ISSN 2149-2263 | E-ISSN 2149-2271
The Anatolian Journal of Cardiology - Anatol J Cardiol: 5 (3)
Volume: 5  Issue: 3 - September 2005
EDITORIAL
1.What is being done abroad
Bilgin Timuralp
PMID: 16140640  Page 157
Abstract |Full Text PDF

2.Our Painful loss: Akif Güney Berki (1929-2005)
Bilgin Timuralp
Page 158
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
3.Transcatheter closure of interatrial communications with Amplatzer device: results, unfulfilled attempts and special considerations in children and adolescents
Alpay Çeliker, Süheyla Özkutlu, Tevfik Karagöz, Canan Ayabakan, Arman Bilgiç
PMID: 16140642  Pages 159 - 164
Objective: We report our clinical experience with the Amplatzer device in transcatheter closure of 80 atrial septal defects (ASD) in children. Methods: Among 99 patients (mean age: 7.2±3.8 years) with ASD selected by transthoracic echocardiography, procedures were performed in 80 patients under general anesthesia with fluoroscopic and transesophageal echocardiographic (TEE) guidance. Optimal device size was selected after stretched balloon sizing of the ASD’s. The patients were discharged at 24 hours after an evaluation with X-ray, electrocardiography and echocardiography. Results: The mean follow-up period (FUP) was 38±14 months. Mean ASD size was 11.5± 3.7 mm at TEE (stretched size: 17.6±3.9 mm). The mean size of the device was 18.6±4.0 mm. Procedure and fluoroscopy time were 52.1±17.8 minutes and 11±4.9 minutes respectively. Immediately after the procedure 35 patients (43.8%) had residual shunts. Trivial shunt remained in only 2 of them (2.5%) after FUP. None of the patients had major complications. Minor and transient rhythm abnormalities were observed in 5 patients and trivial mitral regurgitation was seen in 6 patients. Conclusion: Amplatzer is an effective and safe device for transcatheter closure of ASD especially in pediatric patients.

EDITORIAL COMMENT
4.Closure of atrial septal defects: The good, the bad and the ugly?
Rana Olguntürk
PMID: 16140643  Pages 165 - 166
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
5.PISA method for assessment of mitral regurgitation in children
Osman Başpınar, Sevim Karaaslan, Bülent Oran
PMID: 16140644  Pages 167 - 171
Objective: The purpose of this study was to determine the feasibility and significance of the proximal isovelocity surface area (PISA) method in children with rheumatic mitral regurgitation (MR). Methods: Thirty-one children (mean age 12.3±3.1 years), with chronic MR, were evaluated by semiquantitative and quantitative Doppler, quantitative two-dimensional echocardiography and the PISA methods. Also, we compared the effective regurgitant orifice area, regurgitation volume and systolic left ventricular functions in mild-moderate and severe MR. Results: There were no statistically significant differences in the regurgitant orifice area and regurgitant volume values obtained by the PISA method and the quantitative Doppler (p>0.05) but they were different from the same values obtained by two dimensional echocardiography (p<0.05). There were excellent correlations between the regurgitant orifice area, regurgitant volume and the radius of the proximal flow convergence hemisphere (r=0.882, r=0.925, r=0.880; p<0.05). We found a very good correlation between the regurgitant orifice area obtained by the PISA and left ventricular end-diastolic diameters, the ratio of the jet/left atrial area, grading with color Doppler imaging (r=0.763, r=0.745, r=0.618; p<0.05). Conclusion: It is concluded that MR can be accurately predicted in children by using the PISA method as like as the Doppler method.

