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Amaç: Çalışmamızın amacı, obez ve nonobez obstrüktif uyku apne sendromu (OUAS) hastalarında; doku doppler (DD) ekokardiyografi ile sağ ventrikül sistolik ve diyastolik fonksiyonlarının ve pulmoner arter basınçlarını (PAB) karşılaştırmaktı.Gereç ve Yöntem: Çalışmamıza Uyku Laboratuarında polisomnografik inceleme yapılmış ve orta ya da ağır OUAS tanısı konmuş 35 nonobez ve 34 obez olmak üzere 69 hasta alındı. Tüm hastalarda M-mode, iki boyutlu inceleme, renkli akım Doppler ve Doku Dopler yardımıyla sol ventrikül ve sağ ventrikül boyutları, sol atrium (LA) ve sağ atrium (RA) boyutları, sol ventrikül ve sağ ventrikül sistolik ve diyastolik fonksiyonları ve sistolik PAB’ ları ölçüldü.Bulgular: Her iki grupta da RV diyastolik fonksiyonlarında bozulma saptanmış olup, obez grupta anlamlı olarak daha fazla bozulma saptanmıştır (lateral triküspit annuler bölge geç diyastolik miyokardial hız A’a: nonobez hastalarda 0.13 ±0.03 ve obez hastalarda 0.11±0.04). Obez grupta ortalama sistolik PAB anlamlı olarak daha yüksek bulunmuştur (Sırasıyla 31.2±5.6 ve 27.1±5.8).Sonuç: Obstrüktif Uyku Apne Sendromu kardiyovasküler morbidite ve mortaliteyi arttırır. Çalışmamızda orta ve ağır OUAS hastalarında doku doppler incelemesi ile SV ve RV diyastolik fonksiyonlarında bozulma saptanmıştır. Obezite OUAS‟tan bağımsız olarak bu bozukluğa katkıda bulunmaktadır., Purpose: The aim of our study was to compare the right ventricular systolic and diastolic functions and pulmonary artery pressure (PAP) in obese and non-obese patients with obstructive sleep apnea syndrome (OSAS) by tissue Doppler imaging (TDI) echocardiography.Materials and Methods: This study was conducted with 69 patients, 34 obese and 35 non-obese, diagnosed moderate or severe OSAS by an overnight polysomnographic sleep study. In all patients, LV (left ventricle) and RV (right ventricle) size, left atial (LA) and RA (right atrial) dimensions, LV and RV systolic and diastolic functions and systolic PAPs were measured by M-mode, two-dimensional analysis, color flow Doppler and TDI.Results: RV diastolic dysfunction was detected in both groups; this impairment was significantly higher in the obese group (lateral tricuspid late diastolic myocardial annular zone velocity A'a: 0.13 ± 0.03 in non-obese patients and 0.11 ± 0.04 in obese patients). The mean systolic PAP was significantly higher in obese patients (31.2±5.6, 27.1±5.8, respectively)Conclusion: Obstructive Sleep Apnea Syndrome increases cardiovascular morbidity and mortality. In our study,left ventricul and right ventricul diastolic dysfunction was determined by tissue Doppler imaging in patients with moderate and severe Obstructive Sleep Apnea Syndrome. Obesity contributes to this impairment regardless of Obstructive Sleep Apnea Syndrome .

Objectives: To investigate the relationship between neutrophil/lymphocyte ratio (NLR) and coronary collateral circulation (CCC) in patients with coronary chronic total occlusion. Subjects and Methods: Our study population consisted of 275 consecutive patients with chronic total occlusion. One hundred and thirty-eight patients with chronic total occlusion were included in the study. They were classified into 2 groups as follows: impaired CCC (group 1: Rentrop grades 0-1) and good CCC (group 2: Rentrop grades 2-3). The NLR was calculated from the complete blood count. Results: The NLR values of the patients with impaired CCC (4.5 ± 0.7) were significantly higher than of those with good CCC (2.7 ± 0.6, p < 0.001). In the multivariate logistic regression test, NLR (OR 33.36, 95% CI 8.189-135.7, p < 0.001), high-sensitivity C-reactive protein (hs-CRP; OR 2.152, 95% CI 1.226-3.777, p = 0.008), estimated glomerular filtration rate (OR 1.167, 95% CI 1.049-1.298, p = 0.004) and systolic blood pressure (OR 1.068, 95% CI 1.009-1.1310, p = 0.025) were independent predictors of impaired CCC. The NLR value >3.55 yielded an area under the curve value of 0.957 (95% CI 0.921-0.992, p < 0.001) and demonstrated a sensitivity of 95% and a specificity of 90% for the prediction of CCC. A moderate correlation between NLR and hs-CRP was observed (r = 0.443; p < 0.001). Conclusion: Our findings reveal that NLR correlates with the impaired development of coronary collaterals.

