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Öğe Early- And mid-term effects of percutaneous mitral balloon valvuloplasty on left atrial mechanical functions in mitral stenosis(Turkish Society of Cardiology, 2014) İnci, Sinan; Erol, Mustafa Kemal; Taş, Muhammed Hakan; Bakırcı, Eftal Murat; Hamur, Hikmet; Karakelleoğlu, ŞuleObjectives: The aim of the study was to evaluate left atrial (LA) mechanical functions in MS before and after percutaneous mitral balloon valvuloplasty (PMBV) and to follow it up in short- And mid-term. Study design: We carried out a prospective study of 49 patients with critical mitral stenosis (MS) who had normal sinus rhythm. LA mechanical functions were evaluated before and 24-48 h, 3 months, and 1 year after PMBV, which included LA passive emptying volume (LAPEV), LA active emptying volume (LAAEV), LA total emptying volume (LATEV), LA passive emptying fraction (LAPEF), LA active emptying fraction (LAAEF), LA total emptying fraction (LATEF), and conduit vol-ume. Results: The transthoracic echocardiography parameters of the MS patients before and 24-48 h, 3 months, and 1 year after PMBV were as follows: (a) mitral valve area 1.1 cm2 (0.9-1.6); 2.2 cm2 (1.8-2.8) (p<0.001); 2.2 cm2 (1.7-2.9) (NS); 2.1 cm2 (1.8-2.7) (p<0.001); (b) LAPEV 13 ml/m2 (9-27); 11 ml/m2 (8-19) (p<0.001); 10 ml/m2 (7-19) (p<0.001); 10 ml/m2 (6-18) (p<0.001); (c) LATEV 26 ml/m2 (19-50); 21 ml/m2 (16- 40) (p<0.001); 20 ml/m2 (15-36) (p<0.001); 19 ml/m2 (15-34) (p<0.001); (d) Conduit volume 30 ml/m2 (22-44); 33 ml/m2 (26- 46) (p<0.001); 34 ml/m2 (30-42) (p<0.001); 36 ml/m2 (31-42) (p<0.001), respectively. However, LAAEV, LAPEF, LAAEF, and LATEF were not altered after PMBV. Conclusion: The findings of this study demonstrated an improvement of LA mechanical functions, which continued to improve for 1 year, after successful treatment of MS by PMBV. © 2014 Turkish Society of Cardiology.Öğe Effect of human gestational diabetes mellitus on arterial stiffness(Acta Endocrinologica Foundation, 2014) İnci, Sinan; Nar, Gökay; Balkan, Fevzi; Aksan, Gökhan; De?irmenci, Hüsnü; Hamur, HikmetBackground. The present study aims to evaluate the parameters for aortic stiffness by comparing gestational diabetes mellitus (GDM) with a healthy control group via transthoracic echocardiography. Methods. This was a cross-sectional study involving monitoring of 62 pregnant women (33 with GDM and 29 with uncomplicated pregnancy as controls) during the third trimester. The aortic strain, aortic distensibility, and aortic stiffness values were measured via transthoracic echocardiography. Measurements of GDM group were repeated after 6 months. Results. Blood pressure levels, heart rate, and basic echocardiography were similar in both groups, but BMI was significantly higher in the GDM group (p <0.001). Whereas, aortic strain and distensibility were significantly lower in the GDM group (p <0.001). Aortic stiffness index was significantly higher in the GDM group (p <0.001). Aortic stiffness parameters did not exhibit any significant difference between the insulin-receiving GDM group and the diet-controlled GDM group. Postprandial glucose levels were correlated positively with the aortic stiffness index (p=0.04) and negatively with the level of aortic strain (p<0.01) and distensibility (p=0.03). The aortic stiffness in normoglycemic postpartum group at 6th month showed a significant improvement (p<0.001); but not in hyperglycemic postpartum group. Conclusion. Arterial stiffness was increased in women with GDM compared to the control group. A correlation between postprandial glucose and arterial stiffness was found. The aortic stiffness can be affected irreversibly from increased clinical and subclinical levels of glucose in postpartum period.Öğe Increased epicardial adipose tissue thickness is associated with angiographic thrombus burden in the patients with non-ST-segment elevation myocardial infarction(SAGE Publications Inc., 2015) Bakırcı, Eftal Murat; De?irmenci, Hüsnü; Duman, Hakan; İnci, Sinan; Hamur, Hikmet; Büyüklü, Mutlu; Ceyhun, Gökhan; Topal, ErgünWe aimed to evaluate the relation among epicardial adipose tissue (EAT) thickness, angiographic presence of thrombus, and the no-reflow in the patients with non-ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. The study population consisted of 229 patients. The EAT thickness and neutrophil to lymphocyte ratio (NLR) were significantly higher in the patients with coronary thrombus than in those without coronary thrombus (6.1 ± 1.1 vs 5.1 ± 1.3 mm, P <.001 and 3.4 ± 0.9 vs 2.5 ± 0.7, P <.001, respectively) and in the patients with no-reflow compared to patients with reflow. The EAT thickness was found to be correlated positively with the degree of the thrombus burden, NLR, and waist circumference and negatively with high-density lipoprotein cholesterol. Multivariate logistic regression analysis demonstrated that EAT thickness and NLR independently predicted coronary thrombus formation and no-reflow. We have suggested that EAT can play an important role in the pathophysiology of coronary thrombus formation and the no-reflow. © SAGE Publications.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.
