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Anatol J Cardiol: 17 (5)
Volume: 17  Issue: 5 - May 2017
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1.Periodical publishing policy of the science world
Bilgin Timuralp
doi: 10.14744/AnatolJCardiol.2017.05  Pages 349 - 350
Abstract | Full Text PDF

2.Highlights from ACC.17 scientific sessions
Mehmet Birhan Yılmaz, Mahmut Şahin
doi: 10.14744/AnatolJCardiol.2017.7903  Pages 351 - 352
Abstract | Full Text PDF

3.New oral anticoagulants-TURKey (NOAC-TURK): Multicenter cross-sectional study
Servet Altay, Özlem Yıldırımtürk, Hüseyin Altuğ Çakmak, Lütfü Aşkın, Ümit Yaşar Sinan, Feyzullah Beşli, Ömer Gedikli, Özge Özden Tok
PMID: 28100898  doi: 10.14744/AnatolJCardiol.2016.7472  Pages 353 - 361
Objective: New oral anticoagulants (NOACs) are increasingly used both for prevention of stroke in non-valvular atrial fibrillation (NVAF) and the treatment of venous thromboembolism (VTE). In this study, we aimed to evaluate the current patterns of NOACs treatment in Turkey. Moreover, demographic and clinical parameters and bleeding and/or embolic events under NOACs treatment were analyzed.
Methods: The New Oral Anticoagulants-TURKey (NOAC-TURK) study was designed as a multicenter cross-sectional study. A total of 2,862 patients from 21 different centers of Turkey under the treatment of NOACs for at least three months were included in this study. Demographic, clinical, and laboratory characteristics of study participants with their medications used were obtained through the NOAC-TURK survey database. Additional necessary medical records were obtained from electronic health records of participating centers.
Results: Of the 2. 862 patients, 1.131 (39.5%) were male and the mean age was 70.3±10.2 years. Hypertension was found as the most frequent comorbidity (81%). The most common indication for NOACs was permanent atrial fibrillation (83.3%). NOACs were mainly preferred because of inadequate therapeutic range or overdose during warfarin usage. The most frequent complication was bleeding (n=217, 7.6%), and major bleeding was observed in 1.1% of the patients. Embolic events were observed in 37 patients (1.3%). Rivaroxaban and dabigatran were both more preferred than apixaban. Almost half of the patients (47.6%) were using lower doses of NOACs, which is definitely much more than expected.
Conclusion: The NOAC-TURK study showed an important overview of the current NOACs treatment regimens in Turkey. Although embolic and bleeding complications were lower than or similar to previous studies, increased utilization of low-dose NOACs in this study should be considered carefully. According to the results of this study, NOACs treatment should be guided through CHA2DS2-VASc and HASBLED scores to ensure more benefit and less adverse effects in NVAF patients.

4.Role of simvastatin and RORα activity in the macrophage apoptotic pathway
Neslihan Çoban, Çağrı Güleç, Bilge Özsait Selçuk, Nihan Erginel Ünaltuna
PMID: 28179616  doi: 10.14744/AnatolJCardiol.2016.7411  Pages 362 - 366
Objective: Atherosclerosis is a chronic inflammatory condition and is one of the main causes of death worldwide. Macrophages play important roles in the formation of atherosclerotic plaques. Apoptosis is progressively observed while plaques develop, although the precise mechanisms and outcomes of apoptosis in atherosclerosis development and progression are still contradictory. This study was conducted to explore the ef- fects of simvastatin and retinoic acid receptor-related orphan receptor alpha (RORα) ligands on apoptosis in human acute monocytic leukemia (THP-1) macrophage cells.
Methods: Briefly, the occupancy of RORα in the promoter regions of apoptotic pathway genes was demonstrated in THP-1 cell lines using chromatin immunoprecipitation (ChIP) analysis. In order to modulate RORα activity, THP-1 macrophage cells were treated with specific ligands (CPG52608 and SR1001) and then viability as well as count of THP-1 macrophage cells were analyzed.
Results: We observed that simvastatin and both RORα ligands had a tendency to decrease THP-1 macrophage cell viability in culture. When compared with non-treated controls, simvastatin significantly decreased cell viability (p=0.04) and cell count (p=0.03). However, this negative effect of simvastatin seemed to be partly prevented by RORα ligands. In addition, bioinformatics analysis of ChIP-on-chip data demonstrated that several genes that are involved in the apoptotic pathway were likely RORα target genes. These genes were involved in the regulation of apoptosis through various pathways.
Conclusion: In summary, our study suggest that simvastatin-mediated macrophage apoptosis might be modulated by SR1001 administration. However, involvement of RORα in this modulation through potential apoptotic target genes remains elusive. (Anatol J Cardiol 2017; 17: 000-00)