Introduction: Coronary artery ectasia is characterized as the dilation of a segment of coronary artery at least 1.5 times the adjacent segment in which infl ammation, neurohormonal activity and atherosclerosis are held responsible for the pathogenesis. The association between the coronary artery ectasia and infl ammatory markers has been shown, however there is nodata related to Pentraxine 3 (PTX-3). In this study, we investigated the association between serum PTX-3 and high sensitive C-reactive protein (hs-CRP) levels in patients with coronary artery ectasia. Patients and Methods: The study population consisted of 66 patients who underwent coronary angiography with the suspicion of coronary artery disease and 32 controls. Patients were divided in two groups as the coronary artery ectasia group (n= 34) and coronary artery disease group (n= 32). PTX-3 and hs-CRP levels were measured. Results: Serum PTX-3 levels were comparable between coronary artery disease and coronary artery ectasia groups (0.67 ± 0.29 vs. 0.66 ± 0.34, p= 0.63), coronary artery disease and coronary artery ectasia groups had signifi cantly increased PTX-3 levels when compared to the control group (0.67 ± 0.29 vs. 0.32 ± 0.24, p< 0.001; 0.66 ± 0.34 vs. 0.32 ± 0.24, p< 0.001; respectively). Similarly, hs-CRP levels were comparable in coronary artery disease and coronary artery ectasia groups (1.4 ± 0.7 vs. 1.2 ± 0.5, p= 0.19), coronary artrey disease and coronary artery ectasia groups had signifi cantly increased hs-CRP levels when compared to the control group (1.4 ± 0.7 vs. 0.8 ± 0.5, p< 0.001; 1.2 ± 0.5 vs. 0.8 ± 0.5, p< 0.001 respectively). The correlation analysis revealed that serum PTX-3 was associated with hs-CRP (Rho= 0.24, p= 0.016). Conclusion: PTX-3, a novel infl ammatory marker, is elevated in patients with coronary artery ectasia and may be promising biomarker in refl ecting the infl ammatory status in patients with coronary artery ectasia., Giriş: Koroner arter ektazisi, koroner arterlerin tamamının veya bir bölümünün arterin normal kısmındaki çapına göre 1.5 kat veya daha fazla olmasıyla karakterize durum olup patofi zyolojisinde infl amasyon, nörohormonal aktivite ve ateroskleroz sorumlu tutulmaktadır. Koroner arter ektazisiyle infl amatuvar belirteçlerin ilişkisini gösteren çalışmalar mevcuttur, ancak koroner arter ektazisinin yeni tanımlanan bir infl amatuvar belirteç olan pentraksin-3 (PTX-3) ile ilişkisi konusunda yeterli veri yoktur. Bu çalışmamızda koroner arter ektazisi hastalarında serum PTX-3 ve yüksek duyarlı (high sensitive) C-reaktif protein (hs-CRP) seviyeleri arasındaki ilişkiyi incelemeyi amaçladık. Hastalar ve Yöntem: Bu çalışmaya anjinal semptomları ve pozitif iskemi bulguları olduğu için koroner anjiyografi yapılan 66 hasta ve 32 kontrol hastası dahil edilmiştir. Hastalar koroner arter hastalığı grubu (n= 32) ve koroner arter ektazisi grubuna ayrılmıştır (n= 34). Serum PTX-3 ve hs-CRP seviyeleri ölçülmüştür. Bulgular: Koroner arter ektazisi ve koroner arter hastalığı grubunda kontrol grubuna göre hs-CRP seviyesi yüksekti (koroner arter hastalığı ve kontrol hastası grubu için, 1.4 ± 0.7 vs. 0.8 ± 0.5, p< 0.001; koroner arter ektazisi ve kontrol hastası grubu için, 1.2 ± 0.5 vs. 0.8 ± 0.5, p< 0.001). Koroner arter hastalığı ve koroner arter ektazisi grubunda PTX-3 seviyeleri arasında (0.67 ± 0.29 vs. 0.66 ± 0.34, p= 0.63) belirgin fark olmamasına karşın koroner arter hastalığı (0.67 ± 0.29 vs. 0.32 ± 0.24, p < 0.001) ve koroner arter ektazisi (0.66 ± 0.34 vs. 0.32 ± 0.24, p< 0.001) grubundaki hastaların PTX-3 seviyesi kontrol grubuna göre daha yüksekti. Korelasyon analizi sonucu serum PTX-3 ve hs-CRP seviyeleri birbirleriyle ilişkili bulundu (Rho= 0.24, p= 0.016).Sonuç: Koroner arter ektazisi olan hastalarda yeni bir infl amatuvar belirteç olan PTX-3 yüksek bulunmuştur. Bu durum infl amasyonun koroner arter ektazisi patofi zyolojisinde önemli bir role sahip olduğunu düşündürmektedir.

