ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 16 (7)
Volume: 16  Issue: 7 - July 2016
EDITORIAL
1.Someone is following us, aren't they?
Zeki Öngen
PMID: 27389151  PMCID: PMC5331390  doi: 10.14744/AnatolJCardiol.2016.07  Page 459
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
2.Effects of Nigella sativa L. seed oil on intima–media thickness and Bax and Caspase 3 expression in diabetic rat aorta
Gökhan Cüce, Mehmet Enes Sözen, Seda Çetinkaya, Halime Tuba Canbaz, Hatice Seflek, Serpil Kalkan
PMID: 26680543  PMCID: PMC5331391  doi: 10.5152/AnatolJCardiol.2015.6326  Pages 460 - 466
Objective: Hyperglycaemia is an important risk factor for the development and progression of the macrovascular and microvascular complications that occur in diabetes. The expression of apoptotic markers in the aortic medial layer of diabetic rats and the effects of N. sativa L. seed oil on the expression of these markers were investigated in this study.
Methods: Four-month-old adult female Wistar rats (n=21) were divided into 3 groups: Group 1, control; Group 2, diabetes and Group 3, diabetes+N. sativa L. seed oil. Group 3 received 0.2 mg/kg/day N. sativa L. seed (black cumin) oil intraperitoneally 6 days per week for 30 days. At the end of the experiment, abdominal and thoracic aortas of all animals were collected and fixed in 10% formalin solution. Then, 5-μm-thick sections were stained with Verhoeff–Van Gieson stain to evaluate Bax and Caspase 3 expression. Tunica intima–media thickness was measured using the stained sections.
Results: There were no significant differences in abdominal or thoracic aortic intima–media thickness among the 3 groups. However, there were significant differences in Bax and Caspase 3 expression in the tunica media of the thoracic and abdominal aortas between Group 1 and Group 2 (p<0.05) and between Group 2 and Group 3 (p<0.05) evaluated with the Kruskal–Wallis and Mann–Whitney U tests.
Conclusion: It is understood that N. sativa L. seed oil is effective against diabetes. N. sativa L. seed oil is a plant material and has value for further investigation to develop diabetes treatment strategies for preventing apoptosis in vascular structures. (Anatol J Cardiol 2016; 16: 460-6)

3.Comparison of uninterrupted warfarin and bridging therapy using lowmolecular weight heparin with respect to the severity of bleeding after dental extractions in patients with prosthetic valves
İsmail Erden, Emine Çakcak Erden, Tolga Aksu, Şükriye Ebru Gölcük, Burak Turan, Ayhan Erkol, Mustafa Akçakoyun, Tülin Sayın
PMID: 26645263  PMCID: PMC5331392  doi: 10.5152/AnatolJCardiol.2015.6130  Pages 467 - 473
Objective: The management of anticoagulated patients with warfarin during dental extraction is an intricate issue. We carefully designed the current study so that the amount of bleeding was measured with objective methods and the data from the same patient in different dental extraction appointments could be compared, eliminating the bleeding diathesis differences of patients.
Methods: This prospective and controlled study was conducted in 36 adult patients with prosthetic valve requiring multiple tooth extractions. The first dental extraction was performed without the discontinuation of warfarin therapy, and the second procedure was performed with a discontinuation of warfarin and bridging with low-molecular weight heparin (LMWH). The two dental extraction protocols in the same patient group were compared. The total amount of bleeding was calculated as the difference between the weights of gauze swabs used before and after the tamponade; the number of gauze swabs used for bleeding control in the first 48 h was recorded.
Result: The median number of used gauze swabs was 2.5 (IQR: 1–5) and 3.0 (IQR: 2–7) in the first and second dental extraction procedures, respectively. The median bleeding time was 50.0 (IQR: 20–100) in the first procedure compared with 60.0 (IQR: 40–140) min in the second procedure. The mean amounts of bleeding were 2194±1418 mg in the first dental extraction procedure and 2950±1694 mg in the second dental extraction procedure. The median number of used gauze swabs, the median bleeding time, and the mean amount of bleeding were statistically higher in the second dental extraction procedure (p<0.001).
Conclusion: Continued warfarin treatment at the time of dental extractions reduces the total amount of bleeding compared with bridging therapy in patients with prosthetic valves. (Anatol J Cardiol 2016; 16: 467-73)

