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6. Alterations of cardiometabolic risk profile in polycystic ovary syndrome: 13 years follow-up in an unselected population

Author

Aksun, S., Sonu, N. C., Aygun, S., Karakulak, U. N., Mumusoglu, S., and Yildiz, B. O.

Abstract

Purpose: Cardiometabolic risk factors are common in women with polycystic ovary syndrome (PCOS) during reproductive years. The aim of this study was to determine the impact of aging on cardiometabolic risk of the syndrome by examining women who had previously been diagnosed to have PCOS or to be healthy in an unselected population in 2009. Participants: Forty-one women with PCOS who were diagnosed and phenotyped according to the Rotterdam criteria and 43 age- and body mass index (BMI)-matched healthy women from the same unselected cohort. Methods: All participants were evaluated by structured interview, physical examination, anthropometric, hormonal and biochemical measurements. Additionally, body composition analyses and echocardiographic assessments of 30 women with PCOS and 30 control women were conducted at 13 years of follow-up. Results: There was no difference between the patient and the control groups in terms of anthropometric and body composition measures and metabolic parameters. Echocardiographic assessment showed similar systolic functions, strain measurements and epicardial fat measurements between the groups. PCOS patients still had higher levels of total testosterone, free androgen index (FAI) and dehydroepiandrosterone sulfate (DHEAS) levels compared to controls. Epicardial fat thickness showed positive correlations with BMI, total and truncal body fat, homeostatic model assessment for insulin resistance (HOMA-IR) and free androgen index (FAI). Conclusions: Aging women with PCOS in the population have higher androgen levels and similar cardiometabolic risk profile compared to age- and BMI-matched healthy women. Epicardial fat thickness, a marker of cardiometabolic risk, appear to be associated with hyperandrogenism. Further research is needed on larger community-based cohorts where older patients are assessed with a longer follow-up.

Published
2023
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13. An unusual cause of chest pain: Acute coronary syndrome following administration of ergotamine tartrate

Author

Sercan Okutucu, Karakulak, U. N., Kabakci, G., and Aytemir, K.

Subjects
Clinical Cardiology: Case Report
Abstract

For many years, ergotamine has been used for the acute treatment of migraine. Ergotamine may produce coronary vasospasm, which is often associated with ischemic electrocardiography changes and angina pectoris. A 62-year-old woman who was admitted to the emergency department because of chest pain is described. She had a history of severe migraine attacks and started to use ergotamine tartrate 0.75 mg daily the day before. Electrocardiography revealed sinus tachycardia with left anterior hemiblock and T wave inversion in the precordial leads. Cardiac biomarker levels were elevated. After discontinuation of the drug and initiation of vasodilator treatment, her chest pain resolved. Patients with migraine may have an underlying vasospastic disorder predisposing them to coronary artery spasm. Physicians should be alerted to potential cardiac vasospastic effects of low-dose ergotamine in the treatment of migraine.

