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Ergul Y.,Istanbul University | Nisli K.,Istanbul University | Demirel A.,Istanbul University | Varkal M.A.,Istanbul University | And 5 more authors.
Cardiology Journal | Year: 2011

Background: Left ventricular non-compaction (LVNC) is a specific cardiomyopathy that occurs following a disruption of endomyocardial morphogenesis. This study presents clinical findings, diagnostic features, treatment and follow-up of pediatric patients diagnosed with LVNC. Methods: Patients with LVNC who were followed from January 2006 to March 2010 were included in this study. Diagnosis was made with the use of characteristic findings of magnetic resonance imaging and echocardiography. Holter electrocardiography and metabolic screening tests were also performed in all patients. Results: A total of 24 patients were studied (18 male, six female). Patient age at diagnosis was 50 ± 60 months (eight days to 15 years). Average follow-up period was 22 ± 12 months (four months to four years). Findings at diagnosis were as follows: eight (33%) patients had heart failure, five (20%) had rhythm abnormalities, five (20%) had cardiomegaly, two had murmurs, two had cyanosis, and two presented with fatigue. Ten (41%) patients had been followed previously with other diagnoses. In 21 (87.5%) patients, electrocardiographic abnormalities were noted, especially left ventricular hypertrophy and ST-T changes. Patients had an average ejection fraction of 46% (18-73%) and three of them had additional congenital heart disease (patent ductus arteriosus, aortopulmonary window and complex cyanotic heart disease). Scanning for metabolic diseases revealed fatty acid oxidation disorder in one patient, and mitochondrial disease in another. During follow-up, a permanent pacemaker was implanted in a patient with severe bradycardia and ventricular dysfunction, and three patients died. Conclusion: LVNC can be diagnosed at any age from newborn to adolescent and has a variable clinical course. Closer study of patients with cardiomegaly and heart failure can reduce delays in diagnosis of LVNC. © 2011 Via Medica. Source


Aung S.M.,Fatih University | Guler A.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Guler Y.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Huraibat A.,Fatih University | And 2 more authors.
Herz | Year: 2016

Background: Heart failure with preserved ejection fraction (HFpEF) is a syndrome in which patients have symptoms and signs of heart failure but preserved ejection fraction. Left atrial (LA) volume and function are known to be impaired in these patients. Two-dimensional speckle-tracking echocardiography (2D-STE) has recently enabled the quantification of LA deformation dynamics. In this study, we evaluated the use of 2D-STE for the diagnosis of HFpEF. Patients and methods: The study included 83 patients with suspected HFpEF. Patients were divided into two groups after HFpEF had been diagnosed according to current guidelines. Parameters of diastolic dysfunction were evaluated, including left ventricular mass index (LVMI), LA volume index (LAVI), E/A ratio, deceleration time (DT), E/E’, and STE parameters such as global longitudinal LA strain during ventricular systole (GLAs-res) and strain during late diastole (GLAs-pump). Results: The values of BNP, LVMI, DT, LAVI, and GLAs-res were significantly different between the two groups. In univariate analysis, a strong negative correlation was seen between GLAs-res and BNP (r = −0.567, p < 0.001) as well as between GLAs-res and DT (r = −0.665, p < 0.001), while a moderate negative correlation was found between GLAs-res and LVMI (r = −0.458, p < 0.001) and GLAs-res and LAVI (r = −0.316, p = 0.004). In logistic regression analysis, GLAs-res (p = 0.049, OR = 0.71, 95?% CI = 0.451–0.99), BNP (p = 0.025, OR = 1.08, 95?% CI = 1.01–1.14), and LAVI (p = 0.042, OR = 1.59, 95?% CI = 1.02–2.48) were found to be independent predictors of HFpEF. Conclusion: LA function as assessed by 2D-STE is impaired in patients with HFpEF. A GLAs-res value of < 17.5?% can be useful for the diagnosis of HFpEF. © 2016 Springer Medizin Verlag Source


Anil A.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Oguz K.,Istanbul University | Diyar K.,Ordu Government Hospital | Elnur A.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | And 6 more authors.
Experimental and Clinical Cardiology | Year: 2014

