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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.
Anthracycline Chemotherapy-Induced Electro-Mechanical Changes: Strain Echocardiography Combined with Repolarization Parameters on Electrocardiography to Predict Early Cardiotoxicity
(Aves, 2022) Ozbay, Benay; Simsek, Evrim; Kemal, Hatice; Cakar, Burcu; Yavuzgil, Oguz
Objective: The aim of the study was to describe the acute cardiotoxic effects of anthracycline chemotherapy in echocardiographic strain and electrocardiographic repolarization parameters in patients with breast cancer. Methods: A total of 35 consecutive patients (all females, mean age: 48.9 +/- 11.8 years) who received chemotherapy due to breast cancer were prospectively included. Pre-treatment (T0) and third month (T2) 2-dimensional strain echocardiography and electrocardiography were performed. Additionally, within 3 hours of the first dose of chemotherapy (T1), additional electrocardiographic images were obtained. All mechanical and electrical parameters from different time intervals (T0, T1, and T2) were compared with each other. Results: In the acute period after treatment, electrocardiographic repolarization parameters were prolonged and this prolongation continued to the third month (QT corrected with Bazett formula [440.10 +/- 27.63 (T0), 468.00 +/- 38.98 (T1), 467.86 +/- 35.09 (T2)], QT dispersion [49.85 +/- 19.52 (T0), 69.54 +/- 16.06 (T1), 57.63 +/- 14.42 (T2)], and T-wave peak-to-end interval [94.00 +/- 45.46 (T0), 131.20 +/- 17.79 (T1), 120.00 +/- 18.32 (T2)]; P <.001). There was no significant change in global longitudinal strain values before and after treatment (global longitudinal strain avg: -21 +/- 7.1%; P =.8). However, there were significant reductions in strain parameters including circumferential and radial strain, and torsion (-17.2 +/- 3.5 to -13 +/- 2.84; P <.001, 45.1 +/- 8.3 to 35.6 +/- 10; P <.001, and 12.1 +/- 3.5 to 7.7 +/- 2.1; P <.001, respectively). Conclusion: Both the electrical and mechanical functions of the heart can be impaired acutely extending to 3 months after anthracycline chemotherapy. Therefore, cardiotoxicity should be evaluated early both electrically and mechanically after chemotherapy.
Are there any subclinical myocardial dysfunctions in subjects with aortic valve sclerosis? A 3D-speckle tracking echocardiography study
(Springer, 2020) Dogdus, Mustafa; Yildirim, Arafat; Kucukosmanoglu, Mehmet; Kilic, Salih; Yavuzgil, Oguz; Nalbantgil, Sanem
Aortic valve sclerosis (AVS) is defined as calcified and thickened aortic leaflets without restriction of leaflet motion. We have not found any studies that previously assessed the effect of AVS on myocardial functions with three dimensional-speckle tracking echocardiography (3D-STE). Therefore, we aimed to identify any early changes in left atrial (LA) myocardial dynamics and/or left ventricular (LV) systolic functions in patients with AVS using 3D-STE. Seventy-five patients with AVS and 80 age- and gender-matched controls were enrolled into the study. the baseline clinical characteristics of the study patients were recorded. Conventional 2D echocardiographic and 3D-STE analyses were performed. the LV-global longitudinal strain (LV-GLS) and LV-global circumferential strain (LV-GCS) were significantly decreased in the AVS (+) group than in the control group (p < 0.001 and p = 0.013, respectively). in multivariate logistic regression analysis; LV-GLS (p < 0.001, odds ratio (OR) = 3.16, 95% confidence interval (CI) 1.42-5.63) and Triglyceride (TG) (p = 0.033, OR = 1.29, 95% CI 1.11-1.72) were found to be independent predictors of AVS. ROC analysis was performed to find out the ideal LV-GLS cut-off value for predicting the AVS. A LV-GLS value of > - 18 has 85.8% sensitivity, 67.5% specificity for the prediction of the AVS. Our results support that subjects with AVS may have subclinical LV deformation abnormalities even though they have not LV pressure overload. According to our findings, patients with AVS should be investigated in terms of atherosclerotic risk factors, their dysmetabolic status should be evaluated and closely followed up for their progression to calcific aortic stenosis.