4.Comparison of health-related quality of life among patients using novel oral anticoagulants or warfarin for non-valvular atrial fibrillation
Kevser Gülcihan Balcı, Mustafa Mücahit Balcı, Uğur Canpolat, Fatih Şen, Mehmet K. Akboğa, Muhammed Süleymanoğlu, Serdar Kuyumcu, Orhan Maden, Hatice Selçuk, Mehmet Timur Selçuk
PMID: 26680544  doi: 10.5152/AnatolJCardiol.2015.6334  Pages 474 - 481
Objective: The aim of this study was to compare health-related quality of life (HRQoL) measures between novel oral anticoagulants (NOACs) and warfarin-treated Turkish patients who had been started on oral anticoagulants (OACs) due to non-valvular atrial fibrillation (AF) and to determine the effects of OACs on patient’s emotional status, anxiety and depression.
Methods: A total of 182 patients older than 18 years with non-valvular AF and being treated with OACs for at least 6 months according to current AF guidelines who were admitted to outpatient clinics between July 2014 and January 2015 were included in this cross-sectional study. The exclusion criteria were receiving OACs for conditions other than non-valvular AF and being unable to answer the questionnaire. A questionnaire was administered to all participants to evaluate HRQoL, depression and anxiety. The mean differences between the groups were compared using Student’s t-test; the Mann–Whitney U test was applied for comparisons of the medians.
Results: The annual number of hospital admissions was significantly higher in the warfarin group (p<0.001), and all HRQoL scores were significantly lower and Hospital Anxiety and Depression Scale (HADS) score was higher in the warfarin group (p<0.001). History of any type of bleeding was significantly higher in the warfarin group (p<0.001). However, none of the patients had major bleeding. Among patients who experienced bleeding, all HRQoL scores were significantly lower and HADS score was significantly higher (p<0.001 and p=0.002, respectively).
Conclusion: Warfarin-treated patients had higher levels of self-reported symptoms of depression and anxiety and compromised HRQoL when compared with NOAC-treated patients. The results may be explained by higher rates of bleeding episodes and higher number of hospital admissions, which may cause restrictions in life while on warfarin treatment. (Anatol J Cardiol 2016; 16: 474-81)

5.Prediction of recurrence after cryoballoon ablation therapy in patients with paroxysmal atrial fibrillation
Demet Menekşe Gerede, Başar Candemir, Veysel Kutay Vurgun, Siamak Mousavi Aghdam, Aynur Acıbuca, Özgür Ulaş Özcan, Hüseyin Göksülük, Celal Kervancıoğlu, Çetin Erol
PMID: 26680545  PMCID: PMC5331394  doi: 10.5152/AnatolJCardiol.2015.6309  Pages 482 - 488
Objective: The purpose of this study was to investigate the factors predicting the maintenance of sinus rhythm in patients with paroxysmal atrial fibrillation (PAF) who underwent cryoablation of the pulmonary veins (PVs).
Methods: Fifty-one patients (54.6±10.4 years) with paroxysmal AF who underwent the cryoablation of the PVs were to the prospective trial. The clinical risk factors and echocardiographic parameters [left atrial (LA) diameter, left ventricular ejection fraction and dimensions, left atrial spontaneous echo contrast (LASEC), mitral annulus calcification (MAC), left atrial appendage emptying peak flow velocity (LAAV), and PV flow] were assessed before the cryoablation procedure. Patients with PAF who refused to use any medication because of intolerance or presentation of resistant symptoms, despite the use of at least one antiarrhythmic drug were enrolled to the study, patients with LA/LAA thrombus on echocardiographic examination, severe valvular disease, pericardial fluid, and abnormal thyroid function tests as well as systemic disease were excluded from the study. All parameters were tested for their ability to predict the recurrence of AF during a 1-year follow-up period.
Results: During the period of follow-up, AF recurred in 16 of 51 patients (31.3%/year). All significant parameters associated with the recurrence of AF were evaluated in multivariate logistic regression analysis. The presence of MAC (p<0.001) as well as LA diameter (p<0.0001), LAAV of <30 cm/s (p<0.0001), PV flow systolic wave velocity (p<0.0001), and LASEC (p<0.0001) were detected as independent predictors of recurrence. In the receiver operating characteristic analysis, LAAV of >30 cm/s had a sensitivity of 85% and a specificity of 95% for predicting success after ablation (AUC=0.813; 95% CI: 0.76–0.92; p<0.0001).
Conclusion: The presence of MAC, increased LA diameter, the existence of LASEC, low LAAV, and low peak PV systolic wave velocity are parameters that can predict the recurrence of AF after cryoablation. (Anatol J Cardiol 2016; 16: 482-8)

