Koşuyolu Heart Journal最新文献

{"title":"Early Impairment of Right Ventricular Functions in Patients with Moderate Asthma and the Role of Isovolumic Acceleration","authors":"B. Karasu, H. Ayhan","doi":"10.51645/khj.2022.m207","DOIUrl":"https://doi.org/10.51645/khj.2022.m207","url":null,"abstract":"Introduction: Asthma is a common chronic lung disease that affects people all over the world. Pulmonary hypertension and right ventricular (RV) dysfunction are possible complications that may develop in the advanced stages of asthma. However, the number of studies investigating asthma and its implications on new RV parameters are very rare. This study aims to evaluate the RV functions in patients with moderate asthma before the development of pulmonary hypertension.\u0000 Patients and Methods: Forty-one patients with moderate asthma and 40 healthy individuals were enrolled in this case-control study. All participants underwent a detailed two-dimensional echocardiographic examination. RV functions were measured through RV isovolumic acceleration (IVA) index in addition to conventional parameters. RV IVA, a tissue doppler derived parameter, was calculated as the ratio between maximum isovolumic myocardial velocity during isovolumic contraction and the time interval from the onset of this wave to the time at its maximum velocity.\u0000 Results: There were no significant differences between the two groups in terms of baseline clinical characteristics, laboratory findings and echocardiographic parameters measuring left ventricular functions (p> 0.05). In asthmatic patients, RV isovolumic relaxation time and RV myocardial performance index were higher (p= 0.027 and p<0.001 respectively), while RV fractional area change, tricuspid annular plane systolic excursion (TAPSE) and RV IVA values were all lower (p<0.001). RV IVA was found to be inversely proportional to asthma duration. TAPSE [β= 0.632, 95% CI= (0.121) - (0.225), p<0.001] and pulmonary artery systolic pressure [β= -0.188, 95% CI= (-0.057) - (-0.003), p= 0.032] were shown as independent predictors of RV IVA.\u0000 Conclusion: Asthma is an important disease that may result in subclinical RV dysfunction even before the development of pulmonary hypertension. RV IVA, an easily obtained and load-independent parameter, may be a useful and reliable index that sensitively analyzes subtle deteriorations in the contractile function of RV in asthmatic patients. RV IVA may also correlate with asthma duration.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"243 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132925822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Correction of Transposition of the Great Arteries","authors":"Berra Zümrüt Tan Recep, A. Tongut, A. Hatemi, E. Tunçer, A. A. Yılmaz, H. Ceyran","doi":"10.51645/khj.2022.m255","DOIUrl":"https://doi.org/10.51645/khj.2022.m255","url":null,"abstract":"Introduction: Surgical correction of transposition of the great arteries (TGA) is usually performed in the first week of life. There is no consensus on surgical intervention for patients with a late diagnosis. Our study was designed to evaluate the early results of patients who underwent late-term correction based on surgical techniques.\u0000 Patients and Methods: Our study included patients older than a month, who were operated on due to TGA between 2014 and 2019. Data on the postoperative hospital mortality and morbidity of these patients were examined.\u0000 Results: The study enrolled 11 patients. Arterial switch operation (ASO) was performed in 36.3% (n= 4) of the patients, while an atrial switch operation was performed in 63.7%. After left ventricular (LV) training, ASO was performed in 25% (n= 1) of the patients. Extracorporeal membrane oxygenation (ECMO) support requirement was present in 36.4% (n= 4) of the patients due to postoperative low cardiac output. The mortality rate was 27.3% (n= 3). Of these deaths, 33.3% occurred among patients who had undergone Senning operations, while 66.7% occurred among those who underwent ASO (n= 1). While 66.7% (n= 2) of the mortality was due to low cardiac output, 33.4% was due to sepsis (n= 1).\u0000 Conclusion: There is still no absolute consensus on the timing of surgical intervention in cases of TGA. ASO can be performed in cases with an increased need for ECMO and acceptable mortality among patients over one month of age. For patients with LV regression, two-stage ASO and atrial switch operations are alternative options.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122633388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Effects of Melatonin and Its Supplements on the Arterial Mechanics","authors":"M. Yıldız, B. Şahin Yıldız","doi":"10.51645/khj.2022.m291","DOIUrl":"https://doi.org/10.51645/khj.2022.m291","url":null,"abstract":"Melatonin (5-methoxy-N-acetyltryptamine), a neurohormone, is synthesized from tryptophan taken up by the pineal gland cells. It affects several cardiovascular functions such as arterial blood pressure, heart rate, cardiac rhythms, and mechanical properties of the large arteries and aorta. Melatonin and its supplements, generally made in a laboratory, can improve several cardiovascular functions such as arterial blood pressure and arterial mechanics.