Background Atherosclerosis is a complex inflammatory process in which inflammatory markers are involved. Although pentraxin 3 (PTX-3), a newly identified inflammatory marker, was associated with adverse outcomes in stable angina pectoris, no association between PTX-3 and the complexity of coronary artery disease (CAD) has been reported. Thus, the aim of the present study was to assess the association between the level of PTX-3 and the complexity and severity of CAD assessed with SYNTAX and Gensini scores in patients with stable angina pectoris. Methods The study population consisted of 2 groups: 161 patients with anginal symptoms and evidence of ischemia who underwent coronary angiography and 50 age- and sex- matched control subjects without evidence of ischemia were included. Patients were grouped into 3 groups according to the complexity and severity of coronary lesions assessed by the SYNTAX score (30 patients with a SYNTAX score of 0 were excluded). Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Results The PTX-3 levels demonstrated an increase from low to high SYNTAX groups ( r = 0.72, P < 0.001). Whereas the low SYNTAX group had statistically significantly higher PTX-3 levels when compared with the control group (0.50 ± 0.01 vs 0.24 ± 0.01 ng/mL, P < 0.001), the hs-CRP levels were not different (0.81 ± 0.42 vs 0.86 ± 0.53 mg/dL, P = 0.96). However, the intermediate SYNTAX group had higher hs-CRP levels compared with the low SYNTAX group (1.3 ± 0.66 vs 0.86 ± 0.53 mg/dL, P = 0.002). Serum PTX-3 levels and hs-CRP levels were correlated with the SYNTAX scores and Gensini scores (for SYNTAX: r = 0.87 [ P < 0.001] and r = 0.36 [ P = 0.01]; for Gensini: r = 0.75 [ P < 0.001] and r = 0.27 [ P = 0.002], respectively), and according to the results of univariate and multivariate analyses, for “intermediate and high” SYNTAX scores, age, diabetes mellitus, low-density lipoprotein cholesterol, hs-CRP, and PTX-3 were found to be independent predictors, whereas for the presence of “high” SYNTAX score only PTX-3 was found to be an independent predictor. The receiver operating characteristic curve analysis further revealed that the PTX-3 level was a strong indicator of high SYNTAX score with an area under the curve of 0.91 (95% confidence interval, 0.86-0.96). Conclusions Pentraxin 3, a novel inflammatory marker, was more tightly associated with the complexity and severity of CAD than hs-CRP and was found to be an independent predictor for high SYNTAX score.

OBJECTIVE: Cardiac Syndrome X CSX is defined as typical chest pain, objective signs of ischemia and normal coronary arteries. The association between CSX and inflammation is well known. Red cell distribution width RDW , an index of erythrocyte size, is recently found to be associated with inflammation. We investigated the association between RDW and high sensitive C reactive protein hs-CRP in patients with CSX.METHODS: Total 104 patients were included in the study. Those with evidence of ischemia total of 70 underwent coronary angiography. Patients with a normal coronary angiogram were grouped as the CSX group n=35 and those with significant coronary disease were grouped as the coronary artery disease CAD group n=35 . A total of 34 patients were taken as the control group. RDW and hs-CRP levels were measuredRESULTS: RDW was increased in the CSX group when compared to the Control group 13.9 ± 1.2 vs 12.9 ±0.7, p < 0.001 . However, there was no difference between the CSX and CAD groups 13.9 ± 1.2 vs. 14,1 ± 1,1, p: 0. 63 . Both groups had higher hs-CRP levels than the Control group. RDW is correlated with hs-CRP r=0.24, p: 0.014 .CONCLUSION: RDW, a novel inflammatory marker, is elevated in CSX and may be promising biomarker in reflecting the inflammatory status in CSX patients., AMAÇ: Kardiyak Sendrom X KSX , angina pektoris ve objektif iskemi bulgularına rağmen normal koroner arterlerin saptandığı bir tablodur. KSX’ in patogenezinde inflamasyonun rol oynadığı bulunmuştur. Eritrosit dağılım genişliği RDW , dolaşımdaki eritrositlerin büyüklüğünü gösteren bir indeks olmasının yanında, son çalışmalarda inflamasyonu gösteren bir parametre olarak değerlendirilmeye başlanmıştır. Biz bu çalışmada KSX olan hastalarda inflamasyon ile RDW arasındaki ilişkiyi araştırdıkYÖNTEMLER: Bu çalışmaya iskemik bulguların saptandığı koroner anjiyografisi normal olan 35 KSX hastası KSX grubu , ciddi koroner arter hastalığı bulunan 35 hasta KAH grubu ve 34 kontrol hastası alındı. Her üç gruptan RDW ve hs-CRP çalışıldıBULGULAR: KSX grubunda RDW değerleri kontrol grubuna göre artmış bulundu 13.9 ± 1.2 vs 12.9 ±0.7, p < 0.001 . Ancak KSX grubu ile KAH grubu arasında fark bulunmadı 13.9 ± 1.2 vs. 14,1 ± 1,1, p: 0. 63 . Aynı şekilde KSX ile KAH grubu arasında hs-CRP değerleri arasında fark yoktu 1.03 ± 0.5 vs. 1.05 ± 0.5, p: 0.92 . Kontrol grubunda hs-CRP düzeyi KSX ve KAH grubuna göre anlamlı bir şekilde düşük bulundu. RDW ile hs-CRP arasında pozitif korelasyon olduğu bulundu r=0.24, p: 0.014 . SONUÇ: RDW, klinikte uzun süredir bilinen ancak inflamatuvar marker olarak yeni kullanılan bir parametre olup KSX olan hastalarda yükselmektedir.

