Publications by authors named "Hakan Tas"

34 Publications

A 26-Year-Old Woman with Worsening Dyspnea: Look Closer, Think Critically.

J Cardiovasc Echogr 2020 Apr-Jun;30(2):116-118. Epub 2020 Aug 17.

Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

Pulmonary hypertension due to congenital heart disease continues to be a diagnostic challenge despite modern diagnostic modalities. Herein, we report a 26-year-old woman with an incidentally documented patent ductus arteriosus and Eisenmenger syndrome. She presented with progressive dyspnea and exercise intolerance which was initially attributed to pulmonary embolus. She was started on macitentan and tadalafil therapy aiming to reduce the pulmonary vascular resistance with consideration for heart-lung transplantation should any further deterioration occur.
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http://dx.doi.org/10.4103/jcecho.jcecho_24_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7706375PMC
August 2020

Percutaneous Coronary Intervention in A Rare Case of Single Coronary Ostium Presented with ST Elevation Myocardial Infarction.

Eurasian J Med 2019 Oct 19;51(3):307-309. Epub 2019 Aug 19.

Department of Cardiology, Ataturk University School of Medicine, Erzurum, Turkey.

Anomalous aortic origin of the left coronary artery (AAOLCA) from the right sinus of Valsalva is a very rare coronary anomaly that can lead to sudden cardiac death (SCD), usually during or after strenuous exercise. The anatomical variation can follow five different courses: interarterial, subpulmonic (intraconal or intraseptal), prepulmonic, retroaortic, or retrocardiac. The interarterial variation is the pattern that has a stronger relationship with SCD. In patients with AAOLCA, ST-segment elevation myocardial infarction (STEMI) is a rare clinical presentation, and the management of an anomalous infarct-related coronary artery may be technically challenging. We report a case of a patient with an AAOLCA who presented with inferior STEMI and who underwent a successful percutaneous coronary intervention of the right coronary artery.
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http://dx.doi.org/10.5152/eurasianjmed.2019.18436DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812917PMC
October 2019

Spontaneous Early Resolution of an Iatrogenic Type A Aortic Dissection Following Coronary Angiography.

Aorta (Stamford) 2018 Dec 24;6(6):142-144. Epub 2019 Apr 24.

Department of Anesthesiology, Erzurum Regional Training and Research Hospital, Erzurum, Turkey.

A 74-year-old man was admitted with the diagnosis of non-ST-elevation myocardial infarction. During right coronary angiography, a coronary artery dissection extending into the proximal ascending aorta was noticed without hemodynamic compromise. Immediate computed tomography angiography showed no evidence of dissection in the ascending aorta. The patient remained hemodynamically stable with medical therapy alone. This case report highlights the importance of medical therapy in patients with uncomplicated iatrogenic aortic dissection.
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http://dx.doi.org/10.1055/s-0039-1683956DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6482026PMC
December 2018

Wandering Thrombi in the Right Atrium: A Fatal Journey From the Heart to Lungs.

CASE (Phila) 2019 Feb 25;3(1):11-13. Epub 2018 Oct 25.

Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

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http://dx.doi.org/10.1016/j.case.2018.09.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382951PMC
February 2019

Acute cardiac effects of high dose steroid treatment: A speckle tracking echocardiography study.

J Clin Ultrasound 2019 Jul 20;47(6):351-355. Epub 2019 Feb 20.

Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

Purpose: High-dose steroid therapy (HDST) has frequent side-effects that appear at its cessation and depend on its dose. However, there is a lack of studies about the acute effects of HDST on cardiac function in adult patients.

Methods: We included in this study 30 patients who underwent HDST (intravenously at doses ranging from 250 to 1000 mg) and 30 healthy control subjects with similar demographic and clinical characteristics, between September and December 2016. Echocardiographic measurements were made before and during the first 3 hours after the end of treatment, and results were compared between patients and controls.

Results: There was no difference in baseline biochemical and echocardiographic characteristics between the patient and control groups. While left ventricular global longitudinal strain (LVGLS) and strain rate E were higher after treatment, no significant change was observed in conventional echocardiographic variables.

