ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 1 (4)
Volume: 1  Issue: 4 - December 2001
EDITORIAL
1.On Self-critics, Examinations and Sudden Death
Bilgin Timuralp
Pages 239 - 240
Abstract |Full Text PDF

2.In Memory of Associate Professor Bayram Korku
Hasan Gök
Page 241
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
3.Effects of Factor V Leiden on Prognosis in Patients With Acute Myocardial Infarction
Merih Baykan, Şükrü Çelik, Fahri Uçar, Şahin Kaplan, Ercüment Ovalı, Cevdet Erdöl
PMID: 12101832  Pages 242 - 245
Objective: Factor V Leiden mutation, the genetic defect underlying resistance to activated protein C, is the most common risk factor for venous thrombosis. Factor V Leiden mutation and its relation to post-myocardial infarction (MI) complications including angina pectoris, heart failure, reinfarction and cardiac mortality has not been investigated. We aimed to investigate this relation. Methods: The prevalence of factor V Leiden mutation was investigated in 122 patients with first acute myocardial infarction (aged 56±11, 82 men/40 women). These patients were divided into two groups according to whether the patients had factor V Leiden mutation (Group I) or not (Group II). Post MI complications were evaluated during 18 months. Blood samples from the patients were analyzed for factor V Leiden mutation by DNA analysis, using the polymerase chain reaction (PCR). Results: Factor V Leiden was detected in 11 (9%) patients (aged; 54±10, 5 women/ men) and was not detected in 111(90%) patients (aged; 56±11; 35 women/76 men) of the 122 patients. There were no significant differences between Group I and Group II in terms of post MI complications, including reinfarction (27% vs. 29%; p>0.05, respectively), angina pectoris (45% vs. 38%; p>0.05, respectively), heart failure (27% vs. 23%; p>0.05, respectively) and cardiac mortality (18% vs. 14%; p>0.05, respectively). Conclusion: Post MI complications, including reinfarction, heart failure, angina pectoris and cardiac mortality were not increased in patients with factor V Leiden.

EDITORIAL COMMENT
4.Factor V Leiden Mutation
Nurettin Başaran
PMID: 12803211  Page 246
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
5.Evaluation of Inferior Wall Myocardial Infarctions by 5 Unipolar Retrocordial Leads in Addition to Standart 12 Leads ECG
Mustafa Kılıç, Bekir Küçükkaya, Halil Tanrıverdi, Bülent Polat, Zeki Yurtseven
PMID: 12101833  Pages 247 - 253
Objective: This study was planned to evaluate the change patterns in 5 unipolar retrocordial leads (taken from back) in addition to standard 12 leads ECG in subjects with inferior myocardial infarction (IMI) and to see whether these patterns, if there are any, could be useful to assess the cases with IMI. Methods: A hundred forty two cases were included to study. At first, in order to determine the normal ECG configurations in 5 unipolar retrocordial leads 30 subjects with normal standard 12 lead ECG and normal physical findings were studied. The normal configurations of retrocordial leads were then determined and retrocordial leads were expressed as RE1-5. Later, 60 subjects with chronic IMI and 52 with acute IMI were evaluated. Results: The QS or Qr in VRE1, QR or qR in VRE2, qRs in VRE5 and transitional patterns in VRE3-4 were accepted as normal configurations of the retrocordial leads. Pre- and retrocordial derivations of 60 cases who had old IMI were normal in 21(35 %) cases. There were pathologic Q waves in VRE1-VRE2 leads in 5 (8.3 %) cases, in VRE3-VRE4 leads in 11(18.3 %) cases, in V5-V6 and VRE5 leads in 3 (5 %) cases, in V5-V6 and VRE1-VRE5 leads in 12 (20 %) cases, in VRE1-VRE4 leads in 8 (13,3 %) cases. Pre- and retrocordial leads of 52 cases with acute IMI were normal in 10 (19.5 %) cases. There were ST segment depression in V1-V2 and ST segment elevation in VRE-VRE2 leads in 4 (7.6 %) cases, ST segment depressions in V3-V4 derivations and ST segment elevations in VRE3-VRE4 leads in 5 (9.6 %) cases, ST segment depression in V2-V6, VRE5 leads and ST segment elevation in VRE1-VRE4 leads in 8 (15.3 %) cases, ST segment depression in V1-V4 leads and ST segment elevations in RE1-VRE4 in 12 (23 %) cases. ST segment depression in V1-V4 leads and ST segment elevation in V5-V6 and VRE1-VRE5 were found in 13 (25 %) cases. Conclusion: According to ECG findings which were taken from pre- and retrocordial leads of IMI cases were classified as follows; ST elevation or Q wave or both in DII, DIII, AVF - +; 1 - Pre and retrocordial leads are normal; 2 - ST depression in V1 (sometimes ST elevation if there is right ventricular involvement) - V2, ST elevation or Q wave or both in VRE1-VRE2); 3 - ST depression in V3-V4 and ST elevation or Q wave or both in VRE3-VRE4); 4 - ST depression in V1-V4 and ST elevation or Q wave or both in VRE1-VRE4); 5 - ST depression in V1-V4, ST elevation or Q wave or both inV5-V6 and ST elevation or Q wave or both in VRE1-VRE5); 6 - ST depression in V1-V6 and ST elevation or Q wave or both in VRE1-VRE4 and ST depression in VRE5). It is concluded that, in addition to standard 12 lead ECG, retrocordial 5 leads could be recorded and interpreted easily. ECG patterns taken from 5 unipolar retrocordial leads in patients with IMI are not homogenous. Different groups of ECG findings in certain leads were determined. Further investigations to clarify these different groups ECG findings are needed and these might bring a new approach to assess the subjects with IMI.