Objectives: Cardiac syndrome X (CSX) is a clinical entity that is defined as normal coronary arteries with angina pectoris and objective sins of ischemia. The correlation between CSX and inflammatory markers such as high-sensitivity C-reactive protein (hs-CRP) is well established, however an association with pentraxin- 3 (PTX-3) has not been examined. The aim of this study was to investigate the association between PTX-3 and CSX. Study design: A total of 122 patients (58 female, 64 male, mean age 49.6+-5.8 years) with suspected of coronary artery disease (CAD) were included in the study. Those with evidence of ischemia (50 patients with positive treadmill tests, 32 patients with positive myocardial perfusion scintography) underwent coronary angiography (82 patients). Patients with a normal angiogram were considered the CSX group (n=41) and patients with coronary lesions were referred to as the CAD group (n=41). Patients without signs of ischemia served as the control group. Serum PTX-3 and hs-CRP levels were measured in all patients. Results: The CSX group had significantly increased PTX-3 levels relative to the control group (0.46+-0.16 vs. 0.23+-0.09 ng/ml, p

Amaç: Aort boyutlar ve elastik özelliklerini transtorasik ekokardiyografi (TTE) ve transözofageal ekokardiyografi (TEE) ile karşılaştıran sınırlı veri vardır. Bu nedenle, TTE ve TEE elde edilen aort boyutlar ve aortik elastik indekslerinin karşılaştırmanın yanı sıra bunların sol ventrikül (LV) dolum ve diyastolik parametreleri ile ilişkisini araştırmayı amaçladık. Yöntem: Çalışmaya kırk iki hasta dahil edildi. Tüm hastaların TTE ve TEE kayıtlarından aort boyutları ve ilgili elastikiyet parametreleri, sol ventrikül dolum ve diyastolik parametreleri, sol atriyal volüm indeksi (LAVİ), sol ventrikül kütle i n- deksi hesaplandı. TTE ve TEE elde edilen aort elastikiyeti indeksleri ve sol ventrikül dolum ve diyastolik parametreleri için korelasyon analizi yapıldı. Bulgular: TTE ve TEE ile elde edilen aort boyutları ve elastikiyeti indeksleri arasında anlamlı bir fark yoktu. Korelasyon analizinde yaş, E / A, E / E`ve LAVİ hem TTE hem de TEE ile edilen aort elastikiyeti indeksleri ile anlamlı derecede ilişkili iken, sol ventrikül kitle indeksi sadece TEE ile elde edilen aort elastikiyeti indeksleri ile ilişkili saptandı. Sonuç: TTE ile karşılaştırıldığında, TEE elde edilen aortik elastik özellikleri sol ventrikül dolum ve diyastolik parame treleri ile daha yakından ilişkili bulunmuştur. Buna ek olarak, TEE ve TTE ile elde edilen aort fonksiyon indeksleri iyi gözlemci içi ve gözlemciler arası değişkenliği ile benzerdir., Background: There are limited data comparing aortic d imensions and elastic properties between transthoracic echocardiography (TTE) and transesophage al echocardiography (TEE). Therefore, we aimed to investigate aortic d imensions and indices of aortic elastic properties as well as their relation with left ventricular (LV) filling and diastolic parameters obtained from TTE and TEE. Method: Forty two patients were included in the study. Aortic dimensions and related elasticity parameters, LV filling and diastolic parameters, left atrial volume index (LAVi), LV mass index were calculated from TTE and TEE recordings in all patients. The correlation analyses were performed for aortic elasticity indices and LV filling and diastolic parameters obtained from TTE and TEE. Results: There were no significant differences in aortic d imensions and elasticity indexes obtained from TTE and TEE. The correlation analysis r evealed that while age E/A, E/E` and LAVi were significantly correlated with aortic elasticity indexes obtained from both TTE and TEE, LV mass index was significantly correlated with only TEE aortic elasticity indices. Conclusion: When compared to TTE, aortic elastic properties obtained from TEE were more closely related with LV filling and diastolic parameters. In addition, the indexes of aortic function were comparable between TEE and TTE with good intra and interobserver variability.

