak

Subjects
Male, medicine.medical_specialty, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, acute decompensated heart failure, Acute decompensated heart failure, Renal function, lcsh:Medicine, urologic and male genital diseases, chemistry.chemical_compound, Internal medicine, medicine, Confidence Intervals, Odds Ratio, Humans, Prospective Studies, Renal Insufficiency, Chronic, lcsh:RC31-1245, Aged, Heart Failure, Creatinine, Ejection fraction, urogenital system, business.industry, lcsh:R, Acute kidney injury, Stroke Volume, Odds ratio, Acute Kidney Injury, medicine.disease, Confidence interval, female genital diseases and pregnancy complications, Bicarbonates, Logistic Models, chemistry, lcsh:RC666-701, Cardiology, Lactates, acute kidney injury, lactate, Female, Cardiology and Cardiovascular Medicine, business, Biomarkers, Kidney disease, Glomerular Filtration Rate
Abstract

Objective: Acute decompensated heart failure (ADHF) is a life-threatening medical condition and more than 30% of patients hospitalized for ADHF develop acute kidney injury (AKI), which increases the rate of both mortality and morbidity. Previous research has indicated that several biomar- kers may help to predict the development of AKI. The aim of this study was to investigate the relationship between lactate level at the time of admission and AKI in ADHF patients. Methods: A total of 154 consecutive ADHF patients were prospectively enrolled from June 2018 to December 2018, and after applying the exclusion criteria, a total of 91 patients were included in the study. The patients were divided into 2 groups: those with and without AKI. Results: There were 63 patients in the group without AKI and 28 patients in the group with AKI. The AKI group had a higher percentage of a history of chronic kidney disease (CKD), a higher creatinine level, lower glomerular filtration rate level, lower bicarbonate level, higher lactate level, and a lower left ventricular ejection fraction compared with the non-AKI group (p

