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Öğe Applicability of left distal radial artery access site in ST-segment elevation myocardial infarction; A comparative evaluation with the conventional transfemoral approach(Sage Publications Ltd, 2020) Soydan, Elton; Akin, MustafaBackground: Left distal radial artery (LDRA) has got high popularity as an alternative safe access site in coronary angiography. However, little is known about its applicability in primary percutaneous coronary intervention (PPCI) in ST-segment elevation myocardial infarction (STEMI) patients. We aimed to assess the convenience of LDRA access in STEMI patients and make the comparative evaluation with the transfemoral (TF) route. Materials and methods: A total of 91 consecutive STEMI patients who underwent PPCI from January to June 2019, were analyzed. Experienced operators, unaware of the study were left free of access site decision. Comparative demographic features and clinical outcomes were recorded during hospitalization. Results: LDRA was used in 30 patients, whereas 61 patients underwent a TF approach. Successful PPCI was achieved in high rates in both groups (LDR: 90% vs TF: 91.8%: p = 0.795). on admission, KILLIP (II, III) class was higher in the LDRA group (23.3% vs 3.4%), whereas stent thrombosis, arhythmias were higher in the TF group (0% vs 6.6% p = 0.151; 6.7% vs 18% p = 0.355 respectively). Puncture time was relatively similar between groups (28.63 vs 28.93 s p = 0.767). Fluoroscopy time, total radiation exposure and hospital duration was found lower in the LDRA group (10.11 vs 13.75 min p < 0.001; 917.87 vs 1940.91 mGy p < 0.001; 4.2 vs 6.2 days p = 0.024 respectively). In-hospital mortality was found higher in the TF group (0% vs 18% p = 0.013). Conclusion: in the acute management of STEMI, LDRA access site can be a convenient alternative to TF approach with shorter hospital duration and complication rates.Öğe Assessment of in vitro Cytotoxic, iNOS, Antioxidant and Photodynamic Antimicrobial Activities of Water-soluble Sulfonated Phthalocyanines(Wiley, 2022) Akin, Mustafa; Saki, Neslihan; Guzel, Emre; Orman, Batuhan; Nalbantsoy, Ayse; Kocak, Makbule B.In recent years, much effort has been devoted to the development of effective anticancer agents. In this manner, the utilization of water-soluble sulfonated phthalocyanines is crucial for many cancer cell lines. In this study, phthalonitrile and metallophthalocyanine compounds linked by benzenesulfonic acid groups have been prepared. Antimicrobial behaviors of those compounds were investigated by performing disk diffusion and photodynamic assays on gram-positive and negative bacteria. Indium phthalocyanine (InClPc) (3) showed inhibition activity against B. cereus, B. subtilis and S. aureus with disk diffusion assay. Also, gallium and indium phthalocyanines (2 and 3) exhibited inhibitory activity on both gram-positive and -negative microorganisms after light activation. Increasing the inhibitor concentration and light exposure time increased the inhibition activity for both molecules. GaClPc (2) demonstrated the maximum reducing power capacity among studied compounds, and CoPc (4) showed even better DPPH radical scavenging ability than the standard molecule Trolox at 2000 mu g mL(-1) concentration. The dose-dependent effect of compounds on cytotoxicity was studied against cancer cells PANC-1, MDA-MB-231, HepG2, A549, HeLa, CaCo-2 and non-tumorigenic cells HEK-293. All compounds showed no significant cytotoxic effect on any cell line up to the highest treated concentration at 50 mu g mL(-1). However, all phthalocyanines had significant nitric oxide inhibition activity, and only in copper phthalocyanine (CuPc) (5), the MTT IC50 value was reached on LPS-activated RAW 264.7 macrophage cells. The lowest inducible nitric oxide synthase (iNOS) IC50 values were defined as 6 +/- 1 mu g mL(-1) and 7 +/- 0.5 mu g mL(-1) for CuPc (5) and InClPc (3), respectively.