5.X indening oral liquid improves cardiac function of rats with chronic cardiac failure via TGF-β1/Smad3 and p38 MAPK pathway
Yunliang Wei, Changsheng Guo, Jingsheng Zhao, Jun Yang, Weiguo Yi, Hong Liu, Xinwei Lin, Zhengchen Zhang
PMID: 28100897  doi: 10.14744/AnatolJCardiol.2016.7438  Pages 367 - 373
Objective: Xindening oral liquid (Xin) is a widely used traditional Chinese medicine for the treatment of chronic heart failure (CHF). However, the exact mechanisms related to its therapeutic effects against CHF remain unclear. In the present study, we investigate the effects of Xin on cardiac function in CHF rats and the possible mechanisms involved.
Methods: Transverse aortic constriction (TAC) was conducted to induce a CHF rat model in this study. Sixty male Wistar rats were randomly assigned to six groups 28 days after TAC: sham; CHF model; Xin at concentrations of 5 ml/kg, 10 mL/kg, and 20 mL/kg; and QiLi 0.6 g/kg. After four weeks, the rats were treated with Xin (5, 10, or 20 mL/kg/d) for six weeks consecutively. At the end of the study, the cardiac function, heart weight index (HWI) and left ventricular mass index (LVMI), serum level of LDH, B-type natriuretic peptide (BNP), cTnI and CK-MB, and collagen volume fraction were studied. The expression of transforming growth factor-β1 (TGF-β1), drosophila mothers against decapentaplegic protein 3 (Smad3), and p38 mitogen activated protein kinase (p38 MAPK) were detected.
Results: The results showed that Xin treatment significantly improved cardiac function but decreased the serum level of LDH, BNP, cTnI, and CKMB of CHF rats. In addition, it reduced the HWI, LVMI, and collagen volume fraction compared with the model group. Xin treatment significantly improved cardiac function and attenuated cardiac fibrosis by suppressing the p38 MAPK and TGF-β1/Smad3 signaling pathway in CHF rats.
Conclusion: These results suggested that Xin might be a promising complementary treatment for CHF. More detailed experimental studies will be carried out in our subsequent research.

6.Assessment of atrial conduction times in prediabetic patients with coronary artery disease
Mahdokht Rezaei, Ali Hosseinsabet
PMID: 27965511  doi: 10.14744/AnatolJCardiol.2016.7396  Pages 374 - 380
Objective: Prediabetes is a dysglycemic state and is associated with subtle myocardial injury and dysfunction. We evaluated atrial conduction times (ACTs) and atrial electromechanical delays (EMDs) in prediabetic patients with coronary artery disease (CAD).
Methods: In the present study, we recruited 128 consecutive patient candidates (40 euglycemic, 48 prediabetic, and 40 diabetic patients) for coronary artery bypass grafting. ACTs were measured using tissue Doppler imaging (TDI). The time intervals between the beginning of the P wave in the surface electrocardiogram and the peak of the a′ wave in TDI (PA) in the septal and lateral mitral annuli and the lateral tricuspid annulus were measured and termed as "septal PA," "lateral PA," and "right ventricular (RV) PA," respectively. The differences between lateral and septal PA, septal and RV PA, and lateral and RV PA were termed as "left intra-atrial EMD," "right intra-atrial EMD," and "inter-atrial EMD" respectively.
Results: Septal PA, lateral PA, RV PA, left and right intra-atrial EMDs, and inter-atrial EMD were not statistically different between these three groups. Furthermore, multivariable linear regression models, adjusted for potential confounders, showed that glycemic state was not associated with ACTs, left and right intra-atrial EMDs, and inter-atrial EMD.
Conclusion: There were no significant differences between the euglycemic, prediabetic, and diabetic patients with CAD regarding ACTs and atrial EMDs.

7.Baseline serum globulin as a predictor of the recurrence of lone atrial fibrillation after radiofrequency catheter ablation
Qing Zhou, Hailong Cao, Zhenjun Xu, Rongfang Lan, Xin Chen, Dongjin Wang, Wei Xu
PMID: 28179615  doi: 10.14744/AnatolJCardiol.2016.7393  Pages 381 - 385
Objective: Inflammation and autoimmune responses play an important role in recurrence of atrial fibrillation (AF). Serum globulin levels are a commonly used clinical index that represents inflammation and autoimmune response. This study aimed to determine the relationship between baseline serum globulin levels and the risk of recurrence after ablation in lone AF patients.
Methods: We enrolled 348 lone AF patients undergoing radiofrequency catheter ablation for the first time for whom complete follow-up data were available. Pre-ablation peripheral venous blood samples were obtained for measurement of serum globulin levels.
Results: During the follow-up period of 22 months (range, 6–62), AF recurred in 129 patients (37.1%). Recurrence was associated with a low level of pre-ablation serum globulins. Multiple Cox proportional hazard regression analysis showed that persistent AF, AF duration, left atrial diameter, no amiodarone after ablation, and the serum globulin level in particular were independent predictors of AF recurrence. According to receiver operating characteristic curve analysis, the best diagnostic cut-off serum globulin level was 25.4 g/L, which showed 74.4% sensitivity, 71.3% specificity, and 73.3% accuracy.
Conclusion: The baseline low serum globulin level is associated with AF recurrence after first-time ablation in lone AF patients. Therefore, it may be used as a predictor of AF recurrence in these patients.