Conclusions: LVGLS, but not conventional echocardiographic variables, showed an increase in cardiac systolic function at the acute phase of HDST.
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http://dx.doi.org/10.1002/jcu.22716DOI Listing
July 2019

Successful Management of an Iatrogenic Left Main Coronary Artery Occlusion during Coronary Angiography: A Case Report and Brief Review.

Cardiovasc Revasc Med 2019 05 22;20(5):432-435. Epub 2018 Jul 22.

Ataturk University Faculty of Medicine, Department of Cardiology, Erzurum 25100, Turkey.

Abrupt left main coronary artery (LMCA) closure during diagnostic coronary angiography is a rare but catastrophic event with a poor prognosis. Emergency reperfusion of the LMCA with hemodynamic support should be the primary goal in patients with acute LMCA occlusion. Emergency coronary artery bypass graft surgery may be effective but time-consuming, and carries the risk of extensive and irreversible myocardial damage. We describe a case of abrupt closure of the LMCA due to plaque rupture by a diagnostic angiographic catheter without visible dissection following coronary angiography that was successfully treated with bail-out stenting during cardiopulmonary resuscitation.
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http://dx.doi.org/10.1016/j.carrev.2018.07.007DOI Listing
May 2019

A sad story of a man with two ventricles.

Anatol J Cardiol 2018 Jan;19(1):78

Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5864795PMC
http://dx.doi.org/10.14744/AnatolJCardiol.2017.8207DOI Listing
January 2018

A challenging case of occlusion of the right femoral and right common iliac arteries: diagnostic intervention does not always innocent.

Anatol J Cardiol 2016 12;16(12):990-994

Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5324922PMC
http://dx.doi.org/10.14744/AnatolJCardiol.2016.7500DOI Listing
December 2016

Successful retrieval of an embolized port A catheter using loop snare technique.

Int J Cardiol 2016 Nov 4;222:730-731. Epub 2016 Aug 4.

Ataturk University Faculty of Medicine, Department of Cardiology, Erzurum 25100, Turkey.

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http://dx.doi.org/10.1016/j.ijcard.2016.08.012DOI Listing
November 2016

Comparison of a real-time polymerase chain reaction-based system and Erlich-Ziehl-Neelsen method with culture in the identification of Mycobacterium tuberculosis.

Turk J Med Sci 2016 Jan 5;46(1):203-6. Epub 2016 Jan 5.

Department of Medical Microbiology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey.

Basckground/aim: Mycobacterium tuberculosis is still a major health problem throughout the world, especially in developing countries. Disease control heavily depends on the establishment of early diagnosis. The aim of this study is to compare the efficacy of culture, GeneXpert MTB/RIF device, and Erlich-Ziehl-Neelsen direct microscopic method.

Materials And Methods: A total of 927 samples (243 respiratory and 684 nonrespiratory), which were sent to Ondokuz Mayıs University Medical Faculty Tuberculosis Laboratory on suspicion of M. tuberculosis, were included in the study.

Results: When compared to standard culture, sensitivity, specificity, and positive and negative predictive values of the GeneXpert system for respiratory samples were 100%, 98.7%, 87%, and 100%, respectively; these values for nonrespiratory samples were 71%, 98.6%, 71%, and 98.6%, respectively.

Conclusion: New, reliable, rapid, and easy-to-use methods that display high specificity and sensitivity are required for an effective struggle against tuberculosis. According to these results, we suggest that GeneXpert MTB/RIF is a rapid and reliable system, and when used in company with conventional tests, it would make significant contributions to the diagnosis of tuberculosis.
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http://dx.doi.org/10.3906/sag-1411-34DOI Listing
January 2016

Trial design, statins, atrial fibrillation, and prevention: four horsemen of the apocalypse.

Anatol J Cardiol 2015 Apr;15(4):341

Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey.

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http://dx.doi.org/10.5152/akd.2015.6193DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5336848PMC
April 2015

Comparison of LMWH versus UFH for hemorrhage and hospital mortality in the treatment of acute massive pulmonary thromboembolism after thrombolytic treatment : randomized controlled parallel group study.

Lung 2015 Feb 29;193(1):121-7. Epub 2014 Oct 29.