Published
2020

22. Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol

Author

Gregory G. Schwartz, Michael Szarek, Vera A. Bittner, Rafael Diaz, Shaun G. Goodman, J. Wouter Jukema, Ulf Landmesser, Patricio López-Jaramillo, Garen Manvelian, Robert Pordy, Michel Scemama, Peter R. Sinnaeve, Harvey D. White, Ph Gabriel Steg, P.h. Gabriel Steg, Deepak L. Bhatt, Robert A. Harrington, Andreas M. Zeiher, Pierluigi Tricoci, Matthew T. Roe, Kenneth W. Mahaffey, Jay M. Edelberg, Corinne Hanotin, Guillaume Lecorps, Angèle Moryusef, William J. Sasiela, Jean-François Tamby, Philip E. Aylward, Heinz Drexel, Peter Sinnaeve, Mirza Dilic, Renato D. Lopes, Nina N. Gotcheva, Juan-Carlos Prieto, Huo Yong, Ivan Pećin, Zeljko Reiner, Petr Ostadal, Steen Hvitfeldt Poulsen, Margus Viigimaa, Markku S. Nieminen, Nicolas Danchin, Vakhtang Chumburidze, Nikolaus Marx, Evangelos Liberopoulos, Pablo Carlos Montenegro Valdovinos, Hung-Fat Tse, Robert Gabor Kiss, Denis Xavier, Doron Zahger, Marco Valgimigli, Takeshi Kimura, Hyo Soo Kim, Sang-Hyun Kim, Andrejs Erglis, Aleksandras Laucevicius, Sasko Kedev, Khalid Yusoff, Gabriel Arturo Ramos López, Marco Alings, Sigrun Halvorsen, Roger M. Correa Flores, Rody G. Sy, Andrzej Budaj, Joao Morais, Maria Dorobantu, Yuri Karpov, Arsen D. Ristic, Terrance Chua, Jan Murin, Zlatko Fras, Anthony J. Dalby, José Tuñón, H. Asita de Silva, Emil Hagström, Christian Müller, Chern-En Chiang, Piyamitr Sritara, Sema Guneri, Alexander Parkhomenko, Kausik K. Ray, Patrick M. Moriarty, Robert Vogel, Bernard Chaitman, Sheryl F. Kelsey, Anders G. Olsson, Jean-Lucien Rouleau, Maarten L. Simoons, Karen Alexander, Chiara Meloni, Robert Rosenson, Eric J.G. Sijbrands, John H. Alexander, Luciana Armaganijan, Akshay Bagai, Maria Cecilia Bahit, J. Matthew Brennan, Shaun Clifton, Adam D. DeVore, Shalonda Deloatch, Sheila Dickey, Keith Dombrowski, Grégory Ducrocq, Zubin Eapen, Patricia Endsley, Arleen Eppinger, Robert W. Harrison, Connie Ng Hess, Mark A. Hlatky, Joseph Dedrick Jordan, Joshua W. Knowles, Bradley J. Kolls, David F. Kong, Sergio Leonardi, Linda Lillis, David J. Maron, Jill Marcus, Robin Mathews, Rajendra H. Mehta, Robert J. Mentz, Humberto Graner Moreira, Chetan B. Patel, Sabrina Bernardez Pereira, Lynn Perkins, Thomas J. Povsic, Etienne Puymirat, William Schuyler Jones, Bimal R. Shah, Matthew W. Sherwood, Kenya Stringfellow, Darin Sujjavanich, Mustafa Toma, Charlene Trotter, Sean F.P. van Diepen, Matthew D. Wilson, Andrew Tze-Kay Yan, Lilia B. Schiavi, Marcelo Garrido, Andrés F. Alvarisqueta, Sonia A. Sassone, Anselmo P. Bordonava, Alberto E. Alves De Lima, Jorge M. Schmidberg, Ernesto A. Duronto, Orlando C. Caruso, Leonardo P. Novaretto, Miguel Angel Hominal, Oscar R. Montaña, Alberto Caccavo, Oscar A. Gomez Vilamajo, Alberto J. Lorenzatti, Luis R. Cartasegna, Gustavo A. Paterlini, Ignacio J. Mackinnon, Guillermo D. Caime, Marcos Amuchastegui, Oscar Salomone, Oscar R. Codutti, Horacio O. Jure, Julio O.E. Bono, Adrian D. Hrabar, Julio A. Vallejos, Rodolfo A. Ahuad Guerrero, Federico Novoa, Cristian A. Patocchi, Cesar J. Zaidman, Maria E. Giuliano, Ricardo D. Dran, Marisa L. Vico, Gabriela S. Carnero, Pablo N. Guzman, Juan C. Medrano Allende, Daniela F. Garcia Brasca, Miguel H. Bustamante Labarta, Sebastian Nani, Eduardo D.S. Blumberg, Hugo R. Colombo, Alberto Liberman, Victorino Fuentealba, Hector L. Luciardi, Gabriel D. Waisman, Mario A. Berli, Ruben O. Garcia Duran, Horacio G. Cestari, Hugo A. Luquez, Jorge A. Giordano, Silvia S. Saavedra, Gerardo Zapata, Osvaldo Costamagna, Susana Llois, Jonathon H. Waites, Nicholas Collins, Allan Soward, Chris L.S. Hii, James Shaw, Margaret A. Arstall, John Horowitz, Daniel Ninio, James F. Rogers, David Colquhoun, Romulo E. Oqueli Flores, Philip Roberts-Thomson, Owen Raffel, Sam J. Lehman, Constantine Aroney, Steven G.M. Coverdale, Paul J. Garrahy, Gregory Starmer, Mark Sader, Patrick A. Carroll, Ronald Dick, Robert Zweiker, Uta Hoppe, Kurt Huber, Rudolf Berger, Georg Delle-Karth, Bernhard Frey, Dirk Faes, Kurt Hermans, Bruno Pirenne, Attilio Leone, Etienne Hoffer, Mathias C.M. Vrolix, Luc De Wolf, Bart Wollaert, Marc Castadot, Karl Dujardin, Christophe Beauloye, Geert Vervoort, Harry Striekwold, Carl Convens, John Roosen, Emanuele Barbato, Marc Claeys, Frank Cools, Ibrahim Terzic, Fahir Barakovic, Zlatko Midzic, Belma Pojskic, Emir Fazlibegovic, Azra Durak-Nalbantic, Mehmed Kulić, Dusko Vulic, Adis Muslibegovic, Boris Goronja, Gilmar Reis, Luciano Sousa, Jose C. Nicolau, Flavio E. Giorgeto, Ricardo P. Silva, Lilia Nigro Maia, Rafael Rech, Paulo R.F. Rossi, Maria José A.G. Cerqueira, Norberto Duda, Renato Kalil, Adrian Kormann, José Antonio M. Abrantes, Pedro Pimentel Filho, Ana Priscila Soggia, Mayler O.N. de Santos, Fernando Neuenschwander, Luiz C. Bodanese, Yorghos L. Michalaros, Freddy G. Eliaschewitz, Maria H. Vidotti, Paulo E. Leaes, Roberto V. Botelho, Sergio Kaiser, Euler Roberto F. Fernandes Manenti, Dalton B. Precoma, Jose C. Moura Jorge, Pedro Silva, Jose A. Silveira, Wladmir Saporito, Jose A. Marin Neto, Gilson S. Feitosa, Luiz Eduardo F. Ritt, Juliana A. de Souza, Fernando Costa, Weimar K.S.B. Souza, Helder J.L. Reis, Leandro Machado, José Carlos Aidar Ayoub, Georgi V. Todorov, Fedya P. Nikolov, Elena S. Velcheva, Maria L. Tzekova, Haralambi O. Benov, Stanislav L. Petranov, Haralin S. Tumbev, Nina S. Shehova-Yankova, Dimitar T. Markov, Dimitar H. Raev, Mihail N. Mollov, Kostadin N. Kichukov, Katya A. Ilieva-Pandeva, Raya Ivanova, Maryana Gospodinov, Valentina M. Mincheva, Petar V. Lazov, Bojidar I. Dimov, Manohara Senaratne, James Stone, Jan Kornder, Stephen Pearce, Danielle Dion, Daniel Savard, Yves Pesant, Amritanshu Pandey, Simon Robinson, Gilbert Gosselin, Saul Vizel, Gordon Hoag, Ronald Bourgeois, Anne Morisset, Eric Sabbah, Bruce Sussex, Simon Kouz, Paul MacDonald, Ariel Diaz, Nicolas Michaud, David Fell, Raymond Leung, Tycho Vuurmans, Christopher Lai, Frank Nigro, Richard Davies, Gustavo Nogareda, Ram Vijayaraghavan, John Ducas, Serge Lepage, Shamir Mehta, James Cha, Robert Dupuis, Peter Fong, Sohrab Lutchmedial, Josep Rodes-Cabau, Hussein Fadlallah, David Cleveland, Thao Huynh, Iqbal Bata, Adnan Hameed, Cristian Pincetti, Sergio Potthoff, Juan C. Prieto, Monica Acevedo, Arnoldo Aguirre, Margarita Vejar, Mario Yañez, Guillermo Araneda, Mauricio Fernandez, Luis Perez, Paola Varleta, Fernando Florenzano, Laura Huidobro, Carlos A. Raffo, Claudia Olivares, Leonardo Nahuelpan, Humberto Montecinos, Jiyan Chen, Yugang Dong, Weijian Huang, Jianzhong Wang, Shi'An Huang, Zhuhua Yao, Xiang Li, Lan Cui, Wenhua Lin, Yuemin Sun, Jingfeng Wang, Jianping Li, Xuelian Zhang, Hong Zhu, Dandan Chen, Lan Huang, Shaohong Dong, Guohai Su, Biao Xu, Xi Su, Xiaoshu Cheng, Jinxiu Lin, Wenxia Zong, Huanming Li, Yi Feng, Dingli Xu, Xinchun Yang, Yuannan Ke, Xuefeng Lin, Zheng Zhang, Zeqi Zheng, Zhurong Luo, Yundai Chen, Chunhua Ding, Yi Zhong, Yang Zheng, Xiaodong Li, Daoquan Peng, Shuiping Zhao, Ying Li, Xuebo Liu, Meng Wei, Shaowen Liu, Yihua Yu, Baiming Qu, Weihong Jiang, Yujie Zhou, Xingsheng Zhao, Zuyi Yuan, Ying Guo, Xiping Xu, Xubo Shi, Junbo Ge, Guosheng Fu, Feng Bai, Weiyi Fang, Xiling Shou, Xiangjun Yang, Jian'An Wang, Meixiang Xiang, Yingxian Sun, Qinghua Lu, Ruiyan Zhang, Jianhua Zhu, Yizhou Xu, Zhongcai Fan, Tianchang Li, Chun Wu, Nicolas Jaramillo, Gregorio Sanchez Vallejo, Diana C. Luna Botia, Rodrigo Botero Lopez, Dora I. Molina De Salazar, Alberto J. Cadena Bonfanti, Carlos Cotes Aroca, Juan Diego Higuera, Marco Blanquicett, Sandra I. Barrera Silva, Henry J. Garcia Lozada, Julian A. Coronel Arroyo, Jose L. Accini Mendoza, Ricardo L. Fernandez Ruiz, Alvaro M. Quintero Ossa, Fernando G. Manzur Jatin, Aristides Sotomayor Herazo, Jeffrey Castellanos Parada, Rafael Suarez Arambula, Miguel A. Urina Triana, Angela M. Fernandez Trujillo, Maja Strozzi, Siniša Car, Melita Jerić, Davor Miličić, Martina Lovrić Benčić, Hrvoje Pintarić, Đeiti Prvulović, Jozica Šikić, Viktor Peršić, Dean Mileta, Kresimir Štambuk, Zdravko Babić, Vjekoslav Tomulic, Josip Lukenda, Stanka Mejic-Krstulovic, Boris Starcevic, Jindrich Spinar, David Horak, Zdenek Velicka, Josef Stasek, David Alan, Vilma Machova, Ales Linhart, Vojtech Novotny, Vladimir Kaucak, Richard Rokyta, Robert Naplava, Zdenek Coufal, Vera Adamkova, Ivo Podpera, Jiri Zizka, Zuzana Motovska, Ivana Marusincova, Premysl Svab, Petr Heinc, Jiri Kuchar, Petr Povolny, Jiri Matuska, Steen H. Poulsen, Bent Raungaard, Peter Clemmensen, Lia E. Bang, Ole May, Morten Bøttcher, Jens D. Hove, Lars Frost, Gunnar Gislason, John Larsen, Peter Betton Johansen, Flemming Hald, Peter Johansen, Jørgen Jeppesen, Tonny Nielsen, Kjeld S. Kristensen, Piotr Maria Walichiewicz, Jens D. Lomholdt, Ib C. Klausen, Peter Kaiser Nielsen, Flemming Davidsen, Lars Videbaek, Mai Soots, Veiko Vahula, Anu Hedman, Üllar Soopõld, Kaja Märtsin, Tiina Jurgenson, Arved Kristjan, Heikki Huikuri, Juhani Airaksinen Pierre Coste, Emile Ferrari, Olivier Morel, Gilles Montalescot, Jacques Machecourt, Gilles Barone-Rochette, Jacques Mansourati, Yves Cottin, Florence Leclercq, Abdelkader Belhassane, Nicolas Delarche, Franck Boccara, Franck Paganelli, Jérôme Clerc, Francois Schiele, Victor Aboyans, Vincent Probst, Jacques Berland, Thierry Lefèvre, Bernard Citron, Irakli Khintibidze, Tamaz Shaburishvili, Zurab Pagava, Ramaz Ghlonti, Zaza Lominadze, George Khabeishvili, Rayyan Hemetsberger, Kemala Edward, Ursula Rauch-Kröhnert, Matthias Stratmann, Karl-Friedrich Appel, Ekkehard Schmidt, Heyder Omran, Christoph Stellbrink, Thomas Dorsel, Emmanouil Lianopoulos, Hans Friedrich Vöhringer, Roger Marx, Andreas Zirlik, Detlev Schellenberg, Thomas Heitzer, Ulrich Laufs, Christian Werner, Stephan Gielen, Sebastian Nuding, Bernhard Winkelmann, Steffen Behrens, Karsten Sydow, Mahir Karakas, Gregor Simonis, Thomas Muenzel, Nikos Werner, Stefan Leggewie, Dirk Böcker, Rüdiger Braun-Dullaeus, Nicole Toursarkissian, Michael Jeserich, Matthias Weißbrodt, Tim Schaeufele, Joachim Weil, Heinz Völler, Johannes Waltenberger, Mohammed Natour, Susanne Schmitt, Dirk Müller-Wieland, Stephan Steiner, Lothar Heidenreich, Elmar Offers, Uwe Gremmler, Holger Killat, Werner Rieker, Sotiris Patsilinakos, Athanasios Kartalis, Athanassios Manolis, Dimitrios Sionis, Geargios Chachalis, Ioannis Skoumas, Vasilios Athyros, Panagiotis Vardas, Frangkiskos Parthenakis, John Lekakis, Apostolos Hatzitolios, Sergio R. Fausto Ovando, Juan L. Arango Benecke, Edgar R. Rodriguez De Leon, Bryan P.Y. Yan, David C.W. Siu, Tibor Turi, Bela Merkely, Imre Ungi, Geza Lupkovics, Lajos Nagy, András Katona, István Édes, Gábor Müller, Iván Horvath, Tibor Kapin, Zsolt Szigeti, József Faluközy, Mukund Kumbla, Manjinder Sandhu, Sharath Annam, Naveen Reddy Proddutur, Reddy Regella, Rajendra K. Premchand, Ajaykumar Mahajan, Sudhir Pawar, Atul D. Abhyanakar, Prafulla Kerkar, Ravishankar A. Govinda, Abraham Oomman, Dhurjati Sinha, Sachin N. Patil, Dhiman Kahali, Jitendra Sawhney, Abhijeet B. Joshi, Sanjeev Chaudhary, Pankaj Harkut, Santanu Guha, Sanjay Porwal, Srimannarayana Jujjuru, Ramesh B. Pothineni, Minguel R. Monteiro, Aziz Khan, Shamanna S. Iyengar, Jasprakash Singh Grewal, Manoj Chopda, Mahesh C. Fulwani, Aparna Patange, Patil Sachin, Vijay K. Chopra, Naresh K. Goyal, Rituparna Shinde, Gajendra V. Manakshe, Nitin Patki, Sumeet Sethi, Vengatesh Munusamy, Sunil Karnaand Sunil Thanvi, Srilakshmi Adhyapak, Chandrakant Patil, Ulhas Pandurangi, Rishabh Mathur, Jugal Gupta, Suhas Kalashetti, Ajit Bhagwat, Bagirath Raghuraman, Shiv Kumar Yerra, Prasant Bhansali, Rohidas Borse, Patil Rahul, Srihari Das, Vinay Kumar, Jabir Abdullakutty, Shireesh Saathe, Priya Palimkar, Jabir Abdullkutty, Shireesh Sathe, Shaul Atar, Michael Shechter, Morris Mosseri, Yaron Arbel, Chorin Ehud, Havakuk Ofer, Chaim Lotan, Uri Rosenschein, Amos Katz, Yaakov Henkin, Adi Francis, Marc Klutstein, Eugenia Nikolsky, Robert Zukermann, Yoav Turgeman, Majdi Halabi, Alon Marmor, Ran Kornowski, Michael Jonas, Offer Amir, Yonathan Hasin, Yoseph Rozenman, Shmuel Fuchs, Vered Zvi, Osamah Hussein, Dov Gavish, Zvi Vered, Yoseph Caraco, Mazen Elias, Naveh Tov, Efrat Wolfovitz, Michael Lishner, Nizar Elias, Giancarlo Piovaccari, Annamaria De Pellegrin, Raffaella Garbelotto, Gabriele Guardigli, Valgimigli Marco, Giovanni Licciardello, Carla Auguadro, Filippo Scalise, Claudio Cuccia, Alessandro Salvioni, Giuseppe Musumeci, Michelle Senni, Paolo Calabrò, Salvatore Novo, Pompilio Faggiano, Marco Metra, Nicoletta B. De Cesare, Sergio Berti, Claudio Cavallini, Enrico Puccioni, Marcello Galvani, Maurizio Tespili, Piermarco Piatti, Michela Palvarini, Giuseppe De Luca, Roberto Violini, Alessandro De Leo, Zoran Olivari, Pasquale Perrone Filardi, Maurizio Ferratini, Vittorio Racca, Kazuoki Dai, Yuji Shimatani, Haruo Kamiya, Kenji Ando, Yoshihiro Takeda, Yoshihiro Morino, Yoshiki Hata, Kazuo Kimura, Koichi Kishi, Ichiro Michishita, Hiroki Uehara, Toshinori Higashikata, Atsushi Hirayama, Keiji Hirooka, Yasuji Doi, Satoru Sakagami, Shuichi Taguchi, Akihiro Koike, Hiroyuki Fujinaga, Shinji Koba, Ken Kozuma, Tomohiro Kawasaki, Yujiro Ono, Masatoshi Shimizu, Yousuke Katsuda, Atsuyuki Wada, Toshiro Shinke, Junya Ako, Kenshi Fujii, Toshiyuki Takahashi, Tomohiro Sakamoto, Koichi Nakao, Yutaka Furukawa, Hiroshi Sugino, Ritsu Tamura, Toshiaki Mano, Masaaki Uematsu, Noriaki Utsu, Kashima Ito, Takuya Haraguchi, Katsuhiko Sato, Yasunori Ueda, Akira Nishibe, Kazuteru Fujimoto, Motomaru Masutani, Jung Han Yoon, Hack-Lyoung Kim, Hun Sik Park, In-Ho Chae, Moo Hyun Kim, Myung Ho Jeong, Seungwoon Rha, Chongjin Kim, Hae Young Kim, Taekjong Hong, Seung-Jea Tahk, Youngkwon Kim, Arija Busmane, Natalija Pontaga, Aldis Strelnieks, Iveta Mintale, Iveta Sime, Zaneta Petrulioniene, Roma Kavaliauskiene, Ruta Jurgaitiene, Gintare Sakalyte, Rimvydas Slapikas, Sigute Norkiene, Nerijus Misonis, Aleksandras Kibarskis, Raimondas Kubilius, Stojko Bojovski, Nensi Lozance, Aleksandar Kjovkaroski, Snezana Doncovska, Tiong Kiam Ong, Sazzli Kasim, Oteh Maskon, Balachandran Kandasamy, Houng B. Liew, Wan Mohd Izani Wan Mohamed, Armando García Castillo, Jorge Carrillo Calvillo, Pedro Fajardo Campos, Juan Carlos Núñez Fragoso, Edmundo Alfredo Bayram Llamas, Marco Antonio Alcocer Gamba, Jaime Carranza Madrigal, Luis Gerardo González Salas, Enrique López Rosas, Belinda González Díaz, Eduardo Salcido Vázquez, Alfredo Nacoud Ackar, Guillermo Antonio Llamas Esperón, Carlos Rodolfo