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Kiris A.,Karadeniz Technical University | Erem C.,Karadeniz Technical University | Turan O.E.,Karadeniz Technical University | Civan N.,Karadeniz Technical University | And 5 more authors.
Endocrine | Year: 2013

Acromegaly is associated with a variety of cardiovascular disturbances such as left ventricular hypertrophy, diastolic cardiac dysfunction, and hypertension. Left ventricular (LV) dyssynchrony means the impairment of synchronicity and is defined as the loss of the simultaneous peak contraction of corresponding cardiac segments. The objective of this study was to investigate whether acromegalic patients have left ventricular dyssynchrony. Dyssynchrony was evaluated in 30 patients with active acromegaly and 30 controls. All the patients and controls were subjected to a tissue synchronization imaging. The time to regional peak systolic tissue velocity (Ts) in LV by the six-basal-six-mid-segmental model was measured on ejection phase TSI images and four TSI parameters of systolic dyssynchrony were computed. All TSI parameters of LV dyssynchrony increased in patients with acromegaly compared to the controls: the standard deviation (SD) of the 12 LV segments Ts (43.5 ± 13.5 vs 26.2 ± 12.5, p < 0.001); the maximal difference in Ts between any 2 of the 12 LV segments (133.3 ± 38 vs 84.6 ± 37.6, p < 0.001); the SD of the 6 basal LV segments (41.1 ± 15.9 vs 25.4 ± 14.8, p = 0.001); and the maximal difference in Ts between any 2 of the 6 basal LV segments (102.6 ± 37.5 vs 65.2 ± 36.9, p = 0.001). In addition, there were significant relationships between the levels of growth hormone/insulin-like growth factor-1 and Ts-SD-12. LV synchronicity has been impaired in patients with acromegaly. Left ventricular dyssynchrony is associated with disease activity and it may contribute to the harmful cardiovascular effects of acromegaly. © 2012 Springer Science+Business Media New York. Source


Acar Z.,Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital
European review for medical and pharmacological sciences | Year: 2012

In ST elevation myocardial infarction (STEMI) patients, mean platelet volume (MPV) is associated with infarct related artery patency both before and after reperfusion. In anterior STEMI patients successfully treated with primary percutaneous coronary intervention (PCI), the relationship between left ventricular (LV) function and MPV on admission is unknown. 97 anterior STEMI patients successfully revascularizated with PCI between January 2010 and February 2011 are included. MPV on admission is recorded. All patients underwent transthoracic echocardiography within 3 days or before discharge. Patients were divided into two groups according to left ventricular ejection fraction (LVEF), as systolic dysfunction (LVEF < 50%, 1st group) and normal systolic functions (LVEF > 50%, 2nd group). The 1st group included 61 (47 males) patients and the 2nd group included 36 (35 males) patients. MPV was; 9.5+/-1.1 femtoliter (fL) in the 1st and 8.8+/-0.8 fL in the second group. The difference between the groups was significant (p = 0.001). There was a significant difference in the Troponin I levels and white blood cell (WBC) counts on admission between two groups (30+/-29 vs 12.2+/-15.1 ng/mL, p = 0.001 and 12.3+/-3.8 vs 10.6+/-3.4 counts ×109/L, p = 0.027, respectively). In anterior STEMI patients treated with percutaneous coronary intervention, increased MPV on admission is associated with impairment in left ventricular systolic function. Source


Ilter A.,Kanuni Training and Research Hospital | Krs A.,Karadeniz Technical University | Kaplan S.,Karadeniz Technical University | Kutlu M.,Karadeniz Technical University | And 4 more authors.
Endocrine | Year: 2015

