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1.
Anatol J Cardiol ; 24(1): 43-53, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32628144

RESUMO

OBJECTIVE: The TURKMI registry is designed to provide insight into the characteristics, management from symptom onset to hospital discharge, and outcome of patients with acute myocardial infarction (MI) in Turkey. We report the baseline and clinical characteristics of the TURKMI population. METHODS: The TURKMI study is a nation-wide registry that was conducted in 50 centers capable of percutaneous coronary intervention selected from each EuroStat NUTS region in Turkey according to population sampling weight, prioritized by the number of hospitals in each region. All consecutive patients with acute MI admitted to coronary care units within 48 hours of symptom onset were prospectively enrolled during a predefined 2-week period between November 1, 2018 and November 16, 2018. RESULTS: A total of 1930 consecutive patients (mean age, 62.0±13.2 years; 26.1% female) with a diagnosis of acute MI were prospectively enrolled. More than half of the patients were diagnosed with non-ST elevation MI (61.9%), and 38.1% were diagnosed with ST elevation MI. Coronary angiography was performed in 93.7% and, percutaneous coronary intervention was performed in 73.2% of the study population. Fibrinolytic therapy was administered to 13 patients (0.018%). Aspirin was prescribed in 99.3% of the patients, and 94% were on dual antiplatelet therapy at the time of discharge. Beta blockers were prescribed in 85.0%, anti-lipid drugs in 96.3%, angiotensin converting enzyme inhibitors in 58.4%, and angiotensin receptor blockers in 7.9%. Comparison with European countries revealed that TURKMI patients experienced MI at younger ages compared with patients in France, Switzerland, and the United Kingdom. The most prevalent risk factors in the TURKMI population were hypercholesterolemia (60.2%), hypertension (49.5%), smoking (48.8%), and diabetes (37.9%). CONCLUSION: The nation-wide TURKMI registry revealed that hypercholesterolemia, hypertension, and smoking were the most prevalent risk factors. TURKMI patients were younger compared with patients in European Countries. The TURKMI registry also confirmed that current treatment guidelines are largely adopted into clinical cardiology practice in Turkey in terms of antiplatelet, anti-ischemic, and anti-lipid therapy.

2.
Anatol J Cardiol ; 23(3): 169-175, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32120363

RESUMO

OBJECTIVE: To the best of our knowledge, there is no up-to-date information regarding the presentation, management, and clinical course of patients with acute myocardial infarction (MI) in Turkey. The TURKMI registry is designed to provide an insight into the characteristics, management from the symptoms onset to the hospital discharge, and outcome of patients with acute MI in Turkey. METHODS: The TURKMI study, as a nationwide registry, will be conducted in 50 percutaneous coronary intervention-capable centers, selected from each EuroStat NUTS region in Turkey according to their population sampling weight, prioritizing the hospital volume in each region. All consecutive patients with acute MI admitted to the coronary care units within the 48 hours of the symptoms onset will be prospectively enrolled during a predefined 2-week period. The first step of the study has a cross-sectional design in which baseline information such as symptoms, risk factors, time periods at each step from the symptoms onset to revascularization, way of arrival to hospital, biochemical analysis, and in-hospital management and outcome will be assessed. The second step has a cohort characteristic in which the enrolled patients will be followed-up up to 2 years. Follow-up visits will be conducted at the 1st, 6th, 12th, and 24th month, and predictors and risk of cardiovascular events and implementation of guidelines will be assessed as secondary outcomes. CONCLUSION: The national TURKMI registry is expected to provide important information to improve the national policy regarding diagnosing, management, and outcomes of MI in Turkey.

3.
Turk Kardiyol Dern Ars ; 45(Suppl 5): 71-74, 2017 Sep.
Artigo em Turco | MEDLINE | ID: mdl-28976387

RESUMO

With the dramatic increase in the number of elderly people in most parts of the world and in our country there will be an accompanying increase in patients with sinus node dysfunction (SND) and atrioventricular (AV) block. For this reason, it will be essential for health care personnel to have a basic knowledge of bradyarrhythmias and the special considerations required for managing these rhythms in elderly patients. Because of frailty of this patient group indivualised approach and consideration for management of these patients must be done carefully. Decision for permanent pacemaker therapy and pacemaker mode selection should be done according to the underlying pathology and patient characteristics.