Background Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population. Methods and Results One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow ≤2 or TIMI flow 3 with final myocardial bush grade ≤2 after PCI) and electrocardiographically (ST resolution Conclusions In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.

Objectives: The aim of the present study was to assess the association between the level of pentraxin-3 (PTX-3) and the severity of metabolic syndrome (MS). Subjects and Method: One hundred and two patients with MS and 101 consecutive age- and sex-matched control subjects were included in the study. The MS patients were classified into three groups based on the number of MS criteria, i.e. group 1: patients with 3 MS criteria, group 2: patients with 4 MS criteria, and group 3: patients with 5 MS criteria. Serum PTX-3 and high-sensitivity C-reactive protein (hs-CRP) levels were measured. Results: Group 1 had higher PTX-3 levels compared to the control group (0.58 ± 0.11 ng/ml vs. 0.36 ± 0.15 ng/ml, p < 0.001). PTX-3 levels were higher in group 3 than in both group 1 (0.90 ± 0.06 ng/ml vs. 0.58 ± 0.11 ng/ml, p < 0.001) and group 2 (0.90 ± 0.06 ng/ml vs. 0.63 ± 0.12 ng/ml, p < 0.001). Group 3, however, had higher hs-CRP levels than both group 1 (1.89 ± 0.45 mg/dl vs. 1.40 ± 0.44 mg/dl, p = 0.007) and group 2 (1.89 ± 0.45 mg/dl vs. 1.47 ± 0.58 mg/dl, p = 0.01). The control group had lower hs-CRP levels than group 1 (0.81 ± 0.47 mg/dl vs. 1.40 ± 0.44 mg/dl, p < 0.001) and group 2 (0.81 ± 0.47 mg/dl vs. 1.47 ± 0.58 mg/dl, p < 0.001). Serum PTX-3 levels correlated with serum hs-CRP levels (r = 0.49, p < 0.001). Conclusions: PTX-3, a novel inflammatory marker, was found to be associated with the severity of MS.

Aim: Metabolic syndrome is defined as a clinical entity characterized by insulin resistance, abdominal obesity, glucose intolerance or diabetes mellitus, dyslipidemia and hypertension. In the present study, we aimed to evaluate right ventricular function in metabolic syndrome patients with tissue Doppler echocardiography.Material and Method: The study population consisted of 28 metabolic syndrome patients and sex-age matched 30 control subjects. All the study population underwent echocardiography and right ventricular function was assessed by tissue echocardiography. Results: The mean age of the metabolic syndrome patients was 48±6.7 and control group was 46±8.3 and there was no statistical significant difference. When compared to the control group, right ventricular function assessed by tissue doppler was found to be significantly lower in metabolic syndrome patients (10.3±2.4 vs 16.4±3.6; p, Amaç: Metabolik sendrom, insülin direnciyle başlayan abdominal obezite, glukoz intoleransı veya diabetes mellitus, dislipidemi, hipertansiyon gibi aterosklerotik risk faktörlerini içeren klinik bir durum olarak tanımlanır. Bu çalışmamızda metabolik sendromlu hastalarda sağ ventrikül fonksiyonları doku Doppler ekokardiyografi ile değerlendirmeyi amaçladık.Gereç ve Yöntem: Çalışmamıza 28 metabolik sendrom hastası ve hastalar ile yaş ve cinsiyet açısından eşitlenmiş 30 kontrol dahil edilmiştir. Tüm çalışma grubuna ekokardiyografi yapılmış olup sol ventrikül fonksiyonları normal olan hastalarda sağ ventrikül fonksiyonları doku Doppler ile değerlendirilmiştir.Bulgular: Metabolik sendrom hastalarının ortalama yaşı 48±6.7 olup kontrol grubunun yaş ortalaması ise 46±8.3’dü ve aralarındaki fark istatistiksel anlamlı değildi. Sağ ventrikül doku doppler sistolik dalga (Sm) değerleri metabolik sendrom hastalarında kontrol grubu ile karşılaştırıldığında anlamlı düşük saptandı (10.3±2.4 vs 16.4±3.6; p