EDITORIAL COMMENT
6.Prediction of recurrence after cryoballoon ablation therapy in patients with paroxysmal atrial fibrillation
Ewa Lewicka
PMID: 27389152  PMCID: PMC5331395  doi: 10.14744/AnatolJCardiol.2016.19024  Pages 489 - 490
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
7.Sequencing of mutations in the serine/threonine kinase domain of the bone morphogenetic protein receptor type 2 gene causing pulmonary arterial hypertension
Zeynep Mutlu, Meral Kayıkçıoğlu, Sanem Nalbantgil, Özcan Vuran, Hatice Kemal, Nesrin Moğulkoç, Biray Ertürk, Hüseyin Onay, Zuhal Eroğlu, Hakan Kültürsay
PMID: 26645265  PMCID: PMC5331396  doi: 10.5152/AnatolJCardiol.2015.6297  Pages 491 - 496
Objective: Germline mutations in the bone morphogenetic protein receptor type-2 (BMPR2) gene are considered to be a major risk factor for pulmonary arterial hypertension (PAH). BMPR2 mutations have been reported in 10%–20% of idiopathic PAH and in 80% of familial PAH cases. The aim of this study was to evaluate the frequency of mutations in the serine/threonine kinase domain of the BMPR2 gene in a group of patients from a single PAH referral center in Turkey.
Methods: This cross-sectional study used a DNA-sequencing method to investigate BMPR2 mutations in the serine-threonine-kinase domain in 43 patients diagnosed with PAH [8 with idiopathic PAH and 35 with congenital heart disease (CHD)] from a single PAH referral center. Patients were included if they had a hemodynamically measured mean pulmonary arterial pressure of >25 mm Hg with a mean pulmonary capillary wedge pressure of ≤15 mm Hg. Patients with severe left heart disease and/or pulmonary disease that could cause pulmonary hypertension were excluded. Associations between categoric variables were determined using the chi-square test. Differences between idiopathic and CHD-associated PAH groups were compared with the unpaired Student’s t-test for continuous variables.
Results: We detected a missense mutation, [p.C347Y (c.1040G>A)], in one patient with idiopathic PAH in exon 8 of the BMPR2 gene. The mutation was detected in a 27-year-old female with a remarkable family history for PAH. She had a favorable response to endothelin receptor antagonists. No mutations were detected in the exons 5–11 of the BMPR2 gene in the PAH-CHD group.
Conclusion: A missense mutation was detected in only one of the eight patients with idiopathic PAH. The BMPR2 missense mutation rate of 12.5% in this cohort of Turkish patients with idiopathic PAH was similar to that seen in European registries. The index patient was a young female with a family history remarkable for PAH; she had a good long-term response to PAH-specific treatment, probably due to the early initiation of the treatment. Genetic screening of families affected by PAH might have great value in identifying the disease at an early stage. (Anatol J Cardiol 2016; 16: 491-6)