Assuntos
Bradicardia , Marca-Passo Artificial , Fatores Etários , Idoso , Bradicardia/diagnóstico , Bradicardia/epidemiologia , Bradicardia/fisiopatologia , Bradicardia/terapia , Humanos , Síndrome do Nó Sinusal
4.
Turk Kardiyol Dern Ars ; 43(5): 420-6, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26148073

RESUMO

OBJECTIVE: The aim of this trial was to investigate the impact of corrected balloon occlusive diameter (cBOD) on successful performance of percutaneous atrial septal defect (ASD) closure. METHODS: The trial comprised 86 patients (60 female, 26 male; mean age 36.5±14.3) on whom percutaneous ASD closure was performed. Patients were evaluated using transesophageal echocardiography (TEE). Relation of the defect to surrounding tissues and size of rims was also investigated. Balloon sizing was performed intraoperatively on all patients. Size of device was ascertained according to both durability of rims and whether or not they formed significant indentation, both of which determine cBOD. RESULTS: The ASD closure device was successfully implanted in 84 (97.5%) patients. Mean maximum defect size was 17.4±5.9 mm, and mean color flow diameter was 16.8±5.4 mm. Mean maximum defect size at the moment of loss of shunt flow was 18.4±5.9 mm with TEE, and 18.8±6.1 mm with fluoroscopy. Mean size of Amplatzer occluder device was 20.0±6.5 mm. Device embolization was observed in 2 patients. However, no death occurred during or after the procedure. CONCLUSION: Percutaneous secundum ASD closure is a safe and effective treatment modality in experienced centers. Utilizing corrected balloon occlusive diameter may be of benefit in deciding the size of ASD occluder device.


Assuntos
Oclusão com Balão/instrumentação , Cateterismo Cardíaco/instrumentação , Cateterismo Cardíaco/métodos , Comunicação Interatrial/cirurgia , Dispositivo para Oclusão Septal , Adulto , Ecocardiografia Transesofagiana , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dispositivo para Oclusão Septal/efeitos adversos , Dispositivo para Oclusão Septal/estatística & dados numéricos
5.
Echocardiography ; 32(5): 813-8, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25345485

RESUMO

AIM: The aim of this study was to evaluate the effects of percutaneous mitral balloon valvuloplasty (PMBV) on short- and intermediate-term aortic stiffness in patients with mitral stenosis. MATERIALS AND METHODS: This prospective study included 56 patients with critical mitral stenosis in normal sinus rhythm (68% female; mean age: 42 ± 11 years) and 37 healthy controls. Aortic stiffness was measured using transthoracic echocardiography before PMBV, and 24-48 hours and 1 year post procedure. RESULTS: Aortic strain and distensibility were significantly higher in the patients with mitral stenosis, both after PMBV and 1 year post procedure, whereas the aortic stiffness index (ASI) was significantly lower. There was also a significant decrease in mitral mean gradient (MMG) and systolic pulmonary artery pressure (sPAP) after PMBV, based on echocardiography and catheterization. Mitral valve area (MVA) significantly increased after PMBV. There was a significant correlation between change in ∆MVA and ∆MMG and aortic elastic properties. There was a significantly negative correlation between the ∆MVA and ∆∆ aortic stiffness (r = -0.62, P < 0.001), and a significantly positive correlation between ∆MMG and ∆ASI (r = 0.60, P < 0.001). CONCLUSION: Mitral valve stenosis was associated with impaired aortic stiffness and following PMBV, aortic stiffness decreased during both the acute period and the intermediate period.


Assuntos
Doenças da Aorta/complicações , Doenças da Aorta/diagnóstico por imagem , Valvuloplastia com Balão , Estenose da Valva Mitral/complicações , Rigidez Vascular/fisiologia , Doença Aguda , Adulto , Aorta/diagnóstico por imagem , Doenças da Aorta/fisiopatologia , Feminino , Humanos , Masculino , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/fisiopatologia , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia
6.
Anatol J Cardiol ; 15(4): 289-96, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25413226