Background: Osteopontin (OPN) has been found to be elevated in patients with heart failure (HF). The relationship between OPN and severity of HF has not been widely studied. The aim of this study was to assess correlation of plasma OPN level as a cardiac remodelling biomarker with echocardiographical parameters in patients with idiopathic dilated cardiomyopathy (DCM). Method and results: 62 patients who have idiopathic DCM were included prospectively. Plasma OPN level was determined with a commercially available human OPN enzyme immunoassay (EIA) kit according to its protocol. Echocardiographical parameters were measured according to guidelines. There was no correlation between plasma OPN levels and echocardiographical parameters, NYHA functional capacity, and BNP. Mean plasma OPN level was slightly higher in moderate to severe HF group (NYHA III-IV, n=21) than mild HF group (NYHA I-II, n=41) but it was not statistically significant (6.47±1.92 vs 6.55±2.09, p:0.935). In addition, plasma OPN levels did not show significant difference between idiopathic DCM patients with restrictive pattern and non-restrictive pattern (5.9±1.6 vs 6.72±2.05, p:0.130). Conclusion: We could not find any relation between plasma OPN levels and severity of heart failure in patients with idiopathic DCM. Source


Emiroglu M.Y.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Esen O.B.,Memorial Hospital | Bulut M.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Karapinar H.,Van Cardiovascular Research and Training Hospital | And 7 more authors.
Acta Diabetologica | Year: 2013

Elevated gamma-glutamyltransferase (GGT) level is independently correlated with conditions associated with increased atherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure and myocardial infarction. It is demonstrated that serum GGT activity is an independent risk factor for myocardial infarction and cardiac death in patients with coronary artery disease. Diabetes is also a well-known cardiovascular risk factor and an equivalent of coronary artery disease. Although the relationship between GGT and coronary artery disease has been reported, there are limited data exploring the changes of GGT in acute coronary syndromes, especially in patients with diabetes. So, this study aimed to determine changes in GGT level in diabetic and non-diabetic acute coronary syndromes. This trial was carried out at Kosuyolu Cardiovascular Training and Research Hospital and Van Yuksek Ihtisas Hospital, Turkey. A total of 219 patients (177 men and 42 women) presenting with acute coronary syndrome) and 51 control subjects between September 2007 and September 2008 were included in the study. Serum γ-glutamyltransferase and serum lipoprotein levels were determined. The resuls indicated that serum GGT levels were higher in acute coronary syndrome patients compared with control. In subgroup analyses, there was no difference between diabetic and non-diabetic subgroups. There was also weak correlation between GGT and blood glucose levels. There was no correlation between GGT and serum lipoprotein levels. In conclusion, serum GGT levels were higher in acute coronary syndrome patients. In subgroup analyses, There was no difference between diabetic and non diabetic subgroup. © 2010 Springer-Verlag. Source


Karapinar H.,Cumhuriyet University | Kaya Z.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Acar G.,Kartal Kosuyolu Cardiovascular Research and Training Hospital | Esen O.,Istanbul Memorial Hospital | And 6 more authors.
Postepy w Kardiologii Interwencyjnej | Year: 2012

Background: There are limited data that examine the assessment of subsegmental branches of the pulmonary artery by intravascular ultrasound (IVUS). Aim: To assess the structural characteristics of pulmonary arteries by IVUS in the setting of severe mitral stenosis. Material and methods: Twenty-one consecutive patients (3 men and 18 women; mean age: 38 ±11 years) who were selected for percutaneous mitral balloon valvuloplasty entered the study. Subsegmental branches of the right lower lobe pulmonary artery were imaged by 40 MHz IVUS when the patients underwent right heart catheterization. Minimal lumen diameter (MLD), external elastic membrane diameter (EEMD), lumen area (LA), and area circumscribed by the external elastic membrane (the total vessel area - TVA) were measured. From these measurements, wall area (WA = TVA - LA), intima-media wall thickness [IMT = (EEMD - MLD)/2], relative wall thickness (RWT = IMT/EEMD), and relative wall area (RWA = WA/TVA) were derived. Results: We were able to perform the IVUS examination in all patients without complications. Several IVUS anatomic indexes correlated with hemodynamic data. Pulmonary artery IMT, RWT, and RWA correlated significantly with pulmonary artery systolic pressure (r = 0.763, p = 0.002; r = 0.698, p = 0.001; r = 0.717, p = 0.006, respectively). However, there was no significant correlation between ultrasound measurements and echocardiographic parameters of the mitral valve. Conclusions: The subsegmental branches of the pulmonary artery can be assessed by IVUS. Patients with pulmonary hypertension in the setting of mitral stenosis have greater pulmonary arterial WT. The severity of WT is correlated with pulmonary artery pressure, but it is not associated with mitral valve area. Intravascular ultrasound may provide useful additional information in the management of patients with mitral stenosis. Source

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