8.Neutrophil-to-lymphocyte ratio may be a marker of peripheral artery disease complexity
Ahmet Çağrı Aykan, Engin Hatem, Ezgi Kalaycıoğlu, Can Yücel Karabay, Regayip Zehir, Tayyar Gökdeniz, Duygun Altıntaş Aykan, Şükrü Çelik
PMID: 27004700  PMCID: PMC5331397  doi: 10.5152/AnatolJCardiol.2015.6240  Pages 497 - 503
Objective: The aim of this study was to evaluate the relationship between peripheral artery disease (PAD) severity and complexity, as evaluated by TransAtlantic Inter-Society Consensus-II (TASC-II) classification, and neutrophil-to-lymphocyte (N/L) ratio.
Methods: A total of 407 patients underwent peripheral angiography due to signs and symptoms of PAD; of these, 64 patients were excluded and the remaining 343 patients were enrolled in this cross-sectional study. Patients with previous peripheral revascularizations, acute coronary syndrome, vasculitis, non-atherosclerotic stenosis, and malignancy were excluded. Patients were divided into 4 groups according to TASC-II classification, and clinical and laboratory data were compared. The chi-square test, Student’s t-test, Mann–Whitney U test, analysis of variance, Kruskal–Wallis test, Spearman’s correlation analysis, multiple logistic regression analysis, and receiver operating characteristic (ROC) curve analysis were used for statistical analysis.
Results: Lymphocyte count was weakly correlated (r=–0.169, p=0.002) whereas neutrophil count and N/L ratio were moderately correlated with the TASC score (r=0.432, p<0.001 and r=0.470, p<0.001, respectively). Low-density lipoprotein cholesterol [odds ratio (OR)=1.010, 95% confidence interval (CI) 95%=1.003–1.017, p=0.004], high-density lipoprotein cholesterol (OR=0.940, 95% CI=0.894–0.987, p=0.013), and N/L ratio (OR=1.914, 95% CI=1.515–2.418, p<0.001) were the independent factors for predicting a higher TASC class in multiple logistic regression analysis. The cut-off value of the N/L ratio for predicting TASC C&D class was >3.05 (sensitivity=75.0%, specificity=62.9%, area under the curve=0.678, 95% CI=0.688–0.784, p<0.001) in ROC curve analysis.
Conclusion: The N/L ratio, a marker of inflammation, may be an important predictor of PAD complexity. Therefore, a simple blood count test may provide an important clue about the severity of PAD and risk stratification in patients presenting with intermittent claudication. Additional studies are required to confirm our findings. (Anatol J Cardiol 2016; 16: 497-503)

9.Effects of N-acetyl cysteine on renal functions evaluated by blood neutrophil gelatinase-associated lipocalin levels in geriatric patients undergoing coronary artery bypass grafting
Mustafa Aldemir, Halit Buğra Koca, Elif Doğan Baki, Görkem Çarşanba, Nilgün Öztürk Kavrut, Ali Sait Kavaklı, Fahri Adalı, Mustafa Emmiler, Osman Tansel Darçın
PMID: 27004703  PMCID: PMC5331398  doi: 10.5152/AnatolJCardiol.2015.6287  Pages 504 - 511
Objective: Recent conflicting studies on the renal effects of N-acetyl cysteine (NAC) after cardiac surgery have been published. The aim of this study was to evaluate the renal effects of NAC using neutrophil gelatinase-associated lipocalin (NGAL) blood levels in elderly patients undergoing coronary artery bypass grafting (CABG).
Methods: This randomized, double-blinded, placebo-controlled study was conducted among geriatric patients (>65 years) scheduled to undergo CABG. A total of 60 consecutive patients were randomly assigned to 2 groups. The first group received I.V. NAC (n=30) and the second group received placebo (n=30) at induction of anesthesia and then for 20 h. NGAL values were determined and conventional renal function tests were performed. Statistical analysis was performed using SPSS 17.0 (IL, Chicago, USA). A p value of <0.05 was considered statistically significant
Results: Plasma creatinine levels at 24 h postoperatively were significantly higher in the placebo group than in the NAC group (1.41±0.63 vs. 1.13±0.35; p<0.05). The mean serum NGAL levels at 3 h postoperatively were higher in the placebo group than in the NAC group (104.94±30.51 vs. 87.82±25.18; p<0.05). NGAL levels were similar between the groups at all other measurement time points. Plasma creatinine levels of ≥1.5 mg/dL or >25% of the baseline value at any time during the study period were observed in 27% of patients in the NAC group and 37% of patients in the placebo group; the difference was statistically significant (p<0.05).
Conclusion: In the present study, we found that I.V. NAC infusion in elderly patients undergoing CABG reduced the incidence of acute kidney injury as determined by blood NGAL and creatinine levels. (Anatol J Cardiol 2016; 16: 504-11)

