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    Angiographic analysis of the anatomic relation of coronary arteries to mitral and tricuspid annulus and implications for radiofrequency ablation
    (Excerpta Medica Inc-Elsevier Science Inc, 2007) Hasdemir, Can; Yavuzgil, Oguz; Payzin, Serdar; Aydin, Mehmet; Ulucan, Cern; Kayikcioglu, Meral; Can, Levent H.; Turkoglu, Cuneyt; Kultursay, Hakan
    Coronary artery (CA) narrowings and/or occlusions after radiofrequency ablation (RFA) have been reported. The aim of this study was to describe the in vivo topographic anatomy of CAs and their anatomic relation to the mitral and tricuspid annulus using selective coronary angiography. Fifty consecutive patients undergoing RFA for narrow QRS complex tachycardia were included in the study. Multipolar electrode catheters were inserted into the right atrial appendage, His bundle region, distal coronary sinus (CS), and right ventricle. A mapping catheter was placed across the subeustachian isthmus (SEI). Selective coronary angiography was performed. The maximum and minimum distances between the distal CAs and the mapping catheter located along the mitral and tricuspid annulus were measured during systole and diastole and in right and left anterior oblique projections. The large (>= 1.5 mm) distal right CA was <= 5 mm from the mapping catheter in the SEI in 4 patients (8%). The large posterolateral branch of the right CA was <= 2 mm from the CS Os-middle cardiac vein in 10 patients (20%). The large left circumflex CA was <= 2 mm. from the floor or ceiling of the CS in 7 patients (14%) and <= 2 mm from the CS catheter at the lateral and anterolateral mitral annulus in 12 patients (24%). RFA was canceled in 2 patients because of the close proximity (<= 2 mm) of the distal CA to the ablation site. In conclusion, large CAs are frequently located in close proximity to the common ablation sites. Coronary angiography should be considered in children and adults who may develop any signs or symptoms suggestive of acute CA occlusion until larger controlled series are available. (c) 2007 Elsevier Inc. All rights reserved.
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    Brugada syndrome, Brugada phenocopy or none?
    (Wiley, 2017) Kocabas, Umut; Hasdemir, Can; Kaya, Esra; Turkoglu, Cuneyt; Baranchuk, Adrian
    Brugada syndrome is a form of inherited arrhythmia syndrome characterized by a distinct ST-segment elevation in the right precordial leads. Brugada phenocopies are clinical entities that present with an electrocardiographic pattern identical to Brugada syndrome and may obey to various clinical conditions. We present a case of a suicidal attempt using a high dose of propafenone causing a Brugada-type electrocardiographic pattern. Is this a Brugada syndrome case, a Brugada phenocopy or something else?
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    Effect of Mean Platelet Volume on Postintervention Coronary Blood Flow in Patients with Chronic Stable Angina Pectoris
    (H M P Communications, 2008) Duygu, Hamza; Turkoglu, Cuneyt; Kirilmaz, Bahadir; Turk, Ugur
    Objectives. In our study we sought to determine whether mean platelet volume (MPV), measured on admission, could be used in determining decreased coronary blood flow (CBF) in stable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI). Background. Platelets play a crucial role in the pathophysiology of CAD. MPV reflects platelet function and activity. There are no reports regarding the effect of MPV on CBF in patients with stable CAD undergoing PCI. Methods. A total of 66 consecutive patients (mean age: 58 +/- 5 years, 74% male) with the diagnosis of stable CAD who were hospitalized for PCI were prospectively enrolled in our study. Coronary flow rates of all subjects were documented by corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) for each major coronary artery before and after PCI. Blood samples for MPV estimation, platelet count and other laboratory data obtained on admission were measured on the day of the scheduled PCI. Patients were divided into two groups according to MPV levels measured on admission: 1) high MPV group and 2) normal MPV group. Results. A final TIMI 3 flow was achieved in all patients with no complications. Procedural characteristics of PCI, except left anterior descending artery intervention, were similar in the two groups. Patients with high MPV had significantly higher CTFC than those with a normal MPV (24 +/- 3 vs. 17 +/- 5; p = 0.001). The MPV correlated strongly with post-PCI CTFC (R = 0.625; p = 0.0001). Multiple logistic regression analysis showed that only MPV was an independent predictor of post-PCI CTFC after adjustment for baseline characteristics (OR 1.9, 95% CI 1.2-2.3; p = 0.001). Conclusions. MPV may be considered a useful hematological marker, allowing for early and easy identification of patients with stable CAD who are at a higher risk of post-PCI low-reflow.