14. Poster session 5: Friday 5 December 2014, 14:00-18:00 * Location: Poster area

Author

Turco, A, Duchenne, J, Nuyts, J, Gheysens, O, Voigt, J-U, Claus, P, Vunckx, K, Muhtarov, K, Ozer, N, Turk, G, Sunman, H, Karakulak, U, Sahiner, L, Kaya, B, Yorgun, H, Hazirolan, T, Aytemir, K, Warita, S, Kawasaki, M, Tanaka, R, Houle, H, Yagasaki, H, Nagaya, M, Ono, K, Noda, T, Watanabe, S, Minatoguchi, S, Kyle, AS, Dauphin, C, Lusson, J R, Dragoi Galrinho, R, Rimbas, RC, Ciobanu, AO, Marinescu, B, Cinteza, M, Vinereanu, D, 28343/04.11.2013, number, Medicine, Funding Authority: University of, Davila, Pharmacy Carol, "Young Researchers" Projects – 2013, Buchar, Dragoi Galrinho, R, Ciobanu, AO, Rimbas, RC, Marinescu, B, Cinteza, M, Vinereanu, D, 159/1.5/S/138907, Grant POSDRU, Aparina, O, Stukalova, O, Butorova, E, Makeev, M, Bolotova, M, Parkhomenko, D, Golitsyn, SP, Zengin, E, Hoffmann, B A, Ramuschkat, M, Ojeda, F, Weiss, C, Willems, S, Blankenberg, S, Schnabel, R B, Sinning, C R, Schubert, U, Suhai, F I, Toth, A, Kecskes, K, Czimbalmos, CS, Csecs, I, Maurovich-Horvat, P, Simor, T, Merkely, B, Vago, H, Slawek, D, Chrzanowski, L, Krecki, R, Binkowska, A, Kasprzak, J D, Palombo, C, Morizzo, C, Kozakova, M, Biering-Sorensen, T, Mogelvang, R, Jensen, JS, Charisopoulou, DC, Koulaouzidis, GK, Rydberg, AR, Henein, MH, Kovacs, A, Olah, A, Lux, A, Matyas, C, Nemeth, BT, Kellermayer, D, Ruppert, M, Birtalan, E, Merkely, B, Radovits, T, Sengelov, M, Biering-Sorensen, T, Jorgensen, PG, Bruun, NE, Fritz-Hansen, T, Bech, J, Olsen, FJ, Sivertsen, J, Jensen, JS, Henri, C, Dulgheru, R, Magne, J, Kou, S, Davin, L, Nchimi, A, Oury, C, Pierard, L, Lancellotti, P, Sahin, S T, Cengiz, B, Yurdakul, S, Altuntas, E, Aytekin, V, Aytekin, S, Bajraktari, G, Ibrahimi, P, Bytyci, I, Ahmeti, A, Batalli, A, Elezi, S, Henein, MY, Pavlyukova, EN, Tereshenkova, EK, Karpov, RS, Barbier, P, Mirea, O, Guglielmo, M, Savioli, G, Cefalu, C, Maltagliati, MC, Tumasyan, LR, Adamyan, KG, Chilingaryan, AL, Tunyan, LG, Kowalik, E, Klisiewicz, A, Biernacka, EK, Hoffman, P, Park, CS, Yi, JEY, Cho, JSC, Ihm, SHI, Kim, HYK, Cho, EJC, Jeon, HKJ, Jung, HOJ, Youn, HJY, Mcghie, JS, Menting, ME, Vletter, WB, Roos-Hesselink, JW, Geleijnse, ML, Van Der Zwaan, H, Van Den Bosch, A, Spethmann, S, Baldenhofer, G, Stangl, V, Baumann, G, Stangl, K, Laule, M, Dreger, H, Knebel, F, Erdei, T, Edwards, J, Braim, D, Yousef, Z, Fraser, AG, Cardiff, Investigators, MEDIA, Keramida, K, Kouris, N, Kostopoulos, V, Kostakou, P, Petrogiannos, CH, Olympios, CD, Bajraktari, G, Berisha, G, Bytyci, I, Ibrahimi, P, Rexhepaj, N, Henein, MY, Wdowiak-Okrojek, K, Shim, A, Wejner-Mik, P, Szymczyk, E, Michalski, B, Kasprzak, JD, Lipiec, P, Tarr, A, Stoebe, S, Pfeiffer, D, Hagendorff, A, Haykal, M, Ryu, SK, Park, JY, Kim, SH, Choi, JW, Goh, CW, Byun, YS, Choi, JH, Sonoko, M, Onishi, T, Fujimoto, W, Yamada, S, Taniguchi, Y, Yasaka, Y, Kawai, H, Okura, H, Sakamoto, Y, Murata, E, Kanai, M, Kataoka, T, Kimura, T, Watanabe, N, Kuriyama, N, Nakama, T, Furugen, M, Sagara, S, Koiwaya, H, Ashikaga, K, Matsuyama, A, Shibata, Y, Meimoun, P, Abouth, S, Martis, S, Boulanger, J, Elmkies, F, Zemir, H, Tzvetkov, B, Luycx-Bore, A, Clerc, J, Galli, E, Oger, E, Guirette, Y, Daudin, M, Fournet, M, Donal, E, Galli, E, Guirette, Y, Mabo, P, Donal, E, Keramida, K, Kouris, N, Kostopoulos, V, Psarrou, G, Petrogiannos, CH, Hatzigiannis, P, Olympios, CD, Igual