Yıldırım, Turkey
Yıldırım, Turkey

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Canbay C.,Istanbul University | Oztas D.M.,Istanbul University | Babur Guler G.,Istanbul University | Ertan M.,Istanbul University | And 2 more authors.
Turkiye Klinikleri Cardiovascular Sciences | Year: 2016

Takotsubo cardiomyopathy is a rare pathology and a cardiovascular syndrom which courses with myocardial infarction and left ventricular disfunction without coronary artery disease. Although being rarely asymptomatic, it generally causes symptoms such as chest pain, dyspnea and syncope. Ventriculography reveals antero-apical ballooning and magnetic resonance imaging and echocardiography reveals regional wall function abnormalities. This disease generally effects old, postmenopausal women after physical or emotional stress factors. Patients present to the clinic with various symptoms related to acute coronary syndrome. Therapy is generally supportive medical treatment. In this report, we present the 79-years-old female patient with takotsubo cardiomyopathy whom was admitted to the emergency clinic with sudden onset chest pain and dyspnea. With the initial diagnosis of acute coronary syndrome, cardiac catheterization did not show significant stenosis and indicated apical ballooning which supported the diagnosis. Copyright © 2016 by Türkiye Klinikleri.


Kalayci B.,Halil Sivgin Cubuk Devlet Hastanesi | Kalayci S.,Kardiyoloji Klinigi
Turkiye Klinikleri Cardiovascular Sciences | Year: 2014

Blunt chest trauma may cause of various cardiac problems including mechanical injury and/or dysrhythmia. It may result a wide spectrum of cardiac injury and clinical presentation. It may be completely silent or may result in sudden cardiac death. Definition of myocardial injury after blunt chest trauma is difficult. Because an accepted diagnostic algorithm has not established yet. Dysrhythmias after blunt trauma may be atrial or ventricular origin. These dysrhythmias are usually temporary but may be persistent if permanent histological tissue damage occures. Sometimes it may occur only in the form of the conduction disorders such as bundle branch blocks and conduction delay. The most commonly affected part of the heart is right ventricle due to its retrosternal localization. However multiple heart chambers may be affected as well. Commotio cordis is a rare clinical condition that develops after blunt chest trauma and usually is seen after sport activities. It may be described as a phenomen that result in cardiac arrest and death as a result low-energy blunt chest trauma in patients without structural cardiac defect. Also injury of ventricular and atrial septum and walls, valves, coronary and great vessels should be noted. Electrocardiographic and echocardiographic examinations are of great importance as well assessment of the patient's clinical condition. In this article we are reviewing dysrhthmias after blunt chest trauma. Furthermore we are presenting a case of fifteen year old boy developing transient right bundle branch block after blunt trauma to the front of the chest during a fight from the emergency department. Copyright © 2014 by Türkiye Klinikleri.


Yildiz A.,Kardiyoloji Klinigi | Oduncu V.,Kardiyoloji Klinigi
Turkiye Klinikleri Cardiovascular Sciences | Year: 2013

Objective: Obesity is known to play a key role in the development of coronary heart disease. Beside this, aortic distensibility and aortic stiffness index can be used for early detection of atherosclerosis. Our aim is to present aortic elastic properties in obesity and also to present the factors that damage aortic distensibility and increase aortic stiffness index. Material and Methods: Totally 96 cases of whom 12 were with normal [body mass index (BMI) <25)] weight, 17 were overweight (BMI: 25-29.9), 43 patients were obese (BMI: 30-39.9) and 24 were morbid obese patients (BMI ?40) according to World Health Organization were included to present study. For statistical analysis, according to the 30 kg/ m2 of accepted cut-off value for obesity, patients were evaluated by dividing to two groups of BMI <30 kg/ m2 and BMI ?30 kg/m2. After performing the blood analysis of the patients, aortic stiffness, aortic distensibility, and aortic stiffness index were calculated by echocardiographic measurements. Results: In parallel to weight increment from normal weight to morbid obesity aortic stiffness and distensibility were decreased and stiffness index was increased (decrement in distensibility 0.31±}0.2 and 0.16±}0.3 p= 0.015, increase in stiffness index 0.07±}0.24 and 0.12±}0.4, p=0.029). Although there was not a change in white blood cell count and netrophil/lymphocyte ratio as markers of acute inflammation, it was seen that there was a significant increase in subacute inflammation marker C-reactive protein levels (1.28±}0.6 and 2.97±}1.8 respectively, p<0.001). There was a positive correlation between aortic stiffness index and weight (r: 0.250, p: 0.014), age (r: 0.205, p:0.045), systolic blood pressure (r: 0.224, p: 0.028) and diastolic radius of aorta (r: 0.374, p<0.001). Conclusion: In obesity, aortic stiffness index was significantly increasing and distensibility was decreasing in parallel to weight increment. Calculation of these easily measured parameters especially in morbid obese individuals might help in the early recognition of atherosclerosis. Copyright © 2013 by Türkiye Klinik leri.