6.Do left ventricular mass, diameters and long-axis systolic function differ according to angiotensin converting enzyme genotypes?
Dursun oğlu, Halil Tanrıverdi, Sebahat Turgut, Harun Evrengül, Günfer Turgut, Mustafa Kılıç
PMID: 16140645  Pages 172 - 177
Objective: Angiotensin converting enzyme (ACE) is a key enzyme in angiotensin II production which causes myocardial hypertrophy and hyperplasia. In this study we aimed to investigate the relation between ACE I/D gene polymorphism and left ventricular mass (LVM), dimensions and systolic functions calculated by mitral annular motion (MAM) in young healthy male subjects. Methods: Complete echocardiographic examination was performed in 49 male healthy subjects (mean age 22.9±2.1 years) consisting of 18 ACE DD, 18 ACE DI and 13 ACE II genotypes. We calculated LVM and mass index (LVMI) by M-Mode echocardiography. The systolic MAM was recorded at 4 sites (septal, lateral, anterior, and posterior) by M-mode echocardiography and the MAM-ejection fraction (EF) was calculated from above four sites. Ejection fraction was also calculated by Simpson’s method. Results: There was no significant difference among the three genotypes according to age, body mass index, systolic and diastolic blood pressure and heart rate. Interventricular septum (IVS) and left ventricular posterior wall (LVPW) diastolic thickness, LVM and LVMI were found significantly different among 3 ACE genotypes. Those measurements were higher in DD genotype in comparison to the DI and II genotypes. There was no significant difference among the three genotypes according to EF-MAM and EF by Simpson’s method. Conclusion: In young healthy male subjects having ACE DD genotype, even though LVM and LVMI were within normal limits, their measurements were found to be higher than in subjects with ACE DI and II genotypes respectively. There was no difference among the three genotypes according to left ventricular systolic functions.

7.Effects of beta-blockers on transmitral, pulmonary venous flows, and spontaneous echo-contrast grades in heart failure
Sait Mesut Doğan, Mustafa Aydın, Metin Gürsürer, Aydın Dursun, Fatih Çam, Tolga Onuk, Hediye Madak
PMID: 16140646  Pages 178 - 181
Objective: In this study, we aimed to investigate effects of metoprolol treatment on transmitral, pulmonary venous flows and spontaneous echo contrast in patients with heart failure. Methods: Twenty-four patients (mean age: 55±8 years) with heart failure were enrolled to the study. All were given metoprolol succinate with titrated target dose of 50 mg/d controlled release tablets for 1 month. Transmitral flow and pulmonary venous flow, systolic, diastolic and atrial reversal flow velocities were measured, and compared with the pretreatment values. Results: Heart rate significantly decreased. No significant change was observed in ejection fraction. When the post treatment values were compared with the pretreatment values, it was detected that isovolumetric relaxation time significantly decreased (p<0.05), mitral E wave and E/A ratio were significantly increased (p<0.05 and p<0.05, respectively) after the treatment. A significant increase was observed in pulmonary vein systolic velocity after metoprolol treatment (p<0.05). Conclusion: Metoprolol treatment can cause an improvement in transmitral and pulmonary venous flows.

8.Glycoprotein Ia 807TT/873AA genotype is not associated with myocardial infarction
Evrim Kömürcü, Halim İşsever, Nihan Erginel Ünaltuna
PMID: 16140647  Pages 182 - 186
Objective: The glycoprotein Ia/IIa complex is a major platelet collagen receptor. Its surface expression is influenced by two linked single nucleotide polymorphisms (C807T and G873A) in the glycoprotein Ia (GPIa) gene. In this study we aimed to determine the frequency of GPIa C807T/G873A genotype in patients with myocardial infarction (MI) and healthy controls in Turkish population and association between these dimorphisms and risk factors of MI.
Methods: We examined GPIa (C807T/G873A) genotypes in 158 patients with MI and 145 healthy controls. Distributions of the C807T and G873A dimorphisms were investigated by genotyping DNA using multiplexed allele-specific PCR.
Results: There was no association between GPIa genotypes and MI. We further analysed each group for all known risk factors such as plasma lipid levels, cigarette smoking, diabetes, hypertension, gender, age, MI history and body mass index. When compared with other two genotypes for glycoprotein Ia (GT/GA and CC/GG), TT/AA showed an association with higher high-density lipoprotein (HDL) -cholesterol levels in the healthy control group, but none in the group with MI.
Conclusion: The 807TT/873AA genotype of the GPIa gene alone or in combination with risk factors had no major effect on MI, however, it appears to be associated with higher HDL-cholesterol levels in healthy subjects. (Anadolu Kardiyol Derg 2005; 5: 182-6)