Munoz, B, Erdociain Perales, MEP, Maceira Gonzalez Alicia, AMG, Vazquez Sanchez, ALEJAN, Miro Palau, VMP, Alonso Fernandez, PAF, Donate Bertolin, LDB, Estornell Erill, JEE, Cervera, AC, Montero Argudo Anastasio, AMA, Okura, H, Koyama, T, Maehama, T, Imai, K, Yamada, R, Kume, T, Neishi, Y, Caballero Jimenez, L, Garcia-Navarro, M, Saura, D, Oliva, MJ, Gonzalez-Carrillo, J, Espinosa, MD, Valdes, M, De La Morena, G, Venkateshvaran, A, Sola, S, Dash, P K, Annappa, C, Manouras, A, Winter, R, Brodin, LA, Govind, S C, Laufer-Perl, LM, Topilsky, Y, Stugaard, M, Koriyama, H, Katsuki, K, Masuda, K, Asanuma, T, Takeda, Y, Sakata, Y, Nakatani, S, Marta, L, Abecasis, J, Reis, C, Dores, H, Cafe, H, Ribeiras, R, Andrade, MJ, Mendes, M, Goebel, B, Hamadanchi, A, Schmidt-Winter, C, Otto, S, Jung, C, Figulla, HR, Poerner, TC, Kim, D-H, Sun, BJ, Jang, JY, Choi, HN, Song, J-M, Kang, D-H, Song, J-K, Zakhama, L, Slama, I, Boussabah, E, Antit, S, Herbegue, B, Annabi, MS, Jalled, A, Ben Ameur, W, Thameur, M, Ben Youssef, S, O' Grady, H, Gilmore, M, Delassus, P, Sturmberger, T, Ebner, C, Aichinger, J, Tkalec, W, Eder, V, Nesser, HJ, Caggegi, A M, Scandura, S, Capranzano, P, Grasso, C, Mangiafico, S, Ronsivalle, G, Dipasqua, F, Arcidiacono, A, Cannata, S, Tamburino, C, Chapman, M, Henthorn, RENEE, Surikow, S, Zoontjens, J, Stocker, B, Mclean, T, Zeitz, C J, Fabregat Andres, O, Estornell-Erill, J, Ridocci-Soriano, F, De La Espriella, R, Albiach-Montanana, C, Trejo-Velasco, B, Perdomo-Londono, D, Facila, L, Morell, S, Cortijo-Gimeno, J, Kouris, N, Keramida, K, Kostopoulos, V, Psarrou, G, Kostakou, P, Olympios, CD, Kuperstein, R, Blechman, I, Freimatk, D, Arad, M, Ochoa, J P, Fernandez, A, Vaisbuj, F, Salmo, F, Fava, AM, Casabe, H, Guevara, EG, Fernandes, A, Cateano, F, Almeida, I, Silva, J, Trigo, J, Botelho, A, Sanches, C, Venancio, M, Goncalves, L, Schnell, F, Daudin, M, Oger, E, Bouillet, P, Mabo, P, Carre, F, Donal, E, Petrella, L, Fabiani, D, Paparoni, S, De Remigis, F, Tomassoni, G, Prosperi, F, Napoletano, C, Marchel, M, Serafin, A, Kochanowski, J, Steckiewicz, R, Madej-Pilarczyk, A, Filipiak, KJ, Opolski, G, Abid, L, Ben Kahla, S, Charfeddine, S, Kammoun, S, Monivas Palomero, V, Mingo Santos, S, Goirigoizarri Artaza, J, Rodriguez Gonzalez, E, Restrepo Cordoba, A, Rivero Arribas, B, Garcia Lunar, I, Gomez Bueno, M, Sayago Silva, I, Segovia Cubero, J, Zengin, E, Radunski, U K, Klusmeier, M, Ojeda, F, Rybczynski, M, Barten, M, Muellerleile, K, Reichenspurner, H, Blankenberg, S, Sinning, C R, Romano, G, Licata, P, Tuzzolino, F, Clemenza, F, Di Gesaro, G, Hernandez Baravoglia, C, Scardulla, C, Pilato, M, Hashimoto, G, Suzuki, M, Yoshikawa, H, Otsuka, T, Isekame, Y, Iijima, R, Hara, H, Nakamura, M, Sugi, K, Melnikova, MA, Krestjyaninov, MV, Ruzov, VI, Magnino, C, Omede', P, Avenatti, E, Presutti, D, Moretti, C, Ravera, A, Sabia, L, Gaita, F, Veglio, F, Milan, A, Magda, SL, Mincu, RI, Soare, A, Mihai, CM, Florescu, M, Mihalcea, D, Cinteza, M, Vinereanu, D, POSDRU/159/1.5/S/141531, Grant, 112/2011, grant