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126916323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Aortic Angulation on Outcomes in Transcatheter Aortic Valve Implantation with the Self-Expanding Portico Valve","authors":"S. Aslan, A. Türkvatan, A. Güner, S. Kahraman, Ümit Bulut, Gokhan Demirci, Enes Arslan, Özge Çelik, M. Ertürk","doi":"10.51645/khj.2022.m244","DOIUrl":"https://doi.org/10.51645/khj.2022.m244","url":null,"abstract":"Introduction: Aortic angulation (AA), defined as the angle between the aortic annulus plane and the horizontal plane, may result in failed prosthesis positioning. The effect of AA on the procedural and short-term outcomes with the portico valves for transcatheter aortic valve implantation (TAVI) has not been fully investigated. The present study aimed to evaluate the impact of AA on device success and early outcomes of TAVI using a selfexpanding portico valve.\u0000 Patients and Methods: Preoperative computed tomography scans of 121 consecutive patients treated with the portico valve were analyzed. TAVI device success and outcomes were determined according to VARC-3 definitions. Patients were divided into two groups based on mean AA.\u0000 Results: The mean AA was 48.7 ± 8.9°. There were no differences in technical success (92.2 vs 89.5%, p= 0.604), device success (81.2% vs 77.2%, p= 0.582), and early safety endpoints (68.8% vs 61.4%, p= 0.397) between the AA≤ 48° and AA>48° groups. The frequency and severity of paravalvular aortic regurgitation (PAR) was statistically higher in patients with AA> 48° (p= 0.028). Moreover, an increased AA was also associated with valve malposition (12.3% vs. 1.6%, p= 0.018), prolonged procedure time (85 ± 26 vs. 75 ± 20 minutes, p= 0.028), and greater Δimplantation depth (2.2 ± 0.5 vs. 0.8 ± 0.1 mm; p<0.001).\u0000 Conclusion: Despite comparable device success and early outcomes rates, increased AA is associated with higher rates of PAR and valve malposition, with the self-expanding portico valve.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130243885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Clinical Course of Infective Endocarditis and Independent Predictors of In-Hospital Mortality","authors":"H. Çakır, S. Uysal, A. Karagöz, C. Toprak, L. Öcal, M. Y. Emiroğlu, C. Kaymaz","doi":"10.51645/khj.2022.m259","DOIUrl":"https://doi.org/10.51645/khj.2022.m259","url":null,"abstract":"Introduction: Despite advances in prevention, medical, and surgical treatment, the global prevalence of infective endocarditis (IE) has been gradually rising over the last two decades. However, the profile of IE varies by continent, geographic region, and hospital type. In this study, we aimed to investigate the epidemiological and clinical features of IE and to determine the factors predicting in-hospital mortality.\u0000 Patients and Methods: This retrospective study was carried out at a single tertiary health care hospital in Türkiye. A total of 104 consecutive patients (>18 years old) who were hospitalized with IE between January 2016 and August 2021 were included. Modified Duke criteria were used to diagnose IE. Demographic information (age and gender), underlying heart diseases, comorbidities, causative microorganisms, blood culture results, echocardiographic findings, cardiac and extracardiac complications, surgical requirements, and in-hospital mortality were all examined.\u0000 Results: The study included 104 IE cases (mean age: 57.2 ± 15.9 years; 59.6% males). Fifty-six patients (53.9%) had native valve IE, 37 patients (35.6%) had prosthetic valve IE, and four patients (3.8%) had devicerelated IE. Blood cultures were negative in 62 cases (59.6%). Staphylococcus aureus was the most common responsible microorganism in 17 patients [methicillin-sensitive Staphylococcus aureus in 13 (12.5%), methicillin-resistant Staphylococcus in four (3.8%)]. The overall in-hospital mortality rate was 30.8%. White blood cell count (OR= 1.002, 95% CI= 1.001-1.003) creatinine (OR= 1.45, 95% CI= 1.08-2.00), acute renal failure (OR= 8.60, 95% CI= 2.27-37.81), and cerebrovascular accidents (OR= 4.58, 95% CI= 1.21-18.85) were independent predictors of in-hospital mortality.\u0000 Conclusion: In line with developed countries, the epidemiology and causative pathogens of IE in Türkiye have been changing. Investigating these epidemiological and clinical changes may serve as a basis for strategies to be developed for the prevention and treatment of IE.