Department of Pulmonary Diseases, Ataturk University School of Medicine, 25240, Erzurum, Turkey,

Purpose: Current guidelines recommend the use of low molecular weight heparin (LMWH) for most haemodynamically stable patients with pulmonary thromboembolism (PTE), however, it is not clear whether LMWH is preferable to unfractionated heparin (UFH) for the treatment of massive PTE. We aimed to compare the use of LMWH versus UFH after thrombolytic treatment in the management of acute massive PTE for hemorrhage and hospital mortality.

Methods: The study, a randomized, single center, parallel design trial, included the patients who had confirmed the diagnosis of massive PTE according to clinical findings and computerized thorax angiography and no contraindication to the treatment between January 2011 and October 2013. After thrombolytic treatment, the patients assigned to therapy with LMWH or UFH. Any hemorrhage, major hemorrhage, and hospital mortality were assessed.

Results: A total of 121 patients, 71 female (58.7 %) and 50 male (41.3 %), who had massive PTE with an average age 62.6 ± 15.7 (ranges 22-87) were included for analyses in the study. They were allocated to either LMWH (n = 60) or UFH (n = 61) group. Although the occurrence of any adverse event (21.7 vs 27.9 %) and each individual type of adverse event were all lower in the LMWH group compared to UFH group (6.7 vs 11.5 %, 3.3 vs 9.8 %, and 15.0 vs 19.7 % for death, major hemorrhage, and any hemorrhage, respectively), the differences were not statistically significant.

Conclusions: Our findings suggest that LMWH might be a better option in the management of the patients with massive PTE. Multi-center larger randomized controlled trials are required to confirm our results.
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http://dx.doi.org/10.1007/s00408-014-9660-zDOI Listing
February 2015

Acute effect of primary percutaneous coronary intervention on left ventricular dyssynchrony in ST-segment elevation myocardial infarction.

Anadolu Kardiyol Derg 2014 Nov 8;14(7):591-8. Epub 2014 Apr 8.

Department of Cardiology, Faculty of Medicine, Atatürk University; Erzurum-Turkey.

Objective: The aim of this study was to prospectively evaluate the effect of percutaneous coronary intervention in the acute period on left ventricular dyssynchrony in ST-segment elevation myocardial infarction patients by using Tissue Synchronization Imaging.

Methods: Forty-four ST-segment elevation myocardial infarction (MI) patients (29 male, 15 female), who were admitted within the first 12 hours of chest pain symptoms, were enrolled in the study. According to the localization of MI, the patients were divided into groups as anterior MI (n=26) and inferior MI (n=18). All echocardiography measurements were taken just before percutaneous coronary intervention (PCI) and following PCI at a mean of 3-6 days. They were assessed according to the time to reach the peak systolic velocity, which was calculated by the tissue synchronization imaging method from four pairs of non-apical alternate segments. The difference between the duration to reach the peak systolic velocity in alternate segments was regarded as left ventricle dyssynchrony and the results were compared.

Results: In the anterior MI group, basal anterior (p<0.01), mid-anterior segment (p<0.01) and basal septal segment (p<0.01); in the inferior MI group, the basal septal segment (p=0.02), mid-septal segment (p=0.02), and basal and mid-inferior segment (p<0.01) values were significantly lower in the post-PCI measurements when compared to the measurements taken prior to PCI. In both groups, the intraventricular dyssynchrony indices of the basal anterior-basal inferior (p<0.01), mid-anterior-mid-inferior (p<0.01) segments were found to be significantly lower in the post-PCI period when compared to the pre-PCI period.

Conclusion: It was found that percutaneous coronary intervention in patients with ST-elevation significantly decreases the degree of LV dyssynchrony in the acute period.
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http://dx.doi.org/10.5152/akd.2014.5007DOI Listing
November 2014

Author's reply: To PMID 23395706.

Anadolu Kardiyol Derg 2014 Mar;14(2):212-3

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March 2014

Cor triatriatum dexter, atrial septal defects, and pulmonary stenosis-a rare association.

Echocardiography 2014 Apr 22;31(4):E124-7. Epub 2014 Jan 22.

Faculty of Medicine, Department of Cardiology, Ataturk University, Erzurum, Turkey.