CNCSIS, Chatzistamatiou, E, Mpampatseva Vagena, I, Manakos, K, Moustakas, G, Konstantinidis, D, Memo, G, Mitsakis, O, Kasakogias, A, Syros, P, Kallikazaros, I, Petroni, R, Acitelli, A, Cicconetti, M, Di Mauro, M, Altorio, SF, Romano, S, Petroni, A, Penco, M, Apostolovic, S, Stanojevic, D, Jankovic-Tomasevic, R, Salinger-Martinovic, S, Pavlovic, M, Djordjevic-Radojkovic, D, Tahirovic, E, Dungen, HD, ELD, CIBIS, Jung, I H, Byun, Y S, Goh, C W, Kim, B O, Rhee, K J, Lee, D S, Kim, M J, Seo, H S, Kim, H Y, Tsverava, M, Tsverava, D, Zaletova, T, Shamsheva, D, Parkhomenko, O, Bogdanov, A, Derbeneva, S, Leotescu, A, Tudor, I, Gurghean, A, Bruckner, I, Plaskota, KJ, Trojnarska, O, Bartczak, A, Grajek, S, Sharma, P, Sharma, D, Garg, S, Vazquez Lopez-Ibor, J, Monivas Palomero, V, Solano-Lopez, JM, Zegri Reiriz, I, Dominguez Rodriguez, F, Gonzalez Mirelis, J, Mingo Santos, S, Sayago, I, Garcia Pavia, P, Segovia Cubero, J, Konecny, T, Noseworthy, P, Kapa, S, Cooper, LT, Mulpuru, SK, Asirvatham, S, Florescu, M, Mihalcea, D, Magda, S, Radu, E, Chirca, A, Acasandrei, AM, Jinga, D, Mincu, R, Enescu, OA, Vinereanu, D, 112/2011, no., PN-II-ID-PCE-2011-3-0791, Saura Espin, D, Caballero Jimenez, L, Oliva Sandoval, MJ, Gonzalez Carrillo, J, Garcia Navarro, M, Espinosa Garcia, MD, Valdes Chavarri, M, De La Morena Valenzuela, G, Abul Fadl, AAM, Mourad, MM, team, Primary care Echocardiography, Campanale, C M, Di Maria, S, Mega, S, Nusca, A, Marullo, F, Di Sciascio, G, Pardo Gonzalez, L, Delgado, M, Ruiz, M, Rodriguez, S, Hidalgo, F, Ortega, R, Mesa, D, Suarez De Lezo Cruz Conde, J, Bengrid, T M, Zhao, Y, Henein, MY, Kenjaev, S, Alavi, AL, Kenjaev, ML, Mendes, LM, Lima, S, Dantas, C, Melo, I, Madeira, V, Balao, S, Alves, H, Baptista, E, Mendes, P, Santos, JF, Scali, MC, Mandoli, GE, Simioniuc, A, Massaro, F, Di Bello, V, Marzilli, M, Dini, FL, Cifra, B, Dragulescu, A, Friedberg, MK, Mertens, L, Scali, MC, Bayramoglu, A, Tasolar, H, Otlu, YO, Hidayet, S, Kurt, F, Dogan, A, Pekdemir, H, Stefani, L, Galanti, GG, De Luca, ADL, Toncelli, LT, Pedrizzetti, GP, Gopal, A S, Saha, SK, Toole, RS, Kiotsekoglou, A, Cao, JJ, Reichek, N, Ho, S-J, Hung, S-C, Chang, F-Y, Liao, J-N, Niu, D-M, Yu, W-C, Nemes, A, Kalapos, A, Domsik, P, Forster, T, Siarkos, M, Sammut, E, Lee, L, Jackson, T, Carr-White, G, Rajani, R, Kapetanakis, S, Jarvinen, VM, Sipola, P, Madeo, A, Piras, P, Evangelista, A, Giura, G, Dominici, T, Nardinocchi, P, Varano, V, Chialastri, C, Puddu, PE, Torromeo, C, Sanchis Ruiz, L, Montserrat, S, Obach, V, Cervera, A, Bijnens, B, Sitges, M, Charisopoulou, D, Banner, N R, Rahman-Haley, S, Kim, BJ, Kang, JG, Lee, SH, Sung, KC, Kim, BS, Kang, JH, Lee, ES, Imperadore, F, Del Greco, M, Jermendy, AL, Horcsik, DV, Horvath, T, Celeng, C, Nagy, E, Bartykowszki, A, Tarnoki, DL, Merkely, B, Maurovich-Horvat, P, Jermendy, G, Whitaker, J, Demir, OM, Walton, J, Wragg, A, Alfakih, K, Karolyi, M, Szilveszter, B, Raaijmakers, R, Giepmans, W, Horvath, T, Merkely, B, Maurovich-Horvat, P, Koulaouzidis, GK, Charisopoulou, DC, Mcarthur, TM, Jenkins, PJJ, Henein, MH, Silva, T, Ramos, R, Oliveira, M, Marques, H, Cunha, P, Silva, MN, Barbosa, C, Sofia, A, Pimenta, R, Ferreira, RC, Al-Mallah, M, and Alsaileek, A