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134050169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of the Cardiac Autonomic Functions in Patients with Essential Tremor","authors":"H. Yaşar, Mutlu Büyüklü","doi":"10.51645/khj.2022.m247","DOIUrl":"https://doi.org/10.51645/khj.2022.m247","url":null,"abstract":"Introduction: Essential tremor is a neurological disorder that causes involuntary shaking. The aim of this study was to examine cardiac autonomic functions in patients diagnosed with essential tremor, as previous studies have differed in their findings regarding whether cardiac autonomic functions are affected in essential tremor patients.\u0000 Patients and Methods: The study included 32 patients diagnosed with essential tremor and 26 individuals without any diseases as the control group. Consensus criteria were used for the diagnosis of essential tremor. A clinical rating scale was utilized to measure the characteristics and degree of essential tremor. Based on this scale, patients were classified as having a mild, moderate, marked, or severe disability. An exercise treadmill test was performed in both the tremor and control groups. Chronotropic index values were used to evaluate the sympathetic system, and resting heart rate index values were calculated to evaluate the parasympathetic system. Heart rate recovery values were calculated at one, two, three, four, and five minutes after the exercise treadmill test.\u0000 Results: The descriptive characteristics of the tremor and control groups were similar. The Chronotropic index values were statistically different between the tremor and control groups, as they were significantly decreased in the tremor group. This was evaluated as sympathetic incompetence. The resting heart rate index values did not differ significantly between the tremor and control groups at minutes one or two, but they were significantly higher in the tremor group at minutes three, four, and five. The parasympathetic activity was found to be insufficient in the later period.\u0000 Conclusion: The findings suggest that cardiac autonomic functions may be affected in patients with essential tremor.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"89 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117317550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regression of Q Waves and Clinical Outcomes After Primary Percutaneous Coronary Intervention in St Elevation Myocardial Infarction","authors":"Z. Şimşek, S. Kalkan, R. Zehir, E. Alizade","doi":"10.51645/khj.2022.m254","DOIUrl":"https://doi.org/10.51645/khj.2022.m254","url":null,"abstract":"Introduction: Pathological Q waves are correlated with infarct size, and Q wave regression is associated with left ventricular ejection fraction improvement. There are limited data regarding the association between Q wave regression and clinical outcomes. Our main objective was to assess the association of pathological Q wave evolution after reperfusion with clinical outcomes after ST-elevation myocardial infarction (STEMI).\u0000 Patients and Methods: Standard 12-lead electrocardiograms (ECGs) were recorded in 1553 patients, who presented to our hospital with chest pain and underwent primary percutaneous coronary intervention (p-PCI) with the diagnosis of STEMI and were retrospectively analyzed. ECGs were recorded before and 90 min after PCI, as well as at hospitalization discharge and 12 months of follow-up. The study population was divided into three groups as the Q wave regression group, the Q wave persistent group, and the non-Q wave MI group.\u0000 Results: There were 502 (32%) patients with persistent Q waves (PQ group), 509 (33%) patients with Q wave regression (RQ group), and 542 (35%) patients with non-Q wave MI (NQ group). The degree of LVEF was significantly greater in the RQ group and NQ group than in the PQ group [(47.5 ± 10.1 vs. 49.2 ± 9.9) vs. 43.3 ± 10.5 respectively, p<0.01]. One-year mortality was significantly greater in the PQ group compared to the RQ and NQ groups [19 (3.78%) vs. 11 (2.16%) vs. 6 (1.1%) respectively, p<0.01].\u0000 Conclusion: In a population of STEMI patients, persistent Q waves defined according to the classic ECG criteria after reperfusion were associated with high one-year mortality, and low LVEF, while Q wave regression was associated with significantly lower risk of events.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131511166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous Resolution of Lower Extremity Hypoperfusion in Type B Aortic Dissection: A Case Report","authors":"Z. Duman, Muhammed Bayram, B. Timur, Sinem Aydın, K. Memiç Sancar, M. Yıldız","doi":"10.51645/khj.2022.m264","DOIUrl":"https://doi.org/10.51645/khj.2022.m264","url":null,"abstract":"Lower extremity hypoperfusion occurs in 5.7-30% of Stanford type B aortic dissection cases. A 53-year-old male patient presented with type B aortic dissection. His left femoral pulse was not palpable. The proximal left common iliac artery was nearly occluded in computed tomography angiography. There was no extremitythreatening rest pain, but there was intermittent claudication at 100 meters. Cross femoral bypass was planned for the patient under elective conditions. After two months, the left femoral pulse was palpable, and the patient no longer had intermittent claudication. In this study, we report that lower extremity hypoperfusion, which developed after acute type B aortic dissection resolved without open and endovascular surgery.