Assessment of cardiac remodeling in asymptomatic mitral regurgitation for surgery timing: a comparative study of echocardiography and magnetic resonance imaging
(Biomed Central Ltd, 2010) Ozdogan, Oner; Yuksel, Alper; Gurgun, Cemil; Kayikcioglu, Meral; Yavuzgil, Oguz; Cinar, Cahide S.
Background: Early surgery is recommended for asymptomatic severe mitral regurgitation (MR), because of increased postoperative left ventricular (LV) dysfunction in patients with late surgery. On the other hand, recent reports emphasized a "watchful waiting" process for the determination of the proper time of mitral valve surgery. In our study, we compared magnetic resonance imaging (MRI) and transthoracic echocardiography to evaluate the LV and left atrial (LA) remodeling; for better definitions of patients that may benefit from early valve surgery. Methods: Twenty-one patients with moderate to severe asymptomatic MR were evaluated by echocardiography and MRI. LA and LV ejection fractions (EFs) were calculated by echocardiography and MRI. Pulmonary veins (PVs) were measured from vein orifices in diastole and systole from the tangential of an imaginary circle that completed LA wall. Right upper PV indices were calculated with the formula; (Right upper PV diastolic diameter-Right upper PV systolic diameter)/Right upper PV diastolic diameter. Results: In 9 patients there were mismatches between echocardiography and MRI measurements of LV EF. LV EFs were calculated >= 60% by echocardiography, meanwhile < 60% by MRI in these 9 patients. Severity of MR evaluated by effective regurgitant orifice area (EROA) didn't differ with preserved and depressed EFs by MRI (p > 0.05). However, both right upper PV indices (0.16 +/- 0.06 vs. 0.24 +/- 0.08, p: 0.024) and LA EFs (0.19 +/- 0.09 vs. 0.33 +/- 0.14, p: 0.025) were significantly decreased in patients with depressed EFs when compared to patients with normal EFs. Conclusions: MRI might be preferred when small changes in functional parameters like LV EF, LA EF, and PV index are of clinical importance to disease management like asymptomatic MR patients that we follow up for appropriate surgery timing.
Comparison of anti-factorXa assay and rotational thromboelastogram in evaluating the efficacy of enoxaparine treatment in patients with acute coronary syndrome without ST-segment elevation
(Cukurova Univ, Fac Medicine, 2021) Gunduz, Ramazan; Yildiz, Bekir Serhat; Ozdemir, Ibrahim Halil; Ozen, Mehmet Burak; Cetin, Nurullah; Yavuzgil, Oguz
Purpose: The aim of this study was to compare anti-factor Xa assay and tromboelastogram in evaluation of efficacy of enoxaparin in patients with acute coronary syndrome without ST-segment elevation. Materials and Methods: Twenty-five patients with acute coronary syndrome were involved. Two blood samples were taken on admission and 4 hours after the subcutaneous injection of third dose of 1mg/kg enoxaparin to the patients. AntiFXa, tromboelastogram, activated coagulation time were calculated. Results: A non-significant increase in activated coagulation time was observed after the injection of enoxaparin. After injection enoxaparin thromboelastography parameters changed maximum amplitude(MA) increased (MA basal 65.4 +/- 11.9 after 63.4 +/- 7.8), R time increased (from 5 +/- 1.7 to 8.4 +/- 4.6,), K time increased (from 1.89 +/- 1.06 to 2.56 +/- 1.4), angle increased (from 66.34 +/- 5.6 to 57.9 +/- 11.4). AntiFXa increased. (from 0.122 +/- 0.06 to 0.501 +/- 0.359). Conclusion: Tromboelastography method can be used in assessment of efficacy of enoxaparin in patients with acute coronary syndrome without ST-Segment elevation.
