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    Could Epicardial Adipose Tissue Thickness by Echocardiography Be Correlated with Acute Coronary Syndrome Risk Scores
    (Wiley, 2013) Altun, Burak; Colkesen, Yucel; Gazi, Emine; Tasolar, Hakan; Temiz, Ahmet; Simsek, Hicran Yildiz; Barutcu, Ahmet
    AimThe aim of our study was, echocardiographic epicardial adipose tissue (EAT) thickness could show the severity and the prognosis of acute coronary syndromes (ACS). Methods and ResultsSixty-five ACS patients (mean age 57.412.2years) who underwent coronary angiography were studied. EAT thickness on the free wall of right ventricle was measured at end-diastole from the parasternal long-axis views of 3 cardiac cycles. SYNTAX and Global Registry of Acute Coronary Events (GRACE) scoring considered for severity and the prognosis of ACS. The mean value of the EAT thickness were 5.5 +/- 0.5mm (range 1-12mm). EAT thickness had a positive correlation with high sensitive troponin T (r=0.712, P<0.001) and body mass index (r=0.522, P<0.001.) EAT thickness was significantly correlated patients with high SYNTAX score (r=0.690, P<0.001), but not correlated with GRACE score (r=0.224, P=0.072). ConclusionEpicardial adipose tissue thickness was correlated with angiographic severity of ACS, but not correlated with clinical prognosis risk score.
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    Endothelial function and germ-line ACE I/D, eNOS and PAI-1 gene profiles in patients with coronary slow flow in the Canakkale population: multiple thrombophilic gene profiles in coronary slow flow
    (Clinics Cardive Publ Pty Ltd, 2014) Gazi, Emine; Temiz, Ahmet; Altun, Burak; Barutcu, Ahmet; Sılan, Fatma; Colkesen, Yucel; Özdemir, Öztürk
    Background: We examined the effects of ACE, PAI-1 and eNOS gene polymorphisms on endothelial function. The genes are related to atherosclerosis and endothelial dysfunction in coronary slow flow (CSF). Methods: Thirty-three patients with angiographically proven CSF and 48 subjects with normal coronary flow were enrolled in this study. Coronary flow patterns were determined by the thrombolysis in myocardial infarction (TIMI) frame count method. Endothelial function was assessed in the brachial artery by endothelium-dependent flow-mediated dilatation (FMD). PAI-1 4G/5G, eNOS T-786C and ACE I/D polymorphisms were determined by polymerase chain reaction (PCR) amplification. Results: No difference was found between the groups regarding age, heart rate and blood pressure. Males were more prevalent among patients with CSF than control subjects (58.8 vs 29.8%, p = 0.009). Mean TIMI frame counts were significantly higher in CSF patients (24.2 +/- 4.0 vs 13.1 +/- 2.5 fpm, p = 0.001). FMD was significantly lower in CSF patients than in the controls (4.9 +/- 6.6 vs 7.9 +/- 5.6%, p = 0.029). TIMI frame count and FMD were found to be negatively correlated in a correlation analysis (r = -0.269, p = 0.015). PAI-1 4G/5G, eNOS T-786C and ACE I/D polymorphisms were similar in the two groups. Conclusions: This study showed that endothelial function was impaired in patients with CSF. PAI-1, ACE and eNOS polymorphisms were not related to CSF in our study population.
