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EvaluatIon of the
electrIcal and mechanIcal changes of percutaneous closure of atrIal septal
defect vIa P-wave dIspersIon and tIssue Doppler ImagInatIon
Oflaz B.M., Küçükdurmaz Z, Gül İ, Gümrükçüoğlu A.H., Yolcu M, Yılmaz A,
Karapınar H
We aimed to evaluate the electrical and
mechanical changes of percutaneous closure of atrial septal defect via
p-wave dispersion and tissue Doppler imagination.
We evaluated the P-wave
durations and dispersions and tissue Doppler imagination parameters of 32
ASD patients (19 female, 13 male; mean age 31±9 yıl, min. 7, max. 44 years)
before and 1 and 6 months after the percutaneous closure.
P wave dispersion was found
to be significantly decreased after the percutaneous closure. Mitral lateral
anular E and A waves were found to be significantly decreased at the first
month control. Tricuspid lateral anular E and A waves were also found to be
decreased at the first month control, the decrease was found to be
continuing at the sixth month, but significant only for A wave.
Normalisation trend of the P
wave duration and dispersion and ventricular functional parameters by time
after the closure makes us to think that the atrial and ventricular
electrical and structural remodeling might be partially reversed.
ComparIson of plasma levels of von WIllebrand Factor
(vWF) and PlasmInogen ActIvator InhIbItor-l (PAI-1) In
patIents wIth and wIthout coronary artery ectasIa
Yolcu M, Yetkin E, Heper
G.
Coronary artery
ectasia (CAE) is defined as localized or diffuse dilatation
of the coronary arteries without spesific symptoms
determined during routine coronary angiography. In this
study we aimed to assess the plasma levels of vWF and PAI-1,
that determine the endothelial function, coagulation system
and fibrinolytic activity in patients with and without CAE.
One hundred and fifty seven consecutive patients with CAE,
52 patients with normal coronary arteries (NCA), and 50
patients with coronary artery disease (CAD) were included
into the study and statistical analysis. Plasma levels of
vWF and PAI-1 were measured in all patients.
We found the vWF level as 1,51±0,95 IU/ml in isolated CAE,
1,43±0,89 IU/ml in CAE+CAD, 1,22±1,02 IU/ml in CAD and
1,06±0,73 IU/ml in NCA. We also found PAI-1 levels as
10,93±6,53 ng/ml in CAE, 9,68±5,60 ng/ml in CAE+CAD,
15,63±8,93 ng/ml in CAD and 15,40±6,68 ng/ml in NCA. PAI-1
was found to be decreased and vWF to be increased in CAE
independently from CAD.
We showed the increased vWF and decreased PAI-1 levels in
CAE patients independent of CAD. Increased vWF is a marker
for endothelial dysfunction and activated coagulation
system. Also PAI-1 increase shows the activated fibrinolytic
system and MMP, and makes us to think the activated plasmin
triggered the ectasia formation through the ESM destruction
via MMP activation by activated plasmin.
Decreased heart rate varIabIlIty In
sIckle cell dIsease: Effect of pulmonary hypertensIon
Akgül F, Batyraliev T,
Seyfeli E, Seydaliyeva T, Gali E, Yalçın F.
Computerized analysis
of heart rate variability (HRV) is a noninvasive method for
studying cardiac autonomic function. Decreased HRV is
associated with an increased mortality risk in various
diseases and in general population. The objective of this
study was to examine HRV in patients with sickle cell
disease (SCD) and to assess the effect of pulmonary
hypertension (PHT) on HRV.
We performed
Doppler echocardiographic assessments of pulmonary artery
systolic pressure in 61 (mean age 18.3± 8.0 years) steady
state SCD patients and 22 (mean age 19.6±7.1 years) healthy
subjects.
Low
frequency power (LFP) and high frequency power (HFP) were
decreased in SCD patients compared to the control subjects
(p<0.05, p<0.0001, respectively). However, the low frequency
power to high frequency power ratio (LFP/HFP) was increased
in patients with SCD (p<0.0001). Among SCD patients,
patients with PHT had lowere HFP and higher LFP/HFP ratio
than patients without PHT (p<0.001, p<0.05, respectively).
However, there was no difference in LFP between SCD patients
with PHT and without PHT.
HRV is
significantly decreased in SCD patients in a preclinical
stage of heart disease, especially those with PHT. HRV may
be particularly useful in early detection of PHT patients
that might be at risk for worse prognosis and high
mortality.
Is there
any aortIc dIastolIc dysfunctIon In patIents wIth Increased
aortIc stIffness?
Sürücü H, Boz H, Tatlı E,
Meriç M.
We looked for an answer to the
question "Is there any aortic diastolic dysfunction in patients with
increased aortic stiffness (IAS)?"