Erturk M.,Kardiyoloji Klinigi | Aslan M.,Kardiyoloji Klinigi | Aksu H.U.,Kardiyoloji Klinigi | Akturk I.F.,Kardiyoloji Klinigi | And 6 more authors.
Echocardiography | Year: 2013

Aim The aim of our study was to evaluate atrial electromechanical delay (AEMD) and left atrial mechanical functions (LAMF) in the patients with secundum-type atrial septal defect (ASD). Method We included 72 patients with secundum type ASD in the study group and 35 gender and age-matched healthy volunteers for the control group. Maximal, minimal, and presystolic LA volumes were measured by modified Simpson method and indexed to the body surface area (BSA). Inter-AEMD, right and left intra-AEMD were measured from the lateral and septal mitral annulus and tricuspid annulus using tissue Doppler imaging (TDI). Results The age, gender, systolic and diastolic blood pressure, heart rate (HR), BSA, and body mass index (BMI) parameters were not significantly different between the groups. Left atrial active and total emptying fractions and conduit volumes were significantly lower in the patients with ASD compared with the control group (P = 0.006, P = 0.001, and P = 0.032, respectively). Total emptying volume was increased in patients with ASD (P = 0.021). Passive emptying volume and fraction and active emptying volumes were not different significantly between the groups (P > 0.05). The left intraatrial, right intraatrial, and inter-AEMDs were significantly longer in the ASD group (P = 0.032, P = 0.013, and P = 0.003, respectively). Conclusion The left atrial reservoir and contractile pump functions are reduced; the left intraatrial, right intraatrial, and inter-AEMDs are increased in the patients with ASD. © 2013, Wiley Periodicals, Inc.


Onat A.,Istanbul University | Cakir H.,Kardiyoloji Klinigi | Karadeniz Y.,Hastaliklari Klinigi | Donmez I.,Kardiyoloji Anabilim Dali | And 3 more authors.
Turk Kardiyoloji Dernegi Arsivi | Year: 2014

Objectives: To analyze (1) the sex-specific and age-brack- Et defined all-cause and coronary mortality in the 23-years' follow-up of the Turkish Adult Risk Factor Study, and (2) to determine the nation-wide prevalence of Type-2 diabetes and its recent trend. Study design: Information on the mode of death was obtained from first-degree relatives and/or health personnel of local heath office. Information collected in survivors was based on history, physical examination of the cardiovascular system and Minnesota coding of resting electrocardiograms. Diabetes was defined by criteria of the American Diabetes Association without the use of glycated hemoglobin. Results: Of the 1370 participants to be surveyed, 768 were examined, in 452 subjects information was gathered, and 29 men, 18 women were ascertained to have died. Cumulative assessment of the entire cohort in the age bracket 45-74 years disclosed coronary mortality to be 7.5/1000 person- years in men and 3.74 in women, persisting to be high among the European countries. The recent decline observed in overall mortality seemed to halt as well. Of greatest concern was the finding in the past 12 years that the rate of rise in the age-controlled prevalence of Type-2 diabetes was as high as 5% annually. Conclusion: Overall and coronary mortality in Turkish adults continue to be high, while an elicited annual increase of 5% in the age-controlled prevalence of diabetes is virtually alarming and requires new public health policies. © 2014 Turkish Society of Cardiology.


Akgullu C.,Kardiyoloji Klinigi | Binici S.,Kardiyoloji Klinigi | Katircibasi M.T.,Kardiyoloji Klinigi
Turkiye Klinikleri Journal of Medical Sciences | Year: 2012

Cor triatriatum sinister is a rare congenital heart defect, which is usually diagnosed during childhood. It is characterized with a left atrium dividing fibromuscular membrane. Obs-tructive flow effect of the membrane in the left atrium causes symptoms mimicking mitral steno-sis. It is usually diagnosed during childhood because of its symptoms like dyspnea, fatigue and effort intolerance and it is extremely rare to be diagnosed in the adulthood. In this article, a 43-year-old male patient with exertional dyspnea due to cor triatriatum sinister was presented and relevant literature was discussed. © 2012 by Türkiye Klinikleri.


Karakurt O.,Kardiyoloji Klinigi | Cagirci G.,Kardiyoloji Klinigi | Akdemir R.,Kardiyoloji Klinigi
Turkiye Klinikleri Cardiovascular Sciences | Year: 2012

Paraoxonase [aryldialkylphosphatase (PON)] is an enzyme, that was first discovered during toxicologic researchs. After it was realized that, it takes part in hydrolysis of organophosphat compounds that is widely used as insecticide and nerve gas and, has a critical significance in preventing their toxicity , studies on PON have increased. Organophosphats are mainly detoxified in the liver, organophosphat compounds that escape from the detoxification are destroyed by PON1 in serum and their neurotoxicity is prevented. The reason of the nomenclature of this enzyme is that, paraoxon which is a metabolite of the insectiside parathion is the most widely used substrate for measuring this enzyme's activity. PON is a calcium dependent ester hydrolase with glycoprotein structure. In humans there are three main members of PON gene family. PON 1 is synthesized in liver and released into the blood and closely related to the high density lipoprotein (HDL). PON has a significant effect on HDL's antioxidant and antiatherogenic function. PON shows cardiovascular protection via decreasing the oxidative stress in serum and tissues. PON performs this protective effect on cardiovascular system both preventing low density lipoprotein (LDL) from oxidation and metabolizing the oxidized lipids on the oxidized LDL. Also, PON1 decreases macrophages' lipit peroxide content and prevents phagocytosis of oxidized LDL via macrophages' and thus foam cell formation of macrophages and inhibits one of the fundamental steps of atherosclerosis process. Many studies demonstrated that serum PON1 activity has decreased in atherosclerotic diseases, myocardial infarction, slow coronary flow, cardiac syndrome X, hypercholesterolemia and diabetes mellitus. There are many conflicting results about the relationship of PON polymorphism and coronary artery disease. Furthermore, PON activity may be affected by diet, environmental factors and drugs. Although other two members of PON gene family; PON2 and PON3 has been searhed less, it has been suggested that these have antiatherogenic function too. Copyright © 2012 by Türkiye Klinikleri.