Cor triatriatum dexter (CTD) is an extremely rare congenital anomaly in which the right atrium is divided into 2 chambers by a membrane. The estimated incidence of cor triatriatum has been reported as 0.1% of congenital cardiac malformations. The septation of the right atrium in the setting of CTD is the result of failed resorption of the right valve of the sinus venosus. This results in anterolateral and posteromedial portions of the divided right atrium. CTD can be diagnosed at any age, especially if it is incidentally discovered.
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http://dx.doi.org/10.1111/echo.12516DOI Listing
April 2014

Infraannular dislocation and its successful management: A rare complication following TAVI.

J Cardiol Cases 2014 Apr 18;9(4):148-150. Epub 2014 Jan 18.

Ataturk University, Faculty of Medicine, Department of Cardiology, Erzurum 25100, Turkey.

Transcatheter aortic valve implantation has been increasingly used in symptomatic patients with severe aortic stenosis who are inoperable or at high risk. However it remains associated with the potential for serious complications. We report a case in which an Edwards Sapien (Edwards, Irvine, CA, USA) valve prosthesis dislocated to the left ventricular outflow tract with hemodynamic collapse 6 h following implantation. < Transcatheter aortic valve implantation (TAVI) is an alternative method to surgical aortic valve replacement in patients with severe aortic stenosis and high surgical risk. Despite continuous improvements in operators' expertise and device technology, it remains associated with the potential for serious complications such as valve dislocation. Dislocation after TAVI is a life-threatening complication that requires immediate diagnosis and treatment.>.
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http://dx.doi.org/10.1016/j.jccase.2013.12.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6281737PMC
April 2014

Author's reply: To PMID 23395706.

Anadolu Kardiyol Derg 2013 Sep;13(6):614

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September 2013

The incidence and severity of pulmonary hypertension in obstructive sleep apnea with hypothyroidism.

Med Sci Monit 2013 Oct 23;19:883-7. Epub 2013 Oct 23.

Department of Pulmonary Diseases, Ataturk University School of Medicine, Erzurum, Turkey.

Background: Hypothyroidism and obstructive sleep apnea (OSA) are both common health problems and can be seen together. Each of these 2 diseases can cause pulmonary hypertension (PH). We aimed to determine whether hypothyroidism with OSA has a significant effect on the frequency and severity of PH.

Material And Methods: A total of 236 patients were included in the study. Patients were divided into 3 groups: Group I, Obstructive Sleep Apnea (n=149); Group II, Hypothyroidism (n=56); and Group III, Obstructive Sleep Apnea-Hypothyroidism (n=31). All patients underwent polysomnography and echocardiography and serum levels of thyroid-stimulating hormone (TSH) and free thyroxine 4 (FT4) were analyzed.

Results: There were 167 male and 69 female participants, and the mean age was 47.8 ± 11.5 (Group I: 81.9% male, 18.1% female; Group II: 44.6% male, 55.4% female; Group III: 64.6% male, 35.4% female). Distribution of mean pulmonary arterial pressure on echocardiography was statistically different among the 3 groups (x(2)=14.99, p=0.006). When adjusted according to the apnea-hypopnea index (AHI), age, and body mass index (BMI), a significant relation with PH was determined (p=0.002).

Conclusions: The combination of hypothyroidism with OSA is associated with an increased frequency and severity of PH. When PH is found out of line with the severity of OSA, thyroid dysfunction should be investigated.
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http://dx.doi.org/10.12659/MSM.889619DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3808256PMC
October 2013

Comparison of carotid artery stenting and carotid endarterectomy in patients with symptomatic carotid artery stenosis: a single center study.

Adv Ther 2013 Sep 9;30(9):845-53. Epub 2013 Oct 9.

Department of Cardiology, Faculty of Medicine, Atatürk University, 25240, Erzurum, Turkey,

Introduction: Carotid artery stenting (CAS) is believed to be an alternative to carotid endarterectomy (CEA); however, recent studies have demonstrated an increase of complications with stenting that does not reflect our experience. We thus wanted to compare the periprocedural and 1-year follow-up outcomes of CAS with those of CEA among patients with symptomatic extracranial carotid stenosis in a population from eastern Turkey.

Methods: The hospital records of all patients who underwent carotid artery revascularization were retrospectively reviewed. Patients were divided into two groups based on the type of carotid revascularization performed, namely CEA or CAS. Comparisons were made with respect to 30-day and 1-year outcomes of transient ischemic attack (TIA), myocardial infarction (MI), stroke, and all-cause death rates. Composite endpoints for both groups were also analyzed.