EDITORIAL
6.Are Additional ECG Leads Necessary in Evaluation of Inferior Myocardial Infarction?
Ali Ergin
PMID: 12803212  Page 254
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
7.Utilization of Left Main Coronary Artery Stenting: Early and Late Results
Hüseyin Yılmaz, Oktay Sancaktar, İbrahim Demir, İbrahim Başarıcı, R. Emre Altekin, Selim Yalçınkaya, Filiz Ersel Tüzüner
PMID: 12101834  Pages 255 - 258
Objectives: Percutaneous coronary intervention of left main coronary artery (LMCA) in the setting of acute myocardial infarction or in patients with cardiac and non-cardiac diseases that increase mortality rate after coronary artery bypass surgery has been proposed as “last resort option” and these patients can be managed safely with intracoronary stenting. In this study, we evaluated the short- and long-term follow-up outcomes of patients with left main coronary lesions underwent stent implantation in our clinic. Method: A total of 15 patients (12 M, 3 F; mean age 58±13 years) with left main coronary stenosis considered at high risk for surgical treatment or patients with acute myocardial infarction with LMCA stenosis were enrolled into the study and treated by stenting. Eight patients were treated for unstable angina (53 %), 2 had stable angina (13 %) and 5 had acute myocardial infarction (33 %). Three patients had “protected” and 12 patients “unprotected” LMCA stenosis. An intraaortic balloon pump was used in 6 (40 %) and pacemaker in 4 (26.6%) patients. Results: In the study group the short and long-term mortality rate was 4 (26.6%). Among 13 survived cases, signs of left ventricular failure developed in 2 patients (15.3 %). Restenosis rate on control coronary angiography was revealed in 28.8% of cases. Conclusion: Utilization of elective stenting in patients at high surgical risk with protected and unprotected LMCA lesions and percutaneous coronary intervention in patients with acute myocardial infarction and left main coronary artery lesions could be appraised as an alternative to surgical treatment approaches.

8.Lipoprotein (a) as a Risk Factor for Coronary Artery Disease in Women and Elderly Patients
Akın Serdar, Dilek Yeşilbursa, Zehra Serdar
PMID: 12101835  Pages 259 - 263
Objective: The role of lipoprotein (a) [Lp(a)] as a risk factor for coronary artery disease (CAD) in women and elderly is not clear. In this study we assessed the relation between serum Lp (a) levels and CAD, taking into account the differences in sex and age. Methods: Lp (a) levels and other lipid variables were determined in 535 consecutive patients undergoing coronary angiography for chest pain evaluation. Among 535 patients, 163 patients had angiographically normal coronary arteries (70 men and 93 women) and 372 patients had significant coronary lesions at least one coronary artery (300 men and 72 women). Results: After adjustment for hypertension, smoking, diabetes, low density lipoprotein-cholesterol (LDL-C), triglycerides and high density lipoprotein-cholesterol (HDL-C), elevated Lp (a) was independently predictive for CAD in both sexes under 55 years old (odds ratio [OR]: 5.1, p<0.01 for men and OR: 2.3, p<0.05 for women). In patients more than 55 years old elevated Lp (a) was not associated with CAD for both sexes (OR: 1.3, p= NS for men and OR: 1.2, p=NS for women). Conclusion: We did not find any relation between elevated Lp (a) concentrations and presence of angiographically detectable CAD both in men and women aged more than 55 years old. Our results suggest that elevated Lp (a) is an independent risk factor for premature CAD for both men and women.