8.Impact of serum erythropoietin level on collateral vessel development in patients with coronary artery disease
Nil Özyüncü, Sadi Güleç, Çağdaş Özdöl, Başar Candemir, Aydan Ongun, Cansın Tulunay Kaya, Çetin Erol
PMID: 28315563  doi: 10.14744/AnatolJCardiol.2017.7419  Pages 386 - 391
Objective: Experimental data have shown that Erythropoietin (EPO) stimulates angiogenesis and neovascularization which may result in improved collateral development. The aim of this study was to investigate the association between serum EPO levels and the extent of coronary collaterals. Patient characteristics possibly related with coronary collaterals were also sought.
Methods: A total of 256 patients with high grade coronary stenosis or occlusion were evaluated for the extent of coronary collaterals using Rentrop classification. Patients with grade 0 or 1 collaterals were grouped as poor collaterals, while grade 2 or 3 collaterals were grouped as good collaterals.
Results: Mean age of the study population was 63 years, 77% were males. Subjects with good collaterals were significantly more likely to have anemia (p=0.038) and stable angina pectoris as clinical presentation (p=0.40). Serum EPO levels were not different among good and poor collateral groups (10.4±9.4 mU/mL vs. 9.7±11 mU/mL, p=0.397). The prevalence of all other cardiovascular risk factors, medications, and angiographic characteristics were similar between the two groups. After adjusting for age, gender, and clinical presentation with stable angina pectoris, presence of anemia persisted to be a significant correlate of the good collateral formation (OR: 1.95; 95%; CI: 1.07–3.54, p=0.029).
Conclusion: There has been conflicting results from trials studying the effects of serum EPO on coronary collateral development. The present study, with the largest patient population studying this topic, suggests that presence of anemia, but not serum EPO level, is associated with good collateral development.

9.The effect of high-dose steroid treatment used for the treatment of acute demyelinating diseases on endothelial and cardiac functions
Mehmet Vedat Çaldır, Güner Koyuncu Çelik, Özgür Çiftçi, İbrahim Haldun Müderrisoğlu
PMID: 27965510  doi: 10.14744/AnatolJCardiol.2016.7425  Pages 392 - 397
Objective: The cardiovascular effects of short-term high-dose steroid treatment (pulse steroid treatment) have not yet been clarified. We examined the short- and long-term effects of pulse steroid treatment in demyelinating diseases on endothelial and cardiac functions.
Methods: In this prospective study, we included 35 patients (20 females and 15 males; mean age, 32.8±9.3 years) who were not treated with steroids and who were previously diagnosed with multiple sclerosis or neuromyelitis optica. Patients were evaluated before, 1 week after, and 3 months after the steroid treatment. Brachial artery flow-mediated relaxation and cardiac systolic/diastolic function were evaluated using echocardiography to assess physical examination results, carotid intima–media thickness, and endothelial function.
Results: There was no difference between biochemical values, systolic function, left ventricular dimensions, and carotid intima–media thicknesses in the three evaluation periods. There were significant increases in the body mass index, body weight, and systolic/diastolic blood pressure measurements at 1 week and 3 months after treatment (p<0.001). There was a significant decrease in brachial artery flow-mediated relaxation at 1 week and 3 months (1 versus 2, p=0.042; 1 versus 3, p=0.003). In Doppler measurements at 1 week and 3 months, there was an increase in mitral A velocity, IVRT, and EDT values and a decrease in the E/A ratio in line with diastolic dysfunction.
Conclusion: Pulse steroid therapy used for demyelinating diseases deteriorated endothelial and left ventricular diastolic functions in the early and late periods. Future studies are needed to evaluate the development of cardiovascular mortality and morbidity in patients receiving this type of treatment.