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    Evaluation of left ventricular diastolic function by tissue Doppler imaging in patients with newly diagnosed and untreated primary generalized epilepsy
    (W B Saunders Co Ltd, 2013) Bilgi, Muhammet; Yerdelen, Deniz; Colkesen, Yucel; Muderrisoglu, Haldun
    Purpose: The effects of epilepsy and seizures on cardiac functions have been documented, and this association has drawn attention in recent years. The aim of this study was to investigate left ventricle (LV) diastolic function by tissue Doppler imaging (TDI) in patients with newly diagnosed and untreated primary generalized epilepsy (PGE). Method: Thirty newly diagnosed and untreated PGE patients (14 females, mean age 27.60 +/- 9.64 years) and 30 healthy age- and gender-matched control subjects (14 females, mean age 29.47 +/- 6.89 years) were included in the study. The LV functions of the study cohort were evaluated using conventional echocardiography and TDI. Results: There were no significant differences found between the two groups regarding the left atrium diameter, left atrium volume index, interventricular septum and posterior wall thickness, LV end diastolic diameter, and LV end diastolic:volume (p > 0.05 for each parameter). PGE patients exhibited a higher LV end systolic diameter and LV end systolic volume compared to the controls (p < 0.001 for each parameter). Thus, the fractional shortening and ejection fraction were lower in the PGE patients (p < 0.001 for each parameter). The E to average e' ratio, the most important noninvasive indicator of LV filling pressure, was significantly higher in patients with PGE (8.31 +/- 2.78 vs. 6.95 +/- 1.26, p = 0.018). Conclusion: The present study reports the systolic and diastolic dysfunction of LV in newly diagnosed PGE patients compared to control subjects. Taken together, the screening of epileptic patients using conventional echocardiography and TDI may be useful to evaluate the effects of epilepsy on cardiac functions. (C) 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
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    Novel Therapeutics for Thromboprophylaxis in Nonvalvular Atrial Fibrillation
    (Wiley, 2013) Gazi, Emine; Temiz, Ahmet; Barutcu, Ahmet; Colkesen, Yucel
    Atrial fibrillation (AF) is both a health and a social problem. AF is related to the elevated risk of thromboembolic events with stroke being the most important. It adversely affects life expectancy and quality. The risk of ischemic stroke is increased fivefold in patients with AF. Therapeutic options for lowering the risk of stroke in patients with AF consist of vitamin K antagonists and antiplatelet agents, which have relative risk reductions of approximately 60% and 20%, respectively. Alternative therapeutic options available to reduce the risk of stroke in patients with nonvalvular AF are relatively new. In recent years, new oral anticoagulants have been introduced for this indication. Reversible direct thrombin inhibitors and factor Xa inhibitors are new oral anticoagulant agents that have demonstrated efficacy and good safety profiles for preventing stroke and embolic events. The intent of this overview is to review the novel oral anticoagulants recommended for stroke prevention in patients with AF.
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    Parathyroid Hormone and Heart Failure: Novel Biomarker Strategy
    (Bentham Science Publ Ltd, 2013) Altay, Hakan; Colkesen, Yucel
    Heart failure (HF) is a clinical syndrome featuring cardiac pump failure along with signs and symptoms arising from salt and water retention mediated by activated renin-angiotensin-aldosterone system (RAAS). In addition to this cardiorenal perspective, HF is accompanied by a systemic illness, especially in advanced stages characterized by oxidative stress in various tissues, causing damage to soft tissue and bone. Secondary hyperparathyroidism (SHPT) which is also considered to contribute this systemic illness is therefore prominent in advanced HF. SHPT in HF occurs as a result of RAAS activation, prominent hyperaldosteronism, loop diuretic usage and decreased calcitriol level, all of which results in calcium excretion. We review the evidence that high parathyroid hormone (PTH) is associated with advanced HF, as well as evidence that it's associated with HF with preserved ejection fraction (HFPEF).
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    Successful thrombolytic treatment of prosthetic mitral valve thrombosis
    (2013) Gazi, Emine; Altun, Burak; Temiz, Ahmet; Colkesen, Yucel
    Prosthetic heart valve thrombosis is a rare but serious complication. Surgery is the first-line therapy in symptomatic obstructive mechanical valve thrombosis, thrombolytic therapy has been used as an alternative to surgical treatment. In this case report we described a 47-year-old woman who had undergone coronary artery bypass graft and mitral valve replacement operation 9 months ago. A thrombus was detected on the prosthetic mitral valve with high transmitral gradient by transoesophageal echocardiography. Tissue plasminogen activator treatment was administered successfully. The gradient was improved on prosthetic mitral valve and embolic complications or bleeding were not occurred. Copyright 2013 BMJ Publishing Group. All rights reserved.