10.The use of pre-test and post-test probability values as criteria before selecting patients to undergo coronary angiography in patients who have ischemic findings on myocardial perfusion scintigraphy
Nazlı Pınar Karahan Şen, Recep Bekiş, Ali Ceylan, Erkan Derebek
PMID: 27004704  PMCID: PMC5331399  doi: 10.5152/AnatolJCardiol.2015.6347  Pages 512 - 519
Objective: Myocardial perfusion scintigraphy (MPS) is a diagnostic test which is frequently used in the diagnosis of coronary heart disease (CHD). MPS is generally interpreted as ischemia present or absent; however, it has a power in predicting the disease, similar to other diagnostic tests. In this study, we aimed to assist in directing the high-risk patients to undergo coronary angiography (CA) primarily by evaluating patients without prior CHD history with pre-test and post-test probabilities.
Methods: The study was designed as a retrospective study. Between January 2008 and July 2011, 139 patients with positive MPS results and followed by CA recently (<6 months) were evaluated from patient files. Patients’ pre-test probabilities based on the Diamond and Forrester method and the likelihood ratios that were obtained from the literature were used to calculate the patients’ post-exercise and post-MPS probabilities. Patients were evaluated in risk groups as low, intermediate, and high, and an ROC curve analysis was performed for the post-MPS probabilities.
Results: Coronary artery stenosis (CAS) was determined in 59 patients (42.4%). A significant difference was determined between the risk groups according to CAS, both for the pre-test and post-test probabilities (p<0.001, p=0.024). The ROC analysis provided a cut-off value of 80.4% for post-MPS probability in predicting CAS with 67.9% sensitivity and 77.8% specificity.
Conclusion: When the post-MPS probability is ≥80% in patients who have reversible perfusion defects on MPS, we suggest interpreting the MPS as “high probability positive” to improve the selection of true-positive patients to undergo CA, and these patients should be primarily recommended CA. (Anatol J Cardiol 2016; 16: 512-9)

11.Effects of cinacalcet treatment on QT interval in hemodialysis patients
Gökhan Temiz, Ahmet Uğur Yalçın, Rüya Mutluay, İlter Bozacı, Cengiz Bal
PMID: 27004702  PMCID: PMC5331400  doi: 10.5152/AnatolJCardiol.2015.6284  Pages 520 - 523
Objective: Cinacalcet is a calcimimetic drug that acts via calcium-sensing receptors (CaSRs) and increases the sensitivity of CaSRs on the parathyroid gland; thus, it lowers calcium and phosphorus levels as well as parathormone levels. Prolongation of the QT interval is recognized as a risk factor for the development of ventricular arrhythmias and sudden death. Patients with end-stage renal disease (ESRD) are sensitive for QT prolongation and torsade de pointes more than the normal population. In this study, we aimed to evaluate the effects of cinacalcet on the electrocardiogram (ECG), particularly changes in the QT interval, in patients with ESRD.
Methods: Thirty-seven patients (21 males and 16 females) undergoing maintenance hemodialysis for at least 12 months were included in this retrospective study. Patients receiving cardioactive and antiarrhythmic drugs and those having a history of any cardiac or cerebrovascular events, active malignancy, and infections were excluded. Baseline ECG measurements of patients were performed over the newest ECG measurements that were obtained within 1 month before initiating the cinacalcet treatment, and the ECG measurements of patients after the cinacalcet treatment were performed according to the most recent ECG that was taken within the last 1 week in the clinic. We recorded the heart rate and QT values of patients before and after treatment and then calculated the corrected QT values (QTc). The Statistical Package for the Social Sciences (SPSS) ver. 21.0 was used for statistical analysis.
Results: The mean age of patients was 52.24±14.49 years. Prolongation of QTc was statistically significant compared with the baseline QTc value (baseline: 396.62±42.04 msec; after treatment: 404.97±43.47 msec; p=0.031). We found a positive correlation between the prolongation of QTc and treatment dose of cinacalcet (p<0.005, r=0.560).
Conclusion: Clinicians should be very careful for life-threatening cardiac side effects while increasing the dose of cinacalcet treatment in hemodialysis patients who have a borderline or prolonged QTc interval. (Anatol J Cardiol 2016; 16: 520-3)