Cases were divided into
three groups according to their aortic strain (AS) and aortic
distensibility (AD). We allocated the cases with AS values 8 and below as
group 1, the ones with 12 and above as group 3. In cases with AS values
between 8 and 12 (8<AS>12), we took into consideration AD values. Cases with
AD values 2 and below were included into group 1, cases with AD values 6 and
above were included to group 3. The cases that were not included into groups
1 and 3 were defined as group 2. Group 1 (n=36) represented IAS, group 2
(n=24) possible IAS and group 3 (n=25) elastic aorta.
Ascending aorta diastolic
diameter (AoD) was lower in cases with elastic aorta compared to in
patients with IAS and in patients with possible IAS (respectively p<0.001,
p=0.025). In group 1, early diastolic velocity of aortic pulsed wave
tissue Doppler imaging (Ea-aorta) was lower compared to group 2 and 3
(respectively p=0.040, p=0.09). There was clearly positive correlation
between aortic stiffness parameters (AS and AD) and Ea-aorta (for AS
p=0.008, for AD p=0.050).
In IAS patients, it was
shown that proximal aorta was not enough to recoil. Furthermore, aortic
diastolic parameters (Ea-aorta and AoD) were different in patients with IAS.
When these results were taken into account, aortic diastolic dysfunction
could be mentioned in IAS patients.
The
penetratIon catheter tornus used for percutaneous coronary
InterventIons In case of chronIc total occlusIons: RevIew of
studIes and fIrst experIence wIth the catheter
Fettser D.V., Arystanova Z.H.,
Batyraliev T.A., Pershukov I.V., Sidorenko B.A., Belenkov YU.N.,
Serçelik A, Avşar Ö.
Percutaneous
coronary interventions (PCI) for chronic total occlusions
(CTOs) continue to remain one of the most challenging
sections of interventional cardiology. The introduction of
new instrumentations and techniques of recanalization of
CTOs facilitated greatly conduction of such interventions
and increased the success rate of procedures. However, in
some cases, even after successful guide-wire recanalization
of lesion, the coronary balloon passage through the
occlusion is impossible. A penetration catheter Tornus has
been designed especially for such cases. It allows to create
a channel in CTO and makes subsequent successful balloon
dilatation and coronary stent implantation possible.
During
2009-2010 43 patients with CTO in whom PCI were performed by
using Tornus catheter were included in this study. A
penetration catheter was used only in cases when inserting
the smallest OTW (over the wire) balloon catheter to the CTO
site was unsuccessful. The use of the penetration Tornus
catheter in our study was allowed to perform successful CTO
recanalization followed by stenting in 86% cases. Nonfatal
complications occurred only in 4.6% cases. There was no
Q-wave myocardial infarction, cardiac death and the need for
emergency coronary artery bypass surgery.
Therefore,
usage of the penetration Tornus catheter allows performing
effectively PCI for CTO in conditions when the smallest
balloon has failed to pass the CTO lesion. The complication
rate at PCI with using the penetration catheter is
acceptable and does not exceed the average for such
interventions.
MIld mItral
valve stenosIs and secundum atrIal septal defect:
Percutaneous atrIal septal defect closure In a patIent
dIagnosed wIth Lutembacher's Syndrome
Açıkel S, Kılıç H, Yeter E, Akdemir R.
Lutembacher's syndrome
is a combination of congenital atrial septal defect and
acquired mitral stenosis. The combination of these 2
diseases has hemodynamic influences on each other.
Therefore, optimal evaluation of the anatomy and degree
of both mitral valve stenosis and atrial septal defect
requires detailed cardiac evaluation before intervention.
Here, we describe a 60-year-old female presenting with
effort dyspnea lasting 3 months. The diagnosis of
Lutembacher's syndrome with mild rheumatic mitral valve
stenosis and secundum atrial septal defect was made after
transthoracic, transesophageal echocardiography and
left-right heart catheterization. After the confirmation of
mild mitral valve stenosis, the successful percutaneous
transcatheter closure of secundum atrial defect was
performed without mitral valve intervention.
SIngle
coronary artery: Anomalous orIgIn of the rIght coronary
artery from the left anterIor descendIng coronary artery
Şatıroğlu Ö, Bostan M, Vural M, Karabay K.O.
A 48-year-old female was
referred to our unit for evaluation of chest pain. A very
rare variant of single coronary artery, in which the
anomalous right coronary artery originated as a separate
branch from the left anterior descending artery, was
incidentally found on his coronary angiography. The patient
had chest pain probably related to myocardial ischaemia. In
this case we aimed to present coronary angiography imaging a
patient with an abnormal origin of the right coronary
artery from the left anterior descending artery.
Key
Words: Coronary artery anomalies, Coronary angiography,
Single coronary artery: anomalous origin of the right
coronary artery from the left anterior descending coronary
artery