Abstract

Clinical PET acquisitions of the heart suffer from artefacts and drops in image quality due to the poor spatial resolution of the PET system. Moreover, cardiac PET images are further degraded by the blur caused by the breathing and beating motions, thus hampering diagnosis and evaluation of myocardial pathologies. Anatomy-enhanced PET reconstruction, using a high-resolution CT, has proven useful in brain imaging. In cardiac datasets however, due to the motion artefacts, the application of any restoring technique on datasets affected by motion blur needs to be preceded by the validation of the proposed method on realistic static datasets. In this work, the validation is performed using static cardiac ex vivo datasets obtained from a number of sacrificed sheep, scanned on a clinical PET/CT scanner. The aim of this work is to assess the effectiveness of reconstructions of the acquired datasets with different CT-based anatomical priors, in comparison to reconstructions currently applied in clinical practise. The gold standard to which all reconstructions are compared consists of images of the same hearts scanned on a small-animal PET scanner, whose high spatial resolution allows for almost artefact-free images. Encouraging results were obtained so far, with improvements in volume delineation and uniformity of activity values when anatomical information was used. Fig 1 shows the gold standard image (left) compared to a regular clinical reconstruction (middle) and to a reconstruction using the high-resolution CT as anatomical information (right). Figure

Published
2014
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15. Evaluation of Erectile Dysfunction and Left Ventricular Diastolic Parameters in Lead Exposed Workers.