Results: Thirty-two CEA and 33 CAS procedures were performed for symptomatic occlusive carotid disease. Baseline characteristics were similar between both groups except for the incidence of diabetes mellitus. No significant differences were found with respect to 30-day mortality, MI, and neurologic morbidity endpoints for CEA and CAS procedures. In the postprocedural 1-year follow-up, only TIA was observed to be significantly higher in the CAS group; the other endpoints did not differ significantly. One-year composite endpoints did not differ between both groups (log-rank P = 0.300).

Conclusion: In our trial of patients with symptomatic carotid artery stenosis, no significant difference could be shown in periprocedural outcomes, postprocedural outcomes except TIA, and in composite endpoints between the CEA and CAS groups. CAS is a safe and efficacious alternative for the treatment of symptomatic carotid artery stenosis.
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http://dx.doi.org/10.1007/s12325-013-0058-8DOI Listing
September 2013

Effects of radiofrequency ablation on levels of cardiac biochemical markers in patients with atrioventricular nodal re-entry tachycardia.

Anadolu Kardiyol Derg 2013 Nov 26;13(7):705-7. Epub 2013 Sep 26.

Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum-Turkey.

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http://dx.doi.org/10.5152/akd.2013.229DOI Listing
November 2013

Effects of tirofiban maintenance duration on myocardial perfusion defect severity in anterior myocardial infarction.

Adv Ther 2013 Sep 21;30(9):834-44. Epub 2013 Sep 21.

Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey,

Introduction: Percutaneous coronary intervention (PCI) does not often produce optimal results, despite restoration of coronary blood flow at myocardial recovery, because of impaired microvascular perfusion. This study aimed to investigate and evaluate with (99m)Tc-sestamibi scan whether the results of PCI can be changed by maintenance infusion of tirofiban for 24 or 48 h in patients presenting with anterior ST-elevation myocardial infarction (STEMI).

Methods: The study included 84 patients with anterior STEMI who were candidates for primary PCI and whose occlusion was in the proximal or mid-left anterior descending artery. Patients were given 25 μg/kg/3 min tirofiban and randomized to receive maintenance infusion at 0.15 μg/kg/min for 24 or 48 h. A resting (99m)Tc sestamibi scan was performed on the 5th day post-procedure before discharge. The primary efficacy endpoint was a patient's score on a 5-point scoring system for perfusion defect severity. Major adverse cardiac events (MACE) were defined as death from any cause, re-infarction, and clinically driven target-vessel revascularization within the first 6 months.

Results: Baseline characteristics of the patients were similar in the two infusion groups (n = 42 per group). There was no significant difference in the symptom onset-to-presentation time or door-to-balloon time between the two groups. With the exception of basal anteroseptal and basal anterior segments, significant reductions were obtained on the 5-point scoring system for perfusion defect severity in segments and in the summed rest scores. No significant differences were observed between the two groups in the incidence of MACE at 6 months. The safety profile did not differ between 24 and 48 h infusions of tirofiban.

Conclusion: The use of tirofiban, when administered at a high bolus dose and maintained for 48 h, was safe and significantly reduced perfusion defect severity in patients with anterior STEMI presenting early after symptom onset and undergoing primary PCI.
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http://dx.doi.org/10.1007/s12325-013-0055-yDOI Listing
September 2013

Can statins alter coronary plaque morphology assessed by intravascular ultrasound?

Angiology 2014 Jul 9;65(6):551. Epub 2013 Sep 9.

Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

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http://dx.doi.org/10.1177/0003319713502721DOI Listing
July 2014

Mean platelet volume and acute coronary syndrome.

Angiology 2014 Feb 8;65(2):170. Epub 2013 Aug 8.

1Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

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http://dx.doi.org/10.1177/0003319713498813DOI Listing
February 2014

Uric acid levels and atrial fibrillation.

Angiology 2014 Feb 9;65(2):168. Epub 2013 Jul 9.

1 Department of Cardiology, Ataturk University Faculty of Medicine, Erzurum, Turkey.

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http://dx.doi.org/10.1177/0003319713494464DOI Listing
February 2014

Giant right coronary artery (RCA) aneurysm.