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    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, Cuneyt
    Objective: 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.
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    The relationship between the coronary artery anatomy and the subeustachian isthmus, coronary sinus Os-middle cardiac vein and floor of coronary sinus
    (Elsevier Science Inc, 2007) Hasdemir, Can; Yavuzgil, Oguz; Ulucan, Cam; Kayikcioglu, Meral; Kultursay, Hakan; Turkoglu, Cuneyt; Can, Levant H.; Payzin, Serdar
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    The role of specialized prevention clinics for the short term follow-up of acute coronary syndromes
    (Turkish Soc Cardiology, 2017) Kilic, Salih; Simsek, Evrim; Kemal, Hatice Soner; Yuce, Elif Ilkay; Turkoglu, Cuneyt; Kayikcioglu, Meral
    Objective: This study aimed to investigate the effect of specialized prevention clinics and standard clinics follow-ups on secondary protection after acute coronary syndrome (ACS) on cardiovascular risk factors. Methods: A total of 118 patients who received thrombolytic therapy after being diagnosed with ST-segment elevation myocardial infarction were followed up for 6 months. After ACS, patients in a specialized prevention clinic (Group 1) (n=67) and those in a standard clinic (Group 2) (n=51) were compared in terms of the change in their lifestyle, management of risk factors, and drug compliance. Results: No significant difference was found between groups in terms of baseline clinical and laboratory findings except for triglyceride level (Group 1: median 174 mg/dL; Group 2: median 136 mg/dL; p=0.039). Six months after indexing, smoking cessation (72.4% vs. 50%, p=0.037), diet compliance (43% vs. 19.6%, p=0.012), and exercise rates (31% vs. 13.7%, p= 0.044) were significantly higher in Group 1. Although the weight control rate was higher in Group 1, no significant difference was noted between the groups (27% vs. 15.6%, p=0.219). The rate of systolic and diastolic blood pressures > 140/90 mm Hg was significantly higher in Group 2 (23.5% vs. 9%, p=0.029)at 6 months. The median low-density lipoprotein cholesterol (LDL-C) value was significantly lower in Group 1 patients (Group 1: 91 mg/dL; Group 2: 102 mg/dL; p=0.042). Moreover, the rate of LDL-C = 70 mg/dL or >= 50% reduction compared with baseline was significantly higher in Group 1 (32.8% vs. 13.7%, p=0.016). Although the recommended treatments were similar in both groups, the statin use rate was significantly higher in Group 1 (95.5% vs. 80.3%, p=0.021)at 6 months. Conclusion: The results of the study showed that specialized prevention clinics were more effective during the management of cardiovascular risk factors after ACS.
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    Timing of Coronary Angiography After Successful Fibrinolytic Therapy in ST-Segment Elevated Myocardial Infarction
    (Elmer Press Inc, 2019) Kilic, Salih; Turkoglu, Cuneyt
    Background: We aimed to compare outcomes of patients received successful fibrinolytic treatment (FT) for ST-segment elevated myocardial infarction (STEMI) and performed coronary angiography (CAG) within 24 -72 h or after 72 h. Methods: Between March 2013 and November 2014, 76 STEMI patients received successful FT and performed CAG > 24 h were included in the study. Patients were divided into two groups according to the time-interval from FT admission to CAG performing (Group-1, 24 -72 h (n = 29), Group-2, > 72 h (n = 47)). The primary end point was major adverse cardiac events (MACE) defined as cardiovascular death, non-fatal myocardial infarction, and heart failure. Results: The mean age of patients were 56 +/- 11.4 years old (27.6% female). CAG was performed within mean 2.17 +/- 0.38 days in the Group-1 and 2.9 +/- 11.5 days in the Group 2 (P < 0.001). At short-term follow-up (6 months), MACE rate was higher in Group-2 (21.3%) than Group-1(13.8%), but it was not statistically significant (P = 0.661). The rate of MACE was 37.9% in Group-1 and 38.3% in Group-2 (P = 0.974) in the long-term follow-up (median: 57 months). Overall cardiac mortality rate was 7.9%, the re-infarction rate was 19.7% and heart failure was 17.1% in long-term follow-up, and there were no significant difference between groups. Conclusions: Present study has shown that performance of CAG after 24 h of successful FT, within 24 - 74 h or > 72 h, did not shown any difference in term of MACE both in short and long-term follow-up.