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126504825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Evaluation of the Impact of COVID-19 on Cardiovascular Surgery","authors":"Ş. Menekşe, M. E. Işık, Duygu Sağlam, H. Oğuş, Adile Ece Altınay, A. Polat, M. Kırali","doi":"10.51645/khj.2022.m287","DOIUrl":"https://doi.org/10.51645/khj.2022.m287","url":null,"abstract":"Introduction: We aimed to describe the impact of COVID-19 among the patients who had cardiac surgery, with particular emphasis on pulmonary complications and 30-day mortality.\u0000 Patients and Methods: From March 2020 to June 2021, a total of 2267 patients underwent cardiovascular surgery at Koşuyolu High Specialization Training and Research Hospital.. Patients who tested SARSCoV-2-positive by PCR perioperatively (seven days before or 30 days after surgery), despite testing negative at admission, were included. The primary endpoint of the study was 30-day mortality following surgery. The secondary endpoint was the development of pulmonary complications including acute respiratory distress syndrome (ARDS) or respiratory failure, which were defined according to the Berlin definition, and the need for mechanical ventilation for >48 h after the operation or the need for re-intubation after extubation.\u0000 Results: Eleven patients out of 2267 (0.48%) had a positive PCR test for COVID-19. In the postoperative period, seven patients were diagnosed with COVID-19 in the clinical wards, of whom three patients were readmitted to the ICU. Nine patients had radiological pulmonary involvement. Five patients (45.5%) developed ARDS within four to seven days after a positive PCR test. Eight patients (72.7%) developed respiratory failure and required re-intubation, of whom two could not be extubated. Five patients (45.5%) died within 30 days, and seven (63.6) died during their hospital stay.\u0000 Conclusion: COVID-19 has a severe negative impact on the postoperative course of cardiac surgery patients in terms of cardiovascular outcomes, pulmonary complications, and mortality. Given the dramatic impact of COVID-19 infection on postoperative outcomes, it appears that deferring cardiovascular surgeries may be more suitable if COVID-19 positivity is detected.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"205 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131545064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Correlation Between Right Ventricular Function and Dominance of Right Coronary Artery","authors":"Eyüp Özkan, A. Baktır, E. Demirci, Huseyin Odabas, A. Tok, Engin Dondurmacı, M. Uğurlu","doi":"10.51645/khj.2022.m279","DOIUrl":"https://doi.org/10.51645/khj.2022.m279","url":null,"abstract":"Introduction: The right heart is more unknown than the left heart, because of less research. With it, its importance is understood, when right heart related diseases are considered. The relation between coronary vascularity and cardiac function is indisputable. There are no research about the effect of coronary dominance, that is anatomical variation merely, upon cardiac function. We investigated difference of right or left domination on right ventricle functions using echocardiography.\u0000 Patients and Methods: Working group was contained patients who is done coronary angiography with any indication. Patients were categorized right dominant and non-dominant on coronary angiography. At the same time, the origin of posterior descending artery was determined. There were 2 groups and each of them had 40 patients. Patients who had >50% stenosis on coronary arteries, myocardial infarct previously, cardiac valve disease, chronic obstructive lung disease and pulmoner embolism in past were excluded. Right ventricle functions were investigated using Echocardiography by the same operator. The results were evaluated and calculated average value by two different operators. We used Wilcoxon and Mann-Whitney U Test in evaluation of statistics.\u0000 Results: There was no difference between groups in terms of the right ventricular functions; TAPSE (26.47 ± 3.39 vs 25.31 ± 5.19 p= 0.096), FAC (43.19 ± 9.18 vs 47.5 ± 10.7 p= 0.720), GLS by STE (20.55 ± 4.033 vs 19.73 ± 4.71 p= 0.451), RIMP (53.84 ± 11.2 vs 52.93 ± 9.01 p= 0.947).\u0000 Conclusion: The effect of right coronary artery dominance on right ventricle functions was not obtained significant.","PeriodicalId":239985,"journal":{"name":"Koşuyolu Heart Journal","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134144812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}