Heart Surg Forum 2013 Jun;16(3):E167-9

Department of Cardiovascular Surgery, Atatürk University, 25100 Erzurum, Turkey.

Coronary artery aneurysm (CAA) is a rare type of coronary artery disease. The angiographic incidence of the coronary artery aneurysm is reportedly between 1.5% to 4.9%, and it is more frequent in men. We have successfully carried out a simultaneous "coronary bypass together with aneurysm ligation" operation on a patient with coronary heart disease and an aneurysm within the right coronary artery.
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http://dx.doi.org/10.1532/HSF98.20121133DOI Listing
June 2013

Speckle tracking echocardiographic analysis of left ventricular systolic and diastolic functions of young elite athletes with eccentric and concentric type of cardiac remodeling.

Echocardiography 2013 Nov 25;30(10):1202-8. Epub 2013 Jun 25.

Department of Cardiology, Ataturk University, Erzurum, Turkey.

Aims: In individuals who exercise regularly and for extended periods of time, some structural alterations in the heart, called the athlete's heart, develop in time. These alterations vary in type, can be eccentric or concentric, depending on the nature of exercise. Speckle tracking echocardiography (STE) is a novel, angle-independent method that accurately and reliably measures systolic and diastolic functions of the left ventricle (LV) with considerably lower inter-operator variability.

Methods And Results: Twenty-two marathon runners, 24 wrestlers, and 20 healthy sedentary individuals were included in the study. The average age of subjects is 17.5 ± 2.2 in marathon runners, 16.8 ± 1.9 in wrestlers, and 16.4 ± 1.8 in control group. The parameters of LV longitudinal strain (S), LV longitudinal strain rate systolic (SRS), LV longitudinal strain rate diastolic early filling (SRE), and longitudinal strain rate diastolic late filling (SRA) were evaluated by apical two-, three-, and four-chamber grayscale imaging using the global longitudinal strain (GLS) and GLS rate (GLSR). Conventional echocardiographic parameters demonstrated increased LV diameters and wall thickness in the marathon runners and increased wall thickness without increased LV diameters in the wrestlers. Systolic and diastolic functions were comparable between the marathon runners and wrestlers with conventional echocardiography. Analysis with STE, however, yielded higher systolic strain and strain rates in the athletes. Normalized GLS parameters and end-diastolic volume (EDV) were shown to be correlated.

Conclusion: Overall, conventional echocardiography can detect some differences between young athletes with eccentric and concentric type of athlete's heart but it is incapable of revealing differences in intrinsic myocardial functions. However, analysis using STE demonstrated increased systolic functions in athletes commensurate with increased load, with unaltered diastolic functions.
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http://dx.doi.org/10.1111/echo.12263DOI Listing
November 2013

Speckle-tracking echocardiographic imaging of the right ventricular systolic and diastolic parameters in chronic exercise.

Int J Cardiovasc Imaging 2013 Aug 12;29(6):1265-71. Epub 2013 Mar 12.

Department of Cardiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey.

Morphology and functions of the right ventricle (RV) show differences in the athletes based on whether exercising acutely or chronically. Temporary RV dysfunction occurs during acute exercise. However, RV functions during chronic exercise are speculative. In the present study, we aimed to evaluate RV functions of long-distance runners, who perform chronic exercise, by both conventional and speckle-tracking echocardiography. In this study, we examined 44 long-distance runner and 30 sedentary subjects. RV longitudinal strain (LS), RV systolic longitudinal strain rate (LSRs), RV early diastolic longitudinal strain rate and late diastolic longitudinal strain rate parameters were evaluated by apical 4-chamber gray-scale imaging through the septum and free wall of RV in accordance with automated function imaging protocol. It was observed on the conventional echocardiographic parameters of longdistance runners that RA and RVED diameter have been increased (p = 0.028; p = 0.003 respectively), whereas systolic right ventricle fractional area change and tricuspid annular plane systolic excursion values were similar to those of sedentary subjects (p = 0.65; p = 0.75 respectively). LS and systolic and diastolic strain rate functions were also similar. Morphological adaptation, but not functional change, occurs in the athletes performing chronic exercise.
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http://dx.doi.org/10.1007/s10554-013-0204-zDOI Listing
August 2013

Evaluation of right ventricular functions in patients with nasal polyposis: an observational study.