EDITORIAL COMMENT
9.Lipoprotein (a) and Coronary Artery Disease
İnan Soydan
PMID: 12803215  Pages 264 - 265
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
10.The Relationship Between QT Dispersion and Left and Right Ventricular Diastolic Dysfunction in Patients With Myocardial Infarction
Sibel Enar, Alev Arat Özkan, Seçkin Pehlivanoğlu, Rasim Enar
PMID: 12101836  Pages 266 - 271
Objective: The purpose of this study was to investigate the relation between electrical dispersion and impairment of ventricular filling in patients with acute myocardial infarction (MI). Methods: Thirty patients with recent myocardial infarction (17 patients with anterior and 13 patients with inferior MI) were included in the study. QT dispersion (QTd) was defined as maximum minus minimum QT interval durations. Flow propagation velocity measured by color m-mode echocardiography was used to determine diastolic function. Results: There was a positive correlation between isovolumic relaxation time and QTd, as well as negative correlation existed between left ventricular flow propagation velocity (LVFPV) and QTd. The QTd was greater and LVFPV was lower in patients with anterior myocardial infarction as compared with those with inferior MI. Conclusion: There is an association between electrical dispersion and left ventricular filling abnormalities in patients with acute myocardial infarction.

EDITORIAL COMMENT
11.Exercise-Diet Programme and Lipid Profile in Sedentary Subjects
Berrin Umman, Ahmet Bilge Kaya
PMID: 12101821  Pages 272 - 275
Abstract |Full Text PDF

REVIEW
12.Radiation and the Heart
Suna Kıraç
PMID: 12101838  Pages 276 - 282
The use of radiotherapy in the management of malignant tumors causes low or high radiation exposure doses to normal tissues and undesired side effects may occur in early and late period following irradiation. All mediastinal structures, lungs and heart can exposure to total therapeutic dose during radiation therapy for thoracal or mediastinal malignancies such as Hodgkin disease and breast cancer. While early deaths following irradiation are caused by primary malignancies among these patients, long-term mortalities are resulted from radiation-induced morphological and functional organ abnormalities. Cardiac changes are the most frequently seen. Significant cardiac anatomical changes occur particularly in pericardium, myocardium, valves and result in severe cardiac dysfunctions after 10 to 20 years following administration of radiation into mediastinal or thoracal areas. The precision of the development of radiation-induced cardivascular complications has increased due to achieving the complete cure of primary tumor and to the extended survival time of irradiated cases by using advanced radiotherapy and adjuvant chemotherapy modalities. Early detection of radiation-induced morphological changes leading to cardiac dysfunction offers the possibility for early intervention such as administration of cardiovascular drugs and/or cardiac surgery in order to reduce or delay severe irreversible late complications.

13.Melatonin and Cardiovascular System
Armağan Altun, Arzu Vardar, Betül Uğur Altun
PMID: 12101839  Pages 283 - 288
In recent years, melatonin, the most prominent product of the pineal gland, has evoked considerable interest. In this report we reviewed the effects of melatonin on cardiovascular system.

MISCELLANEOUS
14.Modern Interventional Therapy of Chronic Ischemic Heart Disease
Erdoğan İlkay, Mustafa Ferzeyn Yavuzkır
PMID: 12101840  Pages 289 - 296
Abstract |Full Text PDF

15.Atrial Natriuretic Peptide and Cardiovascular System
V.A. Azizov, S. R. Muradova
PMID: 12101841  Pages 297 - 300
Abstract |Full Text PDF

16.Progress in Heart Failure: 2001 Update
Tuğrul Okay
PMID: 12101842  Pages 301 - 306
Abstract |Full Text PDF

CASE REPORT
17.A Case of Fusiform Aneurysm of Left Main Coronary Artery
Hüseyin Yılmaz, İbrahim Demir
PMID: 12101843  Pages 307 - 308
Abstract |Full Text PDF

18.Course of Myocardial Infarction with ST Segment Elevation in Inferior Leads and Culprit Left Anterior Descending Artery
Yüksel Çavuşoğlu, Tercan Us, Bilnur Yaşar, Salih Bakar, Bilgin Timuralp
PMID: 12101801  Pages 309 - 312
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
19.A Case of Infective Endocarditis
Mustafa Alkan
PMID: 12101845  Pages 313 - 314
Abstract |Full Text PDF

20.The Dance of the Catheter: An Angiographic Diagnostic Feature of the Idiopathic Hypertrophic Subaortic Stenosis
Hulki Meltem Sönmez, Ahmet Ünalır
PMID: 12101846  Page 315
Abstract |Full Text PDF

MISCELLANEOUS
21.What Have We Learnt on Arrhythmias and Electrophysiology During the XXIII. European Congress on Cardiology and Turkish Presentations
Bülent Görenek
Pages 316 - 317
Abstract |Full Text PDF

MISCELLANEOUS
22.Cardiology Professor Altan Onat at the XVII. National Congress on Cardiology

Pages 318 - 319
Abstract |Full Text PDF

23.The XVII. National Congress on Cardiology
Çetin Erol
Page 320
Abstract |Full Text PDF



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