Martínez Sánchez, María Guerrero De Leon, Rodrigo Suarez Otero, Guillermo Fanghänel Salmón, Jesús Antonio Pérez Ríos, José Angel Garza Ruíz, Robert W. Breedveld, Margriet Feenema-Aardema, Alida Borger-Van Der Burg, Pieter A.M. Hoogslag, Harry Suryapranata, Antonius Oomen, Paulus Van Haelst, Margriet Feenema-Aradema, Jacobijne J. Wiersma, Dirk Basart, Ruud M.A. Van Der Wal, Peter Zwart, Pascalle Monraats, Henricus Van Kesteren, Ioannis Karalis, Johan Jukema, Gerardus J.E. Verdel, Bart R.G. Brueren, Roland PTh Troquay, Eric P. Viergever, Nadea Y.Y. Al-Windy, Gerard L. Bartels, Jan H. Cornel, Walter R.M. Hermans, Johannes P.R. Herrman, Robert J. Bos, Reginald G.E.J. Groutars, Coenraad C. Van Der Zwaan, Refik Kaplan, Raymond Lionarons, Eelko Ronner, Bjorn E. Groenemeijer, Patrick N.A. Bronzwaer, Anho A.H. Liem, Bernard J.W.M. Rensing, Marcel J.J.A. Bokern, Remco Nijmeijer, Ferry M.R.J. Hersbach, Frank F. Willems, Antonius T.M. Gosselink, Saman Rasoul, John Elliott, Gerard Wilkins, Raewyn Fisher, Douglas Scott, Hamish Hart, Ralph Stewart, Scott Harding, Ian Ternouth, Nicholas Fisher, Samuel Wilson, Denise Aitken, Russell Anscombe, Laura Davidson, Tadeusz Tomala, Ottar Nygård, Jon Arne Sparby, Kjell Andersen, Lars Gullestad, Jarle Jortveit, Peter S. Munk, Erlend gyllensten Singsaas, Ulf Hurtig, Jorge R. Calderon Ticona, Julio R. Durand Velasquez, Sandra A. Negron Miguel, Enrique S. Sanabria Perez, Jesus M. Carrion Chambilla, Carlos A. Chavez Ayala, Reynaldo P. Castillo Leon, Rolando J. Vargas Gonzales, Jose D. Hernandez Zuniga, Luis A. Camacho Cosavalente, Jorge E. Bravo Mannucci, Javier Heredia Landeo, Nassip C. Llerena Navarro, Yudy M. Roldan Concha, Víctor E. Rodriguez Chavez, Henry A. Anchante Hernandez, Carlos A. Zea Nunez, Walter Mogrovejo Ramos, Arthur Ferrolino, Rosa Allyn G. Sy, Louie Tirador, Generoso Matiga, Raul Martin Coching, Alisa Bernan, Gregorio Rogelio, Dante D. Morales, Edgar Tan, Dennis Jose Sulit, Adrian Wlodarczak, Krystyna Jaworska, Grzegorz Skonieczny, Lidia Pawlowicz, Pawel Wojewoda, Benita Busz-Papiez, Janusz Bednarski, Aleksander Goch, Pawel Staneta, Elzbieta Dulak, Krzysztof Saminski, Wlodzimierz Krasowski, Wanda Sudnik, Aleksander Zurakowski, Marcin Skorski, Roman Lysek, Beata Miklaszewicz, Jacek Kubica, Jan Andrzej Lipko, Edyta Kostarska-Srokosz, Marek Piepiorka, Anna Drzewiecka, Ryszard Sciborski, Arkadiusz Stasiewski, Tomasz Blicharski, Leszek Bystryk, Michal Szpajer, Marek Korol, Tomasz Czerski, Ewa Mirek-Bryniarska, Jacek Gniot, Andrzej Lubinski, Jerzy Gorny, Edward Franek, Grzegorz Raczak, Hanna Szwed, Pedro Monteiro, Jose Mesquita Bastos, Helder H. Pereira, Dinis Martins, Filipe Seixo, Carlos Mendonça, Ana Botelho, Francisca Caetano, Bogdan Minescu, Octavian Istratoaie, Dan N. Tesloianu, Gabriel Cristian, Silviu Dumitrescu, Cristian G.C. Podoleanu, Mircea C.A. Constantinescu, Cristina M. Bengus, Constantin Militaru, Doina Rosu, Irinel R. Parepa, Adrian V. Matei, Tom M. Alexandru, Mihaela Malis, Ioan Coman, Rodica Stanescu-Cioranu, Doina Dimulescu, Yury Shvarts, Olga Orlikova, Zhanna Kobalava, Olga L. Barbarash, Valentin Markov, Nadezhda Lyamina, Alexander Gordienko, Konstantin Zrazhevsky, Alexander Y. Vishnevsky, Victor Gurevich, Raisa Stryuk, Nikita V. Lomakin, Igor Bokarev, Tatiana Khlevchuk, Sergey Shalaev, Larisa Khaisheva, Petr Chizhov, Inna Viktorova, Natalya Osokina, Vladimir Shchekotov, Evgenia Akatova, Galina Chumakova, Igor Libov, Mikhail I. Voevoda, Tatyana V. Tretyakova, Evgeny Baranov, Sergey Shustov, Sergey Yakushin, Ivan Gordeev, Niiaz Khasanov, Olga Reshetko, Tatiana Sotnikova, Olga Molchanova, Konstantin Nikolaev, Liudmila Gapon, Elena Baranova, Zaur Shogenov, Elena Kosmachova, Yuriy Karpov, Anton Povzun, Liudmila Egorova, Vadim V. Tyrenko, Igor G. Ivanov, Masterov Ilya, Sergey Kanorsky, Dragan Simic, Nikola Ivanovic, Goran Davidovic, Nebojsa Tasic, Milika R. Asanin, Stevo Stojic, Svetlana R. Apostolovic, Stevan Ilic, Biljana Putnikovic Tosic, Aleksandar Stankovic, Aleksandra Arandjelovic, Slavica Radovanovic, Branislava Todic, Jovan Balinovac, Dragan V. Dincic, Petar Seferovic, Ana Karadzic, Slobodan Dodic, Sinisa Dimkovic, Tamara Jakimov, Kian-Keong Poh, Hean Yee Ong, Justin Tang I-Shing, Karol Micko, Jan Nociar, Daniel Pella, Peter Fulop, Marian Hranai, Juraj Palka, Juraj Mazur, Ivan Majercák, Andrej Dzupina, František Fazekas, Jozef Gonsorcik, Viliam Bugan, Juraj Selecky, Gabriel Kamensky, Jaroslava Strbova, Rudolf Smik, Andrej Dukat, Peter Olexa, Ivan Žuran, Janez Poklukar, Nataša Černič Šuligoj, Matija Cevc, Henry P. Cyster, Naresh Ranjith, Clive Corbett, Junaid Bayat, Ellen Makoali Makotoko, Hendrik du Toit Theron, Ilse E. Kapp, Matthys M. de V Basson, Hanlie Lottering, Dina Van Aswegen, Louis J. Van Zyl, Peter J. Sebastian, Thayabran Pillay, Jan A. Saaiman, Patrick J. Commerford, Soraya Cassimjee, Garda Riaz, Iftikhar O. Ebrahim, Mahomed Sarvan, Joseph H. Mynhardt, Helmuth Reuter, Rajendran Moodley, Manuel Vida, Angel R. Cequier Fillat, Vicente Bodí Peris, Francisco Fuentes Jimenez, Francisco Marín, Jose M. Cruz Fernández, Rafael Jesus Hidalgo Urbano, Blas Gil-Extremera, Pablo Toledo, Fernando Worner Diz, David Garcia-Dorado, Andres Iñiguez, José Tuñón Fernández, Jose R. Gonzalez-Juanatey, Javier Fernandez Portales, Fernando Civeira Murillo, Laia Matas Pericas, Jose Luis Zamorano, Manuel De Mora Martin, Jordi Bruguera Cortada, Joaquin J. Alonso Martin, Jose Maria Serrano Antolin, José R. De Berrazueta Fernández, José Antonio Vázquez de Prada, Jose Francisco Díaz Fernández, José Alberto García Lledó, Juan Cosín Sales, Javier Botas Rodriguez, Gabriel Gusi Tragant, Amparo Benedicto, Carlos Gonzalez-Juanatey, Mercedes Camprubí Potau, Ignacio Plaza Perez, César Morís De La Tassa, Pablo Loma-Osorio Rincon, Javier Balaguer Recena, Juan M. Escudier, Antonio Coca Payeras, Norberto Alonso Orcajo, Pedro Valdivielso, Godwin Constantine, Ruvaiz Haniffa, Nirmali Tissera, Stanley Amarasekera, Chandrike Ponnamperuma, Nimali Fernando, Kaputella Fernando, Jayanthimala Jayawardena, Santharaj Wijeyasingam, Gotabhaya Ranasinghe, Ruvan Ekanayaka, Sepalika Mendis, Vajira Senaratne, Gnanamoorthy Mayurathan, Ajantha Rajapaksha, Thilak Sirisena, Jagath I. Herath, Naomali Amarasena, Stefan Berglund, Gundars Rasmanis, Ola Vedin, Nils Witt, Georgios Mourtzinis, Peter Nicol, Ole Hansen, Stefano Romeo, Steen Agergaard Jensen, Ingemar Torstensson, Ulf Ahremark, Torbjörn Sundelin, Tiziano Moccetti, Francois Mach, Ronald Binde, Oliver Gämperli, Wei-Chuan Tsai, Kwo-Chang Ueng, Wen-Ter Lai, Ming-En Liu, Juey-Jen Hwang, Wei-Hsian Yin, I-Chang Hsieh, Ming-Jer Hsieh, Wei Hsiang Lin, Jen-Yuan Kuo, Tsuei-Yuan Huang, Chih-Yuan Fang, Pinij Kaewsuwanna, Wasant Soonfuang, Woravut Jintapakorn, Apichard Sukonthasarn, Nattawut Wongpraparut, Krisada Sastravaha, Nakarin Sansanayudh, Wirash Kehasukcharoen, Dilok Piyayotai, Paiboon Chotnoparatpat, Ahmet Camsari, Hakan Kultursay, Bulent Mutlu, Murat Ersanli, Mustafa Demirtas, Cevat Kirma, Ertan Ural, Lale Koldas, Oleksandr Karpenko, Alexander Prokhorov, Ihor Vakaluyk, Halyna Myshanych, Dmytro Reshotko, Valeriy Batushkin, Leonid Rudenko, Ihor Kovalskyi, Mykola Kushnir, Vira Tseluyko, Yuriy Mostovoy, Mykola Stanislavchuk, Yulian Kyiak, Yuriy Karpenko, Yaroslav Malynovsky, Andriy Klantsa, Oles Kutniy, Ekaterina Amosova, Viktor Tashchuk, Oleh Leshchuk, Mykola Rishko, Mykola Kopytsya, Andriy Yagensky, Mykola Vatutin, Andriy Bagriy, Olga M. Barna, Olexiy Ushakov, Georgiy Dzyak, Borys Goloborodko, Anatolii Rudenko, Volodymyr Zheleznyy, Jasper Trevelyan, Azfar Zaman, Kaeng Lee, Andrew Moriarty, Rajesh K. Aggarwal, Piers Clifford, Yuk-Ki Wong, Syed M.R. Iqbal, Eduardas Subkovas, Denise Braganza, David Sarkar, Robert Storey, Huw Griffiths, Sam Mcclure, Rangasamy Muthusamy, Simon Smith, John Kurian, Terry Levy, Craig Barr, Honer Kadr, Robert Gerber, Audrius Simaitis, Handrean Soran, Anthony Mathur, Adrian Brodison, Mohammad Ayaz, Muhammad Cheema, Richard Oliver, Simon Thackray, Telal Mudawi, Gohar Rahman, Ayyaz Sultan, Timothy Reynolds, David Sharman, null david Sprigings, Rob Butler, Peter Wilkinson, Gregory Y.H. Lip, Julian Halcox, Sean Gallagher, Nicholas Ossei-Gerning, Gil Vardi, Duccio Baldari, David Brabham, Charles Treasure, Charles Dahl, Bruce Palmer, Alan Wiseman, Abul Khan, Sanjeev Puri, Ann Elizabeth Mohart, Carlos Ince, Enrique Flores, Scott Wright, Shi-Chi Cheng, Michael Rosenberg, William Rogers, Edward Kosinski, Les Forgosh, Jonathan Waltman, Misal Khan, Mohammad Shoukfeh, Georges Dagher, Patrick Cambier, Ira Lieber, Priya Kumar, Cara East, Perry Krichmar, Mian Hasan, Lindsey White, Thomas Knickelbine, Thomas Haldis, Eve Gillespie, Thomas Amidon, David Suh, Imran Arif, Mouhamad Abdallah, Faiq Akhter, Eric Carlson, Michael D'Urso, Fadi El-Ahdab, William Nelson, Katie Moriarty, Barry Harris, Steven Cohen, Luther Carter, Daniel Doty, Kenneth Sabatino, Tariq Haddad, Amir Malik, Sunder Rao, Angel Mulkay, Ion Jovin, Kim Klancke, Vinay Malhotra, Sai K. Devarapalli, Michael Koren, Harish Chandna, George Dodds, Tauqir Goraya, James Bengston, Matthew Janik, Joseph Moran, Andrew Sumner, John Kobayashi, William Davis, Shahram Yazdani, John Pasquini, Maitreya Thakkar, Amarnath Vedere, Wayne Leimbach, James Rider, Sarah fenton, Narendra Singh, Anil V. Shah, Denise Janosik, Carl Pepine, Brett Berman, Joseph Gelormini, Christopher Daniels, Kerensky Richard, Friederike Keating, Nicholas I. Kondo, Sanjay Shetty, Howard Levite, Winfried Waider, Theodore Takata, Mazen Abu-Fadel, Vipul Shah, Rahul Aggarwal, Mark Izzo, Anil Kumar, Brack Hattler, Rose Do, Chad Link, Anna Bortnick, George Kinzfogl, Arnold Ghitis, John Larry, Edward Teufel, Peter Kuhlman, Brent Mclaurin, Wenwu Zhang, Stephen Thew, Jalal Abbas, Matthew White, Othman Islam, Sumeet Subherwal, Nandkishore Ranadive, Babak Vakili, Christian Gring, David Henderson, Timothy Schuchard, Naim Farhat, Geoffrey Kline, Sharan Mahal, Jack Whitaker, Shawn Speirs, Rolf Andersen, Nizar Daboul, Phillip Horwitz, Firas Zahr, George Ponce, Zubair Jafar, Joseph Mcgarvey, Vipul Panchal, Stephen Voyce, Thomas Blok, William Sheldon, Masoud M. Azizad, Carsten Schmalfuss, Mark Picone, Robert Pederson, William Herzog, Keith Friedman, Jason Lindsey, Rosemary Nowins, Eichenlaub Timothy, Parilak Leonard, Norman Lepor, Mahfouz El Shahawy, Howard Weintraub, Anand Irimpen, Alvaro Alonso, Wade May, Daniels Christopher, Thomas Galski, Alan Chu, Freny Mody, Ebrahimi Ramin, Zachary Hodes, Joseph Rossi, Gregory Rose, James Fairlamb, Charles Lambert, Ajit Raisinghani, Antonio Abbate, George Vetrovec, Marilyn King, Charles Carey, Jaime Gerber, Liwa Younis, Hyeun Park, Mladen Vidovich, Thomas Knutson, Dennis Friedman, Fred Chaleff, Arthur Loussararian, Phillip Rozeman, Carey Kimmelstiel, Jeffrey Kuvin, Kevin Silver, Malcolm Foster, Glen Tonnessen, Andrey Espinoza, Mohamadali Amlani, Andreas Wali, Christopher Malozzi, Geert T. Jong, Clara Massey, Keattiyoat Wattanakit, Philip J. O'Donnell, Dinesh Singal, Naseem Jaffrani, Sridhar Banuru, Daniel Fisher, Mark Xenakis, Neal Perlmutter, Ravi Bhagwat, James Strader, Ronald Blonder, Ayim Akyea-Djamson, Ajay Labroo, Kwan Lee, H. John Marais, Edmund Claxton, Robert Weiss, Rohr Kathryn, Martin Berk, Peter Rossi, Parag Joshi, Amit Khera, Ajit S. Khaira, Greg Kumkumian, Steven Lupovitch, Joshua Purow, Stephen Welka, David Hoffman, Stuart Fischer, Eugene Soroka, Donald Eagerton, Samir Pancholy, Michael Ray, Norman Erenrich, Michael Farrar, Stewart Pollock, William J. French, Steve Diamantis, Douglas Guy, Lawrence Gimple, Mark Neustel, Steven Schwartz, Edward Pereira, Seals Albert, Douglas Spriggs, Janet Strain, Suneet Mittal, Anthony Vo, Majed Chane, Jason Hall, Nampalli Vijay, Kapildeo Lotun, F. Martin Lester, Ahed Nahhas, Theodore Pope, Paul Nager, Rakesh Vohra, Mukesh Sharma, Riyaz Bashir, Hinan Ahmed, Michael Berlowitz, Robert Fishberg, Robert Barrucco, Eric Yang, Michael Radin, Daniel Sporn, Dwight Stapleton, Steven Eisenberg, Joel Landzberg, Martin Mcgough, Samir Turk, Michael Schwartz, P. Sandy Sundram, Diwakar Jain, Mark Zainea, Carlos Bayron, Ronald Karlsberg, Suhail Dohad, Henry Lui, William Keen, Donald Westerhausen, Sandeep Khurana, Himanshu Agarwal, Jessica Birchem, William Penny, Mark Chang, Sherrill Murphy, John Henry, Branislav Schifferdecker, John M Gilbert, Gopal Chalavarya, Charles Eaton, John F. Schmedtje, Stuart Christenson, Imran Dotani, Douglas Denham, Alexander Macdonell, Paul Gibson, Aref Rahman, Tammam Al Joundi, Nizar Assi, Gary Conrad, Purushotham Kotha, Michael Love, Gregory Giesler, Howard Rubenstein, Dawood Gamil, Laura Akright, Justine Krawczyk, Joanne Cobler, Terry Wells, James Welker, Robert Foster, Richard Gilmore, Jay Anderson, Douglas Jacoby, Bill Harris, Geraldine Gardner, Ramprasad Dandillaya, Kishor Vora, John Kostis, John Hunter, David Laxson, Eric Ball, Flavia Egydio, Anelise Kawakami, Janaina Oliveira, Julianna Wozniak, Alexander Matthews, Caroline Ratky, Janine Valiris, Lisa Berdan, Anita Hepditch, Kirby Quintero, Tyrus Rorick, Melissa Westbrook, Andrea Pascual, Carla Rovito, Madeleine Bezault, Elodie Drouet, Tabassome Simon, Caroline Alsweiler, Anne Luyten, Julie Butters, Liddy Griffith, Michelle Shaw, Lena Grunberg, Shahidul Islam, Marie-France Brégeault, Nathalie Bougon, Douglas Faustino, Sylvie Fontecave, Judith Murphy, Melanie Verrier, null Veronique Agnetti, Dorthe Andersen, Emmy Badreddine, Mhamed Bekkouche, Cecile Bouancheau, Imane Brigui, Maddy Brocklehurst, Joseph Cianciarulo, Dawn Devaul, Szilvia Domokos, Cecile Gache, Caroline Gobillot, Severine Guillou, Jan Healy, Megan Heath, Gayatri Jaiwal, Carine Javierre, Julien Labeirie, Myriam Monier, Ulises Morales, Asmaa Mrabti, Bicky Mthombeni, Betim Okan, Lucile Smith, Jennifer Sheller, Sebastien Sopena, Valerie Pellan, Fadela Benbernou, Nafissa Bengrait, Maud Lamoureux, Katarina Kralova, Raphael Bejuit, Anthony Coulange, Christelle Berthou, Jérôme Repincay, Christelle Lorenzato, Alexis Etienne, Valerie Gouet, Virginie Loizeau, Mickael Normand, Anne Ourliac, Christelle Rondel, Antony Adamo, Pascale Beltran, Pauline Barraud, Helene Dubois-Gache, Benjamin Halle, Lamia Metwally, Maxime Mourgues, Marc Sotty, Marion Vincendet, Raluca Cotruta, Zhu Chengyue, Dominique Fournie-Lloret, Christine Morrello, Aurelie Perthuis, Patrick Picault, Isabelle Zobouyan, Helen M. Colhoun, Michael A. Dempsey, Mark A. McClanahan, Masira, and Laucevičius, Aleksandras