12.Association between the corrected QT interval, carotid artery intima-media thickness, and hepatic steatosis in obese children
Ghaniya Daar, Halil İbrahim Serin, Hüseyin Ede, Haşim Hüsrevşahi
PMID: 26645264  PMCID: PMC5331401  doi: 10.5152/AnatolJCardiol.2015.6279  Pages 524 - 528
Objective: Childhood obesity is related to subclinical atherosclerosis. Carotid intima-media thickness (CIMT) and hepatosteatosis are parameters that reflect subclinical atherosclerosis and are shown to be associated with obesity. However, their relation with the corrected QT interval (QTc) has not been thoroughly studied in children. Here, we aimed to research the relation between QTc, hepatic steatosis, and CIMT among obese children.
Methods: Fifty-three obese and 53 age- and sex-matched non-obese children aged 6–16 years were included in this prospective cross-sectional study. The QTc of each subject was accordingly obtained from lead II on a 12-lead resting electrocardiogram. Thus, CIMT measurement and abdominal ultrasonographic examination were performed. The data for obese and non-obese children were analyzed and compared.
Result: The age and gender distribution of the subjects were statistically similar. The CIMT value of the obese group was higher than that of the non-obese group (p<0.001). The obese group had a higher frequency of hepatosteatosis at grade 1 or 2 than the non-obese group (p<0.001). The QTc values were also found to be more prolonged in the obese group than in the other group (p<0.001). With Student's t-test and Mann-Whitey U test accordingly.
Conclusion: We demonstrated that obese children had higher CIMT and QTc values as well as more frequent hepatosteatosis, and that the presence of hepatosteatosis or increased CIMT had an association with prolonged QTc values in obese children. Therefore, with the aim of detecting cardiovascular effects of obesity, it may be beneficial to perform the measurements of QTc in the presence of hepatosteatosis and/or increased CIMT among obese children. (Anatol J Cardiol 2016; 16: 524-8)

REVIEW
13.Cardiac findings in patients with Behçet’s disease: Facts and controversies
Heba Farouk, Hania Salah Zayed, Karim El- Chilali
PMID: 27389153  PMCID: PMC5331402  doi: 10.14744/AnatolJCardiol.2016.7029  Pages 529 - 533
Behçet’s disease (BD) is a systemic vasculitis of unknown etiology. It is characterized by recurrent oral and genital ulcers, uveitis, and a number of systemic manifestations. Although the disease is recognized worldwide, its prevalence is highly variable. A detailed review and analysis of the worldwide published reports on BD showed that not only the prevalence of the disease but also its cardiac complications differ according to the geographic distribution of the studied population. With the exception of France, Greece, Spain, and Italy, very few reports and studies regarding BD have been published from the western countries. Cardiovascular complications are an important cause of poor outcome in patients with BD. Over the past few years, many case reports and studies have been published, providing more facts about these complications. For example, peculiar echocardiographic findings in patients with aortic valve regurgitation and intracardiac thrombi secondary to BD were recently described. The role of these findings in the initial diagnosis of the disease, however, remains to be evaluated. On the other hand, some reports present contradictory results, especially concerning the left ventricular diastolic function, pathogenesis of coronary artery disease, and proper management of the cardiac complications in BD. Importantly, management of these complications is based mainly on the discretion of the treating physician due to the absence of large controlled studies and clear guidelines. This approach sometimes creates inconsistent data and allows controversies to persist. The review presented here will discuss some of the facts and controversies related to cardiac complications in BD. (Anatol J Cardiol 2016; 16: 529-33)

EDUCATION
14.Non-alcoholic fatty liver disease–From the cardiologist perspective
Oana Sîrbu, Mariana Floria, Petru Dascalita, Victorita Şorodoc, Laurentiu Şorodoc
PMID: 27389154  PMCID: PMC5331403  doi: 10.14744/AnatolJCardiol.2016.7049  Pages 534 - 541
Non-alcoholic fatty liver disease (NAFLD) includes a range of disorders characterized by excess accumulation of triglycerides within the liver. While simple steatosis may be clinically stable, non-alcoholic steatohepatitis (NASH) can be progressive. Inflammation is believed to be the driving force behind NASH and the progression to fibrosis and subsequent cirrhosis. NAFLD is globally considered a significant health concern not only because of its incidence but also because of its economic impact. The fact that NAFLD is associated with cardiovascular disease is widely recognized, as well as the fact that NAFLD patient mortality rises when such an association is present. In particular, NAFLD is associated with coronary and carotid atherosclerosis, endothelial dysfunction and arterial rigidity, ventricles function, valves morphology, congestive heart failure, and arrhythmias (especially atrial fibrillation). Additionally, the hypercoagulability status in NAFLD patient may be suggested by the presence of inflammatory and coagulation markers. In order to differentiate between milder forms and the more severe ones that necessitate aggressive therapy, individualized risk scores may be used. This narrative review will analyze and interpret the papers published in PubMed in the last 16 years, in an attempt to expand our understanding of the NASH as a possible cardiovascular risk factor. (Anatol J Cardiol 2016; 16: 534-41)