RESUMO

OBJECTIVE: To evaluate the short- and mid-term effects of percutaneous mitral balloon valvuloplasty (PMBV) on right ventricular functions in mitral stenosis. METHODS: A prospective study was conducted in 61 patients who had mitral stenosis in normal sinus rhythm (68% female, age: 42±11-16 years). Right ventricular functions were measured before, immediately after, and at 3 months and 1 year after PMBV by conventional and tissue Doppler echocardiography imaging methods. Additionally, the patients were evaluated in two groups (PAP≥40 mm Hg, n: 46; PAP<40 mm Hg, n: 15) according to the systolic pulmonary artery that was measured by echocardiography prior to PMBV. RESULTS: Post-PMBV mean gradient, pulmonary artery pressure (PAP), and left atrial size decreased significantly, and the mitral valve area increased significantly in both patient groups. This significance in pulmonary artery pressure was lost at 1 year. The significant post-PMBV increase in tricuspid annular point systolic excursion (TAPSE), systolic velocity, early diastolic velocity, and peak myocardial velocity during isovolumic contraction (IVV), indicating right ventricular functions, disappeared at 1 year. The significant post-PMBV decrease in myocardial performance index (MPI) and late diastolic velocity lost its significance at 1 year. No significant change was observed in myocardial acceleration during isovolumic contraction (IVA). The group with pulmonary hypertension demonstrated significance similar to the results of the overall group. Post-PMBV TAPSE, systolic velocity, early diastolic velocity, IVV, and IVA increased significantly, and this increase was maintained up to 1 year in the group without pulmonary hypertension. MPI and late diastolic velocity maintained their significantly decreased values up to 1 year. CONCLUSION: The positive effect of PMBV on right ventricular function in the acute period decreases and even disappears in the mid-term in patients developing pulmonary hypertension. Intervention in the patients prior to the development of hypertension is very important for the improvement in right ventricular functions.


Assuntos
Estenose da Valva Mitral/terapia , Cardiopatia Reumática/terapia , Disfunção Ventricular Direita/terapia , Adulto , Valvuloplastia com Balão , Ecocardiografia Doppler , Feminino , Humanos , Masculino , Estenose da Valva Mitral/diagnóstico por imagem , Estudos Prospectivos , Cardiopatia Reumática/diagnóstico por imagem , Resultado do Tratamento , Disfunção Ventricular Direita/diagnóstico por imagem
7.
Turk Kardiyol Dern Ars ; 42(6): 517-23, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25362941

RESUMO

OBJECTIVES: The aim of the study was to evaluate left atrial (LA) mechanical functions in MS before and after percutaneous mitral balloon valvuloplasty (PMBV) and to follow it up in short- and mid-term. STUDY DESIGN: We carried out a prospective study of 49 patients with critical mitral stenosis (MS) who had normal sinus rhythm. LA mechanical functions were evaluated before and 24-48 h, 3 months, and 1 year after PMBV, which included LA passive emptying volume (LAPEV), LA active emptying volume (LAAEV), LA total emptying volume (LATEV), LA passive emptying fraction (LAPEF), LA active emptying fraction (LAAEF), LA total emptying fraction (LATEF), and conduit volume. RESULTS: The transthoracic echocardiography parameters of the MS patients before and 24-48 h, 3 months, and 1 year after PMBV were as follows: (a) mitral valve area 1.1 cm² (0.9-1.6); 2.2 cm² (1.8-2.8) (p<0.001); 2.2 cm² (1.7-2.9) (NS); 2.1 cm² (1.8-2.7) (p<0.001); (b) LAPEV 13 ml/m² (9-27); 11 ml/m² (8-19) (p<0.001); 10 ml/m² (7-19) (p<0.001); 10 ml/m² (6-18) (p<0.001); (c) LATEV 26 ml/m² (19-50); 21 ml/m² (16-40) (p<0.001); 20 ml/m² (15-36) (p<0.001); 19 ml/m² (15-34) (p<0.001); (d) Conduit volume 30 ml/m² (22-44); 33 ml/m² (26-46) (p<0.001); 34 ml/m² (30-42) (p<0.001); 36 ml/m² (31-42) (p<0.001), respectively. However, LAAEV, LAPEF, LAAEF, and LATEF were not altered after PMBV. CONCLUSION: The findings of this study demonstrated an improvement of LA mechanical functions, which continued to improve for 1 year, after successful treatment of MS by PMBV.


Assuntos
Função do Átrio Esquerdo , Estenose da Valva Mitral/cirurgia , Adulto , Valvuloplastia com Balão , Ecocardiografia Transesofagiana , Feminino , Humanos , Masculino , Estenose da Valva Mitral/diagnóstico por imagem , Estenose da Valva Mitral/fisiopatologia , Complicações Pós-Operatórias , Estudos Prospectivos , Volume Sistólico
8.
Clin Appl Thromb Hemost ; 20(3): 304-10, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23076777

RESUMO

BACKGROUND: Previous studies have demonstrated that platelet activation occurs in patients with aortic stenosis (AS). This study sought to evaluate the changes in hematologic and clinical parameters noted with the improvement in AS following transcatheter aortic valve implantation (TAVI) in patients with severe AS at high risk of surgery. PATIENTS AND METHODS: The study included 33 patients who underwent TAVI. In addition to biochemical, clinical, and echocardiographic examinations, hematologic blood parameters were recorded before TAVI, at discharge, and at 1 and 4 months. RESULTS: Mean platelet volume (MPV) showed a progressive decrease after TAVI. On echocardiography at 1 month, aortic valve area significantly increased, with significant decreases in peak and mean gradients. Progressive decreases were also noted in N-terminal proB-type natriuretic peptide levels. CONCLUSION: Our findings show that TAVI improves hemodynamic parameters of the valve with marked clinical and echocardiographic improvement, resulting in decreased platelet activation and MPV in patients with severe AS.