Öğe Circadian and Infradian Rhythms of Vasovagal Syncope in Young and Middle-Aged Subjects(Blackwell Publishing, 2008) Zoghi, Mehdi; Duygu, Hamza; Gungor, Hasan; Nalbantgil, Sanem; Ozerkan, Filiz; Akilli, Azem; Akin, MustafaBackground: The most cardiovascular physiological and pathophysiological events show a circadian rhythm. It is thought that the autonomic nervous system and biologic factors play a key role in the pathogenesis of vasovagal syncope (VVS). In this study, we investigated the circadian and infradian variation of VVS. Methods: A prospective consecutive series of 246 patients (142 women; mean age 36 +/- 7 years) with recurrent syncope and with a positive head-up tilt testing (HUT) were included in this study. The daily and weekly distributions of the syncopal episodes were investigated. The assessments of episodes were done according to the days of the week and three time periods of the day (6 a.m.-12 noon, 12 noon-6 p.m., 6 pm-12 midnight). Results: According to the results of HUT, 76 patients (31%) had cardioinhibitory, 62 patients (25%) had vasodepressor, and 108 patients (44%) had mixed type of VVS. During the initial passive phase, 40% of patients (99/246) showed positive response. Time to syncope was 20 +/- 2 minutes during HUT. The mean number of syncopal episodes was 4 +/- 2/years. In all, 1,070 episodes were evaluated. The distribution of the episodes in 6-hour intervals was significantly different from uniform occurrence (38%, 33%, and 29%, respectively) (P = 0.02). The frequency of episodes was higher in the morning (P = 0.045) and in the middle of the week (P = 0.046). A significant difference was found between week and weekend days in terms of the frequency of episodes (75.5% vs 24.5%, P = 0.01). Conclusion: VVS may show a circadian and infradian rhythm. (PACE 2008; 31:1581-1584).Öğe Comparison of Ischemic Side Effects of Levosimendan and Dobutamine with Integrated Backscatter Analysis(John Wiley & Sons Inc, 2009) Duygu, Hamza; Nalbantgil, Sanern; Zoghi, Mehdi; Ozerkan, Filiz; Yildiz, Ahmet; Akilli, Azem; Akin, MustafaBackground: Levosimendan improves cardiac contractility without increasing oxygen consumption. However, its effects on ischemia were not supported with the utilization of a noninvasive parameter of myocardial characterization. Hypothesis: The changes observed in integrated backscatter (IBS) may be reflective of change in myocardial ischemia. In this study, the effect of levosimendan on ischemia detected by IBS was evaluated in patients with ischemic heart failure (HF). Methods: Patients who had LVEF <40% and NYHA III-IV symptoms of HF were included in this study. Patients were randomized to levosimendan (n = 21), or to dobutamine (n = 25) groups. The cyclic variation of integrated backscatter (CVIBS) was determined as the difference between the maximal and minimal values in a cardiac cycle.. average of three consecutive beats. CVIBS was taken from the mid-anteroseptal, mid-inferior, and mid-posterolateral areas of the parasternal short axis images before the drug administration and at the end of the 24-hour infusion period. Results: Baseline characteristics and concomitant medications were similar in both groups. A significant reduction in CVIBS was detected in anteroseptal (7.6 +/- 1.4 dB versus 5.9 +/- 0.8 dB, p = 0.01), inferior watt (7.4 +/- 0.8 dB versus 6.7 +/- 1.5 dB, P = 0.03), and posterolateral wall (9.0 +/- 1.2 dB versus 8.2 +/- 0.6 dB, P = 0.04) after dobutamine administration, while no significant changes were observed in the levosimendan group in all walls. Conclusions: Unlike dobutamine, levosimendan may not induce myocardial ischemia as shown by CVIBS at commonly used dosages in the setting of decompensated HF without active ischemia.