The aim of this study was to evaluate atrial electromechanical delay (EMD), P wave dispersion (Pwd), and left atrial (LA) mechanical functions in patients with active acromegaly. Twenty-three patients with active acromegaly and 27 age- and sex-matched controls were included in this study. All atrial electromechanical interval parameters (PA lateral, PA septum, PA tricuspid, interatrial EMD, intra-LA EMD, and intra-right atrial EMD) were measured from mitral lateral annulus, mitral septal annulus, and right ventricular tricuspid annulus by tissue Doppler imaging. LA volumes were measured by the disk method in the apical four-chamber view and were indexed to the body surface area. Mechanical function parameters of LA were calculated. Pwd was performed by 12-lead electrocardiograms. Atrial electromechanical intervals (PA lateral, PA septum, PA tricuspid, interatrial EMD, intra-LA EMD, and intra-right atrial EMD) and Pwd were similar between patients with acromegaly and control subjects (all p > 0.05). LA volumes (maximum, minimum, and presystolic) and LA mechanical functions were not significantly different between the groups (all p > 0.05). Additionally, serum levels of growth hormone and insulin-like growth factor-1 were not correlated with atrial electromechanical parameters and LA mechanical functions. Atrial electrical conduction times were not prolonged and LA mechanical functions were not impaired in patients with active acromegaly compared with controls. And the prevalence of supraventricular arrhythmia risk may not increase in this population. © 2014, Springer Science+Business Media New York. Source


Kaplan S.,Karadeniz Technical University | Ozturk M.,Caycuma State Hospital | Kiris G.,Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital | Kaplan S.T.,Trabzon Kanuni Education and Research Hospital
International Journal of Clinical and Experimental Medicine | Year: 2014

Aim: Epicardial adipose tissue (EAT) is a tissue around the heart with visceral adipose properties. It can affect the structure and functions of the myocardium and coronary arteries through inflammatory markers and regulators. The myocardial performance (Tei) index is a parameter capable of globally assessing systolic and dia-stolic heart functions. This study investigated the relation between EAT thickness and the Tei index. Methods: The study population was selected from patients without structural heart disease. EAT thickness was measured with two-dimensional imaging in parasternal long axis view and from the anterior face of the right ventricle. Tei index measurement was calculated with tissue Doppler echocardiography from the mitral lateral annulus. The relation between the Tei index and EAT was assessed using multivariate linear regression analysis. Results: Forty-three patients (36 female, 7 male; mean age 50.2 ± 10.6 years) were included in the study. Mean Tei index was 0.39 ± 0.09, and mean EAT thickness 4.7 ± 2.4 mm. A significant correlation was determined between tissue Doppler Tei index and EAT thickness at correlation analysis (r = 0.522, P < 0.001). EAT thickness was independently correlated with Tei index at multivariate linear regression analysis (Beta = 0.443, t = 3.522, P = 0.001). Conclusion: EAT thickness is independently correlation with Tei index. Increased EAT thickness may therefore be a predictor of left ventricular dysfunction. Source


Kiris A.,Karadeniz Technical University | Karaman K.,Cardiology Clinic | Kiris G.,Ahi Evren Cardiovascular and Thoracic Surgery Training and Research Hospital | Sahin M.,Karadeniz Technical University | And 5 more authors.
Echocardiography | Year: 2012

Objectives: Left ventricular (LV) systolic synchrony, defined as simultaneous peak contractions of corresponding cardiac segments, is well documented to be impaired in hypertension but its effect on LV function is not clear. The aim of this study was to assess the impacts of LV systolic dyssynchrony on LV function in newly diagnosed hypertensives. Methods: Forty-eight newly diagnosed hypertensive patients and 33 controls were enrolled. All study population underwent a comprehensive echocardiographic evaluation including tissue synchrony imaging. The time to regional peak systolic tissue velocity (Ts) in LV by 12 segmental models was measured and two parameters of systolic dyssynchrony were computed. Results: Baseline demographic characteristics were similar in both study groups. Dyssynchrony parameters prolonged in newly diagnosed hypertensive patients compared to controls: the standard deviation (SD) of 12 LV segments Ts (40.2 ± 21 vs. 26.2 ± 13.4, P = 0.003); the maximal difference in Ts between any 2 of 12 LV segments (123.3 ± 61.5 vs. 79.8 ± 37.9, P = 0.001). In multivariable analysis, Ts-SD-12 was found to be an independent predictor for systolic function (β=-0.29, P = 0.008). But, both diastolic and global functions were not independently related to Ts-SD-12. Conclusion: LV synchronization is impaired in newly diagnosed hypertensive patients. LV dyssynchrony is one of the independent predictors of systolic function in hypertensive patients. © 2012, Wiley Periodicals, Inc. Source

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