Assuntos
Estenose da Valva Aórtica/sangue , Estenose da Valva Aórtica/cirurgia , Valva Aórtica/cirurgia , Implante de Prótese de Valva Cardíaca/métodos , Idoso , Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/diagnóstico por imagem , Estenose da Valva Aórtica/patologia , Feminino , Hemodinâmica , Humanos , Masculino , Fatores de Risco , Resultado do Tratamento , Ultrassonografia
9.
Cardiol J ; 21(4): 442-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-23990185

RESUMO

BACKGROUND: Isovolumic acceleration (IVA) is a new tissue Doppler parameter in the assessment of systolic function of both left and right ventricles. It remains unaffected with the changes in pre- and after-load within the physiological range. The aim of our study was to assess the effect of mitral stenosis degree, which is determined by echocardiography, on the left ventricular (LV) function using IVA. METHODS: A total number of 62 patients with mitral stenosis (MS) and 32 healthy controls were examined. The severity of MS (mild, moderate, and severe) was determined on the basis of mitral valve area (MVA) and the mean diastolic mitral gradient findings. The peak myocardial velocities during isovolumic contraction, systole, early diastole and late diastole were measured by using tissue Doppler imaging (TDI). RESULTS: All TDI-derived global LV basal wall systolic (peak myocardial isovolumic contraction velocity, peak myocardial systolic velocity and IVA), and diastolic velocities (peak early and late diastolic velocities) were significantly decreased in the patients with MS, compared to the healthy patients (p < 0.001, for all). However, IVA was not different when the degree of MS was evaluated (p = 0.114). In addition, IVA was not correlated with the MVA (r = 0.185, p = 0.150). CONCLUSIONS: Left ventricular function is impaired in patients with MS regardless of the severity of the disease.


Assuntos
Ecocardiografia Doppler , Estenose da Valva Mitral/diagnóstico por imagem , Valva Mitral/diagnóstico por imagem , Sístole , Disfunção Ventricular Esquerda/diagnóstico por imagem , Função Ventricular Esquerda , Aceleração , Adulto , Fenômenos Biomecânicos , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Valva Mitral/fisiopatologia , Estenose da Valva Mitral/complicações , Estenose da Valva Mitral/fisiopatologia , Valor Preditivo dos Testes , Índice de Gravidade de Doença , Fatores de Tempo , Disfunção Ventricular Esquerda/etiologia , Disfunção Ventricular Esquerda/fisiopatologia
10.
Kardiol Pol ; 72(4): 331-8, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24142755

RESUMO

BACKGROUND: Cardiovascular diseases (CVD) are the leading cause of death in patients with chronic kidney diseases (CKD). Aspirin resistance (AR) worsens prognosis in CVD. AIM: The aim of this study was to detect AR prevalence in this patient group. METHODS: The 203 patients (mean age 61.84 ± 11.51 years, 128 [63.1%] male) with stable coronary artery disease included in the study were grouped into four study groups according to their estimated glomerular filtration rate (eGFR) values. Multiplate test was used to determine AR. Platelet aggregation results were presented as aggregation unit (AU) × min and values over 300 AU × min were accepted as AR. RESULTS: 61 (30.04%) patients in the whole study population were found to have AR. Differences were detected between AR ratios and multiplate values of the patient groups (p = 0.006 and p = 0.002). AR ratio was highest in patient group 4 (eGFR < 30 mL/min/1.73 m²) and/or on chronic haemodialysis therapy, whereas there was little difference among the other three groups. In multivariate analysis, while AR status was independently related to female sex (OR = 2.31,CI 1.14-4.65, p = 0.019) and mean platelet volume (MPV) (OR = 1.68, CI 1.21-2.33, p = 0.002), multiplate test results were independently related to MPV (b = 0.265, p < 0.0001) and eGFR (b = -0.165, p = 0.025). CONCLUSIONS: The AR ratio was found to be high in severe CKD patients, especially haemodialysis patients, but not in mild and moderate CKD patients. This increased AR ratio in severe CKD patients may affect the prognosis in patients who already have an increased risk for cardiovascular complications.