EDITORIAL COMMENT
9.Platelet collagen receptor gene polymorphisms and risk of myocardial infarction- is there a relation?
Bahar Pirat
PMID: 16140648  Pages 187 - 188
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
10.The investigation of ischemic myocardial damage in patients with carbon monoxide poisoning
Şahin Aslan, Mustafa Kemal Erol, Özgür Karcıoğlu, Mehmet Meral, Zeynep Çakır, Yavuz Katırcı
PMID: 16140649  Pages 189 - 193
Objective: Poisoning with carbon monoxide (CO) due to flash gas heater or stove being an important health problem in our region, causes significant pathologies in the body as well as death by decreasing oxygen-carrying capacity of blood. This study was planned to assess whether or not myocardial damage occurs in patients with CO poisoning. Methods: Forty consecutive adult patients with CO poisoning (30 females and 10 males) were included in this study. The mean age of the patients was 28.5±9.9 years (range: 15-56). The demographic characteristics, vital signs, the origin of CO gas, risk factors for coronary artery disease (CAD) and smoking habit of the patients were recorded. The evaluation of Glasgow Coma Scale score, electrocardiogram (ECG), peripheral arterial blood gases, complete blood count, creatine kinase (CK), creatine kinase-myocardial band (CKMB), troponin-T measurements were performed in all cases. Additionally, myocardial perfusion SPECT was performed in three cases with carboxyhemoglobin (COHb) levels over 50%. Results: Sinus tachycardia, was observed in 9 cases. Ventricular bigeminy was seen in a case with troponin-T positive test. Six of 40 cases (15%) had significantly increased CK and CK-MB levels with normal troponin-T measurements. High troponin-T levels (0.13 ng/ml) were detected only in 1 case with COHb level of 61.3%. Myocardial SPECT was performed in 3 cases with COHb levels higher than 50% and no images compatible with defects could be identified. Conclusion: The results suggested that significant myocardial damage and life-threatening cardiac hemodynamic changes do not develop in CO-poisoned patients with COHb level below 60 % and without any known underlying CAD. It is not necessary to routinely measure CK, CK-MB and troponin-T, and perform myocardial perfusion SPECT in acute CO poisoning cases without any ECG abnormality, ischemic cardiac symptoms or known CAD.

EDITORIAL COMMENT
11.Carbon monoxide poisoning and cardiovascular toxicity
Ali Serdar Fak
PMID: 16140650  Pages 194 - 195
Abstract |Full Text PDF

ORIGINAL INVESTIGATION
12.The prevalence of metabolic syndrome among young adults in İzmir, Turkey
Ahmet Soysal, Yücel Demiral, Dilek Soysal, Reyhan Uçku, Mehmet Köseoğlu, Gazanfer Aksakoğlu
PMID: 16140651  Pages 196 - 201
Objective: The aim of this study was to determine the prevalence of metabolic syndrome and its components among the young adult ages in İzmir, Turkey. Methods: A population-based cross-sectional study was held including 885 subjects aged between 20 to 39 years from 45 primary health care centres in Konak, which is the biggest urban area in İzmir. A stratified sampling method was used to select the participants of 318 males and 567 females. In the study, metabolic syndrome was classified according to NCEP ATP III criterion on the basis of metabolic risk factors evaluated between December 2001 and April 2002. Results: The crude prevalence of metabolic syndrome (having three or more of the metabolic risk factors) was 3.6% among 20 and 29 years old men and 19.6% among 30 and 39 years old men and the increase by age was significant (p<0.001). The results were similar in women and the crude prevalence of metabolic syndrome increased significantly from 7.5 % in 20 and 29 years old women to 24 % in 30 and 39 years old women (p<0.001). With regard to the highest prevalences of the first three metabolic risk factors, hypertriglyceridemia, low HDL-cholesterol and high blood pressure, the age-adjusted prevalence of the metabolic syndrome was significantly higher in women than in men and all subjects (15% vs 10.2% vs 13.6%, p<0.01) respectively. Conclusion: This study revealed that the prevalence of metabolic syndrome was extremely high between young adults in urban areas and the most prevalent components of the metabolic syndrome were found to be high triglycerides, low HDL cholesterol, high blood pressure, abdominal obesity and high fasting glucose, respectively