Öğe Comparison of the effects of new and conventional hormone replacement therapies on left ventricular diastolic function in healthy postmenopausal women: a Doppler and ultrasonic backscatter study(Springer, 2009) Duygu, Hamza; Akman, Levent; Ozerkan, Filiz; Akercan, Fuat; Zoghi, Mehdi; Nalbantgil, Sanem; Erturk, Umit; Akilli, Azem; Onder, Remzi; Akin, MustafaWe aimed to compare the effects of new treatment modalities to conventional hormone replacement therapy (HRT) on left ventricular (LV) diastolic function, by means of conventional and tissue Doppler echocardiography and the myocardial integrated backscatter (IBS) in postmenopausal women. One hundred and fifty healthy postmenopausal women were included in this study. Subjects were assigned to one of the five groups receiving 1 year of treatment (estrogen, estrogen plus progesterone, raloxifene, tibolone or placebo). E and A wave velocity, E/A ratio, isovolumic relaxation time (IVRT), deceleration time (DT), peak early (Em) diastolic mitral annular velocity, E/Em ratio, the cyclic variation of integrated backscatter (CVIBS) and the mean value of the IBS signal (MIBS) were determined before and 12 months after therapy. E (76 +/- A 10 vs. 98 +/- A 8 cm/s, P = 0.0001 and 78 +/- A 10 vs. 90 +/- A 12 cm/s, P = 0.02, respectively), Em (14.3 +/- A 2.4 vs. 16.4 +/- A 2.5 cm/s, P = 0.001 and 15.1 +/- A 3.4 vs. 16.2 +/- A 3.5 cm/s, P = 0.01, respectively), and E/A ratio (1.15 +/- A 0.3 vs. 1.42 +/- A 0.4, P = 0.0001 and 1.0 +/- A 0.2 vs. 1.22 +/- A 0.2, P = 0.01, respectively) were increased significantly compared to pretreatment in both estrogen and raloxifene groups while DT, A, E/Em, and IVRT were significantly decreased. A significant increase in CVIBS and decrease in MIBS were detected 12 months after estrogen and raloxifene administration while no significant changes were observed in other groups. Changes in the MIBS and CVIBS were found to be independently associated with the observed changes in the diastolic function indexes during therapy. Both estrogen and raloxifene regimens may improve LV diastolic functions in healthy postmenopausal women. This improvement may be a result of direct cardiac effects on LV myocardium.Öğe Congenital left ventricular diverticulum as a cause of chest pain in an adult(Cambridge Univ Press, 2007) Duygu, Hamza; Ozerkan, Filiz; Akin, MustafaÖğe Coronary angiography using the left distal radial approach - An alternative site to conventional radial coronary angiography(Turkish Soc Cardiology, 2018) Soydan, Elton; Akin, MustafaObjective: To share our experience with the left distal radial approach for transradial coronary angiography and interventions. By performing the radial puncture in the fossa radialis or the so called anatomical "Snuffbox" we aimed to present the feasibility and complications of this new technique. Methods: Left distal radial artery was used as an access site in 54 patients admitted to our clinic for coronary angiography and intervention between May 25th and October 20th 2017. All of them had pulse in their left distal radial artery. In the laboratory, they had their left arm gently flexed at the shoulder so that the hand was placed over their right groin. The operator stood on the right side of the patient and performed coronary angiography and interventions. During the hospital stay, demographic features and complications were recorded. Results: Mean age of patients was 59.3 years and 80% were male. We used Judkins 6 French catheters for the procedures. Seventeen patients admitted with acute coronary syndrome. They all underwent successful left distal transradial coronary angiography and intervention. Primary angioplasty was performed in 10 patients. In total, 20 patients had coronary intervention. Left anterior descending artery was the artery requiring most intervention (11 patients). Two patients experienced brachial spasm requiring crossover to right femoral artery. There were no cases of radial artery occlusion, hematoma, or hand numbness. The radial sheath was removed at procedure termination. Hemostasis was achieved with manual compression. Conclusion: Left distal radial approach is safe and feasible as a new technique for coronary angiography and interventions.