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Objective: In this study, the associations between pulmonary artery stiffness (PAS) and aortic stiffness, left ventricular diastolic parameters, and left ventricular mass (LVM) index in moderate to severe obstructive sleep apnea syndrome (OSAS) patients without coexisting disorders were investigated. Methods: A total of 66 non-diabetic, non-hypertensive, and non-smoking volunteers were enrolled. Participants were categorized by apnea-hypopnea index (AHI; event/hour). The control group was defined as no OSAS: AHI15 (n=31). Echocardiographic and biochemical tests, including measurement of C-reactive protein (CRP), were performed. PAS (kHz/s) was calculated by dividing the maximal frequency shift of the pulmonary flow by the acceleration time. Results: PAS (kHz/s), obtained by echocardiography, was statistically significantly higher in the OSAS group than the control group (28+-5 vs 18+-4, p

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.

All prosthetic valves are at least mildly stenotic and have relatively high transvalvular pressure gradients that can be observed despite normal prosthesis function. Such gradients may be due to a mismatch between prosthesis effective orifice area (EOA) and patient's body size. Valve prosthesispatient mismatch (VP-PM) may occur due to mismatches of both parameters, the expected hemodynamic performance of the prosthesis and the cardiac output requirements of the patient, which are largely related to the body size at rest. In other words, a prosthesis may be adequate for patients with a small body surface area (BSA) but might become obstructive for patients with a large BSA. The only parameter that has proven to be consistently and realistically useful to predict and describe VP-PM is the effective orifice area index (EOAI). The projected EOAI was identified as the best parameter to predict the VP-PM occurrence after surgery. VP-PM has been known to be independently and significantly associated with clinical outcomes. Severe VP-PM has a significant impact on early and late mortality, whereas moderate VP-PM may have a significant effect on mortality only in vulnerable subsets of patients, and particularly in those with depressed LV systolic function. The surgeon's anticipation of VP-PM prior to surgery, and successfully implented preventive strategies can reduce the incidence of VP-PM. Preventive strategies to avoid VPPM should be individualized according to the anticipated severity of VP-PM and of the patient's baseline risk profile.

Objectives: Although atrial fibrillation (AF) is one of the most common rhythm disorders observed in clinical practice, a multicenter epidemiological study has not been conducted in our country. This study aimed to assess our clinical approach to AF based upon the records of the first multicenter prospective Atrial Fibrillation in Turkey: Epidemiologic Registry (AFTER) study. Study design: Taking into consideration the distribution of the population in our country, 2242 consecutive patients with at least one AF attack determined by electrocardiographic examination in 17 different tertiary health care centers were included in the study. Inpatients and patients that were admitted to emergency departments were excluded from the study. Epidemiological data of the patients and the treatment administered were assessed. Results: The mean age of the patients was determined as 66.8+-12.3 years with female patients representing 60% of the study population. While the most common AF type in the Turkish population was non-valvular AF (78%), persistent/permanent AF was determined in 81% of all patients. Hypertension (%67) was the most common comorbidity in patients with AF. While a stroke or transient ischemic attack or history of systemic thromboembolism was detected in 15.3% of the patients, bleeding history was recorded in 11.2%. Also, 50% of the patients were on warfarin treatment and 53% were on aspirin treatment at the time of the study. The effective INR level was detected in 41.3% of the patients. The most frequent cause of not receiving anticoagulant therapy was physician neglect. Conclusion: These results demonstrate the necessity for improved quality of physician care of patients with AF, especially with regards to antithrombotic therapy.