REVIEW
13.On the use of computational models for the quantitative assessment of surgery in congenital heart disease
Simone Pittaccio, Francesco Migliavacca, Gabriele Dubini, Ergin Koçyıldırım, Marc R de Leval
PMID: 16140652  Pages 202 - 209
The surgical repair of congenital heart disease often involves significant modifications to the circulatory tree. Resections, reconstructions, graft insertions and the deployment of implants and biomedical devices have an impact on local and systemic haemodynamics, which may be difficult to foresee or to assess quantitatively by clinical investigation alone. Mathematical models can be employed to visualise, estimate or predict events and physical quantities that are difficult to observe or measure, and can be successfully applied to the study of the pre- and post-operative physiology of cardiovascular malformations. This paper analyses the potentialities of computation fluid dynamics in this respect, outlining the method, its requirements and its limitations. Examples are given of lumped parameter models, axi-symmetric models, three-dimensional models, fluid-structure interaction simulations and multiscale computing applied to total cavo-pulmonary connection, aortic coarctation and aortic arch reconstruction

14.Robotic coronary artery surgery: past, present and future
Selami Doğan, Birkan Akbulut, Tayfun Aybek, Stefan Mierdl, Anton Moritz, Gerhard Wimmer- Greinecker
PMID: 16140653  Pages 210 - 215
Minimally invasive endoscopic procedures in cardiac surgery have only become possible since the introduction of telemanipulator systems. In this study we review robotic assisted telemanipulation systems and procedures on beating and arrested heart for total endoscopic revascularization. Robotic surgery is still under development. The most important factors limiting this new technique are high costs and the fact that only selected patients are able to be operated on. But studies on technology especially to improve anastomotic techniques are going on to produce an alternative for coronary revascularisation. We didn’t yet hit all goals but the future seems promising..

15.Diverse origin of vascular smooth muscle cells in the neointima
Xianghua Zhou, Caroline Beck, Jan Boren, Levent M. Akyürek
PMID: 16140654  Pages 216 - 220
Vascular smooth muscle cells accumulate excessively in the formation of neointima and have a key role in the pathogenesis of vasculoproliferative disorders such as atherosclerosis, allograft vasculopathy, bypass graft occlusion, in-stent restenosis and restenosis after percutaneous balloon angioplasty. To date there is no clinically established treatment to prevent the accumulation of smooth muscle cells in the neointima. However, much attention has been devoted to experimentally targeting the inhibition of migration and proliferation of medial smooth muscle cells. The recent identification of circulating bone marrow-derived smooth muscle progenitor has challenged the classical concept of infiltration of solely medial smooth muscle cells in the neointima. In addition, other potential sources such as circulating smooth muscle cell precursors that may not be of direct bone marrow origin, adventitial stem cells or smooth muscle cell progenitors that are released from other organs into the circulation have been demonstrated to have the potential to differentiate into smooth muscle cells. These discoveries have motivated us to reconsider how neointima forms in pathological conditions in the adult human. This update discusses recent insights on smooth muscle progenitors both from a biological and therapeutic perspective.

MISCELLANEOUS
16.Acute pulmonary embolism
Kaan Okyay, Mustafa Cemri, Atiye Çengel
PMID: 16140655  Pages 221 - 226
Abstract |Full Text PDF

SCIENTIFIC LETTER
17.Preliminary results of the study to determine depression prevalence in patients who had been treated as acute coronary syndrome in Kırşehir: prevalence ratios are higher than expected values
Mehmet Acer, Mutlu Vural
PMID: 16140656  Pages 227 - 228
Abstract |Full Text PDF

CASE REPORT
18.Coronary artery fistulas and coil embolization
Bagrat Alekyan, Carina Cardenas, Mehmet Reşat Ayalp
PMID: 16140657  Pages 229 - 231
Abstract |Full Text PDF

19.An unusual type of single coronary artery anomaly in a patient with hypertrophic obstructive cardiomyopathy
Hürkan Kurşaklıoğlu, Atila İyisoy, Turgay Çelik, Cem Barçın, Sedat Köseoğlu, Ersoy Işık
PMID: 16140658  Pages 232 - 233
Abstract |Full Text PDF

20.Kawasaki disease recurrence with cardiac tamponade
Zülal Ülger, Ertürk Levent, Rahmi Özdemir, Arif Ruhi Özyürek
PMID: 16140659  Pages 234 - 236
Abstract |Full Text PDF