CASE REPORT
15.Acute myocardial infarction and ischemic stroke coexistence due to marijuana abuse in an adolescent
Muhammed Keskin, Mert İlker Hayıroğlu, Ümran Keskin, Mehmet Eren
PMID: 27389155  PMCID: PMC5331404  doi: 10.14744/AnatolJCardiol.2016.6978  Pages 542 - 543
Abstract |Full Text PDF | Video

16.Severe hypocalcemia and hypercalciuria due to contrast medium in the course of acute myocardial infarction
Ali Çoner, Gültekin Gençtoy, Serhat Balcıoğlu, Haldun Müderrisoğlu
PMID: 27389156  PMCID: PMC5331405  doi: 10.14744/AnatolJCardiol.2016.7130  Pages 543 - 545
Abstract |Full Text PDF

17.Coronary-subclavian steal syndrome in a hemodialysis patient with ipsilateral subclavian artery occlusion and contralateral vertebral artery stenosis “Case Report”
Saim Sağ, Ömer Fatih Nas, Ömer Bedir, İbrahim Baran, Sümeyye Güllülü, Bahattin Hakyemez
PMID: 27389157  PMCID: PMC5331406  doi: 10.14744/AnatolJCardiol.2016.7101  Pages 545 - 546
Abstract |Full Text PDF | Video

LETTER TO THE EDITOR
18.Can neutrophil-to-lymphocyte ratio be a valuable marker in defining peripheral artery disease severity?
Can Ramazan Öncel
PMID: 27389158  PMCID: PMC5331407  doi: 10.14744/AnatolJCardiol.2016.7036  Page 547
Abstract |Full Text PDF

19.Author`s Reply
Ahmet Çağrı Aykan
PMID: 27389159  PMCID: PMC5331408  Pages 547 - 548
Abstract |Full Text PDF

20.Mitral annular calcification: left atrial size and left ventricular dysfunction
Mariana Floria, Livia Genoveva Baroi, Catalina Arsenescu Georgescu
PMID: 27389160  PMCID: PMC5331409  doi: 10.14744/AnatolJCardiol.2016.7060  Page 548
Abstract |Full Text PDF

21.Author`s Reply
Adil Bayramoğlu, Hakan Taşolar, Yılmaz Ömür Otlu
PMID: 27389161  PMCID: PMC5331410  Page 549
Abstract |Full Text PDF

22.Postoperative atrial fibrillation may be associated with other factors
Ali Rıza Akyüz, Levent Korkmaz
PMID: 27389162  PMCID: PMC5331411  doi: 10.14744/AnatolJCardiol.2016.7084  Pages 549 - 550
Abstract |Full Text PDF

23.Author`s Reply
Çetin Geçmen
PMID: 27389163  PMCID: PMC5331412  Page 550
Abstract |Full Text PDF

24.Effects of energy drinks on blood pressure, heart rate, and electrocardiographic parameters: an experimental study onhealthy young adults
Levent Cerit
PMID: 27389164  PMCID: PMC5331413  doi: 10.14744/AnatolJCardiol.2016.7184  Pages 550 - 551
Abstract |Full Text PDF

25.Author`s Reply
Shokoufeh Hajsadeghi
PMID: 27389165  PMCID: PMC5331414  Page 551
Abstract |Full Text PDF

26.When is the best time to mobilize patients after myocardial infarction? An issue that merits further research
Hassan Sharifi, Amir Emami Zeydi
PMID: 27389166  PMCID: PMC5331415  doi: 10.14744/AnatolJCardiol.2016.7237  Page 552
Abstract |Full Text PDF



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