Hayri Alici

Reliable echocardiographic markers additional to plasma biomarkers that would establish prognosis of chronic heart failure and guide therapeutic approach would be beneficial. In our hypothesis, echocardiographic assessment of coronary sinus anatomic alteration, which has been ignored, may be part of remodeling process in heart failure. We also aimed to evaluate relationship between coronary sinus anatomic alteration and left ventricular systolic dysfunction. We echocardiographically analysed 112 patients with heart failure and 61 normal subjects. Left/right ventricular volumes, left atrial area and mean coronary sinus were measured. Coronary sinus diameter was significantly higher in patients than in control group. Statistically positive correlation were present between coronary sinus measurements and left/right ventricular volumes (R = 0.5, P < 0.001; R = 0.4, P < 001, respectively), left atrial area (R = 0.6, P < 0.001), NYHA class (R = 0.3, P < 0.001), mitral regurgitation (R = 0.329, P < 0.001), tricuspid regurgitation (R = 0.215, P < 0.02) and left ventricular mass (R = 0.482, P…

... Murat Yüce, Çayan Akkoyun, Mustafa Oylumlu, Vedat Davutoğlu, Musa Çakıcı, İbrahim Sarı, Hayri Alıcı, Fethi Yavuz ... tanı kriterleri vardır ve hastalığın var olandan az veya daha çok tanı almasına yol açabilir. ... Elektrokardiyografide sıklıkla özgün olmayan değişiklikler vardır. ...

Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2011;39(1):35-40 ... Sekundum atriyal septal defektlerin Amplatzer cihazı ile kapatılması ... Closure of secundum atrial septal defects by the Amplatzer occluder device ... Dr. Murat Yüce, Dr. Orhan Özer, Dr. Musa Çakıcı, Dr. ...

In the presence of resistance to circumferential expansion of atherosclerotic plaques due to mechanical dilation high shear stresses between stiff plaques and normal vessel segments may occur and thus may result in coronary dissection. Limited data are available on the clinical and angiographic outcome of severe (type E, type F) coronary dissections. Herein, we report a case of type F dissection (causing total occlusion) of proximal right coronary artery during balon angioplasty which healed spontaneously. In conclusion, although the type F dissection has worse prognosis due to complete cessation of distal vessel perfusion, the possibility of spontaneous healing should be kept in mind after unsuccessful intervention.

Acute viral myocarditis (AVM) is an inflammatory heart disease that may lead to acute heart failure caused by cardiomyocyte loss. AVM may result in fatal outcome due to hemodynamic compromise. There is no specific treatment for AVM. Treatment is generally same as the treatment of conventional heart failure. Levosimendan is a new molecule with inotropic and vasodilator effect and is widely used for acute decompensated heart failure. Case 1: A 48-years-old, previously healthy male patient admitted to our clinic with complaints of acute onset of rest dyspnea and orthopnea, started the day before. Cardiac chambers were enlarged on echocardiography with global hypokinesia and ejection fraction (EF) was 25%. The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μg/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiographic follow-up revealed a rapid improvement in left ventricular EF (50%) after 24 h. Case 2: A 33-years-old male patient admitted to our clinic with new onset shortness of breath and palpitation complaints. Echocardiography revealed enlarged left heart cavities with global hypocinesia (EF was 25%). The patient was diagnosed as AVM complicated with decompensated heart failure. Continuous infusion of 0·2 μg/kg/min levosimendan for 24 h with treatment of conventional heart failure. Echocardiography revealed dramatic improvement of left ventricular systolic function (EF = 55%) 24 h later. To our knowledge, there is no report or study on levosimendan therapy for AVM in humans to date. Herein, we share two cases that revealed dramatic improvement in the myocardial function with levosimendan usage during the early phase of AVM.

Background: Syncope is a transient loss of consciousness, associated with loss of postural tone, with spontaneous return to baseline neurologic function. Syncope is a common complaint in the emergency department. Objectives: Cough syncope occurs immediately after coughing. Cough syncope rapidly recovers in 1-2 second. Although cough syncope has been classified in vasovagal syncope, it may differ from pathogenetic mechanism. Physicians should be aware of this easily recognizable cough induced syncope. Case report: We present a 59-year-old obese man was referred for clinical evaluation because of recurrent syncope without seizures following coughing who developed cough syncope. Conclusions: Physicians should be aware of this easily recognizable cough induced syncope in all subjects admitted with syncope and should screen possible underlying sources of cough.