10.Investigating the effect of traditional Persian music on ECG signals in young women using wavelet transform and neural networks
Behzad Abedi, Ataollah Abbasi, Atefeh Goshvarpour
PMID: 28100896  doi: 10.14744/AnatolJCardiol.2016.7436  Pages 398 - 403
Objective: In the past few decades, several studies have reported the physiological effects of listening to music. The physiological effects of different music types on different people are different. In the present study, we aimed to examine the effects of listening to traditional Persian music on electrocardiogram (ECG) signals in young women.
Methods: Twenty-two healthy females participated in this study. ECG signals were recorded under two conditions: rest and music. For each ECG signal, 20 morphological and wavelet-based features were selected. Artificial neural network (ANN) and probabilistic neural network (PNN) classifiers were used for the classification of ECG signals during and before listening to music.
Results: Collected data were separated into two data sets: train and test. Classification accuracies of 88% and 97% were achieved in train data sets using ANN and PNN, respectively. In addition, the test data set was employed for evaluating the classifiers, and classification rates of 84% and 93% were obtained using ANN and PNN, respectively.
Conclusion: The present study investigated the effect of music on ECG signals based on wavelet transform and morphological features. The results obtained here can provide a good understanding on the effects of music on ECG signals to researchers.

11.Heart rate variability in normal-weight patients with polycystic ovary syndrome
Celal Kilit, Türkan Paşalı
PMID: 28315565  doi: 10.14744/AnatolJCardiol.2017.7473  Pages 404 - 409
Objective: Polycystic ovary syndrome (PCOS) is an endocrine disease closely related to several risk factors of cardiovascular disease. Obese women with PCOS show altered autonomic modulation. The results of studies investigating cardiac autonomic functions of normal-weight women with PCOS are conflicting. The aim of the study was to assess the reactivity of cardiac sympathovagal balance in normal-weight women with PCOS by heart rate variability analysis.
Methods: We examined the heart rate variability in 60 normal-weight women with PCOS and compared them with that in 60 age-matched healthy women having a similar metabolic profile. Time and frequency domain parameters of heart rate variability were analyzed based on 5-min-long continuous electrocardiography recordings for the following 3 periods: (1) during rest in supine position, (2) during controlled breathing, and (3) during isometric handgrip exercise.
Results: Time and frequency domain parameters of heart rate variability for the 3 periods assessed were similar in the two groups. Although modified Ferriman–Gallwey score and serum testosterone and luteinizing hormone levels were significantly higher in women with PCOS, homeostatic model assessment-insulin resistance (HOMA-IR) was not different the between the PCOS and control groups. There were no significant correlations between serum testosterone levels and heart rate variability parameters among the study population.
Conclusion: The findings of this study suggest that the reactivity of cardiac sympathovagal balance is not altered in normal-weight women with PCOS having a normal HOMA-IR.

12.Heart rate variability in normal-weight patients with polycystic ovary syndrome
Renza Perini
doi: 10.14744/AnatolJCardiol.2017.24541  Pages 410 - 411
Abstract | Full Text PDF

13.Kounis syndrome not induced but prevented by the implantation of a drug-eluting stent: a case report
Kadriye Terzioğlu, Dane Ediger, Raziye Tülümen Öztürk, Eda Durmuş, Mehmet Fethi Alışır
doi: 10.14744/AnatolJCardiol.2017.7690  Pages 412 - 413
Abstract | Full Text PDF

14.Extracorporeal cardiopulmonary resuscitation after pediatric cardiac surgery
Orhan Gökalp, Yüksel Beşir, Hasan İner, Levent Yılık, Ali Gürbüz
doi: 10.14744/AnatolJCardiol.2017.7715  Page 414
Abstract | Full Text PDF

15.Author`s Reply
Ersin Erek
Pages 414 - 415
Abstract | Full Text PDF

16.Epicardial adipose tissue and atrial fibrillation: The other side of the coin
Massimo Leggio, Paolo Severi, Stefania D’emidio, Andrea Mazza
doi: 10.14744/AnatolJCardiol.2017.7752  Pages 415 - 416
Abstract | Full Text PDF

17.Author`s Reply
Sinan Altan Kocaman
Page 416
Abstract | Full Text PDF

18.P2Y12 inhibition after thrombotic thrombocytopenic purpura remission
Serkan Kahraman, Murat Ziyrek
doi: 10.14744/AnatolJCardiol.2017.7772  Pages 416 - 417
Abstract | Full Text PDF

19.Author`s Reply
Ali Doğan
Page 417
Abstract | Full Text PDF

20.IRAK-4 Variants in acute coronary syndrome patients
Arzu Ergen, Osman Fazlıoğulları, Cem Başaran, Faruk Çelik, Gonca Candan, Özlem Timirci Kahraman, Ümit Zeybek
doi: 10.14744/AnatolJCardiol.2017.7795  Pages 417 - 418
Abstract | Full Text PDF

21.Multimodality imaging of huge coronary cameral fistula
Bayram Arslan, Mustafa Oylumlu, Ebru Tekbaş, Hasan Kaya
doi: 10.14744/AnatolJCardiol.2017.7806  Page E4
Abstract | Full Text PDF

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