The Effect of Foot Reflexology Applied Before Coronary Angiography and Percutaneous Transluminal Coronary Angioplasty on Anxiety, Stress, and Cortisol Levels of Individuals A Randomized Controlled Trial
(Lippincott Williams & Wilkins, 2021) Dogru, Birgul Vural; SenuzunAykar, Fisun; Yildirim, Yasemin; Yavuzgil, Oguz; Sozmen, Eser; Memmedov, Hikmet
Background Coronary angiography and percutaneous transluminal coronary angioplasty procedures cause anxiety and stress in individuals. Objective The aim of this study was to determine the effect of foot reflexology applied before coronary angiography and percutaneous transluminal coronary angioplasty on the anxiety, stress, and cortisol levels of individuals. Methods A simple randomized trial design was used. The patients who met the inclusion criteria were divided into 4 groups including experimental and control groups of coronary angiography patients (30 patients in each group) and percutaneous transluminal coronary angioplasty (26 patients in each group) by randomization method. Data were collected with the State-Trait Anxiety Inventory and Distress Thermometer 90 minutes before coronary angiography and percutaneous transluminal coronary angioplasty and the laboratory samples were taken. After these procedures, foot reflexology was applied to both feet of the patients in the experimental group for 30 minutes, and the control group received only standard care. The inventories were reapplied 30 minutes after the reflexology application and after coronary angiography and percutaneous transluminal coronary angioplasty. Results Whereas there was no statistically significant difference (P > .05) between the coronary angiography and percutaneous transluminal coronary angioplasty experimental and control groups in Anxiety Inventory and stress median scores before reflexology, a significant difference was found (P < .001) 30 minutes after reflexology application and after coronary angiography and percutaneous transluminal coronary angioplasty. After the reflexology, anxiety and stress scores were significantly lower in the experimental group compared with the control group (P < .001). Whereas there was a significant difference (P < .001) in the within-group cortisol values of both reflexology groups, no significant difference was found in the control groups (P > .05). Conclusions The application of reflexology before coronary angiography and percutaneous transluminal coronary angioplasty reduces the levels of anxiety, stress, and cortisol without any side effects.
The effects of short term statin treatment on left ventricular function and inflammatory markers in patients with chronic heart failure
(Elsevier Ireland Ltd, 2008) Gurgun, Cemil; Ildizli, Muege; Yavuzgil, Oguz; Sin, Aytuel; Apaydin, Anil; Cinar, Cahide; Kultursay, Hakan
Background: Statins may provide additional benefits in patients with cardiac failure due to their pleiotropic effects besides their cholesterol-lowering actions. In this study, we aimed to evaluate the impact of 12-week fluvastatin therapy on the inflammatory cytokines and the ventricular performance markers in patients with heart failure. Methods and results: Fourty chronic heart failure patients, twenty with idiopathic dilated cardiomyopathy (DCM group) and 20 with ischemic cardiomyopathy (ICM group), for whom statin treatment was indicated according to Adult Treatment Panel III were included to this open label and prospective study. After a 12-week treatment with fluvastatin 80 mg/day; clinical functional capacity, echocardiographic indices of cardiac performance and inflammatory markers were evaluated. After the treatment, functional capacity (in DCM group: 2.05 +/- 0.4 versus 1.65 +/- 0.6, p = 0.005; in ICM group: 2.25 +/- 0.5 versus 1.8 +/- 0.6, p= 0.003), left ventricular ejection fraction, LVEF (from 30 +/- 5% to 33 +/- 5%, p= 0.001 in DCM and 29 +/- 4% to 31 +/- 5%, p= 0.001 in ICM group) and tissue Doppler mitral annular systolic velocity, Sm (5.8 +/- 1 cm/s to 7 +/- 1 cm/s, p= 0.001 in DCM and 5.4 +/- 0.8 cm/s to 7 +/- 1 cm/s, p= 0.001 in ICM group) improved. Tumor necrosis factor-alpha and interleukin-6 levels decreased, but no significant changes in high sensitive C-reactive protein and brain natriuretic peptide levels were detected with the fluvastatin treatment in both groups. Conclusion: Fluvastatin improved cardiac functions and the clinical symptoms in HF patients with either idiopathic dilated or ischemic etiology. This positive effect of fluvastatin which might be secondary to inflammatory modulation was more marked in patients with ischemic etiology. Statins in HF deserves special attention by means of further large-scale trials. (c) 2007 Elsevier Ireland Ltd. All rights reserved.