Although it is known that ankylosing spondylitis (AS) is associated with cardiovascular complications, the extent of these complications has not been clearly demonstrated in young adult patients. We have therefore investigated myocardial diastolic functions, carotid intima-media thickness (CIMT), and aortic elastic properties of young adult patients diagnosed with AS. Sixty-six AS patients and 21 age/gender-matched healthy subjects were enrolled in the study. Spectral and tissue Doppler echocardiography, CIMT, aortic strain and distensibility, and serum B-type natriuretic peptide values were compared with disease activity indexes of AS, including the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the role of other variables, such as anti-tumor necrosis factor-alpha (anti-TNF-α) treatment, lipid parameters, erythrocyte sedimentation rate, and C-reactive protein. Both mitral early diastolic flow speed (mE) and late diastolic flow speed (mA) scores were lower among patients than among the control subjects (p = 0.015 and p = 0.035, respectively). The Em ratio of the patients was remarkably lower than that of the control subjects (p = 0.044). BASDAI scores of >4 were used to identify patients with more active disease. The mA and mE/mA ratios were significantly different between patients with a BASDAI score of >4 and those with a BASDAI score of <4 (p = 0.026 and p = 0.021, respectively). While aortic elasticity were not significantly different between the groups, AS patients treated with anti-TNF-α had significantly improved aortic strain and distensibility values (p = 0.022 and p = 0.014, respectively) compared to those treated with non-steroidal anti-inflammatory drugs (NSAIDs). Myocardial diastolic functions were significantly deteriorated in the AS patients, and disease activity and myocardial diastolic functions were associated. An interesting finding was that patients receiving anti-TNF-α had better aortic elasticity than those treated with NSAIDs.

... Murat Yüce, Çayan Akkoyun, Mustafa Oylumlu, Vedat Davutoğlu, Musa Çakıcı, İbrahim Sarı, Hayri Alıcı, Fethi Yavuz ... tanı kriterleri vardır ve hastalığın var olandan az veya daha çok tanı almasına yol açabilir. ... Elektrokardiyografide sıklıkla özgün olmayan değişiklikler vardır. ...

We thank Ozturk et al1 for their comments regarding our study.2 Cardiovascular diseases and hypertension were exclu-sion criteria in our study, and none of the patients were using b-blockers.2 If we look at the antidepressants which patients received, 6 patients used paroxetine, 3 venlafaxine, 2 escitalo-pram, 1 sertraline, 1 duloxetine, and 4 patients used alprazolam as additional treatment. We showed that night-time blood pres-sure (BP) dipping was less in patients with panic disorder, and night-time diastolic BP was higher in patients who received antidepressants than those who did not.2 Venlafaxine and duloxetine are antidepressants of the serotonin–norepinephrine reuptake inhibitor class and these are known to increase systolic and diastolic BP.3,4 There was no statistically significant difference between drugs in our study but we do not claim a definitive conclusion on this issue because of the small sample size. Are the antidepressants suspects for the nondipper BP pattern in...

Türk Kardiyol Dern Arş - Arch Turk Soc Cardiol 2011;39(1):35-40 ... Sekundum atriyal septal defektlerin Amplatzer cihazı ile kapatılması ... Closure of secundum atrial septal defects by the Amplatzer occluder device ... Dr. Murat Yüce, Dr. Orhan Özer, Dr. Musa Çakıcı, Dr. ...

Ventricular tachycardia may terminate by means of the mechanical energy that arises during coughing. It might be considered a simple treatment method terminating of ventricular tachyarrhythmias in some cases. Herein, we wish to share a demonstrative case of ventricular tachycardia terminating with cough. In our view, coughing procedure may first be tried in all patients ventricular tachycardia. Because of important learning points of this case we thought that it can draw attention of Family Physicians. Keywords: ventricular tachycardia; cough; treatment Received: April 17, 2012; Accepted: May 29, 2012; Published online: June 3, 2012 Corresponding Author: Ebru Tekbas, MD, Dicle University, School of Medicine, Department of Cardiology, Diyarbakir 21200, Turkey. E-mail: dretekbas@yahoo.com

In the presence of resistance to circumferential expansion of atherosclerotic plaques due to mechanical dilation high shear stresses between stiff plaques and normal vessel segments may occur and thus may result in coronary dissection. Limited data are available on the clinical and angiographic outcome of severe (type E, type F) coronary dissections. Herein, we report a case of type F dissection (causing total occlusion) of proximal right coronary artery during balon angioplasty which healed spontaneously. In conclusion, although the type F dissection has worse prognosis due to complete cessation of distal vessel perfusion, the possibility of spontaneous healing should be kept in mind after unsuccessful intervention.

Background and aims: Reliable echocardiographic markers additional to plasma biomarkers that would establish prognosis of chronic heart failure and guide therapeutic approach would be beneficial. In our hypothesis, echocardiographic assesment of coronary sinus anatomic alteration, which has been ignored, may be part of remodeling process in heart failure. We also aimed to evaluate relationship between coronary sinus anatomic alteration and