We report a patient with coronary artery by-pass grafting who was admitted to our hospital due to acute occlusive thrombosis of prosthetic mitral valve. His INR level was subtherapeutic. The diagnosis was made with transthorasic echocardiography. Fibrinolytic therapy was given to him and a successful clinical result was obtained.

Objective: We aimed to investigate left atrium (LA) function by speckle tracking echocardiography in patients with metabolic syndrome (MetSyn) and to show a possible relationship between the severity of MetSyn and LA function and to determine the predictors of low strain in MetSyn patients. Methods: Our study design was observational and cross-sectional design consisted of 80 MetSyn patients without overt diabetes and 50 con- trols. The patients were classified into three groups based on the number of MetSyn criteria. The peak LA strain at the end of the ventricular systole (LAs-strain) as well as the LA strain with LA contraction (LAa-strain) was obtained. Correlation analysis performed to assess the asso- ciation of LA strain parameters with the severity of MetSyn and logistic regression analysis performed to assess the relationship of low LA strain with MetSyn. Results: Both LAs (37.5±8.7 vs. 26.0±10.2, p

Amaç: Koroner bifurkasyon lezyonlarının anatomik ve morfolojik özelliklerini araştırmayı amaçladık. Çalışma planı: Çalışmaya koroner anjiyografi yapılan 542 stabil hasta alındı. Bifurkasyon lezyonları en az 2.5 mm çaplı ve en az %50 darlık olan ana dal ve yan dal lezyonları olarak tanımlandı. Bu ölçütler kullanılarak, bifurkasyon lezyonlarının varlığı ve sayısı, bu lezyonların bulunduğu damarlar, Medina sınıflandırmasına göre lezyonun tipi ve bifurkasyon lezyonunun açısı belirlendi. Bulgular: Bifurkasyon tanımına göre hastaların %19.3’ünde (n=105) bifurkasyon lezyonu vardı. Bunların %77’sinde, bifurkasyon açısı 70°’nin altında idi. Tüm lezyonların yaklaşık %37’si Medina 1.1.1 sınıflandırması ile uyumlu idi. Tüm bifurkasyon lezyonlarının yaklaşık %56’sı sol ön inen arter (LAD), %25.4’ü sirkumfleks arter (Cx) ve %12.5’i sağ koro- ner arter (RCA) bölgesinde idi. Medina 1.1.1 tip lezyonlar en sık LAD ve RCA’da gözlenirken en az Cx ve sol ana koro- ner bölgesinde saptandı. Diyabet bifurkasyon lezyonu olan hastalarda olmayanlara göre anlamlı olarak yüksek sıklıkta saptandı. Sonuç: Bifurkasyon lezyonları koroner anjiyografi pratiğinde sıkça gözlenmektedir. Bunların anjiyografik özellikleri ve bu lezyonların klinik durumla ile ilişkisi uygun girişimsel tedavinin seçiminde çok önemli olabilir., Objectives: We aimed to investigate the anatomical and morphological characterization of coronary bifurcation lesions. Study design: The study population consisted of 542 stable patients who underwent coronary angiography. Bifurcation lesions were defined as a lesion ≥50% diameter stenosis involving a main branch and/or contiguous side branch with a diameter of ≥2.5 mm. Using these criteria, the presence and number of bifurcation lesions, bifurcation lesion location, lesion classification according to Medina classification and the angle of the bifurcation lesion were determined. Results: According to the bifurcation definition 19.3% (n=105) of our patients had bifurcation lesions. In 77% of all bifurcation lesions, the bifurcation angle was