Assuntos
Aspirina/efeitos adversos , Doenças Cardiovasculares/tratamento farmacológico , Resistência a Medicamentos , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/tratamento farmacológico , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco
11.
J Invasive Cardiol ; 25(6): 305-9, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-23735359

RESUMO

AIMS: Permanent pacemaker requirement is a known complication after transcatheter aortic valve implantation (TAVI). The aim of the present study was to analyze the effects of Edwards SAPIEN prosthesis implantation on atrioventricular conduction. METHODS: The study included 28 patients who underwent TAVI due to severe aortic valve stenosis. An electrophysiological study was performed in the catheterization room immediately before the initial balloon valvuloplasty and immediately after Edwards SAPIEN prosthesis implantation. RESULTS: His-ventricle interval was significantly prolonged postprocedure (55.9 ± 11.5 ms) vs preprocedure (47.3 ± 7.8 ms) (P<.001). The antegrade Wenckebach point was observed to be significantly prolonged postprocedure (354.4 ± 41.3 ms) vs preprocedure (333.7 ± 45.4 ms) (P=.001). Despite atrial-His interval prolongation, it was not statistically significant. After the procedure, we observed significant conduction disturbances in 3 patients (10.7%). These conduction problems recovered before discharge. One of the patients (3.6%) with right bundle branch block + left anterior fascicular block required permanent pacemaker implantation. At postprocedure electrocardiogram, QRS duration increased, QRS axis shifted to the left, and both of the values became normal before discharge. The patient's echocardiographic and clinical parameters were improved during follow-up. CONCLUSION: The effect of Edwards SAPIEN on the conduction system was mostly infranodal and temporary. The physical properties of the Edwards SAPIEN prosthesis may explain this observation. This complication may be lessened if the frame height characteristics can be improved.


Assuntos
Valva Aórtica , Nó Atrioventricular/fisiopatologia , Cateterismo Cardíaco/efeitos adversos , Técnicas Eletrofisiológicas Cardíacas/métodos , Sistema de Condução Cardíaco/fisiopatologia , Implante de Prótese de Valva Cardíaca/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica/cirurgia , Valvuloplastia com Balão/métodos , Cateterismo Cardíaco/métodos , Eletrocardiografia , Feminino , Seguimentos , Implante de Prótese de Valva Cardíaca/métodos , Humanos , Masculino , Marca-Passo Artificial , Estudos Retrospectivos , Resultado do Tratamento
12.
Echocardiography ; 30(6): 699-705, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23305270

RESUMO

AIM: The aim of our study was to evaluate atrial electromechanical delay (AEMD) and left atrial mechanical functions (LAMF) in the patients with secundum-type atrial septal defect (ASD). METHOD: We included 72 patients with secundum type ASD in the study group and 35 gender and age-matched healthy volunteers for the control group. Maximal, minimal, and presystolic LA volumes were measured by modified Simpson method and indexed to the body surface area (BSA). Inter-AEMD, right and left intra-AEMD were measured from the lateral and septal mitral annulus and tricuspid annulus using tissue Doppler imaging (TDI). RESULTS: The age, gender, systolic and diastolic blood pressure, heart rate (HR), BSA, and body mass index (BMI) parameters were not significantly different between the groups. Left atrial active and total emptying fractions and conduit volumes were significantly lower in the patients with ASD compared with the control group (P = 0.006, P = 0.001, and P = 0.032, respectively). Total emptying volume was increased in patients with ASD (P = 0.021). Passive emptying volume and fraction and active emptying volumes were not different significantly between the groups (P > 0.05). The left intraatrial, right intraatrial, and inter-AEMDs were significantly longer in the ASD group (P = 0.032, P = 0.013, and P = 0.003, respectively). CONCLUSION: The left atrial reservoir and contractile pump functions are reduced; the left intraatrial, right intraatrial, and inter-AEMDs are increased in the patients with ASD.


Assuntos
Ecocardiografia/métodos , Acoplamento Excitação-Contração , Átrios do Coração/diagnóstico por imagem , Átrios do Coração/fisiopatologia , Comunicação Interatrial/diagnóstico por imagem , Comunicação Interatrial/fisiopatologia , Contração Miocárdica , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
13.
J Invasive Cardiol ; 24(10): 537-8, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23043038

RESUMO

Transcatheter aortic valve implantation (TAVI) is an alternative therapy in patients with severe aortic stenosis (AS) and high surgical risk. Despite continuous improvements in operators' expertise and device technology, complications associated with TAVI are common. We present a case in which an Edwards SAPIEN prosthetic valve dislocated to the left ventricular outflow tract with hemodynamic collapse 4 hours following implantation and embolized into the left ventricle (LV) during resuscitation.