Anadolu Kardiyol Derg 2013 May 6;13(3):251-6. Epub 2013 Feb 6.

Clinic of Ear, Nose and Throat, Erzurum Region Education and Research Hospital, Erzurum, Turkey.

Objective: The aim of this study was to assess the right ventricular functions in patients with nasal polyposis using the strain (S) and strain rate (SR) echocardiography.

Methods: A prospective, cross-sectional observational study was performed. The study included 40 patients with nasal polyposis (NP) (Group 1), and 25 healthy controls (Group 2). The study comprised patients with Stage 2 and Stage 3 nasal obstruction and no symptoms that could be associated with right ventricular heart failure. Longitudinal peak systolic strain (PSS) and peak systolic strain rate (PSSR) were measured from the basal-mid and apical segments of the right ventricle free wall. Student's t-test, Pearson's correlation analysis and Bland-Altman test were used for statistical analysis.

Results: Pulmonary arterial systolic pressure was significantly higher in group 1 than group 2 (31.2 ± 5.8, 19.7 ± 4.3, respectively, p<0.001). PSS and PSSR values at the basal, mid and apical segments of the right ventricular lateral wall of the group I were significantly lower compared to the control group (p<0.001, p=0.002 and p=0.002 for PSS, p=0.003, p<0.001 and p<0.001 for PSSR, respectively). The comparison of Stage 2 and Stage 3 NP patients revealed a significant difference only in the SR measurement of the right ventricular mid segment (p=0.002). There was a significant correlation between the systolic pulmonary arterial pressure (sPAP) and right ventricular S and SR values (p<0.001).

Conclusion: In this study, S/SR echocardiography showed a subclinical deficit of the right ventricular longitudinal functions in patients with NP who are considered to have normal right ventricular functions.
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http://dx.doi.org/10.5152/akd.2013.072DOI Listing
May 2013

Efficacy of ivabradin to reduce heart rate prior to coronary CT angiography: comparison with beta-blocker.

Diagn Interv Radiol 2012 Nov-Dec;18(6):537-41. Epub 2012 Jun 22.

Department of Radiology, Atatürk University School of Medicine, Erzurum, Turkey.

Purpose: The objective of our study was to assess the effect of ivabradine on image quality of ECG-gated multidetector computed tomography (MDCT) coronary angiography.

Materials And Methods: Computed tomography coronary angiography (CTCA) was performed on two groups. In Group 1 (n=54), an intravenous beta-blocker was administered to patients with a heart rate >70 beats per minute (bpm) just before CTCA. In Group 2 (n=56), oral ivabradine 5 mg was administered twice a day for three days prior to CTCA examination to patients with a heart rate >70 bpm and contraindication to beta-blockers. Images acquired on two different MDCT scanners were scored in terms of image quality of the coronary artery segments using a 5-point grading scale (Grade 1, unreadable; Grade 5, excellent).

Results: The mean heart rates during CTCA were 64 ± 6.7 bpm for Group 1 and 59 ± 4.1 bpm for Group 2 (P < 0.05). Mean heart rate reduction was 9 ± 5% and 14 ± 8% for Groups 1 and 2, respectively (P < 0.001). A total of 880 segments were evaluated in 110 patients. When the best reconstruction interval was used, 89.8% and 95.5% of all the coronary segments showed acceptable image quality in Groups 1 and 2, respectively. Acceptable image quality of the middle right coronary artery was obtained in 78.3% of Group 1 and 92.4% of Group 2. These ratios for the other segments were 88.4% for Group 1 and 95.2% for Group 2.

Conclusion: Reduction of heart rates with ivabradine premedication improves the image quality of CTCA. It should be considered as an alternative drug, particularly in patients with contraindications to beta-blockers.
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http://dx.doi.org/10.4261/1305-3825.DIR.5981-12.1DOI Listing
November 2013

An intracardiac mobile mass: ruptured left-ventricular false tendon with big vegetation due to Brucella endocarditis.

Anadolu Kardiyol Derg 2010 Dec 10;10(6):557-8. Epub 2010 Nov 10.

Department of Cardiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey.

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http://dx.doi.org/10.5152/akd.2010.172DOI Listing
December 2010