Subjects
Male, Acute coronary syndrome, medicine.medical_specialty, Cardiac & Cardiovascular Systems, Randomization, PCSK9 inhibitor, LOW-DENSITY-LIPOPROTEIN, Antibodies, Monoclonal, Humanized, acute coronary syndrom, Placebo, Gastroenterology, lipoprotein(a), Internal medicine, medicine, Humans, Low-density lipoprotein cholesterol, Aged, Alirocumab, RISK, low-density lipoprotein cholesterol, Science & Technology, biology, business.industry, PCSK9, PCSK9 Inhibitors, Hazard ratio, ALIROCUMAB, acute coronary syndrome, Cholesterol, LDL, Lipoprotein(a), Middle Aged, EFFICACY, medicine.disease, Cardiovascular Diseases, CARDIOVASCULAR-DISEASE, SAFETY, Cardiovascular System & Cardiology, biology.protein, Female, lipids (amino acids, peptides, and proteins), STATIN, low-density lipoprotein, cholesterol PCSK9 inhibitor, CORONARY, Cardiology and Cardiovascular Medicine, business, Life Sciences & Biomedicine, Mace
Abstract

Digital, Background Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk. Objectives In a post hoc analysis of the ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial, the authors evaluated the benefit of adding the proprotein subtilisin/kexin type 9 inhibitor alirocumab to optimized statin treatment in patients with LDL-C levels near 70 mg/dL. Effects were evaluated according to concurrent lipoprotein(a) levels. Methods ODYSSEY Outcomes compared alirocumab with placebo in 18,924 patients with recent acute coronary syndromes receiving optimized statin treatment. In 4,351 patients (23.0%), screening or randomization LDL-C was 13.7 mg/dL or ≤13.7 mg/dL; corresponding adjusted treatment hazard ratios were 0.82 (95% CI: 0.72-0.92) and 0.89 (95% CI: 0.75-1.06), with Pinteraction = 0.43. Conclusions In patients with recent acute coronary syndromes and LDL-C near 70 mg/dL on optimized statin therapy, proprotein subtilisin/kexin type 9 inhibition provides incremental clinical benefit only when lipoprotein(a) concentration is at least mildly elevated. (ODYSSEY Outcomes: Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab; NCT01663402), Ciencias Médicas y de la Salud

Published
2021

23. Relationship between SYNTAX score and myocardial viability in ischemic cardiomyopathy

Author

Semi Öztürk, Cevat Kirma, and Ahmet Seyfeddin Gurbuz

Subjects
Male, medicine.medical_specialty, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, Myocardial Ischemia, lcsh:Medicine, Coronary Artery Disease, 030204 cardiovascular system & hematology, Logistic regression, Severity of Illness Index, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Text mining, Internal medicine, Medicine, Humans, lcsh:RC31-1245, Aged, Ischemic cardiomyopathy, medicine.diagnostic_test, Receiver operating characteristic analysis, business.industry, lcsh:R, Heart, 030229 sport sciences, Odds ratio, Middle Aged, medicine.disease, Prognosis, positron emission tomography, syntax score, viability, Confidence interval, Positron emission tomography, lcsh:RC666-701, Positron-Emission Tomography, Cardiology, Female, Cardiology and Cardiovascular Medicine, business, Cardiomyopathies, cardiomyopathy
Abstract

Objective: The SYNTAX score (SS) is not just a measure of the severity of coronary artery disease, but also complexity. The aim of this study was to evaluate the relationship between the SS and myocardial viability/non-viability assessed by positron emission tomography (PET) in patients with ischemic cardiomyopathy (IC). Methods: A total of 107 IC patients who had undergone PET were enrolled in the study. The patients were divided into two groups according to the presence or absence of viable myocardium. SS was analyzed from recorded conventional coronary angiographies. Results: Patients with a non-viable myocardium (n=21; 19.6%) had a significantly higher SS compared to those with a viable myocardium (17.6+-3.7 vs. 14.1+-5.2, respectively; p=0.004). Point-biserial correlation coefficient analysis indicated that the presence of myocardial non-viability was mildly correlated with a higher SS (rpb=-0.28, p=0.004). In multivariate logistic regression analysis, the SS was identified as the sole independent predictor of myocardial non-viability (odds ratio [OR]: 1.164, 95% confidence interval [CI]: 1.044–1.297; p =0.006]. Receiver operating characteristic analysis revealed a cutoff point of 16 for predicting a non-viable myocardium (area under curve: 0.71, 95% CI: 0.61–0.82) with a sensitivity of 76.2% and a specificity of 61.6%. Conclusion: The results of the present study indicates that a high SS is associated with the presence of a non-viable myocardium in IC patients.

Published
2019

24. The Relationship Between Coronary Collateral Circulation and Serum Endocan Levels in Patients with Coronary Chronic Total Occlusions

Author

Semi Ozturk, Süleyman Çağan Efe, Ahmet Seyfeddin Gurbuz, Cevat Kirma, Yakup Alsancak, and Ali Yaman

Subjects
coronary collateral circulation, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, business.industry, lcsh:R, lcsh:Medicine, Collateral circulation, angiogenesis, lcsh:RC666-701, Internal medicine, Cardiology, Medicine, In patient, Endocan, business, coronary artery disease
Abstract

Introduction: Endocan, a dermatan sulfate proteoglycan, is synthesized and secreted by the vascular endothelium. It is involved in the pathogenesis of vascular diseases, organ-specific inflammations, and angiogenesis. The aim of the present study was to investigate the relationship between serum endocan level and development of coronary collateral circulation (CCC) in patients with stable angina pectoris. Patients and Methods: Patients with stable angina with at least one chronic total coronary occlusion (CTO) (n= 44) and who had normal coronary artery (n= 29) were included in the study. Collateral degree was evaluated according to the Rentrop and Cohen’s classification. Patients who had grade 0 or 1 collateral filling were included in the poorly developed collateral group (n= 19), and those with grade 2 or 3 collateral filling were included in the well-developed collateral group (n= 23). Results: Endocan levels were significantly higher in patients in the well CCC group than in those in the poor CCC and control groups (p< 0.001). Endocan level is higher in patients with poorly developed CCC than in the control group. Endocan was only found as an independent predictor of well CCC in regression analysis (odds ratio 1.002, 95% confidence interval (CI) 1.001-1.005, p= 0.001). Receiver operating characteristic curve analysis detected an optimal cut-off value for endocan level of 1773.9 ng/L that predicted the presence of well development of CCC with a sensitivity of 84% and specificity of 63% (area under the receiver operating characteristic (ROC) curve: 0.749, 95% CI: 0.654-0.849, p< 0.001). Conclusion: Elevated endocan level is associated with better CCC in patients with CTO. Endocan may play an important role in the development of CCC.

Published
2019

25. Galectin-3 in Middle-Aged Patients with First Episode of Non-valvular Atrial Fibrillation: a Speckle-tracking Study

Author

Ali Yaman, Cevat Kirma, Mehmet Fatih Yılmaz, Süleyman Çağan Efe, Ahmet Seyfettin Gurbuz, Fatih Yilmaz, Emrah Acar, Gökhan Kahveci, İbrahim Akın İzgi, and Alev Kilicgedik

Subjects
First episode, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, strain rate, business.industry, lcsh:R, Non valvular atrial fibrillation, lcsh:Medicine, Atrial fibrillation, Atriyal fibrilasyon,strain,strain rate,galectin, Aged patients, Tıp, Speckle pattern, strain, Galectin-3, lcsh:RC666-701, Internal medicine, galectin-3, medicine, Cardiology, Medicine, business, Atrial fibrillation,strain,strain rate,galectin-3
Abstract

Introduction: Recentstudies have shown a significant association between left atrial (LA) globallongitudinal strain (GLS) and the progression of atrial fibrillation (AF) withsignificantly decreased LA GLS in patients with paroxysmal AF. Significantlyhigher levels of serum galectin-3 have also been found in patients with non-valvularAF. This study aimed to examine the relationship of the early stage of atrialfibrosis and reduced atrial deformation with serum galectin-3 concentration inmiddle-aged patients with a first episode of non-valvular AF.Patients and Methods:Thisstudy prospectively enrolled 34 patients who were admitted to our emergencydepartment and required either a medical or electrical cardioversion due to thefirst episode of AF, without any structural or coronary heart disease and withnormal LA size. Additionally, 31 control subjects were also enrolled. Thediameter, volume, and mechanical function of LA, including strain (S) andstrain rate (SR), and serum galectin-3 levels were measured.Results: Theaverage age was 48.5 ± 10.4 years. Galectin-3 values were not significantlydifferent between the AF and control groups (r= 0.42; p= 0.51) and were foundto correlate inversely with peak negative SR on apical four chamber (r= −0.31,p= 0.02) and two chamber (r= −0.25, p= 0.04) views. In comparison to the controlgroup, the AF group had significantly lower values of peak systolic S on fourchamber view (p= 0.037), peak late diastolic S (p= 0.04), peak positive SR onapical four-chamber view (p= 0.04), and peak late negative SR on apical fourchamber (p= 0.03) and two-chamber (p= 0.02) views.Conclusion: Middle-aged patients withthe first episode of AF and normal LA sizes had reduced LA reservoir and activeatrial functions. Although beginning signs of LA functional remodeling wereshown on S and SR imaging, these were not completely reflected by serumgalectin-3 levels., Giriş: Biz bu çalışmada ilk atak non-valvular atriyal fibrilasyon (AF)’lu ortayaşlı hasta grubunda serum galectin konsantrasyonu ile AF erken evresiarasındaki ilişkiyi araştırdık.Hastalar veYöntem: Bu çalışmaya acil servisimize ilk atak AF ile başvuran,medikal ya da elektriki kardiyoversiyon yapılmış, yapısal ya da koroner kalphastalığı olmayan normal LA boyuta sahip 34 hasta ve 31 kontrol hastasıprospektif olarak dahil edildi. Ekokardiyografik bulgular kayıt altına alındıve serum galectin düzeyleri ekokardiyografi öncesi alınan kan örneklerindenölçüldü.Bulgular: Hastaların ortalama yaşı 48.5 ± 10.4 yıldı. Galectin değerleri arasında AFve kontrol grubu arasında anlamlı fark saptanmadı (r= 0.42 ; p= 0.51) ve apikaldört boşluk (r= -0.31, p= 0.02) ve iki boşluk görüntüden (r= -0.25 , p= 0.04)pik negatif SR ile negatif korele bulundu. Kontrol grubu ilekarşılaştırıldığında, AF grubunda dört boşluk görüntüden pik sistolik strain(p= 0.037), pik geç diastolik strain (p= 0.04), pik positif SR (p= 0.04) ve pikgeç negatif SR apikal dört (p= 0.03) ve iki boşluk (p= 0.02) görüntüdendeğerleri anlamlı olarak daha düşük olarak bulunmuştur.Sonuç: İlk atak AF’li orta yaşlıve normal LA boyutuna sahip hastalarda LA rezervuar ve aktif atriyalfonksiyonlar azalmıştır. Strain ve SR görüntüleme ile gösterilmiş LAfonksiyonel remodeling belirtileri başlamış olmasına rağmen bu durum serumgalectin düzeyleri ile tam olarak gösterilememiştir.