Evaluation of the Severity of Mitral Regurgitation by the Use of Signal Void in Magnetic Resonance Imaging
(Wiley-Blackwell Publishing, Inc, 2009) Ozdogan, Oner; Yuksel, Alper; Gurgun, Cemil; Kayikcioglu, Meral; Yavuzgil, Oguz; Cinar, Cahide Soydas
Background: The study was designed to evaluate the severity of mitral regurgitation by cardiac magnetic resonance imaging (MRI). We proposed a new measurement of signal void by MRI and tried to define threshold values for the severity of regurgitation with different sequences. Methods: Twenty-one patients with mitral regurgitation were evaluated by echocardiography and MRI. We measured the length, width, and the area of jet flow void from long-axis and four-chamber views. The regurgitant area was measured with TrueFISP, FLASH sequences, and phase images by tracing the signal-void area in left atrium parallel to mitral annulus. This new parameter for grading of the severity of mitral regurgitation by cine MRI was called regurgitant area from short axis (RAFSA). Results: All methods (EROA, vena contracta) were correlated for determining the regurgitation severity (P < 0.01). There was a correlation between EROA by echocardiography and RAFSA by MRI with the TrueFISP, FLASH sequences, and phase images (P < 0.01). Stepwise regression analysis revealed that EROA was significantly correlated with RAFSA by phase images (P < 0.001). After regression analysis, threshold values of RAFSA by phase imaging were calculated and found to be 0.27 cm(2) and 0.92 cm(2) between mild, moderate, and severe mitral regurgitations (100% sensitivity, 67% specificity, and 100% sensitivity, 78% specificity, respectively) (P < 0.01, P < 0.05). Conclusions: MRI is an alternative method for evaluating mitral regurgitation. Our study suggests a new parameter, RAFSA by cine MRI, to grade the severity of mitral regurgitation and provides threshold values in order to define mild, moderate, and severe regurgitations. (ECHOCARDIOGRAPHY, Volume 26, November 2009)
Evaluation of the Severity of Mitral Regurgitation by the Use of Signal Void in Magnetic Resonance Imaging
(Wiley-Blackwell Publishing, Inc, 2009) Ozdogan, Oner; Yuksel, Alper; Gurgun, Cemil; Kayikcioglu, Meral; Yavuzgil, Oguz; Cinar, Cahide Soydas
Background: The study was designed to evaluate the severity of mitral regurgitation by cardiac magnetic resonance imaging (MRI). We proposed a new measurement of signal void by MRI and tried to define threshold values for the severity of regurgitation with different sequences. Methods: Twenty-one patients with mitral regurgitation were evaluated by echocardiography and MRI. We measured the length, width, and the area of jet flow void from long-axis and four-chamber views. The regurgitant area was measured with TrueFISP, FLASH sequences, and phase images by tracing the signal-void area in left atrium parallel to mitral annulus. This new parameter for grading of the severity of mitral regurgitation by cine MRI was called regurgitant area from short axis (RAFSA). Results: All methods (EROA, vena contracta) were correlated for determining the regurgitation severity (P < 0.01). There was a correlation between EROA by echocardiography and RAFSA by MRI with the TrueFISP, FLASH sequences, and phase images (P < 0.01). Stepwise regression analysis revealed that EROA was significantly correlated with RAFSA by phase images (P < 0.001). After regression analysis, threshold values of RAFSA by phase imaging were calculated and found to be 0.27 cm(2) and 0.92 cm(2) between mild, moderate, and severe mitral regurgitations (100% sensitivity, 67% specificity, and 100% sensitivity, 78% specificity, respectively) (P < 0.01, P < 0.05). Conclusions: MRI is an alternative method for evaluating mitral regurgitation. Our study suggests a new parameter, RAFSA by cine MRI, to grade the severity of mitral regurgitation and provides threshold values in order to define mild, moderate, and severe regurgitations. (ECHOCARDIOGRAPHY, Volume 26, November 2009)
Flow-safe disposable CPAP efficiency in cardiogenic pulmonary oedema
(W B Saunders Co-Elsevier Inc, 2020) Uz, Ilhan; Kiyan, Guclu Selahattin; Ozcete, Enver; Yalcinli, Sercan; Korgan, Mehmet Birkan; Altunci, Yusuf Ali; Yavuzgil, Oguz
[No abstract available]
Hereditary thrombophilia (factor V R2-mutation) as a contributing factor in premature myocardial infarction associated with pregnancy
(Turkish Soc Cardiology, 2014) Kayikcioglu, Meral; Yavuzgil, Oguz; Eroglu, Zuhal; Onay, Huseyin; Ergenoglu, Mete; Can, Levent
Is the flow-safe disposable continuous positive airway pressure (CPAP) system as effective as non-invasivemechanical ventilation (NIMV) in the treatment of acute cardiogenic pulmonary Oedema?