Assuntos
Estenose da Valva Aórtica/cirurgia , Embolia/etiologia , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas/efeitos adversos , Falha de Prótese/efeitos adversos , Disfunção Ventricular Esquerda/etiologia , Idoso , Valva Aórtica/diagnóstico por imagem , Valva Aórtica/cirurgia , Procedimentos Cirúrgicos Cardiovasculares , Ecocardiografia , Embolia/diagnóstico por imagem , Embolia/cirurgia , Hemodinâmica/fisiologia , Humanos , Masculino , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem , Disfunção Ventricular Esquerda/fisiopatologia
14.
Turk Kardiyol Dern Ars ; 40(4): 298-308, 2012 Jun.
Artigo em Turco | MEDLINE | ID: mdl-22951845

RESUMO

OBJECTIVES: The aim of this study was to determine the prevalence of heart failure (HF) in adult residents of Turkey based on echocardiography and N-terminal B type natriuretic factor. STUDY DESIGN: 4650 randomly selected residents aged ≥ 35 years were enrolled. Height, weight, waist and hip circumference, and blood pressure measurements were taken, and a 12-lead ECG was performed. Advanced age, hypertension (HT), diabetes mellitus (DM), obesity, and chronic renal failure (CRF) were assessed. History of any heart disease, any abnormal ECG, or an NT-proBNP ≥ 120 pg/mL was accepted as echocardiography indication. Patients with systolic and/or diastolic dysfunction, or NT-proBNP ≥ 2000 pg/mL were classified as having HF if their functional capacity was NYHA ≥ Class II, and were classified as having asymptomatic left ventricular dysfunction (ASVD) if their functional capacity was NYHA

Assuntos
Insuficiência Cardíaca/epidemiologia , Adulto , Fatores Etários , Idoso , Ecocardiografia , Eletrocardiografia , Feminino , Cardiopatias/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/etiologia , Humanos , Hipertensão/complicações , Falência Renal Crônica/complicações , Masculino , Pessoa de Meia-Idade , Peptídeo Natriurético Encefálico/sangue , Fragmentos de Peptídeos/sangue , Prevalência , Fatores de Risco , Fatores Sexuais , Turquia/epidemiologia , Disfunção Ventricular Esquerda/complicações , Disfunção Ventricular Esquerda/diagnóstico
15.
Anadolu Kardiyol Derg ; 12(5): 377-83, 2012 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22564267

RESUMO

OBJECTIVE: We evaluated regional left atrial (LA) myocardial deformations by strain (S) and strain rate (SR) imaging during LA pump, reservoir, and conduit phases in patients with chronic rheumatic mitral regurgitation (MR). METHODS: This cross-sectional observational study included 42 patients with moderate-to-severe MR who had normal left ventricular (LV) function, and 36 healthy control subjects. Conventional echocardiographic data were used to calculate LV and LA dimensions, volumes and functional indices (LA ejection fraction, LA active and passive emptying fraction). Longitudinal S/SR indices of the mid and superior segments of LA walls were measured during the three LA phases. Student t-test, Mann-Whitney U test, Chi-square test and Bland-Altman analysis were used for statistical analysis. RESULTS: LV systolic functions were similar in the patient and control groups. LV diameters, LA diameters and LA volumes were greater in the patient group compared with the control group (p<0.05, p<0.001, and p<0.001). LA ejection fraction and LA active emptying fraction values were lower in the patient group than in the control group (56 ± 7 vs. 63 ± 5%, 33 ± 9 vs. 40 ± 4%, p<0.05 for both). During the three LA phases, longitudinal S/SR values were significantly lower in all the segments in the patient group compared with the control group (p<0.001 for S, p<0.001 and p<0.05 for SR). CONCLUSION: Regional LA longitudinal myocardial deformations are observed to be impaired during all the mechanical phases in patients with moderate-to-severe MR. Volume overload, remodeling and rheumatic effects may be responsible for the LA myocardial dysfunction in these patients.