Ucar O.,Kardiyoloji Klinigi
Turkiye Klinikleri Cardiovascular Sciences | Year: 2012

Mitral L-wave is recorded at the mitral valve by M-mode echocardiography or pulsed wave Doppler during mid-diastole. It is believed to be the consequence of fluctuations in diastolic left atrial and left ventricular pressure gradients in the setting of reduced left ventricular active diastolic relaxation and increased left ventricular stiffness. The equivalent of this wave on tissue Doppler is the L' wave. This wave, which is an indicator of pseudonormal diastolic flow, has prognostic value. It suggests increased likelihood of future hospitalization for heart failure in patients with left ventricular systolic dysfunction or hypertrophy. In this report we aimed to present a hypertensive case with left ventricular hypertrophy and mitral L-wave and we discussed this important but usually ignored echocardiographic finding accordingly. Copyright © 2012 by Türkiye Klinikleri.


Akturk E.,Adiyaman University | Kurtoglu E.,Kardiyoloji Klinigi | Ermis N.,Inonu University
Turkiye Klinikleri Cardiovascular Sciences | Year: 2014

Widening the array of active antineoplastic agents has resulted in a prolongation of lifespan of cancer patients, but also increased the possibility of manifestation of adverse effects of anticancer treatment. Cardiovascular toxicity is a potential short- or long-term complication of anticancer therapy. The mechanisms of particular cardiovascular toxicities in cancer patients may differ from those of general population and the presence of cancer may limit the therapeutic options. Therefore, general treatment guidelines in cardiovascular disorders may not be appropriate in cancer patients. Additionally, cardiovascular toxicities reported in clinical trials do not always reflect those of "real world" patients. More research is needed to assess and manage the cardiovascular safety of patients treated with anticancer agents, beginning with a dynamic partnership between oncologists and cardiologists and the development of a new generation of "cardiooncologic" investigators. Cardiac toxicity associated with cancer therapies can range from asymptomatic subclinical abnormalities, including electrocardiographic changes and temporary left ventricular ejection fraction decline, to life-threatening events such as heart failure or acute coronary syndromes. The aim of this review is to summarize potential cardiovascular toxicities for a range of cancer chemotherapeutics. Given the rate of new drug development designed to fulfill unmet oncologic needs, efforts are needed to promote strategies for cardiac risk detection and management and to avoid unintended consequences potentially impeding development of, regulatory approval for, manage the cardiovascular safety of patients treated with anticancer agents, as well as a well-organized collaboration between oncologists and cardiologists. Copyright © 2014 by Türkiye Klinikleri.


The aim of this single-center prospective study is to investigate the silent and clinically apparent cerebral embolic events after transcatheter closure of atrial septal defect (ASD) and patent foramen ovale (PFO).Although transcatheter closure of ASD and PFO is a widely accepted technique and has been proven to be safe and effective with different kinds of devices, there are few studies in the literature that report the peri-interventional cerebral embolism risk and neurological complications. In this study, we investigated the peri-interventional cerebral embolism incidence with diffusion-weighted magnetic resonance imaging (DW-MRI) and its relation to patients clinical neurologic examination findings and plasma neuron-specific enolase (NSE) levels.Sixteen patients with hemodynamically significant ASD and 14 symptomatic PFO patients underwent transcatheter closure procedures with new-generation PFO or ASD occluder devices. All cases were examined with DW-MRI before and after the transcatheter closure procedure. Patients were clinically examined for any signs of neurologic deficit at the time of MRI studies. Blood samples for NSE, a marker of brain tissue damage involved in an ischemic event, were taken before the procedure and at 12 and 24 hours after the procedure.Successful transcatheter closure of PFO or ASD was achieved in all patients. In the DW-MRI exam following the procedure, a new microembolic lesion was found in only 1 of 30 patients (3.3%). None of the patients had positive clinical neurological exam findings. NSE levels after the procedure were found to be not correlated with presence of DWMRI lesion and intervention times.With the new-generation ASD and PFO occluder devices, the incidence of clinically silent peri-interventional cerebral embolic lesions after transcatheter closure of ASD and PFO is low. Plasma NSE levels offered no additional benefit for monitoring ischemic events after ASD and PFO transcatheter closure procedures.

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