Author

Nadir Karakulak U, Okutucu S, Lokman U, Bilgin O, Tutkun E, Hinc Yilmaz O, and Oto A

Abstract

Background: Lead exposure causes a wide range of vascular diseases through oxidative stress, sympathetic hyperactivity and impairment in nitric oxide bioavailability. In this study, the association between the effects of lead exposure on left ventricular diastolic indices and erectile function were assessed., Methods: A total of 94 lead-exposed workers without known cardiovascular diseases or risk factors and 30 healthy subjects were enrolled. Systolic and diastolic functions were measured using transthoracic echocardiography. All participants were non-smokers. The International Index of Erectile Function Questionnaire (IIEF-5) was used to diagnose and grade erectile dysfunction (ED). Echocardiographic parameters, IIEF-5 score and blood lead level (BLL) were analyzed., Results: The mean age and median BLL were 32.3 ± 6.4 years and 19 μg/dL in the workers, respectively. Sixty-five (69.1%) workers and 9 control subjects (30%) had ED. The IIEF-5 score was lower in the workers (17.0 ± 6.1) than in the controls (22.7 ± 2.1). In the workers, E and e' waves and E/A ratio were lower, and A wave, E/e' ratio, and left atrial volume index (LAVI) were higher than in the controls. Additionally, BLL was correlated with IIEF-5 score, e' wave, and E/e' ratio. IIEF-5 score was correlated with e' wave, E/e' ratio and LAVI. BLL was an independent risk factor for a decreased e' wave and IIEF-5 score and increased E/e' ratio in the lead-exposed workers., Conclusions: Impairment of diastolic and erectile functions, despite a younger age and in the absence of accompanying risk factors, was correlated with increased BLL.

Published
2019
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16. [Pulmonary vein isolation with the cryoballoon technique in atrial fibrillation treatment: single centre experience].

Author

Oto A, Aytemir K, Canpolat U, Karakulak U, Evranos B, Sahiner L, Okutucu S, Kaya EB, Tokgözoğlu L, and Kabakcı G

Subjects
Adolescent, Adult, Aged, Cryosurgery, Disease-Free Survival, Female, Humans, Male, Middle Aged, Postoperative Complications, Treatment Outcome, Atrial Fibrillation therapy, Catheter Ablation methods, Pulmonary Veins
Abstract

Objectives: Pulmonary vein (PV) isolation with cryothermal energy is a recently introduced technique in patients with atrial fibrillation (AF). It may reduce procedural times and serious complications associated with radiofrequency (RF) ablation. We aimed to present the baseline characteristics and follow-up data of our study population undergoing cryoballoon AF ablation., Study Design: A total of 236 patients (126 male, 110 female; mean age 54.6±10.45; range 16 to 78 years) underwent PV isolation with 28 mm cryoballoon due to symptomatic AF. These patients failed with at least one previous antiarrhythmic drug. The postprocedure in the first 3 months was defined as blanking period. Median follow-up time was 14 (3-24) months. Procedural success, complicaitons, and follow-up results were defined according to Heart Rhythm Society guidelines., Results: Acute procedural success rate (>=3 PV isolation) was 99.5%. Mean procedural and fluoroscopy times were 72.5±5.3 (50-90) min and 14±3.5 (12-24) min. Major complications were observed in 3 patients (1.2%). At the median 14 month follow-up, 80.6% of paroxysmal AF patients and 49.2% of persistant AF patients were free from AF recurrence. RF ablation was performed in 10 patients with recurrence. Smoking, body mass index, non-paroxysmal AF type, AF duration (years), left atrial size, and early recurrence were the predictors of recurrence in multivariate regression analysis., Conclusion: This study represents the first experience with cryoballoon ablation for AF in Turkey. The efficacy and safety of cryoballoon AF ablation technique was shown due to the acceptable success and low complication rates in paroxysmal AF patients. Particularly, patients with early recurrence should be closely followed-up.

Published
2013
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17. Predictors of atrial fibrillation recurrence after atrial fibrillation ablation with cryoballoon.