Published
2017

26. Subclinical Left Ventricular Dysfunction in Chronic Asymptomatic Alcoholic Patients

Author

Gonenc Kocabay, Akin Izgi, Ruken Bengi Bakkal, Arzu Kalayci, Ayhan Erkol, Can Yücel Karabay, Taylan Akgun, Vecih Oduncu, Cevat Kirma, and Ahmet Guler

Subjects
left ventricular dysfunction, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, business.industry, lcsh:R, lcsh:Medicine, Asymptomatic, Alcoholic patients, speckle tracking, lcsh:RC666-701, Internal medicine, Cardiology, Medicine, echocardiography, medicine.symptom, business, Subclinical infection
Abstract

Introduction: The aim of this study was to use speckle-tracking echocardiography (STE) for identifying subclinical global systolic function abnormalities in chronic asymptomatic alcoholic patients with a normal ejection fraction. Patients and Methods: We included 30 healthy subjects (age 34.8 ± 5.8 years) and 75 asymptomatic alcoholic patients (age 39.8 ± 6.5 years) and divided them into two groups according to their total lifetime dose of ethanol (TLDE): group I (TLDE < 15 kg ethanol/kg body weight) and group II (TLDE ≥ 15 kg ethanol/kg body weight). In the two-dimensional (2D)-STE analysis, the left ventricular (LV) global longitudinal strain (G-LS), longitudinal global strain rate in systole (G-SRsys), longitudinal global strain rate in early diastole (G-SRearly) and longitudinal global strain rate in late diastole (G-SRlate) values were obtained. Results: Alcoholic patients had larger end-systolic and end-diastolic dimensions, thicker interventricular septal and posterior wall and higher LV mass index. However, there were no differences in the end-systolic and end-diastolic dimensions and LV mass index among them. The ejection fraction did not differ between the groups. The G-LS values were lower in alcoholic patients (p< 0.001). G-LS was found to be significantly lower among alcoholic patients, although the LV mass index and LV dimensions remained unchanged. Although G-SRsys was lower in alcoholic patients compared with that in controls (p= 0.03), there were no differences in the G-SRearly and G-SRlate values. There was a significant correlation between G-LS values and TLDE (r= 0.49, p< 0.001). Conclusion: To the best of our knowledge, this is the first study demonstrating the presence of early functional abnormalities of longitudinal systolic function by 2D-STE in chronic alcoholic patients. These functional mechanics have a parallel impairment with the increase in alcohol consumption.

Published
2016

27. Optical coherence tomography guided successful fibrinolytic treatment without the need for percutaneous coronary intervention in a patient with acute ST-segment elevation myocardial infarction

Author

Can Yücel Karabay, Mehmet Emin Kalkan, Arzu Kalayci, Gonenc Kocabay, Onur Taşar, and Cevat Kirma

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, Acute ST segment elevation myocardial infarction, medicine.medical_treatment, Percutaneous coronary intervention, Text mining, Optical coherence tomography, Image in Intervention, Internal medicine, Cardiology, Medicine, Cardiology and Cardiovascular Medicine, business
Published
2018

29. Transcatheter Closure or Surgery for Symptomatic Paravalvular Leaks: The Multicenter KISS Registry

Author

Ahmet Güner, Cevat Kırma, Mehmet Ertürk, Muhsin Türkmen, Gökhan Alıcı, Can Yücel Karabay, Fatih Uzun, Alev Kılıçgedik, Sabahattin Gündüz, Gamze Babur Güler, Ali Kemal Kalkan, Birol Özkan, Münevver Sarı, Mustafa Ozan Gürsoy, Meltem Tekin, Mustafa Yıldız, Fatma Can, Kaan Kırali, Ali Fedakar, Sabit Sarıkaya, Ünal Aydın, Serkan Kahraman, Taner İyigün, Mehmet Aksüt, Eren Karpuzoğlu, Koray Çiloğlu, Mustafa Azmi Sungur, İbrahim Halil Tanboğa, and Mehmet Özkan

Subjects
death, echocardiography, paravalvular leak, surgery, transcatheter closure, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract

Background The optimal treatment of symptomatic paravalvular leak (PVL) remains controversial between transcatheter closure (TC) and surgery. This large‐scale study aimed to retrospectively evaluate the long‐term outcomes of the patients who underwent reoperation or TC of PVLs. Methods and Results A total of 335 (men, 209 [62.4%]; mean age, 58.15±12.77 years) patients who underwent treatment of PVL at 3 tertiary centers between January 2002 and December 2021 were included. Echocardiographic features, procedure details, and in‐hospital or long‐term outcomes were assessed. The primary end point was defined as the all‐cause death during follow‐up. The regression models were adjusted by applying the inverse probability weighted approach to reduce treatment selection bias. The initial management strategy was TC in 171 (51%) patients and surgery in 164 (49%) cases. Three hundred cases (89.6%) had mitral PVL, and 35 (10.4%) had aortic PVL. The mean left ventricular ejection fraction was 52.03±10.79%. Technical (78.9 versus 76.2%; P=0.549) and procedural success (73.7 versus 65.2%; P=0.093) were similar between both groups. In both univariate and multivariable logistic regression analysis, the in‐hospital mortality rate in the overall population was significantly higher (15.9 versus 4.7%) in the surgery group compared with the TC group (unadjusted odds ratio, 3.13 [95% CI, 1.75–5.88]; P=0.001; and adjusted odds ratio (inverse probability‐weighted), 4.55 [95% CI, 2.27–10.0]; P

Published
2024
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30. ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in non-valvular atrial fibrillation (RAMSES study)

Author

Özcan Başaran, Mehmet Yaman, Ahmet Çağrı Aykan, Mehmet Tekinalp, Ibrahim Altun, Volkan Doğan, Macit Kalçık, Özgen Şafak, Osman Beton, Onur Taşar, Murat Biteker, Ezgi Kalaycıoğlu, Ismail Bolat, Mustafa Özcan Soylu, Cevat Kirma, MÜ, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Başaran, Özcan, Doğan, Volkan, Biteker, Murat, [Basaran, Ozcan -- Dogan, Volkan -- Altun, Ibrahim -- Soylu, Mustafa Ozcan -- Biteker, Murat] Mugla Sitki Kocman Univ, Fac Med, Dept Cardiol, Mugla, Turkey -- [Beton, Osman] Sivas Cumhuriyet Univ, Fac Med, Dept Cardiol, Sivas, Turkey -- [Tekinalp, Mehmet] Kahramanmaras Necip Fazil State Hosp, Dept Cardiol, Kahramanmaras, Turkey -- [Aykan, Ahmet Cagri -- Kalaycioglu, Ezgi] Trabzon Ahi Evren Chest Cardiovasc Surg Educ & Re, Dept Cardiol, Trabzon, Turkey -- [Bolat, Ismail] Fethiye State Hosp, Dept Cardiol, Fethiye, Turkey -- [Tasar, Onur] Elazig Educ & Res Hosp, Dept Cardiol, Elazig, Turkey -- [Safak, Ozgen] Burdur State Hosp, Dept Cardiol, Burdur, Turkey -- [Kalcik, Macit] Iskilip Atif Hoca State Hosp, Dept Cardiol, Corum, Turkey -- [Yaman, Mehmet] Samsun Educ & Res Hosp, Dept Cardiol, Samsun, Turkey -- [Kirma, Cevat] Kartal Kosuyolu Heart Educ & Res Hosp, Dept Cardiol, Istanbul, Turkey, Demir, Vahit -- 0000-0001-8349-6651, and BASARAN, OZCAN -- 0000-0002-6384-6455

Subjects
medicine.medical_specialty, Turkey, Non valvular atrial fibrillation, Administration, Oral, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, prevention, Risk Factors, Internal medicine, Surveys and Questionnaires, Atrial Fibrillation, medicine, Humans, Oral Anticoagulant Therapy, Medical history, 030212 general & internal medicine, Stroke, Aged, Aged, 80 and over, Mitral regurgitation, Univariate analysis, business.industry, Prevention, Hot Topic, Anticoagulants, Atrial fibrillation, oral anticoagulant therapy, Middle Aged, medicine.disease, stroke, Cross-Sectional Studies, Stroke prevention, Multicenter survey, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

WOS: 000392195800004, PubMed ID: 27723665, Objective: Data regarding stroke prevention strategies in non-valvular atrial fibrillation (NVAF) are limited to vitamin K antagonists (VKAs). This study aimed to evaluate real-life stroke prevention strategies for NVAF patients in the era of non-VKA oral anticoagulants (NOACs). Methods: We established a cross-sectional, multicenter, nationwide registry of NVAF patients. All consecutive atrial fibrillation (AF) patients and without mechanical heart valves or rheumatic mitral stenosis (but including those with any degree of mitral regurgitation) were enrolled in the ReAl-life Multicenter Survey Evaluating Stroke Prevention Strategies (RAMSES Study; ClinicalTrials. gov identifier NCT02344901) in Turkey. Base-line demographic data, medical history, and medications prescribed for NVAF treatment were collected. Univariate analyses were performed for continuous variables, and the chi-square test was used for categorical variables. Results: In total, 6273 patients from 29 provinces of Turkey were enrolled in the study between February and May 2015, with the contribution of 83 investigators. The mean age was 69.6 +/- 10.7 years; 56% of the patients were females, and one-fifth of the patients had at least one comorbid disease, the most common being hypertension (69%). The mean CHA(2)DS(2)-VASc and HAS-BLED scores were 3.3 +/- 1.6 and 1.6 +/- 1.1, respectively. The rate of oral anticoagulant (OAC) therapy use was 72% (37% NOAC and 35% VKA). Conclusion: The RAMSES study showed a higher prevalence of OAC use among NVAF patients than that reported in previous studies. Although NOACs were preferred over VKAs in daily cardiology practice, there is a need for improved OAC therapies for NVAF patients.

Published
2016

31. Predictive role of left atrial and ventricular mechanical function in postoperative atrial fibrillation: a two-dimensional speckle-tracking echocardiography study

Author

Gökhan Gözübüyük, Tansu Karaahmet, Cevat Kirma, Ahmet Guler, Onur Taşar, Kursat Tigen, Murat Biteker, Özcan Başaran, Cihan Dündar, M Bulut, and Can Yücel Karabay

Subjects
Male, medicine.medical_specialty, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, Heart Ventricles, Adrenergic beta-Antagonists, lcsh:Medicine, Speckle tracking echocardiography, Coronary Artery Disease, Coronary artery disease, Postoperative Complications, Predictive Value of Tests, Internal medicine, Natriuretic Peptide, Brain, medicine, Humans, Sinus rhythm, atrial fibrillation, Heart Atria, Prospective Studies, Coronary Artery Bypass, Prospective cohort study, lcsh:RC31-1245, Aged, E/A ratio, business.industry, lcsh:R, Atrial fibrillation, Middle Aged, medicine.disease, Peptide Fragments, medicine.anatomical_structure, Echocardiography, lcsh:RC666-701, Predictive value of tests, Cardiology, Atrial Function, Left, Female, coronary artery disease, left atrial strain, left ventricular strain, speckle tracking echocardiography, Cardiology and Cardiovascular Medicine, business, Artery
Abstract

Objective: The aim of this study was to determine the role of leftsided mechanical parameters in postoperative atrial fibrillation (POAF) in patients undergoing coronary artery bypass grafting (CABG). Methods: Ninety patients with coronary artery disease and normal left ventricular (LV) function in sinus rhythm were enrolled in the study. Preoperative LV and left atrial (LA) mechanics were evaluated by two-dimensional (2D) speckle-tracking echocardiography (STE), including strain and rotation parameters, and volume indices. Patients were monitored in order to detect POAF during the postoperative period. Results: Twenty-three of 90 patients (25.6%) developed POAF. Age (p70 pg/ml, OR 22.377, CI 3.286–152.381, p

Published
2016

32. Copeptin in Severe Mitral Regurgitation Caused by Degenerative Mitral Disease

Author

Gökhan Kahveci, İbrahim Akın İzgi, Ali Yaman, Cevat Kirma, Süleyman Çağan Efe, Ahmet Guler, Alev Kilicgedik, and Ahmet Seyfettin Gurbuz

