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Öğe Abnormal Left Ventricular Mechanics in isolated Bicuspid Aortic Valve Disease may be independent of aortic distensibility: 2D Strain Imaging Study(I C R Publishers, 2012) Kurt, Mustafa; Tanboga, Ibrahim Halil; Bilen, Emine; Isik, Turgay; Kaya, Ahmet; Karakas, Mehmet Fatih; Buyukkaya, EyupBackground aim of the study: In this study, we hypothesized that subclinical impairment of left ventricular (LV) mechanical function in bicuspid aortic valve (BAV) patients is independent of valvular hemodynamics represented by valvuloarterial impedance and aortic elastic characteristics. Therefore, we aimed to test left ventricular mechanics in cases of isolated non-stenotic BAV with non-dilated aorta. Methods: Thirty-three patients with isolated BAV exhibiting non-dilated aorta, and 25 age-and gender-matched healthy subjects were included in the study. Patients with aortic valve velocity > 1.5 m/s and mild-to-moderate aortic regurgitation or ascending aorta diameter >3.5 cm were excluded from the study. Aortic elasticity parameters and valvulo-arterial impedance were calculated. Strain measurements were reported as the peak longitudinal strain (LS) for four chamber (4C), long axis (LAX) and two chamber (2C) views. Strain rate (Sr) measurements were reported as the peak systolic strain rate (Sr-sm), early diastolic strain rate (Sr-ern) and late diastolic strain rate (Sr-am) for 4C, LAX and 2C views. Results: Systolic and diastolic diameters of the ascending aorta, aortic elastic properties (aortic strain, aortic distensibility, aortic stiffness and aortic elastic modulus), and valvulo-arterial impedances were found to be comparable between the BAV and control groups. BAV group was observed to have statistically significantly lower 4C (18.9 +/- 1.7 vs 17.8 +/- 1.5, p=0.02), LAX (19.7 +/- 1.7 vs 17.7 +/- 1.3, p=0.001) and 2C (20.1 +/- 1.8 vs 17.7 +/- 1.2, p<0.001) peak longitudinal strain values compared with the control group. Moreover, LV-GS values were found to be significantly lower in the BAV group than in the control group (19.6 +/- 1.1 vs 17.7 +/- 0.9, p<0.001). However, there was no statistically significant difference between the groups in terms of Sr-sm, Sr-em ye Sr-am values in the 4C, LAX, and 2C views. Conclusion: BAV might affect LV systolic functions, assessed by 2D strain imaging, in a fashion independent from the valvular dynamics and aortic elasticity. This might show that BAV is not only a valvular disease, but possibly a ventricular disease as well. The Journal of Heart Valve Disease 2012;21:608-614Öğe Are plasma resistin and omentin levels different in patients with psoriasis with or without atherosclerosis?(Springer, 2013) Sen, Bilge Bulbul; Rifalioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Sen, Nihat[Abstract Not Available]Öğe Assessment of Atrial and Ventricular Mechanics in Patients with Sickle Cell Disease without Overt Pulmonary Hypertension: A Two-Dimensional Deformation Imaging Study(Wiley-Blackwell, 2012) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Celik, Murat; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak[Abstract Not Available]Öğe Assessment of left ventricular dyssynchrony in dipper and non-dipper hypertension(Taylor & Francis Ltd, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak; Sen, NihatBackground. Ventricular dyssynchrony is an co-determinant of progression and exacerbation of heart failure (HF). The co-existence of ventricular dyssynchrony with hypertension (HT) and HF were shown, however there is no data regarding the effect of circadian rhythm of blood pressure (BP) on ventricular synchrony. Therefore, we aimed to study the left ventricular synchrony in dipper and non-dipper normotensive and hypertensive participants. Methods. Participants (n = 142) were categorized into four groups as Normotensive-Dipper (NT-D) (n = 40), Normotensive-Non-dipper (NT-ND) (n = 30), Hypertensive-Dipper (HT-D) (n = 38) and Hypertensive-Non-dipper (HT-ND) (n = 34). Left ventricular dyssynchrony was investigated by color-coded tissue Doppler imaging. Results. Non-dippers had higher 24-h and night-time BP both in normotensives and hypertensives. The incidence of ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) was higher in the hypertensive group (47.2% vs 24.3%, p = 0.005). The frequency of ventricular dyssynchrony was higher in the HT-ND group than the HT-D group (58.8% vs 36.8%, p = 0.05); however, the frequency of ventricular dyssynchrony was similar among the normotensives (26.7% vs 22.5%, p = 0.45). Ts-SD-12 and Ts-12 were higher in NT-ND group than the NT-D group. Conclusions. Non-dipping BP pattern was associated with impaired left ventricular contraction synchrony in both normotensive and hypertensive participants, which may be related with short-and long-term effects of HT on myocardium.