(W B Saunders Co-Elsevier Inc, 2021) Uz, Ilhan; Kiyan, Guclu Selahattin; Ozcete, Enver; Yalcinli, Sercan; Korgan, Mehmet Birkan; Altunci, Yusuf Ali; Yavuzgil, Oguz
[No Abstract Available]
The left atrial phasic functions and the relationship with plasma N-terminal pro-B-type natriuretic peptide levels and symptomatic states in patients with hypertrophic cardiomyopathy
(Turkish Soc Cardiology, 2014) Tuluce, Kamil; Tuluce, Selcon Yakar; Yavuzgil, Oguz; Isayev, Elnur; Bilgin, Murat; Akcay, Fitiz Akyildiz; Nalbantgil, Sanem; Ozerkan, Filiz
Objective: We aimed to evaluate left atrium (LA) phasic functions and relation with N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and symptomatic states of the patients with hypertrophic cardiomyopathy (HCM). Methods: Left atrial volume was calculated at end-systole (Vmax), end-diastole and pre-atrial contraction by echocardiography in 75 patients with HCM and 75 control subjects. Left atrial ejection fraction (LAEF), expansion index (LAEI), active emptying volume index (LAAEVI) and fraction (LAAEFr), passive emptying volume index (LAPEVI) and fraction (LAPEFr) were calculated. NT-proBNP levels were measured. Results: Left atrial active emptying volume (LAAEV) positively correlated with Vmax (r=0.343, p=0.003) up to a point, but then reached a plateau with larger LA volumes in HCM group. The LAAEFr was the only variable which was similiar between asymptomatic patients and controls, but was significantly decreased in symptomatic patients (p<0.05). NT-proBNP was correlated with LAEF (r=-0.32, p=0.005), LAEI (r=-0387, p=0.001), and LAAEFr (r=-0.25, p=0.035) but not related with LAPEFr (p=0.4). In receiver operating characteristic curve analysis an NT-proBNP cut-off value of 1415 pg/mL identified reduced LAEF with 87% specificity and 59% sensitivity [AUC=0.77 (95% CI: 0.65-0.89), p=0.004], a cut-off value of 820 pg/mL predicted impaired LAEI with 81% specificity ve 67% sensitivity [AUC=0.78 (95% CI: 0.66-0.9), p<0.001]; while a cut-off value of 1320 pg/mL predicted impaired LAAEFr with 76% specificity and 67% sensitivity [AUC=0.79 (95% CI: 0.68-0.91), p=0.02]. Conclusion: In HCM, LA phasic functions alter according to the Frank-Starling mechanism indicating occurrence of a secondary atrial myopathy. Impairment of LA booster pump function seems to be associated with appearance of symptoms and NT-proBNP levels predict the deterioration of LA reservoir and pump functions in HCM population.