Öğe Effect of levosimendan on E/E' ratio in patients with ischemic heart failure(Elsevier Ireland Ltd, 2008) Duygu, Hamza; Ozerkan, Filiz; Nalbantgil, Sanem; Zoghi, Mehdi; Akilli, Azem; Akin, Mustafa; Nazli, Cem; Ergene, OktayBackground: Levosimendan is a novel positive inotropic calcium sensitizer agent used in acute heart failure. In acute heart failure, it improves hemodynamic parameters more favorably than the conventional positive inotropes. In this study, the effect levosimendan on E/E' ratio as a non-invasive indicator of LV filling pressure was evaluated compared to dobutamine in a prospective, randomized, patient-blind manner. Methods: Patients with an LVEF < 40% admitting with acute heart failure attack with ischemic origin were included to this study. Patients were randomized to levosimendan (n=30, mean age: 64 +/- 10 years, 63% male) or dobutamine (n=32, mean age: 66 +/- 8 years, 54% male) groups. The ratio of the peak E wave velocity taken from mitral inflow with PW Doppler to the peak E' wave velocity taken from mitral lateral annulus with tissue Doppler was determined. Pre-treatment and 24-hour after the treatment E/E' ratios were calculated and then compared in both groups. Results: Age, gender, concomitant medications were similar in both groups ( p > 0.05). There was no difference for pre-treatment baseline E/E' ratios between levosimendan and dobutamine groups (15.7 +/- 4.0 vs 15.2 +/- 7.5 respectively, p=0.1). There were significant reductions in post-treatment E/E' ratios in levosimendan ( 15.7 +/- 4.0 vs 9.3 +/- 2.8, p=0.01) and dobutamine groups ( 15.2 +/- 7.5 vs 12.9 +/- 5.6, p=0.04). However, the reduction in levosimendan group was greater compared to dobutamine group (p=0.01). Conclusions: Levosimendan causes a greater reduction of E/E' ratio compared to dobutamine in acute systolic left heart failure. This may explain the more favorable hemodynamic effects of levosimendan when compared to conventional positive inotropics in patients with systolic left heart failure. (c) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe The effects of different hormone treatment on endothelial function in healthy postmenopausal women(Informa Healthcare, 2013) Akman, Levent; Duygu, Hamza; Akercan, Fuat; Ulukus, Murat; Ozerkan, Filiz; Akin, MustafaWe aimed to compare the effects of different types of hormone treatment (HT) on endothelial function by means of brachial artery ultrasonographic examination in postmenopausal women. Sixty-two healthy postmenopausal women were included in this study. Subjects were assigned to one of the five groups receiving 6 months of treatment [estrogen (conjugated estrogen), estrogen (conjugated estrogen) plus progesterone (medroxyprogesterone acetate; MPA), raloxifene, tibolone or control]. Endothelial function was assessed by measurement of flowmediated dilatation (FMD) and nitrate-dependent dilatation in the brachial artery. At the end of 6 months, FMD values were found to be significantly increased in women with HT use than the control group (p= 0.001). In subgroups, FMD increased significantly in the estrogen [12 7 versus 25 8, p= 0.0011 and raloxifene groups [7+5 versus 11 3, p< 0.01] compared to tibolone and estrogen plus progesterone groups. In conclusion, endothelial function is impaired in postmenopausal women. Both estrogen and raloxifene regimens may improve endothelial functions in healthy postmenopausal women. The direct protective effects of these HT on the healthy endothelium may be more remarkable than the favorable effects on lipid profile.