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Mitral regurgitation, business.industry, Kopeptin,mitral yetersizlik, Copeptin, lcsh:R, lcsh:Medicine, Mitral disease, Tıp, lcsh:RC666-701, Internal medicine, Cardiology, medicine, Medicine, mitral regurgitation, business, Copeptin,mitral regurgitation
Abstract

Introduction:Copeptinis known to be increased in cardiac heart failure. The role of copeptin inpatients with severe mitral regurgitation has not been assessed in patientswith preserved ejection fraction. The objective of this study is to evaluatethe role of severe mitral regurgitation caused by degenerative mitral diseasein copeptin release.Patientsand Methods: 39 patients with degenerative mitral regurgitation (DMRgroup) and 30 control subjects (control group) were included in the study. Theclinical and echocardiographic findings were recorded. Blood samples wereobtained in 15 min before echocardiographic examination for determination ofplasma copeptin. Global left ventricular longitudinal and circumferentialstrains were evaluated by applying 2D speckle-tracking imaging.Results: There wasno statistical difference among copeptin levels of all groups (median valuesare for DMR:10.7 (9.0-17.1); control group:13.2 (10.6-20.7; p= 0.42). GCSTR andGLSTR were significantly lower in the DMR group (-19.2 ± 5.5 vs. -23.8 ± 5.3;p= 0.002 and -17.1 ± 4.3 vs. -19.9 ± 2.4 p= 0.002 respectively). LAV (83.7 ±38.8 vs. 34.1 ± 7.5 p= 0.0001), E/e’ (9.6 ± 4.0 vs. 6.0 ± 1.4; p= 0.0001), andE/A (1.79 ± 0.5 vs. 0.9 ± 0.24 p= 0.0001) ratios were significantly higher inthe DMR group.Conclusion: Our study demonstrated thatthere is no significant change in serum copeptin concentrations in severemitral regurgitation due to degenerative mitral disease. This can be attachedto the filling changes of left atrium, atrial stretch receptors, and increasedstroke volume., Giriş: Kopeptinin kalp yetersizliğinde yükseldiği bilinmektedir.Korunmuş ejeksiyon fraksiyonlu ileri mitral yetersizliği olan hastalardakopeptinin rolü bilinmemektedir. Bu çalışmanın amacı kopeptin salınımındadejeneratif mitral hastalığa bağlı ileri mitral yetersizlikliğinin rolünüdeğerlendirmektir.Hastalar ve Yöntem: Dejeneratif ileri mitralyetersizliği olan 39 hasta (DMR grubu) ve 30 kontrol deneği (kontrol grubu)çalışmaya alındı. Klinik ve ekokardiyografik bulgular kayıt altına alındı.Plasma kopeptin düzeyini belirlemek için ekokardiyografik incelemeden 15 dakikaönce kan örnekleri alındı. Global sol ventriküler longitudinal vesirkumferensiyal değerlendirme 2D specle tracking görüntüleme ile yapıldı.Bulgular: Gruplar arasında kopeptin düzeyleri açısından anlamlıfark yoktu (median değerleri DMR: 10.7 (9.0-17.1); kontrol grup:13.2(10.6-20.7) (p= 0.42)). GCSTR ve GLSTR değerleri DMR grubunda control grubunagöre daha düşüktü ( -19.2 ± 5.5 vs. -23.8 ± 5.3; p= 0.002 ve -17.1 ± 4.3 vs.-19.9 ± 2.4 p= 0.002 sırasıyla). LAV (83.7 ± 38.8 vs. 34.1 ± 7.5 p= 0.0001),E/e’ (9.6 ± 4.0 vs. 6.0 ± 1.4; p= 0.0001) ve E/A (1.79 ± 0.5 vs. 0.9 ± 0.24 p=0.0001) oranları DMR grubunda anlamlı olarak yüksekti.Sonuç: Bizim çalışmamız;dejeneratif mitral hastalığa bağlı ileri mitral yetersizliğinde kontrol grubunagöre kopeptin düzeylerinde anlamlı değişiklik olmadığını göstermiştir. Bu bulgusol atriyal dolum değişiklikleri, atriyal stretch reseptörleri ve artmış strokevolüm ile ilişkilidir.

Published
2017

33. The effects of tirofiban infusion on clinical and angiographic outcomes of patients with STEMI undergoing primary PCI

Author

Alper Özkan, Muhsin Turkmen, Nihal Özdemir, Mehmet Mustafa Can, Cevat Kirma, Hacer Ct. Demircan, Ali Metin Esen, İbrahim Akın İzgi, Nursen Keles, Ibrahim Halil Tanboga, Cihangir Kaymaz, and Fatih Koca

Subjects
Male, medicine.medical_specialty, tirofiban, medicine.medical_treatment, Coronary Angiography, Drug Administration Schedule, Bolus (medicine), Fibrinolytic Agents, Internal medicine, medicine, Humans, angiography, Myocardial infarction, cardiovascular diseases, Infusions, Intravenous, Letter to the Editor, Aged, Retrospective Studies, Original Investigation, Aspirin, business.industry, percutaneous coronary intervention, Percutaneous coronary intervention, Tirofiban, Middle Aged, medicine.disease, Clopidogrel, surgical procedures, operative, myocardial infarction, Conventional PCI, Cardiology, treatment outcome, Tyrosine, Female, Cardiology and Cardiovascular Medicine, business, TIMI, medicine.drug
Abstract

Objective: The present study was designed to determine the effects of tirofiban (Tiro) infusion on angiographic measures, ST-segment resolution, and clinical outcomes in patients with STEMI undergoing PCI. Glycoprotein (GP) IIb/IIIa inhibitors are beneficial in ST-segment elevation myocardial infarction (STEMI) patients undergoing percutaneous coronary intervention (PCI), while the most effective timing of administration is still under investigation. Methods: A total of 1242 patients (83.0% males, mean (standard deviation; SD) age: 54.7 (10.9) years) with STEMI who underwent primary PCI were included in this retrospective non-randomized study in four groups, composed of no tirofiban infusion [Tiro (-); n=248], tirofiban infusion before PCI (pre-Tiro; n=720), tirofiban infusion during PCI (peri-Tiro; n=50), and tirofiban infusion after PCI (post-Tiro; n=224). In all Tiro (+) patients, bolus administration of Tiro (10 pg/kg) was followed by infusion (0.15 pg/kg/min) for a mean (SD) duration of 22.4±6.8 hours. Results: The pre-PCI Tiro group was associated with the highest percentage of patients with TIMI 3 flow (99.4%; p75% ST-segment resolution (78.1%; p

Published
2014

34. Zofenopril and Ramipril in Combination with Acetyl Salicylic Acid in Postmyocardial Infarction Patients with Left Ventricular Systolic Dysfunction: A Retrospective Analysis of the SMILE-4 Randomized, Double-Blind Study in Diabetic Patients

Author

BORGHI, CLAUDIO, AMBROSIONI, ETTORE, Omboni, Stefano, Novo, Salvatore, Vinereanu, Dragos, Ambrosio, Giuseppe, Dimitrios, Alexopolulus, Ioannis, Nanas, Marco, Agrusta, Antonio, Barsotti, Serena, Bergerone, Luigi, Caliendo, Pio, Caso, Antonio, Castello, Domenico, Cianflone, Tommaso, Cipolla, Gaetano, De Ferrari, Giuseppe, De Nittis, Livio, Dei Cas, Paolo, Di Pasquale, Rosario, Evola, Luciano, Fattore, Raffaele, Ferrante, Antonio, Fiscella, Achille, Gaspardone, Giuseppe, Ielasi, Niccoló, Marchionni, Giancarlo, Marenzi, Filippo, Marte, Federico, Miccoli, Patrizia, Noussan, Mario, Orlandi, Giancarlo, Piovaccari, Maurizio, Porcu, Patrizia, Presbitero, Antonio, Raviele, Emiliano, Renaldini, Jorge, Salerno Uriarte, Giovanni, Storti, Corrado, Tamburino, Pierfranco, Terrosu, Roberto, Testa, Rita, Trinchero, Bernardino, Tuccillo, Ludovico, Vasquez, Quinto, Villani Giovanni, Garcia, Alvés Mario, Aurora, Andrade, Silva, Cardoso, Ilidio, Moreira Joseà, Catalina, Arsenescu Georgescu, Mircea, Cinteza, Maria, Dorobantu, Dominic, Ionescu, Ioan, Manitiu, Florin, Ortan, Calin, Pop, Mariana, Radoi, Yuriy, Alexandrovich Vasyuk, Victor, Avenirovitch Kostenko, Yuriy, Borisovich Karpov, Vira, Iosifovna Tseluiko, Abram, Lvovich Syrkin, Boris, Mikhailovich Goloschekin, Evgeniy, Mikhaylovich Nifontov, Sergey, Nikolaevich Tereschenko, Natalia, Nikolaevna Burova, Konstantin, Nikolayevich Zrazhevsky, Grigory, Pavlovich Arutuynov, Valentin, Sergeevich Moiseev, Leonid, Victorovich Rudenko, Alexander, Yurievich Vishnevsky, Diaz, D. L. Y. De La Yera, Fernández, Romero, Cevat, Kirma, Kayikcioglu, Meral, Abdurrahman, Oğuzhan, Dilek, Ural Komsuoglu, Olena, Ankindinovna Koval, Alexan, Nikolaevich Parkhomenko, Igor, Petrovich Vakalyuk, Mykola, Tihonovich Vatutin, Valerii, Vladimirovich Batushkin, Borghi, Claudio, Omboni, Stefano, Novo, Salvatore, Vinereanu, Drago, Ambrosio, Giuseppe, Ambrosioni, Ettore, Dimitrios, Alexopolulu, Ioannis, Nana, Marco, Agrusta, Antonio, Barsotti, Serena, Bergerone, Luigi, Caliendo, Pio, Caso, Antonio, Castello, Domenico, Cianflone, Tommaso, Cipolla, Gaetano, De Ferrari, Giuseppe, De Nitti, Livio, Dei Ca, Paolo, Di Pasquale, Rosario, Evola, Luciano, Fattore, Raffaele, Ferrante, Antonio, Fiscella, Achille, Gaspardone, Giuseppe, Ielasi, Niccoló, Marchionni, Giancarlo, Marenzi, Filippo, Marte, Federico, Miccoli, Patrizia, Noussan, Mario, Orlandi, Giancarlo, Piovaccari, Maurizio, Porcu, Patrizia, Presbitero, Antonio, Raviele, Emiliano, Renaldini, Jorge, Salerno Uriarte, Giovanni, Storti, Corrado, Tamburino, Pierfranco, Terrosu, Roberto, Testa, Rita, Trinchero, Bernardino, Tuccillo, Ludovico, Vasquez, Quinto, Villani Giovanni, Garcia, Alvés Mario, Aurora, Andrade, Silva, Cardoso, Ilidio, Moreira Joseà, Catalina, Arsenescu Georgescu, Mircea, Cinteza, Maria, Dorobantu, Dominic, Ionescu, Ioan, Manitiu, Florin, Ortan, Calin, Pop, Mariana, Radoi, Yuriy, Alexandrovich Vasyuk, Victor, Avenirovitch Kostenko, Yuriy, Borisovich Karpov, Vira, Iosifovna Tseluiko, Abram, Lvovich Syrkin, Boris, Mikhailovich Goloschekin, Evgeniy, Mikhaylovich Nifontov, Sergey, Nikolaevich Tereschenko, Natalia, Nikolaevna Burova, Konstantin, Nikolayevich Zrazhevsky, Grigory, Pavlovich Arutuynov, Valentin, Sergeevich Moiseev, Leonid, Victorovich Rudenko, Alexander, Yurievich Vishnevsky, Diaz, D.L.Y.De La Yera, Fernández, Romero, Cevat, Kirma, Kayikcioglu, Meral, Abdurrahman, Oğuzhan, Dilek, Ural Komsuoglu, Olena, Ankindinovna Koval, Alexan, Nikolaevich Parkhomenko, Igor, Petrovich Vakalyuk, Mykola, Tihonovich Vatutin, Valerii, Vladimirovich Batushkin, on behalf of the SMILE-4 Working, Party, and Cianflone, Domenico

Subjects
Male, Captopril, Diabetic Cardiomyopathies, Myocardial Infarction, Infarction, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, chemistry.chemical_compound, Ventricular Dysfunction, Left, 0302 clinical medicine, Diabetes mellitus, Ramipril, Retrospective Studie, Cardiovascular Disease, Medicine, Pharmacology (medical), 030212 general & internal medicine, Myocardial infarction, Diabetic Cardiomyopathie, Randomized Controlled Trials as Topic, Aspirin, Left ventricular dysfunction, General Medicine, Acetyl salicylic acid, Acute myocardial infarction, Angiotensin-converting enzyme inhibitors, Zofenopril, Cardiology and Cardiovascular Medicine, Pharmacology, Middle Aged, Cardiovascular Diseases, Cardiology, Platelet aggregation inhibitor, Drug Therapy, Combination, Female, medicine.drug, Human, medicine.medical_specialty, Diabetes mellitu, Systole, 03 medical and health sciences, Internal medicine, Humans, Aged, Retrospective Studies, business.industry, Platelet Aggregation Inhibitor, Angiotensin-Converting Enzyme Inhibitor, medicine.disease, chemistry, Angiotensin-converting enzyme inhibitor, business, Mace, Platelet Aggregation Inhibitors
Abstract

Summary Objective In the SMILE-4 study, zofenopril + acetyl salicylic acid (ASA) was more effective than ramipril + ASA on 1-year prevention of major cardiovascular events (MACE) in patients with acute myocardial infarction complicated by left ventricular dysfunction. In this retrospective analysis, we evaluated drug efficacy in subgroups of patients, according to a history of diabetes mellitus. Methods The primary study endpoint was 1-year combined occurrence of death or hospitalization for cardiovascular causes. Diabetes was defined according to medical history (previous known diagnosis). Results A total of 562 of 693 (81.0%) patients were classified as nondiabetics and 131 (18.9%) as diabetics. The adjusted rate of MACE was lower under zofenopril than under ramipril in both nondiabetics [27.9% vs. 34.9% ramipril; odds ratio, OR and 95% confidence interval: 0.55 (0.35, 0.86)] and diabetics [30.9% vs. 41.3%; 0.56 (0.18, 1.73)], although the difference was statistically significant only for the nondiabetic group (P = 0.013). Zofenopril was superior to ramipril as regards to the primary study endpoint in the subgroup of 157 patients with uncontrolled blood glucose (≥126 mg/dL), regardless of a previous diagnosis of diabetes [0.31 (0.10, 0.90), P = 0.030]. Zofenopril significantly reduced the risk of hospitalization for cardiovascular causes in both nondiabetics [0.64 (0.43, 0.96), P = 0.030] and diabetics [0.38 (0.15, 0.95), P = 0.038], whereas it was not better than ramipril in terms of prevention of cardiovascular deaths. Conclusions This retrospective analysis of the SMILE-4 study confirmed the good efficacy of zofenopril plus ASA in the prevention of long-term MACE also in the subgroup of patients with diabetes mellitus.