Author

Evranos B, Aytemir K, Oto A, Okutucu S, Karakulak U, Şahiner L, Kaya B, and Kabakçı G

Subjects
Adult, Age Factors, Aged, Area Under Curve, Atrial Fibrillation blood, Atrial Fibrillation diagnosis, Biomarkers blood, Blood Sedimentation, Echocardiography, Doppler, Electrocardiography, Ambulatory, Equipment Design, Female, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multidetector Computed Tomography, Predictive Value of Tests, ROC Curve, Recurrence, Risk Factors, Time Factors, Treatment Outcome, Atrial Fibrillation surgery, Cardiac Catheters, Cryosurgery adverse effects, Cryosurgery instrumentation
Abstract

Background: Catheter ablation of atrial fibrillation is recommended for patients with symptomatic paroxysmal atrial fibrillation (PAF) despite anti-arrhythmic drugs (AADs). Radiofrequency ablation is widely accepted as an effective treatment for PAF. Cryoenergy by cryoballoon technique is an alternative to radiofrequency (RF) ablation. Cryoballoon ablation is safe, and has a similar success rate in comparison to RF ablation. AF recurrence with cryoballoon ablation is roughly 30%. The aim of this study is to determine the predictors of AF recurrence after cryoballoon ablation., Methods and Results: Sixty one patients with symptomatic PAF despite AADs without structural heart disease were included. Cryoballoon ablation was performed in 60 patients (36 males, mean age: 54.6 ± 10.7, mean left atrium size: 3.74 ± 0.39 mm). Transthoracic echocardiography including tissue Doppler imaging was performed in all subjects during sinus rhythm at baseline and after the ablation. Intra-atrial and inter-atrial electromechanical delays, and PA-lateral were measured. All patients were scheduled for 24 h Holter recording at baseline and at 3, 6, 9 months follow-up. Venous samples were collected to measure CK-MB, Troponin-T (TnT), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels at baseline and 24 h after ablation. Median follow up was 10 (8-12) months. Forty eight (80%) patients were in sinus rhythm during the follow up. In receiver operating curve (ROC) analysis, intraleft atrial electromechanical delay and PA-lateral achieve an area under the curve (AUC) 0.97 (p < 0.001) and 0.69 (p < 0.001) for the ability to predict AF recurrence. A cut-off value for baseline intra left atrial electromechanical delay of 29.5 ms predicted AF recurrence with sensitivity of 85% and specifity of 98%. A cut-off value for PA-lateral of 125 ms predicted AF recurrence with sensitivity of 80% and specifity of 90%. In ROC analysis, age achieves an AUC 0.822 (p = 0.006) for the ability to predict AF recurrence. A cut-off value for age of 64 predicted AF recurrence with sensitivity of 71% and specifity of 90%. Early recurrence of AF (HR = 60, 95% CI 18.61-417.86, p < 0.001) predicted also late recurrence of AF., Conclusions: The increase in AF recurrence by increased intraleft atrial electromechanical delay, PA-lateral and older age show the importance of substrate in AF mechanism. Early recurrence was the strongest predictor of late recurrence of AF; therefore, existence of blanking period for cryoballoon ablation should be questioned.

Published
2013
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18. Visualization of dual coronary artery fistulae drainage to the right ventricle by transthoracic echocardiography.

Author

Okutucu S, Karakulak UN, Jam F, Kaya EB, Aytemir K, and Oto A

Subjects
Humans, Male, Middle Aged, Coronary Vessel Anomalies diagnostic imaging, Coronary Vessels diagnostic imaging, Echocardiography methods, Fistula diagnostic imaging, Heart Ventricles abnormalities, Heart Ventricles diagnostic imaging
Abstract

Coronary artery fistula is a rare abnormality of coronary circulation. It is mostly congenital but acquired forms can also occur. Fistulae are usually asymptomatic and can sometimes be visualized during cardiac imaging such as transthoracic echocardiogram, cardiac magnetic resonance imaging, coronary computed tomography angiography and coronary angiography.

Published
2012
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