Öğe Effects of Levosimendan on Left Atrial Functions in Patients with Ischemic Heart Failure(John Wiley & Sons Inc, 2008) Duygu, Hamza; Nalbantgil, Sanem; Ozerkan, Filiz; Zoghi, Mehdi; Akilli, Azem; Erturk, Umit; Akin, Mustafa; Nazli, Cem; Ergene, OktayBackground: With further progression of left ventricular (LV) dysfunction, the left atrial (LA) contribution to LV filling gradually decreases, and LA dysfunction deteriorates the decreased LV filling in patients with heart failure (HF). Hypothesis: This study sought to investigate the effects of levosimendan on LA function in patients with HF. Methods: A total of 60 patients having acute decompensated HF with ischemic cardiomyopathy and LV ejection fraction (LVEF) < 40% were included in the study. Patients were randomized to levosimendan (n = 30) or to dobutamine (n = 30). Before and 24 h after treatment, LVEF, mitral inflow peak E and A wave velocity, E/A ratio, mitral lateral annulus peak Em wave velocity, E/Em ratio, LA volumes, and from the LA volumes the active emptying fraction (AEF), passive emptying fraction (PEF), and reservoir fraction (RF) were measured. Results: All LA volumes were significantly reduced after levosimendan administration, but in the dobutamine group only minimal volume (Vmin) was reduced. Although AEF increased in both groups, the improvement of AEF was greater in the levosimendan group than in the dobutamine group (14% +/- 9% versus 2%+/- 1%, p = 0.001). The PEF (12%+/- 8% versus 21%+/- 6%, P = 0.04) and RF (23%+/- 4% versus 38%+/- 3%, P = 0.001) significantly increased after levosimendan administration, whereas these parameters did not change after dobutamine. In patients receiving levosimendan, there was a significant, positive correlation between PEF and Ern (r = 0.475, p = 0.008), and there were significant negative correlations between PEF and E/Em (r = -0.491, p = 0.006), and AEF and E/Em (r = -0.654, P = 0.001). Conclusions: Left atrial functions respond better to levosimendan than to dobutamine in decompensated HEÖğe Eosinophilic myocarditis presenting as acute coronary syndrome(Turkish Soc Cardiology, 2017) Simsek, Evrim; Cakan, Filiz Ozerkan; Akin, MustafaEosinophilic myocarditis (EM) is a rare condition that may result from several heterogeneous eosinophilic diseases, including parasite infection, hypersensitivity reaction, vasculitis, and hypereosinophilic syndrome. Regardless of etiology, the disease may present with various cardiac conditions, such as acute coronary syndrome, heart failure, or arrhythmia. Irreversible endomyocardial fibrosis, which causes restrictive cardiomyopathy, occurs in the late phase of the disease. Early diagnosis and treatment is crucial to prevent disease progression. Presently described is a case of EM presenting as acute coronary syndrome that was treated with steroids.Öğe Evaluating functional capacity, and mortality effects in the presence of atrial electromechanical conduction delay in patients with systolic heart failure(Turkish Soc Cardiology, 2016) Bilgin, Murat; Yildiz, Bekir Serhat; Tuluce, Kamil; Gul, Ilker; Alkan, Mustafa Beyazit; Sayin, Ahmet; Islamli, Aysel; Efe, Tolga Han; Alihanoglu, Yusuf Izzettin; Zoghi, Mehdi; Akin, MustafaObjective: Atrial functions are relatively suppressed in heart failure (HF). We aimed to investigate the associations of intra-and inter-atrial electromechanical conduction delay (EMCD) with functional class and mortality over a 12-month follow-up period. Methods: The prospective study included 65 patients with systolic HF and 65 healthy subjects with normal sinus rhythm. Left ventricular (LV) systolic functions and left atrial (LA) dimensions and volumes were evaluated by transthoracic echocardiography. Tissue Doppler imaging (TDI) signals at the lateral border of the mitral annulus (lateral PA'), septal mitral annulus (septal PA'), and tricuspid annulus (tricuspid PA') were measured. Intra-and inter-atrial EMCD were calculated. Results: Mitral inflow velocities were studied using pulsed-wave Doppler after placing the sample volume at the leaflets' tips. The peak early (E wave) and late (A wave) velocities were measured. The septal annular E/E' ratio was relatively higher and lateral, septal, and right ventricular S,E', and A' waves were significantly lower in the HF group than in the control group (12.49 +/- 6.03-7.16 +/- 1.75, pE/E' <0.0001). Intra-atrial EMCD was detected as 117.5 ms and inter-atrial EMCD as 127.5 ms in patients with prolonged atrial EMCD. A significant increase was found in prolonged intra-and inter-atrial EMCD according to functional capacity increase (p=0.012 and p=0.031, respectively). The incidence of mortality was significantly higher in patients with prolonged atrial EMCD (p=0.025), and 5 patients in the HF group died during the study over the 12-month follow-up period. Conclusions: In this study, we found a relationship between prolonged atrial conduction time and increased functional class and mortality in patients with systolic HF.Öğe Evaluating the Early and Late Period Functional Capacity, Morbidity and Mortality Effects in the Presence of Intra-atrial Electromechanical Conduction Delay in Heart Failure Patients(Wiley-Blackwell, 2012) Bilgin, Murat; Yildiz, Bekir Serhat; Gul, Ilker; Sayin, Ahmet; Islamli, Aysel; Zoghi, Mehdi; Akin, MustafaÖğe Evaluation of radial artery endothelial functions in transradial coronary angiography according to different radial access sites(Turkish Soc Cardiology, 2021) Soydan, Elton; Kis, Mehmet; Akin, MustafaObjective: Radial endothelial dysfunction may occur after transradial coronary angiography (CAG). This study aimed to make a comparative evaluation of the radial endothelial functions before and after catheterization between three different radial access sites: left radial (LR) artery, left distal radial (LDR) artery, and right radial (RR) artery. Methods: Seventy patients scheduled for elective transradial CAG and intervention from September 6, 2017 to March 6, 2018 were consecutively enrolled. Radial artery endothelial functions of the catheterization arm were measured by flow-mediated vasodilation (FMD) upon admission, at 24 hours, and 2 months following the procedure. Results: LR access was used in 17 patients, whereas the LDR and the RR access were used in 27 and 26 patients, respectively. Basal radial diameters and FMD median values measured on the intervention arm were found to be similar between groups (LR 3.04 +/- 0.29 mm, 13.33%; LDR 2.79 +/- 0.31 mm; 13.64%; RR 2.74 +/- 0.29 mm; 12.52%, p=0.952). The radial vasodilation percentage change expressed as median decreased in all groups 24 hours after the procedure; however, the one with the LDR access was found to be significantly higher than with the LR (9.7% vs. 6.25% p=0.013) and the RR access (9.7% vs. 3.39 p<0.001). A partial recovery of endothelial functions was seen at 2 months after the procedure, approximating to basal values (11.11%; 12%; 10.62%, p=0.079, respectively). Conclusion: Radial artery functions deteriorate early after transradial catheterization. The LDR access seems safer than the other conventional radial access sites in terms of preservation of radial endothelial functions.Öğe Excimer laser assisted implantable cardioverter defibrillator lead extraction: An alternative treatment to the surgery?(Turkish Soc Cardiology, 2009) Gungor, Hasan; Duygu, Hamza; Yildiz, Bekir Serhat; Gul, Ilker; Zoghi, Mehdi; Akin, MustafaÖğe Excimer laser assisted implantable cardioverter defibrillator lead extraction: An alternative treatment to the surgery?(Turkish Soc Cardiology, 2009) Gungor, Hasan; Duygu, Hamza; Yildiz, Bekir Serhat; Gul, Ilker; Zoghi, Mehdi; Akin, MustafaÖğe A gold standard method for early detection of transplant vasculopathy after heart transplantation: intravascular ultrasound(Aves Yayincilik, 2008) Saygi, Serkan; Zoghi, Mehdi; Nalbantgil, Sanem; Yagdi, Tahir; Akin, Mustafa; Oezbaran, Mustafa; Durmaz, IsaÖğe High-sensitivity C-reactive protein may be an indicator of the development of atherosclerosis in myocardial bridging(Elsevier Ireland Ltd, 2008) Duygu, Hama; Zoghi, Mehdi; Nalbantgil, Sanem; Ozerkan, Filiz; Cakir, Cayan; Ertas, Faruk; Yuksek, Umit; Akilli, Azern; Akin, Mustafa; Ergene, OktayBackground: Inflammation is one of the key mechanism in the