Published
2016

35. Perforation of anterior mitral leaflet aneurysm: A rare cause of severe mitral regurgitation

Author

Can Yücel Karabay, Süleyman Çağan Efe, Cevat Kirma, Semi Öztürk, Emrah Acar, Ahmet Guler, Ahmet Seyfeddin Gurbuz, and Alev Kilicgedik

Subjects
medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Perforation (oil well), Aortic regurgitation, 02 engineering and technology, Regurgitation (circulation), Internal medicine, Mitral valve, 0202 electrical engineering, electronic engineering, information engineering, medicine, Endocarditis, Mitral valve prolapse, cardiovascular diseases, Mitral regurgitation, Perforation, business.industry, 020206 networking & telecommunications, medicine.disease, Cardiac surgery, medicine.anatomical_structure, Three dimensional echocardiography, lcsh:RC666-701, Infective endocarditis, Cardiology, cardiovascular system, 020201 artificial intelligence & image processing, Cardiology and Cardiovascular Medicine, business
Abstract

Mitral valve perforation is a rare cause of severe mitral regurgitation. Infective endocarditis, connective tissue disease, cardiac surgery and aortic regurgitation jet are blaming causes of mitral valve perforation. We present a case of anterior mitral leaflet perforation accompanied with mitral valve prolapse identified by real-time three-dimensional transesophageal echocardiography.

Published
2016

36. Gender-related differences in presentation and treatment of patients with non-valvular atrial fibrillation: results from RAMSES study

Author

Macit Kalçık, Volkan Doğan, Osman Beton, Mehmet Tekinalp, Özgen Şafak, Ahmet Çağrı Aykan, Özcan Başaran, Cevat Kirma, Ezgi Kalaycıoğlu, Ismail Bolat, Onur Taşar, Murat Biteker, MÜ, [Dogan, Volkan -- Basaran, Ozcan -- Biteker, Murat] Mugla Sitki Kocman Univ, Dept Cardiol, Fac Med, Mugla, Turkey -- [Beton, Osman] Sivas Cumhuriyet Univ, Dept Cardiol, Fac Med, Sivas, Turkey -- [Tekinalp, Mehmet] Kahramanmaras Necip Fazil State Hosp, Dept Cardiol, Kahramanmaras, Turkey -- [Aykan, Ahmet Cagri -- Kalaycioglu, Ezgi] Trabzon Ahi Evren Chest Cardiovasc Surg Training, Dept Cardiol, Trabzon, Turkey -- [Bolat, Ismail] Fethiye State Hosp, Dept Cardiol, Mugla, Turkey -- [Tasar, Onur] Elazig Training & Res Hosp, Dept Cardiol, Elazig, Turkey -- [Safak, Ozgen] Burdur State Hosp, Dept Cardiol, Burdur, Turkey -- [Kalcik, Macit] Iskilip Atif Hoca State Hosp, Dept Cardiol, Corum, Turkey -- [Kirma, Cevat] Kartal Kosuyolu Heart Training & Res Hosp, Dept Cardiol, Istanbul, Turkey, and BASARAN, OZCAN -- 0000-0002-6384-6455

Subjects
Male, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Turkey, Cross-sectional study, Non valvular atrial fibrillation, lcsh:Medicine, Management of atrial fibrillation, 030204 cardiovascular system & hematology, Non-Valvular Atrial Fibrillation, Severity of Illness Index, oral anticoagulan therapy, Brain Ischemia, Coronary artery disease, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Risk Factors, non-valvular atrial fibrillation, Internal medicine, Atrial Fibrillation, Severity of illness, gender, medicine, Humans, 030212 general & internal medicine, Practice Patterns, Physicians', lcsh:RC31-1245, Stroke, Aged, business.industry, lcsh:R, Age Factors, Anticoagulants, Gender, Middle Aged, medicine.disease, Oral Anticoagulan Therapy, Cross-Sectional Studies, lcsh:RC666-701, Heart failure, Cardiology, Female, Observational study, Cardiology and Cardiovascular Medicine, business
Abstract

WOS: 000396440200005, PubMed ID: 28106016, Objective: Gender is an important feature in the management of atrial fibrillation (AF). This study investigated gender-related differences in patients with AF in Turkey. Methods: As a part of RAMSES (ReAl-life Multicenter Survey Evaluating Stroke prevention strategies in Turkey, NCT02344901) study, information of the patients with AF who successively applied to the hospital was analyzed. This cross-sectional, multi-center, nationwide observational study enrolled 6264 non-valvular AF (NVAF) outpatients (55.9% women) from Turkey. Results: Compared with men, women with NVAF were older (71 years [range: 65-78 years] vs. 70 years [range: 62-77 years]; p= 1 [male], >= 2 [female]) had not received any anticogulant therapy. Conclusion: Although women with NVAF receive better treatment than men, anticoagulation therapy is suboptimal in large proportion of men and women, with underuse in high-risk patients and overuse in low-risk patients. There is an urgent need to improve optimization of anticoagulation in patients with NVAF.

Published
2017

37. Guideline-adherent therapy for stroke prevention in atrial fibrillation in different health care settings: Results from RAMSES study

Author

Selami Demirelli, Murat Civan, Ezgi Kalaycıoğlu, Ismail Bolat, Seref Ulucan, Emine Altuntas, Beytullah Çakal, Mehmet Tekinalp, Yiğit Çanga, Kadriye Memiç Sancar, Cem Doğan, Zeki Şimşek, Fatma Özpamuk Karadeniz, Ulaankhu Batgharel, Onur Taşar, Arif Arısoy, Kamuran Tekin, Özkan Candan, Gökhan Gözübüyük, Özgür Kaplan, Ceyhan Türkkan, Müjgan Tek Öztürk, Ahmet Çağrı Aykan, Oguz Karaca, Yasin Çakıllı, Mehmet Hamidi, Bingül Dilekçi Şahin, Ahmet İlker Tekkeşin, Zübeyde Bayram, Adnan Kaya, Tahir Bezgin, Aleks Degirmencioglu, Kadriye Akay, Ozlem Ozcan Celebi, Aytekin Aksakal, Özcan Başaran, Ali Ekber Ata, Sinan Inci, Gökhan Göl, İdris Pektaş, Savas Celebi, Mehmet Yaman, Sedat Kalkan, Mehmet Hayri Alıcı, Adem Tatlısu, Bernas Altıntaş, Macit Kalçık, Gurbet Özge Mert, Ibrahim Altun, Hacı Murat Güneş, Kadir Uğur Mert, Gökhan Aksan, Aslı Tanındı, Osman Beton, Sabri Seyis, Emrah Ermiş, Cevat Kirma, Mehmet Ballı, Edip Güvenç Çekiç, İbrahim Rencüzoğulları, Mustafa Ozan Gürsoy, Vahit Demir, Ayşe Çolak, Serkan Gökaslan, Füsun Helvacı, Feyza Çalık, Nesrin Filiz Başaran, Volkan Doğan, Serdar Bozyel, Murat Biteker, Mehmet Aytürk, Özgen Şafak, Fethi Yavuz, and Tıp Fakültesi

Subjects
Male, medicine.medical_specialty, Turkey, Stroke Prevention, Administration, Oral, Inappropriate Prescribing, Comorbidity, 030204 cardiovascular system & hematology, Tertiary Care Centers, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, Health care, Atrial Fibrillation, Internal Medicine, medicine, Humans, In patient, Oral Anticoagulant Therapy, 030212 general & internal medicine, Registries, Aged, Aged, 80 and over, business.industry, ComputerSystemsOrganization_COMPUTER-COMMUNICATIONNETWORKS, Anticoagulants, Atrial fibrillation, Guideline, Middle Aged, medicine.disease, Stroke, ComputingMilieux_MANAGEMENTOFCOMPUTINGANDINFORMATIONSYSTEMS, Cross-Sectional Studies, Logistic Models, ComputingMethodologies_PATTERNRECOGNITION, Stroke prevention, Baseline characteristics, Healthcare settings, Physical therapy, Population study, Female, Guideline Adherence, InformationSystems_MISCELLANEOUS, business
Abstract

PubMed ID: 28238569, Objective No studies have been conducted in Turkey to compare the quality of stroke prevention therapies provided in different healthcare settings in patients with atrial fibrillation (AF). Therefore, we aimed to evaluate possible differences between secondary (SH) and tertiary hospital (TH) settings in the effectiveness of implementing AF treatment strategies. Methods Baseline characteristics of 6273 patients with non-valvular AF enrolled in the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke Prevention Strategies in Turkey) study were compared. Results Of the study population, 3312 (52.8%) patients were treated in THs and 2961 (47.2%) patients were treated in SHs. Patients treated in the SH setting were older (70.8 ± 9.8 vs. 68.7 ± 11.4 years, p

Published
2017

38. Resistin, A Potential Actor in Coronary Artery Disease

Author

Nezaket Eren, Elif Kilic, Saban Yayla, Abdurrahim Koçyiğit, Fatma Turgay, Şebnem Ciğerli, and Cevat Kirma

Subjects
medicine.medical_specialty, lcsh:R5-920, business.industry, General Engineering, nutritional and metabolic diseases, medicine.disease, Coronary artery disease, hsCRP, inflammation, Internal medicine, Cardiology, Medicine, Resistin, business, lcsh:Medicine (General), coronary artery disease
Abstract

Objective:Biochemical observations of the decrease in mortality rate and prediction of the degree of coronary artery stenosis before symptomatic improvement are gaining importance. In our study, we aimed to evaluate the etiological value of the recently discovered resistin biomolecule in coronary atherosclerosis pathogenesis.Methods:In this study, we evaluated and compared serum resistin levels in patients with angiographically proven coronary artery disease (stenosis ratio >25%) (n=43) and in the control group with angiographically proven normal coronary artery diameter (stenosis ratio 0.05). While considering both patient and control group correlations, we determined a positive correlation between resistin and fasting insulin (p=0.012, r=0.304), HOMA-IR (p=0.046, r=0.243), homocysteine (p=0.05; r 0.239), and hsCRP (p=0.029, r=0.265).Conclusion:Resistin values differ between patients and control subjects but were not statistically significant. The modifying effect of anti-hyperlipidemic agents over serum resistin levels may have a preventive role in the process of atherosclerosis. We think that effective results will be obtained in raising the selected threshold level of atherosclerosis diagnosis and increasing the number of patients.

Published
2014

39. Evaluation of the long-term effect of percutaneous balloon valvuloplasty on right ventricular function using tissue Doppler imaging in patients with mitral stenosis

Author

Göksel Açar, Mustafa Akçakoyun, Hasan Kaya, Hekim Karapinar, Zekeriya Kaya, Ali Metin Esen, Ozlem Esen, and Cevat Kirma

Subjects
Adult, Male, balloon valvuloplasty, medicine.medical_specialty, lcsh:Internal medicine, lcsh:Diseases of the circulatory (Cardiovascular) system, Percutaneous, right, ventricular function, lcsh:Medicine, Doppler imaging, Cohort Studies, Young Adult, Basal (phylogenetics), Mitral valve stenosis, Internal medicine, medicine, Humans, Mitral Valve Stenosis, echocardiography, In patient, lcsh:RC31-1245, Ventricular function, business.industry, lcsh:R, medicine.disease, Echocardiography, Doppler, Stenosis, Treatment Outcome, lcsh:RC666-701, balloon dilatation/methods, doppler, heart catheterization, follow-up studies, mitral valve stenosis, ventricular dysfunction, Heart catheterization, Ventricular Function, Right, Cardiology, Female, Cardiology and Cardiovascular Medicine, business
Abstract

Objectives: We investigated the effects of percutaneous mitral balloon valvuloplasty (PMBV) on right ventricular function in the long term using tissue Doppler imaging. Study design: Twenty-seven patients who underwent successful PMBV were enrolled in the study. Echocardiographic examination, including color tissue Doppler imaging, was done from the lateral tricuspid annulus 24 hours before the intervention, and the examination was repeated 24 hours and 6 months after the intervention. Results: At 24 hours after the intervention, S wave velocity and A' wave velocity were seen to have increased significantly (9.52+-1.85 cm/s vs. 10.92+-1.20 cm/s, p=0.012; -10.44+-2.64 cm/s vs. -11.73+-2.05 cm/s, p=0.029, respectively). E' wave velocity and E'/A' ratio did not change significantly (p>0.05 for both). In the late period, S wave velocity was similar to the value in the early period and significantly higher than the basal level (9.52+-1.85 cm/s vs. 10.69+-1.72 cm/s, p=0.023). However, A' wave velocity in the late period was decreased compared to the early period and was not different from the basal level (-10.44+-2.64 cm/s vs. -10.74+-2.63 cm/s, p>0.05). The increase in E' wave velocity in the late period when compared to the basal level was found to be statistically significant (-7.85+-1.54 cm/s vs. -9.21+-1.81 cm/s, p=0.046). Conclusion: Right ventricular systolic function improved in the early period, and this improvement was seen to continue in the late period of PMBV. Diastolic function did not improve in the early period, but did improve in the late period. Right atrium systolic function improved in the early period; however, in the late period, levels were similar to the basal levels.