LETTER TO THE EDITOR
21.The more Turkish without the racism
İlker Alat
PMID: 16140660  Page 237
Abstract |Full Text PDF

22.Graft patency after surgical endarterectomy of a previously stented coronary arter
Tekin Yıldırım, Serdar Akgün, Sinan Arsan
PMID: 16140661  Pages 238 - 239
Abstract |Full Text PDF

23.A patient operated because of mechanical valve dysfunction due to thrombosis during second pregnancy after mitral valve replacement
Mustafa Mahmut Ulaş, Kerim Çağlı, Erdem Çetin, Emre Boysan, Levent Mavioğlu, Ahmet Sarıtaş
PMID: 16140662  Pages 240 - 241
Abstract |Full Text PDF

24.Noncompaction cardiomyopathy is frequently associated with myopathy (Left ventricular noncompaction with hypothyroidism and sensorineural hearing loss)
Josef Finsterer, Claudia Stöllberger
PMID: 16140663  Pages 242 - 243
Abstract |Full Text PDF

SCIENTIFIC LETTER
25.The effects of phase II cardiac rehabilitation programme on patients undergone coronary bypass surgery
Mehmet Uzun
PMID: 16140664  Pages 244 - 245
Abstract |Full Text PDF

26.The fragile point of cardiac rehabilitation: exercise compliance (The effects of phase II cardiac rehabilitation programme on patients undergone coronary bypass surgery) -
Erdem Kaşıkçıoğlu
PMID: 16140665  Pages 246 - 247
Abstract |Full Text PDF

27.Blood pressure control rate in hypertensive patients and it's determining factors in two urban regions of İzmir
Belgin Ünal Aslan
PMID: 16140666  Pages 248 - 250
Abstract |Full Text PDF

28.Spontaneous echo contrast: a finding to remember in studies on coagulation and fibrinolysis in heart disease (Thrombotic, fibrinolytic and proliferative activities of pulmonary vascular bed in secondary phulmonary hypertension)
Dilek Ural
PMID: 16140667  Pages 251 - 252
Abstract |Full Text PDF

LETTER TO THE EDITOR
29.Perivalvular pseudoaneurysm, abscess and vegetation along with coronary embolism in aortic prosthetic valve
Serdar Ener
PMID: 16140668  Pages 253 - 254
Abstract |Full Text PDF

E-PAGE ORIGINAL IMAGES
30.Patent ductus arteriosus with right-to-left shunt can be diagnosed by direct visualization of microbubbles passage into descending aorta during contrast echocardiography
Recep Demirbağ, Remzi Yılmaz
PMID: 16140669  Pages 255 - 256
Abstract |Full Text PDF

31.Percutaneous retrieval of an intracardiac catheter fragment using a snare-loop catheter
Birsen Uçar, Zübeyir Kılıç, Meltem Ayata, Baran Tokar, Hüseyin İlhan
PMID: 16140670  Page 257
Abstract |Full Text PDF

32.Abdominal aortic aneurysm associated with coronary artery aneurysm
İbrahim Adaletli, Doğan Selçuk, Vedat Davutoğlu
PMID: 16140671  Page 258
Abstract |Full Text PDF

33.Catheter knotting during cardiac catheterization
Bayer Çınar, Onur S. Göksel, İzzet Erdinler, Olgar Bayserke, Ergin Eren
PMID: 16140672  Pages 259 - 260
Abstract |Full Text PDF

34.Tricuspid valve vegetation in a chronic renal failure patient with an ostium secundum type atrial septal defect after placement of a peripheral catheter
Serkan Çay, Şule Korkmaz
PMID: 16140673  Page 261
Abstract |Full Text PDF

35.Giant aneurysm of a tiny coronary branc
A. Teddy Weiss, Yücel Çölkesen, David Meerkin, Chaim Lotan
PMID: 16140674  Pages 262 - 263
Abstract |Full Text PDF

MISCELLANEOUS
36.Dedication
Robert W. Mahley
Pages 264 - 265
Abstract |Full Text PDF

37.To Editor
Siddharth Singh
Page 266
Abstract |Full Text PDF



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