To evaluate the relationship between the levels of plasma coenzyme Q10 (CoQ10), a known antioxidant, and severity of the coronary atherosclerosis (AS) measured by Gensini score.Patients with coronary artery disease (CAD) were enrolled to the study between 2010 and 2011 in cardiology outpatient clinics. They were admitted for diagnostic coronary angiography or angioplasty for typical indications. The Gensini scoring system was used to calculate CAD severity. Serum CoQ10, total cholesterol (TC), HDL cholesterol, LDL cholesterol, and triglyceride levels were assessed.One hundred thirteen subjects (83 CAD, 30 controls) were included. The patients with CAD were separated into three groups according to Gensini score. The serum levels of CoQ10, CoQ10/ TC, CoQ10/LDL-C, CoQ10/TG rates in the subjects of mild and severe AS groups were significantly lower than the control group ( p less than 0.016 for all control vs. AS group comparisons). There were no significant differences in serum levels of CoQ10 and CoQ10/ TC, CoQ10/LDL-C, CoQ10/TG rates between the mild and severe AS groups.This study revealed that although the serum CoQ10 levels were lower in stable CAD, there was no relationship between the severity of CAD and serum CoQ10 levels in patients with stable angina pectoris.

Amaç: Bu çalışmada, atriyum içi ve atriyumlar arası elektromekanik gecikme (AEMG) ve P dalga dispersiyonu (PDD) ile metabolik sendrom (MetS) varlığı ve şiddeti arasındaki ilişki incelendi. Çalışma planı: Çalışmaya MetS olan (n=72) ve olmayan (kontrol grubu, n=72) toplam 144 hasta alındı. MetS ciddiyetinin belirlenmesi için hastalar MetS ölçütlerinin sayısına göre üç gruba ayrıldı: Grup 1 (üç ölçütlü hastalar), Grup 2 (dört ölçütlü hastalar) ve Grup 3 (beş ölçütlü hastalar). Hastaların 12 derivasyonlu elekrokardiyografilerinden PDD ve doku Doppler parametrelerinden kulakçıklar arası ve kulakçıklar içi AEMG hesaplandı. Bulgular: Kulakçılar arası AEMG (22.9±15 ve 11.5±14, p, Objectives: In this study, we aimed to investigate the association between the presence and severity of metabolic syndrome (MetS) with intra- and inter-atrial electromechanical delay (AEMD) and P-wave dispersion (PWD). Study design: A total of 144 patients (72 MetS patients and 72 age- and sex-matched control subjects) were included in the study. Patients with MetS were classified into three groups based on the number of MetS criteria as follows: Group 1 (patients with three MetS criteria), Group 2 (patients with four MetS criteria) and Group 3 (patients with five MetS criteria). Intra- and inter-AEMD were measured from parameters of tissue Doppler imaging. PWD was calculated from the 12-lead electrocardiogram. Results: Both inter-AEMD (22.9±15 vs. 11.5±14, p

OBJECTIVES We investigated the correlation of serum paraoxonase-1 (PON-1) activity with coronary artery disease (CAD) in patients with metabolic syndrome (MetS). STUDY DESIGN The study included 21 patients (mean age 55 ± 9 years) with MetS, stable angina pectoris, and angiographically shown CAD, 24 patients (mean age 51 ± 10 years) with MetS and angiographically normal coroner arteries, and 28 healthy controls (mean age 49 ± 12 years). Demographic and clinical characteristics, insulin levels, homeostasis model assessment of insulin resistance index, and PON-1 activity were assessed in all the groups. Severity of CAD was assessed using the Gensini score. RESULTS Paraoxonase-1 activity was significantly lower in patients with MetS compared to the control group (p=0.02). The two MetS groups with and without CAD exhibited similar characteristics in all the parameters including PON-1 activity (p>0.05). Univariate correlation analysis performed in MetS-CAD patients showed a significant negative correlation between the Gensini score and PON-1 activity (r=-0.48, p=0.02). The overall PON-1 activity of all the subjects showed no correlation with the parameters examined. CONCLUSION Decreased PON-1 activity in patients with MetS compared to the control group suggests increased oxidative stress in MetS. Detection of similar PON-1 activity levels in MetS groups with and without CAD suggests that disturbance of oxidative-antioxidative balance occurs before the development of CAD. The negative correlation between the Gensini score and PON-1 activity implies that decreased PON-1 activity may be one of the etiologic causes of atherosclerotic progress in MetS.

Capsaicin is the active component of chili peppers, which has been shown to possess several beneficial effects. Currently, the best-known medical use of capsaicin is as a topical painkiller. Drug-induced myocardial infarction is not a common phenomenon and the underlying mechanism has been related with coronary spasm in the majority of cases. We present a 29-year-old man who experienced coronary vasospasm and acute myocardial infarction (AMI) which were possibly induced by the use of a topical capsaicin patch to relieve lumbago. He presented with chest pain of one hour onset. The electrocardiogram showed ST-segment elevation in the leads II, III, and aVF, consistent with inferior wall AMI. Echocardiography confirmed inferior hypokinesia. Urgent coronary angiography showed normal right and left coronary arteries. Since he had no cardiac risk factors for coronary artery disease, nor a history of recent emotional or physical stress, or ingestion of any illicit substance, the vasospasm and subsequent AMI was attributed to the use of the capsaicin patch for six days. Upon institution of appropriate treatment and removal of the patch, no new anginal attacks or ischemic episodes were seen within a follow-up of one month. This is the first case report of AMI induced by the use of a topical capsaicin patch.