Published
2014

40. Complete aortic prosthetic valve dehiscence after modified Bentall-De Bono procedure

Author

Arzu Kalayci, Onur Taşar, Cevat Kirma, and Can Yücel Karabay

Subjects
medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, business.industry, Complete dehiscence, Dehiscence, Chest pain, medicine.disease, prosthetic valve, Surgery, Aortic aneurysm, Aortic valve replacement, lcsh:RC666-701, Infective endocarditis, medicine, cardiovascular system, endocarditis, Ventricular outflow tract, Cardiac skeleton, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Coronary sinus
Abstract

A 56-year-old male patient was admitted to our clinic due to persistent fever despite the use of antibiotics for 2 weeks, chest pain, and presyncope. His medical history revealed that the patient underwent modified Bentall-De Bono procedure 2 months ago due to ascending aortic aneurysm and severe aortic insufficiency. Transthoracic apical 5 chamber view showed that mobile vegetation prolapsed into the left ventricular outflow tract during ventricular diastole and that mechanical prosthetic valve was superior to the aortic annulus. Transesophageal echocardiography revealed normal aortic mechanical prosthetic valve function; however, the valve was positioned more superior to the annular plane and a dense vegetation was observed. Moreover, a complete dehiscence of the prosthetic valve was attached to aortic annulus with a single stitch in an area between noncoronary sinus and left coronary sinus. Dense thrombus formation was observed in the perivalvular region. Many cases with prosthetic valve endocarditis and partial dehiscence as its complication have been reported in the literature. However, to the best of our knowledge, there is no reported case of complete dehiscence secondary to infective endocarditis following complete ascending aortic graft and prosthetic aortic valve replacement (modified Bentall-De Bono procedure).

Published
2018

41. Real-life use of digoxin in patients with non-valvular atrial fibrillation: data from the RAMSES study

Author

Mehmet Yaman, Macit Kalçık, Onur Taşar, Özcan Başaran, Osman Beton, Ezgi Kalaycıoğlu, Ismail Bolat, Volkan Doğan, A. Çağrı Aykan, Murat Biteker, Özgen Şafak, Mehmet Tekinalp, Cevat Kirma, [Biteker, M. -- Basaran, O. -- Dogan, V.] Mugla Sitki Kocman Univ, Dept Cardiol, Fac Med, Mugla, Turkey -- [Beton, O.] Sivas Cumhuriyet Univ, Fac Med, Dept Cardiol, Sivas, Turkey -- [Tekinalp, M.] Kahramanmaras Necip Fazil State Hosp, Dept Cardiol, Kahramanmaras, Turkey -- [Aykan, A. Cagri -- Kalaycioglu, E.] Trabzon Ahi Evren Chest Cardiovasc Surg Educ & Re, Dept Cardiol, Trabzon, Turkey -- [Bolat, I.] Fethiye State Hosp, Dept Cardiol, Mugla, Turkey -- [TaSar, O.] Elazig Educ & Res Hosp, Dept Cardiol, Elazig, Turkey -- [Safak, O.] Burdur State Hosp, Dept Cardiol, Burdur, Turkey -- [Kalcik, M.] Iskilip Atif Hoca State Hosp, Dept Cardiol, Iskilip, Turkey -- [Yaman, M.] Samsun Educ & Res Hosp, Dept Cardiol, Samsun, Turkey -- [Kirma, C.] Kartal Kosuyolu Heart Educ & Res Hosp, Istanbul, Turkey, and BASARAN, OZCAN -- 0000-0002-6384-6455

Subjects
Male, medicine.medical_specialty, Digoxin, Turkey, Heart Ventricles, Population, Comorbidity, 030204 cardiovascular system & hematology, Coronary artery disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Atrial Fibrillation, Medicine, Humans, Pharmacology (medical), Medical history, atrial fibrillation, cardiovascular diseases, 030212 general & internal medicine, Prospective Studies, Medical prescription, education, Aged, Pharmacology, Heart Failure, education.field_of_study, business.industry, Atrial fibrillation, digoxin, medicine.disease, Stroke, congestive heart failure, Heart failure, Cardiology, Female, business, medicine.drug
Abstract

WOS: 000386930500018, PubMed ID: 27671101, What is known and objectiveAlthough inappropriate use of digoxin has been described in various populations, a real-world evaluation of patterns of digoxin prescription has not been well studied in patients with atrial fibrillation (AF). The aim of this study was to identify prevalence, indications and appropriateness of digoxin use in the general population of patients with non-valvular AF (NVAF) in Turkey. MethodsWe included and classified patients from the RAMSES (ReAl-life Multicentre Survey Evaluating Stroke prevention strategies in Turkey) study, a prospective registry including 6273 patients with NVAF, on the basis of digoxin use. After excluding the data of 73 patients whose medical history about digoxin use or left ventricle function was absent, 6200 patients were included for the final analysis. Digoxin use was considered inappropriate if patients did not have left ventricular systolic dysfunction or symptomatic heart failure (HF). Results and discussionDigoxin was used in 1274 (20.5%) patients. Patients treated with digoxin were older (71.4 9.8 years vs. 69.2 +/- 10.9 years, P < 0.001), more likely to be female (58.8% vs. 55.9%, P = 0.019) and had more common comorbidities such as HF (40.2% vs. 17.4%), diabetes (26.4% vs. 21.1%), coronary artery disease (35.3 vs. 27.6%) and persistent/permanent AF (93.4% vs. 78.4%; P < 0.001 for each comparison). Of the 1274 patients, the indication of digoxin use was considered inappropriate in 762 (59.8%). What is new and conclusionOur findings show that nearly one-fifth of the patients with NVAF were on digoxin therapy and nearly 60% of these patients were receiving digoxin with inappropriate indications in a real-world setting.

Published
2016

44. Systolic murmur in a young man who had previous ventricular septal defect repair: The double-chambered right ventricle

Author

Emre Durakoglugil, Gökhan Kahveci, Ibrahin Akın Izgi, Süleyman Çağan Efe, Ahmet Seyfeddin Gurbuz, Semi Ozturk, Emrah Acar, Raziye Ecem Yanik, and Cevat Kirma

Subjects
medicine.medical_specialty, Defect repair, RD1-811, medicine.diagnostic_test, business.industry, Ventricular septal defect, Systolic murmur, Double-chamber right ventricle, Case Vignette, Text mining, medicine.anatomical_structure, Cardiac magnetic resonance imaging, Ventricle, RC666-701, Internal medicine, cardiovascular system, Cardiology, Diseases of the circulatory (Cardiovascular) system, Medicine, Surgery, cardiovascular diseases, Cardiology and Cardiovascular Medicine, business
Published
2015

45. An unusual presentation of peripartum cardiomyopathy: Recurrent transient ischemic attacks

Author

Taylan Akgun, Can Yücel Karabay, Cevat Kirma, Regayip Zehir, Gonenc Kocabay, and Arzu Kalayci

Subjects
Adult, medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Heart Diseases, Peripartum cardiomyopathy, Cardiomegaly, Pregnancy, Recurrence, Internal medicine, Peripartum Period, medicine, Humans, Thrombus, General Environmental Science, Heart Failure, business.industry, Incidence (epidemiology), Thrombosis, Dilated cardiomyopathy, medicine.disease, Radiography, medicine.anatomical_structure, Ischemic Attack, Transient, Ventricle, lcsh:RC666-701, Heart failure, Cardiology, General Earth and Planetary Sciences, Female, Presentation (obstetrics), Cardiology and Cardiovascular Medicine, business
Abstract

Peripartum cardiomyopathy (PPCM) is a rare form of dilated cardiomyopathy that is associated with high maternal morbidity and mortality. Onset is usually between the last month of pregnancy and up to the fifth month postpartum. PPCM usually presents with signs and symptoms of heart failure and rarely with thromboembolic complications. The true incidence of thromboemboli in PPCM is unknown. Herein we report an unusual case of PPCM in a previously healthy woman who presented with recurrent transient ischemic attacks due to thrombus in the left ventricle. Resumo: A miocardiopatia periparto (MPP) é uma forma rara de miocardiopatia dilatada, associada a elevada mortalidade e morbilidade materna. A doença manifesta-se habitualmente entre o último mês de gravidez até ao 5.° mês depois do parto. A MPP apresenta-se habitualmente com sinais e sintomas de insuficiência cardíaca e, raramente, com complicações tromboembólicas. A verdadeira incidência de tromboembolismo na MPP não é conhecida. Apresentamos um caso, pouco habitual, de MPP em mulher previamente saudável que se apresentou com acidentes isquémicos transitórios recorrentes, devido à presença de trombo no ventrículo esquerdo. Keywords: Peripartum cardiomyopathy, Transient ischemic attacks, Transthoracic echocardiography, Palavras-chave: Miocardiopartia periparto, Acidente isquémico transitório, Ecocardiografia transtorácica

Published
2014

46. Successful Recanalization of Acute Superior Mesenteric Artery Thrombotic Occlusion

Author

İbrahim Akın İzgi, Çetin Geçmen, Taylan Akgun, Cevat Kirma, Arzu Kalayci, Can Yücel Karabay, and Vecih Oduncu

Subjects
medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Thrombotic occlusion, business.industry, lcsh:RC666-701, medicine.artery, Internal medicine, lcsh:R, Cardiology, Medicine, lcsh:Medicine, Superior mesenteric artery, business
Published
2016

47. One of the most urgent vascular circumstances: Acute limb ischemia

Author

Cevat Kirma, Rezzan Deniz Acar, and Muslum Sahin

Subjects
medicine.medical_specialty, medicine.medical_treatment, Revascularization, Internal medicine, amputation, medicine, Limb perfusion, Acute limb ischemia, thrombosis, lcsh:R5-920, business.industry, General Medicine, Thrombolysis, medicine.disease, Thrombosis, Surgery, body regions, Catheter, medicine.anatomical_structure, Amputation, Embolism, Cardiology, Original Article, revascularization, business, lcsh:Medicine (General), Artery
Abstract

Acute limb ischemia is a sudden decrease in limb perfusion that threatens limb viability and requires urgent evaluation and management. Most of the causes of acute limb ischemia are thrombosis of a limb artery or bypass graft, embolism from the heart or a disease artery, dissection, and trauma. Assessment determines whether the limb is viable or irreversibly damaged. Prompt diagnosis and revascularization by means of catheter-based thrombolysis or thrombectomy and by surgery reduce the risk of limb loss and mortality. Amputation is performed in patients with irreversible damage. Despite urgent revascularization, amputation rate is 10%–15% in patients during hospitalization, mostly above the knee, and mortality within 1 year is 10%–15% due to the coexisting conditions.

Published
2013

50. Infective Endocarditis Complicating Hypertrophic Obstructive Cardiomyopathy: Is Antibiotic Prophylaxis Really Unnecessary?

Author

Can Yücel Karabay, Yeliz Güler, Ahmet Guler, Beytullah Çakal, Cevat Kirma, and Soe Moe Aung

Subjects
Adult, medicine.medical_specialty, Obstructive cardiomyopathy, Asymptomatic, Article, Fatal Outcome, Internal medicine, Mitral valve, medicine, Humans, In patient, Antibiotic prophylaxis, Ultrasonography, business.industry, Hypertrophic cardiomyopathy, Mitral Valve Insufficiency, General Medicine, Endocarditis, Bacterial, Antibiotic Prophylaxis, Cardiomyopathy, Hypertrophic, medicine.disease, hypertrophic cardiomyopathy, Surgery, prophylaxis, medicine.anatomical_structure, Infective endocarditis, Cardiology, cardiovascular system, Mitral Valve, Female, medicine.symptom, Cardiology and Cardiovascular Medicine, business, Complication
Abstract

Infective endocarditis is a relatively rare complication of hypertrophic cardiomyopathy. Infective endocarditis in hypertrophic cardiomyopathy is almost always seen in patients with outflow obstruction and is more common in those with both outflow obstruction and atrial dilatation. We present a case of culture negative mitral valve endocarditis in a previously asymptomatic woman with hypertrophic cardiomyopathy who died in the course of the disease.

Published
2013

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