Predictive value of CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores for failed reperfusion after thrombolytic therapy in patients with ST-segment elevation myocardial infarction
(Via Medica, 2019) Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oguz; Cetin, Mustafa; Zoghi, Mehdi
Background: Thrombolytic therapy is recommended for patients with acute ST-segment elevation myocardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study was to demonstrate the value of CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy. Methods: A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis. Thrombolysis failure was defined with the lack of symptom relief < 50% ST resolution-related electrocardiography within 90 min from initiation of the thrombolytic therapy, presence of hemodynamic or electrical instability or in-hospital mortality. CHA(2)DS(2)-VASc and CHA(2)DS(2)-VASc-HS scores, which incorporate hyperlipidemia, smoking, switches between female and male gender; were previously shown to be markers of the severity of coronary artery disease (CAD). Results: History of hypertension, diabetes mellitus, hyperlipklemia, heart failure, smoking, and CAD were significantly common in failed reperfusion patients (far all; p < 0.05). Far prediction of failed reperfusion, the cut-off value of CHA(2)DS(2)-VASc score was >= 2 with a sensitivity of 80.90% and a specificity of 41.01% (area under curve IAUC] 0.660; 95% confidence interval [CI] 0.618-0.700; p < 0.001) and the cut-off value of CHA(2)DS(2)-VASc-HS score was 3 with a sensitivity of 76.13% and a specificity of 67.63% (AUC 0.764; 95% CI 0.725-0.799; p < 0.001). The CHA,DS r VASc-HS score was found to be statistically and significantly better than CHA(2)DS(2)-VASc score to predict failed reperfusion (p < 0.001). Conclusions: The findings suggest that the CHA(2)DS(2)-VASc and especially CHA(2)DS(2)-VASc-HS scores could be considered as predictors of risk of failed repolusion in STEMI patients.
Pseudonormalization: clinical, electrocardiographic, echocardiographic, and angiographic characteristics
(Turkish Soc Cardiology, 2007) Ulucan, Cem; Yavuzgil, Oguz; Kayikcioglu, Meral; Can, Levent; Payzm, Serdar; Kultursay, Hakan; Soydan, Inan; Hasdemir, Can
Objective: Spontaneous pseudonormalization (PN) is a unique 12-lead electrocardiography (ECG) finding which has been reported to be associated with severe, transmural myocardial ischemia. To date, a paucity of data exists about the incidence and clinical characteristics of patients with PN. Therefore the aim of this study was to investigate the incidence and the electrocardiographic, echocardiographic, and angiographic characteristics of patients with PN. Methods: Clinical, laboratory, electrocardiographic, echocardiographic, and angiographic characteristics of 12 consecutive patients with PN on 12-lead ECG (Group 1) were compared with patients (Group 2, n = 28) presenting with acute coronary syndrome (ACS) associated with ST-T wave changes without PN. Results: All patients presented with chest pain. The incidence of PN among patients presenting with ACS was 1%. Pseudonormalization was present in precordial leads in 11 and in inferior leads in 1 patient. Nine out of 12 (75%) patients in Group 1, 16 out of 28 (57%) patients in Group 2 had elevation of cardiac enzymes compatible with acute myocardial infarction. Severely narrowed or totally occluded ischemia and/or infarction-related coronary arteries were present in all patients in Group 1, in 20 (71%) patients in Group 2. Three patients in Group 1 and one patient in Group 2 had coronary artery thrombus formation. Group 1 patients had worse coronary collateral grading in comparison to Group 2 patients. Conclusion: Pseudonormalization is a rare entity and it is typically associated with severely narrowed or totally occluded coronary arteries along with thrombus formation, and poor coronary collateral development.