OBJECTIVE: Slow coronary flow SCF is defined as late opacification in the epicardial coronary artery without significant stenosis on the coronary angiographic images. The association between SCF and inflammation and inflammatory markers such as high sensitivity-C reactive protein hs-CRP is well known. Pentraxin-3 PTX-3 , a new acute phase reactant, is a member of pentraxine family like hs-CRP. We investigated the association between PTX-3 and hs-CRP in patients with SCF.METHODS: The study included 25 patients with SCF and 26 patients with coronary artery disease CAD whose diagnoses were made by coronary angiography. The control group consisted of 24 healthy subjects admitted cardiology outpatient clinic without any sign of ischemia. From the all study population PTX-3 and hs-CRP levels were measured.RESULTS: The SCF group had significantly increased PTX-3 and hs-CRP levels than the control group 0.52 ± 0.2 ng/ml vs 0.20 ±0.08 ng/ml, p< 0.001; 1.1±0.4 mg/dl vs 0.6±0.5 mg/dl, p< 0.001, respectively . However there were no differences in levels of PTX-3 and hs-CRP between the SCF and the CAD groups 0.52 ± 0.2 ng/ml vs 0.58 ± 0.18 ng/ml, p: 0.24; 1.1 ± 0.4 mg/dl vs 1.1 ± 0.6 mg/dl; p: 0.32, respectively . Correlation analysis revealed a positive correlation between serum PTX-3 levels and hs-CRP levels r=0.34, p: 0.003 .CONCLUSION: PTX-3, a novel inflammatory marker, is elevated in patients with SCF and may be reflecting the inflammatory status in patients with SCF., AMAÇ: Koroner yavaş akım YKA , anjiyografisinde normal koroner arterlere sahip olup opak maddenin koronerlerin distaline geç ulaşması ile karakterizedir. YKA’ın inflamasyon ve yüksek duyarlıklı C reaktif protein hs-CRP gibi inflamatuvar belirteçler ile ilişkisi bilinmektedir. Pentraksin-3 PTX-3 , yeni bir akut faz reaktanı olup CRP gibi pentraksin ailesinin bir üyesidir. Biz bu çalışmada YKA hastalarında PTX-3 düzeyini araştırdık.YÖNTEMLER: Çalışmaya YKA saptanan 25 hasta ve koroner arter hastalığı KAH olan 26 hasta alındı. Yavaş koroner akım ve KAH tanısı koroner anjiyografi ile konuldu. Kardiyoloji polikliniğine başvurmuş iskemik bulguların gözlenmediği 24 sağlıklı birey kontrol grubu olarak alındı. Tüm grubun PTX-3 ve hs-CRP çalışıldıBULGULAR: KYA grubundaki hastaların PTX-3 ve hs-CRP seviyesi kontrol grubuna göre daha yüksekti sırasıyla 0.52 ± 0.2 ng/ml ve 0.20 ±0.08 ng/ml, p< 0.001; 1.1±0.4 mg/dl ve 0.6±0.5 mg/dl, p< 0.001 . Ancak KYA grubu ile KAH grubu arasında serum PTX-3 ile hs-CRP seviyesinde fark bulunmadı sırasıyla 0.52 ± 0.2 ng/ml ve 0.58 ± 0.18 ng/ml, p: 0.24; 1.1 ± 0.4 mg/dl ve 1.1 ± 0.6 mg/dl; p: 0.32 . Korelasyon analizi sonucu serum PTX-3 ve hs-CRP seviyeleri birbirleriyle ilişkili bulundu. Rho=0.34, p: 0.003 .SONUÇ: PTX-3, yeni bir inflamatuvar marker olup YKA olan hastalarda yükselmiştir ve bu hastalarda inflamatuvar durumu yansıtmada bir belirteçtir.

OP-182 Carotid intima-media thickness (CIMT) is a potential indicator of subclinical atherosclerosis in patients with psoriasis. Epicardial fat thickness (EFT) is proposed as a new cardiometabolic risk factor. We evaluated the association between EFT and CIMT in patients with psoriasis. The