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Öğe Cardiac manifestations in Behcet's disease(International Advancement Center for Medicine and Health Research, 2015) Demirelli, Selami; Değirmenci, Hüsnü; İnci, Sinan; Arısoy, ArifBehcet's disease (BD) is a chronic inflammatory disorder, with vasculitis underlying the pathophysiology of its multisystemic effects. Venous pathology and thrombotic complications are hallmarks of BD. However, it has been increasingly recognised that cardiac involvement and arterial complications are also important aspects of the course of the disease. Cardiac lesions include pericarditis, endocarditis, intracardiac thrombosis, myocardial infarction, endomyocardial fibrosis, and myocardial aneurysm. Treatment of cardiovascular involvement in BD is largely empirical, and is aimed towards suppressing the vasculitis. The most challenging aspect seems to be the treatment of arterial aneurysms and thromboses due to the associated risk of bleeding. When the prognosis of cardiac involvement in BD is not good, recovery can be achieved through oral anticoagulation, immunosuppressive therapy, and colchicine use. In this review, we summarise the cardiovascular involvement, different manifestations, and treatment of BD.Öğe Ivabradine on aortic stiffness in patients with heart failure(Lippincott Williams and Wilkins, 2015) Nar, Gökay; İnci, Sinan; Aksan, Gökhan; Demirelli, Selami; Soylu, Korhan; Yüksel, Serkan; Gülel, Okan; İçli, AtillaAim: The aim of this study was to evaluate the effect of ivabradine treatment on aortic stiffness by measuring aortic elastic parameters in patients with heart failure (HF) receiving ivabradine treatment. Materials and Methods: The study included clinical patients who were diagnosed with HF (ejection fraction, <35%), had sinus rhythm and persistent symptoms despite full medical treatment. The study group consisted of patients with a heart rate greater than 70 beats per minute and the control group consisted of patients with a heart rate less than 70 beats per minute. Echocardiographic measurements were conducted and aortic strain, aortic distensibility, and aortic stiffness index were calculated. Results: By the end of the twelfth month, a decrease was observed in the left ventricular end-diastolic and end-systolic volumes, whereas ejection fraction was increased (P < 0.001). When aortic elastic parameters were evaluated between the 2 groups, therewas no significant difference regarding aortic strain, aortic distensibility, and aortic stiffness index at the time of enrollment and during the visit at 3 months. At the twelfth month visit, aortic strain (P < 0.001) and distensibility (P < 0.001) were significantly increased, whereas there was a significant decrease in the aortic stiffness index (P < 0.001). Conclusions: During the follow-up at 12 months, significant improvements were observed in the left ventricular functions and aortic elastic parameters along with decreased heart rate in patients with HF receiving ivabradine treatment. This outcome may indicate that ivabradine treatment may correct aortic stiffness and may reduce aortic stiffness after 1 year of follow-up.Öğe The effects of successful percutaneous mitral balloon valvuloplasty on acute and intermediate term aortic stiffness(Blackwell Publishing, 2015) İnci, Sinan; Nar, Gökay; Erol, Mustafa Kemal; Demirelli, Selami; Duman, Hakan; Serdar, Serkan; Erol, FatihAim The aim of this study was to evaluate the effects of percutaneous mitral balloon valvuloplasty (PMBV) on short- and intermediate-term aortic stiffness in patients with mitral stenosis. Materials and Methods This prospective study included 56 patients with critical mitral stenosis in normal sinus rhythm (68% female; mean age: 42 ± 11 years) and 37 healthy controls. Aortic stiffness was measured using transthoracic echocardiography before PMBV, and 24-48 hours and 1 year post procedure. Results Aortic strain and distensibility were significantly higher in the patients with mitral stenosis, both after PMBV and 1 year post procedure, whereas the aortic stiffness index (ASI) was significantly lower. There was also a significant decrease in mitral mean gradient (MMG) and systolic pulmonary artery pressure (sPAP) after PMBV, based on echocardiography and catheterization. Mitral valve area (MVA) significantly increased after PMBV. There was a significant correlation between change in ?MVA and ?MMG and aortic elastic properties. There was a significantly negative correlation between the ?MVA and ?? aortic stiffness (r = -0.62, P < 0.001), and a significantly positive correlation between ?MMG and ?ASI (r = 0.60, P < 0.001). Conclusion Mitral valve stenosis was associated with impaired aortic stiffness and following PMBV, aortic stiffness decreased during both the acute period and the intermediate period. © 2014, Wiley Periodicals, Inc.Öğe The importance of speckle tracking echocardiography in the early detection of left ventricular dysfunction in patients with polycystic ovary syndrome(Association of Basic Medical Sciences Federation of Bosnia and Herzegovina, 2015) Demirelli, Selami; De?irmenci, Hüsnü; Ermiş, Emrah; İnci, Sinan; Nar, Gökay; Ayhan, Mehmet Emin; Fırtına, Serdar; Hamur, Hikmet; Durmaz, Şenay ArıkanPolycystic ovary syndrome (PCOS) is characterized by hormonal and metabolic abnormalities and is thought to increase a risk for cardiovascular diseases. In this study we use speckle tracking echocardiography (STE) to evaluate left ventricular (LV) dysfunction in the early period of the disease. We enrolled 31 patients with PCOS and 32 healthy volunteers as a control group. The participants’ ages ranged between 18 and 40 years. PCOS was diagnosed according to the Rotterdam criteria. LV strain (LS) and strain rate (SR) were evaluated using apical two-chamber (2C), three-chamber (3C), and four-chamber (4C) imaging. Global LS and SR were calculated as average of three apical views. The waist-to-hip ratio, homeostasis model assessment-insulin resistance (HOMA-IR), and fasting insulin and triglyceride levels were higher in the PCOS group than in the controls (p = 0.001, p = 0.001, p = 0.001, and p = 0.005, respectively). In the PCOS group, the mitral A wave, deceleration time (DT), and isovolumetric relaxation time (IVRT) were significantly higher than in the controls (all p < 0.05). The LV global longitudinal strain (GLS) and global longitudinal SR systolic (GLSRS) were significantly lower in the PCOS patient group (both p = 0.001). There were strong negative correlations between GLS and both fasting insulin (r = -0.64) and DT (r =-0.62) (both p < 0.05). The study demonstrated that PCOS patients had decreased LV function using STE. Therefore, STE imaging appears to be useful for the early detection of subclinical LV dysfunction in patients with PCOS. © 2015 ABMSFBIH.