Assuntos
Insuficiência da Valva Mitral/fisiopatologia , Adulto , Remodelamento Atrial , Estudos de Casos e Controles , Estudos Transversais , Ecocardiografia , Feminino , Átrios do Coração/fisiopatologia , Humanos , Masculino , Insuficiência da Valva Mitral/diagnóstico por imagem , Cardiopatia Reumática/fisiopatologia , Índice de Gravidade de Doença , Volume Sistólico
16.
Cardiology ; 121(4): 255-60, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22584439

RESUMO

BACKGROUND: The aim of this study was to evaluate the efficiency of left atrial strain (S) and strain rate (SR) imaging in assessing left atrial appendage (LAA) function. METHODS: We studied 78 consecutive patients (35 females and 43 males; mean age 38 ± 15 years) referred for transesophageal echocardiography (TEE). LAA late emptying velocity (LAA-EV) was calculated. Real-time color Doppler myocardial velocity imaging (MVI) data were recorded from the LAA by TEE and the lateral wall of the left atrium (LA) by transthoracic echocardiography. Longitudinal S and SR were measured in the mid portion of the lateral LA wall and lateral LAA wall during the contractile period. LAA late systolic velocity (LSV) and LA-LSV were obtained from Doppler analysis. RESULTS: A significant positive correlation was detected between LAA-EV and MVI parameters (for LAA-S, r = 0.88, p < 0.001; for LAA-SR, r = 0.84, p < 0.001; for LAA-LSV, r = 0.83, p < 0.001; for LA-S, r = 0.84, p < 0.001; for LA-SR, r = 0.79, p < 0.001, and for LA-LSV, r = 0.70, p < 0.001). In addition, a significant positive correlation was detected between LAA-S and LA-S (r = 0.85, p < 0.001). CONCLUSION: We suggest that LA-S and LA-SR imaging is a beneficial method to evaluate LAA functions noninvasively.


Assuntos
Apêndice Atrial/fisiopatologia , Função do Átrio Esquerdo/fisiologia , Átrios do Coração/fisiopatologia , Apêndice Atrial/diagnóstico por imagem , Ecocardiografia Doppler de Pulso , Ecocardiografia Transesofagiana , Feminino , Átrios do Coração/diagnóstico por imagem , Humanos , Masculino , Tromboembolia/etiologia
17.
Diagn Interv Radiol ; 18(3): 261-9, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22261852

RESUMO

In this review, we aimed to outline the clinical and pathological conditions for which multidetector computed tomography coronary angiography (MDCT-CA) should be the preferred method because of its advantages over conventional coronary angiography (CCA). A consistent body of literature suggests that MDCT-CA is more than just complementary to CCA and that it provides more valuable diagnostic information in certain clinical situations, such as complex coronary artery variations, aorto-ostial lesions, follow-up of bypass grafts, myocardial bridging, coronary artery fistulas, aortic and coronary artery dissections, and cases in which the coronary ostia cannot be cannulated by a catheter because of massive atherosclerosis or extremely tortuous vascular structures.


Assuntos
Angiografia Coronária/métodos , Doença da Artéria Coronariana/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Humanos
18.
Turk Kardiyol Dern Ars ; 39(6): 479-86, 2011 Sep.
Artigo em Turco | MEDLINE | ID: mdl-21918318

RESUMO

OBJECTIVES: We evaluated left ventricular (LV) myocardial functions with strain (S) and strain rate (Sr) echocardiography and tissue Doppler imaging (TDI) before and after pericardiocentesis in patients with cardiac tamponade. STUDY DESIGN: The study included 27 patients (19 men, 8 women; mean age 51.4 ± 16.3 years) who underwent pericardiocentesis following clinical and echocardiographic diagnosis of cardiac tamponade. Besides echocardiographic parameters of LV functions, S/Sr parameters and TDI velocities were measured before and five days after pericardiocentesis, including peak systolic S, peak systolic Sr (Sr-s), peak early diastolic Sr (Sr-e), peak late diastolic Sr (Sr-a), peak lateral and septal mitral annular systolic (Sm), early diastolic (E'), and late diastolic (A') velocities. RESULTS: Pericardiocentesis was successful in all the patients, resulting in significant patient comfort and symptomatic improvement. In segmental analysis, there were no significant differences in peak systolic S and Sr values obtained before and after pericardiocentesis (p>0.05), except for basal lateral segment S and apical anterior segment Sr-s values (p<0.05). After pericardiocentesis, Sr-e and Sr-a values measured in all the walls and segments, and TDI-derived lateral and septal mitral E' and A' velocities showed significant decreases (p<0.05). All these changes demonstrated by S and Sr echocardiography corresponded well to those obtained by TDI. CONCLUSION: We concluded that S and Sr echocardiography was not superior to TDI in the assessment of LV functions in patients with cardiac tamponade.