A rare cause of dyspnea: Left atrial angiosarcoma
(Turkish Soc Cardiology, 2019) Turkoglu, Ebru Ipek; Yavuzgil, Oguz
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
Relationships between P wave dispersion, atrial electromechanical delay, left atrial remodeling, and NT-proBNP levels, in patients with hypertrophic cardiomyopathy
(Via Medica, 2015) Tuluce, Kamil; Ozerkan, Filiz; Tuluce, Selcen Yakar; Yavuzgil, Oguz; Gurgun, Cemil; Bilgin, Murat; Eren, Nihan Kahya; Kocabas, Ugur; Nalbantgil, Sanem; Cinar, Cahide Soydas
Background: We evaluated the associations among the well-known atrial fibrillation (AF) predictors including P-wave dispersion (PWD), intra- and inter-atrial electromechanical dyssynchrony (EMD), left atrial (LA) phasic functions, and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels, in patients with hypertrophic cardiomyopathy (HCM). Methods: Seventy patients with HCM and age and sex matched 70 subjects were enrolled. PWD, LA total emptying fraction (LATEFr), active emptying fraction (LAAEFr), passive emptying fraction (LAPEFr), expansion index (LAEI) intra-and inter-atrial EMD were calculated. Levels of NT-proBNP of all subjects were determined. Results: Higher PWD (p = 0.006), significantly decreased LAEI (p < 0.001), LATEFr, and LAPEFr (both p values < 0.001) values and significantly increased inter-atrial (p < 0.001), LA (p = 0.001), and right atrial dyssynchrony (p < 0.001) were observed in the HCM group compared to controls. PWD was negatively correlated with LAEI (r = -0.236, p = 0.005) and LATEFr (r = -0.242, p = 0.04), however not with LAPEFr (p = 0.7), or LAAEFr (p = 0.3). Except for the LA lateral wall PA' (r = 0.283, p = 0.02), PWD was not correlated with any atrial EMD parameter. Inter-atrial dyssynchrony was related to LAEI (r = -0.272, p = 0.001), LATEFr (r = -0.256, p = 0.03), and LAPEFr (r = -0.332, p = 0.006), but not, however, to LAAEFr (p = 0.4). The plasma NT-proBNP levels of patients were not correlated with either PWD (p = 0.927) or inter-atrial dyssynchrony (p = 0.102). Conclusions: PWD and inter-atrial dysynchrony seem to independently promote AF, although both are associated with LA reservoir function in HCM populations. The NT-proBNP level is not associated with these two AF predictors in patients with HCM. NT-proBNP seems to be a poor marker of atrial electrical remodeling in HCM patients.
Reoperative Off-Pump Right Subclavian Artery to Right Coronary Artery Bypass Grafting Without Full Sternotomy
(Wiley-Blackwell, 2011) Apaydin, Anil Z.; Oguz, Emrah; Posacioglu, Hakan; Calkavur, Tanzer; Ayik, Fatih; Turhan, Soysal; Yavuzgil, Oguz; Ceylan, Naim
P>Stenosis or occlusion of a large right coronary artery or its vein grafts in symptomatic patients who underwent previous bypass grafting procedure with patent left-sided grafts is mostly managed by percutaneous interventions. When percutaneous interventions fail, it is a difficult decision to reoperate on a such patient for a single-vessel disease considering the risk of resternotomy. We present our technique which involves small anterior thoracotomy and partial sternotomy. (J Card Surg 2011;26:148-150).
The Severity of Coronary Arterial Stenosis in Patients With Acute ST-Elevated Myocardial Infarction: A Thrombolytic Therapy Study
(Elmer Press Inc, 2018) Kilic, Salih; Kocabas, Umut; Can, Levent Hurkan; Yavuzgil, Oguz; Zoghi, Mehdi
Background: It is widely believed that ST-elevated myocardial infarction (STEMI) generally occurs at the site of mild to moderate coronary stenosis. The aim of this study was to determine the degree of stenosis of infarct-related artery (IRA) in STEMI patients who underwent coronary angiography (CAG) after successful reperfusion with thrombolytic therapy (TT). Methods: A total of 463 consecutive patients between January 2008 and December 2013 with acute STEMI treated with TT were evaluated retrospectively. The patients in whom reperfusion failed (n = 120), death occurred before CAG (n = 12), IRA cannot be determined (n = 10), and CAG was not performed in index hospitalization (n = 54) were excluded from the study. To determine the severity of stenosis of IRA, two experienced cardiologists who were unaware of each other used quantitative CAG analysis. Significant stenosis was defined as a >= 50% stenosis in the coronary artery lumen. A total of 267 patients who were successfully reperfused with TT and in whom CAG was performed during hospitalization with median 8 (1 - 17) days after myocardial infarction were included in the study. Results: The mean age of patients was 55.7 +/- 10.8 years (85.5% male). Most of the patients had a significant stenosis in IRA (>= 50%, n = 236, group 1) after successful TT; whereas only 11.6% had stenosis < 50% (n = 31, group 2). In addition, majority of the patients had >= 70.4% (n = 188, 70.4%) stenosis in IRA. Average of stenosis in IRA was 74 +/- 16%. Conclusions: In contrast to the general opinion, we detected that majority of STEMI patients had a significant stenosis in IRA.

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