development and progression of coronary artery disease. Myocardial bridging (MB) increases the tendency for development of atherosclerosis. The role of inflammation on the development of atherosclerosis in the MB is not clear. In this study, we investigated the existence of inflammation in the patients who have atherosclerotic plaque in the bridged segment. Methods: This study included 40 patients (group I) presented with stable angina pectoris and detected MB in LAD on coronary angiography and 30 control subjects (group II) with normal coronary angiogram. Patients in group I were divided into two subgroups based on the findings on intravascular ultrasound (IVUS): group IA included 25 patients without atherosclerotic lesion in any coronary artery and group IB included 15 patients with atherosclerotic lesion in addition to MB in bridged segment of LAD. High-sensitivity C-reactive protein (hs-CRP) levels were compared between group I and II and group IA and IB. Results: IVUS showed an atherosclerotic involvement with the proximal segment of MB in 15 patients (=group IB). No plaques were seen in other coronary arteries, in distal of MB or in the bridged segment. With regards to the level of hs-CRP, while no difference was established between group I and group II(1.7 +/- 0.4 mg/L vs 1.9 +/- 0.6 mg/L,p > 0.05), hs-CRP was significantly higher in group IB than in group IA (3.2 +/- 0.3 mg/L vs 1.5 +/- 0.2 mg/L, p=0.001) and control group (3.2 +/- 0.3mg/L vs 1.9 +/- 0.6 mg/L, p=0.03). A significant positive correlation was detected between the hs-CRP and the percentage of atherosclerotic stenosis on IVUS in group IB (R=0.639,p=0.01). Conclusions: These results indicate the presence of a low grade inflammation in patients with atherosclerotic lesion in bridged segment. (c) 2007 Elsevier Ireland Ltd. All rights reserved.Öğe Impaired endothelial function in patients with myocardial bridge(Blackwell Publishing, 2006) Zoghi, Mehdi; Duygu, Hamza; Nalbantgil, Sanem; Kirilmaz, Bahadir; Turk, Ugur; Ozerkan, Filiz; Akilli, Azem; Akin, Mustafa; Turkoglu, CuneytObjective: The relationship between myocardial bridging (MB) and ischemic heart disease is still controversial. In this study, we aimed to evaluate the existing atherosclerosis and noninvasive endothelial function of brachial artery in patients with MB. Methods: The present study included 50 patients (group I) who had MB in left anterior descending (LAD) on coronary angiography. All of the coronary artery segments were evaluated by intravascular ultrasound (IVUS). Endothelial function was assessed with measurement of flow-mediated dilatation (FMD) and nitrate-dependent dilatation in the brachial artery. The study also included 30 healthy control subjects (group II). Patients in the group I were further subdivided into two subgroups based on the findings on IVUS: group IA included 20 patients without atherosclerotic lesions and group IB included 30 patients with atherosclerotic coronary artery disease in addition to MB. Results: FMD values were found to be significantly lower in the patients with MB (group I) than in the control (6.4 +/- 3% vs 11 +/- 4%, P < 0.001). In regard to FMD values in subgroups, FMD was 7 +/- 2% in the group IA and 5.8 +/- 1% in the group IB (P = 0.023). On IVUS, atherosclerotic plaque was found proximal to the bridge in the same coronary artery segment in addition to MB in 75% of the patients in group I (group IB). No atherosclerotic plaque was found in within or distal segments of MB. Conclusion: Endothelial function is impaired in patients with MB and there is an increased tendency for atherosclerosis proximal to the bridge in the patients with MB. Endothelial dysfunction is more severe in the patients with atherosclerosis proximal to the bridge.Öğe In response to: Radial Artery Cannulation at the Anatomical Snuffbox: Hype or Hope in Interventional Cardiology?(Galenos Publ House, 2021) Soydan, Elton; Akin, Mustafa[No Abstract Available]