Assuntos
Tamponamento Cardíaco/fisiopatologia , Disfunção Ventricular Esquerda/fisiopatologia , Tamponamento Cardíaco/diagnóstico por imagem , Tamponamento Cardíaco/terapia , Ecocardiografia Doppler de Pulso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pericardiocentese , Valor Preditivo dos Testes , Volume Sistólico , Resultado do Tratamento , Disfunção Ventricular Esquerda/diagnóstico por imagem
19.
Turk Kardiyol Dern Ars ; 39(5): 378-84, 2011 Jul.
Artigo em Turco | MEDLINE | ID: mdl-21743261

RESUMO

OBJECTIVES: We evaluated regional left ventricular myocardial functions by strain (S) and strain rate (Sr) echocardiography in patients with type II diabetes mellitus (DM) without microvascular complications. STUDY DESIGN: The study included 40 DM patients (20 women, 20 men; mean age 52.4 ± 7.9 years) without microvascular complications, and 40 healthy controls (20 women, 20 men; mean age 52.8 ± 10.1 years). Left ventricular functions were evaluated by conventional Doppler, tissue Doppler, and S-Sr echocardiography. Longitudinal peak systolic S and Sr were measured from the basal, mid and apical segments of the left ventricle walls. Patients with DM duration of >3 years (n=24) and receiving medical therapy for DM (n=30) were also evaluated. RESULTS: Conventional Doppler findings were similar in the patient and control groups. Among tissue Doppler variables, only early diastolic mitral annular velocity (Em) was significantly decreased (10 ± 2.9 vs. 11.4 ± 3.2 cm/sec, p<0.05), and accordingly, mitral inflow E/Em ratio was significantly increased (7.3 ± 2.5 vs. 6.3 ± 2, p<0.05) in patients with DM. The two groups were similar with respect to systolic S and Sr values, except for apical-lateral S, mid-anterior S, basal-anteroseptal S, apical-anterior Sr, and mid-anteroseptal Sr (p<0.05, for all). Patients with DM duration of >3 years and receiving medical therapy showed similar changes as the overall patient group. CONCLUSION: The frequency of left ventricular diastolic dysfunction was higher in patients with DM. Irregular distribution of systolic S and Sr indices in the left ventricular segments may indicate that DM leads to heterogeneous myocardial involvement also in the early period.


Assuntos
Doença da Artéria Coronariana/fisiopatologia , Diabetes Mellitus Tipo 2 , Disfunção Ventricular Esquerda/fisiopatologia , Estudos de Casos e Controles , Doença da Artéria Coronariana/diagnóstico por imagem , Diástole , Ecocardiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sístole , Disfunção Ventricular Esquerda/diagnóstico por imagem
20.
Anadolu Kardiyol Derg ; 10(6): 479-87, 2010 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21047726

RESUMO

OBJECTIVE: To prospectively evaluate the regional myocardial deformation changes and viability in anterior acute myocardial infarction (AMI) patients before and after primary coronary intervention (PCI) by strain (S)/strain rate (Sr) imaging. METHODS: Twenty-one patients presented during the first six hours of an anterior AMI and twenty controls were included in this study. Echocardiographic recordings were obtained from the apical/parasternal images just before PCI, one week and one month after PCI. The S/Sr and velocity (V) were measured from the basal mid and apical segments of the walls supplied by the left anterior descending artery. Myocardial perfusion scintigraphy was performed in the 1st month after PCI. Mann-Whitney U and Wilcoxon tests were used for statistical analysis. RESULTS: Acute myocardial infarction resulted in the reduction of deformation indices (S/Sr/V) in all segments. Deformation indices were increased after successful PCI. The S/Sr values of the normal and ischemic segments after PCI were higher compared to the baseline (ischemic Sr:-1.3 ± 0.3 vs. -1.1 ± 0.3, p=0.04). No difference was noted in the S/Sr values of the necrotic segments during the first week (Sr:-1.1 ± 0.3 vs. -1.0 ± 0.3, p=0.054). For V measurements, no difference was observed between the viability types at the follow-up measurements (p ≤ 0.05). CONCLUSION: The remedial effect of PCI on the deformation values was observed in the first week and continued during the first month. In the early reperfusion period, S/Sr indices have the potential to differentiate necrotic tissue from other viability types. Strain/Strain rate imaging can be used for determination of myocardial deformation changes and parameters of viability. However, V values were insufficient.


Assuntos
Infarto Miocárdico de Parede Anterior/diagnóstico por imagem , Infarto Miocárdico de Parede Anterior/patologia , Ecocardiografia , Coração/fisiopatologia , Remodelação Ventricular , Doença Aguda , Idoso , Angioplastia/métodos , Infarto Miocárdico de Parede Anterior/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Miocárdio/patologia , Estudos Prospectivos , Resultado do Tratamento
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