Öğe Assessment of left ventricular dyssynchrony in patients with psoriasis(Wiley-Blackwell, 2014) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Mehmet Fatih; Buyukkaya, SuleBackground Psoriasis is an inflammatory disorder, which has been reported to be associated with cardiovascular (CV) risks. Although increased CV risks in psoriasis are well established, there are no data about changes of contraction synchrony in psoriasis. Therefore, we aimed to study the left ventricular (LV) contraction synchrony in patients with psoriasis with narrow QRS and normal ejection fraction. Methods Fifty patients with psoriasis and 50 age- and sex-matched control subjects were included in the study. LV dyssynchrony was investigated by color-coded tissue Doppler imaging. Results In the psoriasis group, the mean high-sensitive C-reactive protein values were significantly higher compared with the controls. Peak A velocity, deceleration time, isovolumetric relaxation time, and E/E' values were higher in the psoriasis group; however, E/A ratio and average Em were higher in the control group. LV systolic dyssynchrony parameters [including standard deviation of Ts of the 12 LV segments (Ts-SD-12), maximal difference in Ts between any two of the 12 LV segments, standard deviation of Ts of the six basal LV segments, and maximal difference in Ts between any two of the six basal LV segments] were found to be higher in the psoriasis group. The patients with ventricular dyssynchrony (a Ts-SD-12 > 34.4 ms) were higher in the psoriasis group than the control group (34% vs. 6%, P < 0.01). Conclusion In patients with psoriasis with normal ejection fractions and narrow QRS, LV systolic dyssynchrony is an early manifestation of heart involvement and may coexist with diastolic dysfunction.Öğe Assessment of subclinical left ventricular dysfunction in patients with psoriasis by speckle tracking echocardiography: A Speckle Tracking Study(Wiley, 2016) Bulbul Sen, Bilge; Ekiz, Ozlem; Rifaioglu, Emine Nur; Buyukkaya, Eyup; Karakas, Mehmet Fatih; Buyukkaya, Sule; Bilen, PerihanBackgroundPsoriasis is a systemic inflammatory disease and is reportedly associated with adverse cardiovascular risks. Left ventricular (LV) function has not been studied comprehensively in psoriasis. ObjectivesThis study was conducted to study LV mechanics in patients with psoriasis by speckle tracking echocardiography. MethodsThe study population consisted of 40 patients with psoriasis and 35 age- and sex-matched control subjects. Two-dimensional echocardiography images were obtained from LV apical four-chamber (4C), long axis (LAX), and two-chamber (2C) views. Peak longitudinal strain and strain rate were obtained from 4C, LAX, and 2C views. Global strain and strain rate were calculated by averaging data for the three apical views. ResultsPatients with psoriasis had significantly lower meanstandard deviation (SD) 4C (17.1 +/- 1.7 vs. 19.2 +/- 2.3; P<0.01), LAX (16.6 +/- 1.5 vs. 19.5 +/- 2.3; P<0.01), and 2C (16.5 +/- 1.5 vs. 19.4 +/- 2.2; P<0.01) peak longitudinal strain values compared with the control group. Moreover, mean +/- SD LV global strain (16.6 +/- 1.5 vs. 19.9 +/- 2.1; P<0.01) and strain rate (1.39 +/- 0.30 vs. 1.51 +/- 0.20; P<0.01) values were found to be significantly lower in the psoriasis group. In a multiple regression model, global strain was independently associated with high-sensitivity C-reactive protein (=0.29, P=0.04), duration of disease (=0.35, P<0.01), ejection fraction (EF) (=0.38, P=0.01), and the ratio of early diastolic mitral inflow velocity to early diastolic annular velocity (E/E ratio) (=0.34, P=0.02). Also, in a multiple regression model, global strain rate was independently associated with duration of disease (=0.36, P<0.01), EF (=0.32, P=0.01), and E/E ratio (=0.35, P<0.01). ConclusionsUsing 2-D strain imaging, we have demonstrated that patients with psoriasis have lower LV functions.Öğe Bilateral pulmonary sequestration in the elderly adult(Biomed Central Ltd, 2012) Erden, Ersin Sukru; Bayarogullari, Hanifi; Bilgic, Hatice; Yetim, Tulin; Buyukkaya, EyupPulmonary sequestration (PS) is a rare malformation consisting of aberrant lung tissue which is not affiliated with the normal bronchial system and is fed by an aberrant artery that derives from systemic arteries. However, PS is usually seen unilaterally but, only rarely, it is bilateral. Most patients with PS are diagnosed because of symptoms due to pulmonary infection or cardiac disease, while a small portion of patients are asymptomatic and diagnosed incidentally. In this report, we present an extremely rare case of asymptomatic bilateral PS which was diagnosed at advanced age. To our knowledge, this case represents the oldest patient in the literature, and the second case that was diagnosed in a patient over the age of 50.Öğe Correlation of Neutrophil to Lymphocyte Ratio With the Presence and Severity of Metabolic Syndrome(Sage Publications Inc, 2014) Buyukkaya, Eyup; Karakas, Mehmet Fatih; Karakas, Esra; Akcay, Adnan Burak; Tanboga, Ibrahim Halil; Kurt, Mustafa; Sen, NihatPurpose: The aim of this study is to investigate the relationship between the criteria comprising metabolic syndrome (MS) and neutrophil-lymphocyte ratio (NLR), a simple and reliable indicator of inflammation. Method: Seventy patients with MS and 71 age- and sex-matched control participants were included. Patients were classified into 3 groups based on the number of MS criteria: group 1 (with 3 criteria), group 2 (with 4 criteria), and group 3 (with 5 criteria). The NLR was calculated from complete blood count. Results: Patients with MS had significantly higher NLR compared to the control group. Moreover, the group 3 patients had higher NLR than those in groups 2 and 1 (P = .008 and P = .078, respectively), whereas there was no difference between the patients meeting 3 and 4 MS criteria (P = .320). Besides, NLR increased as the severity of MS increased (r = .586, P < .001). The cutoff level for NLR with optimal sensitivity and specificity was calculated as 1.84. Serum glucose and high-sensitive C-reactive protein level were found to be independent predictors of an NLR value greater than 1.84. Conclusion: The present study indicated a significant correlation between the criteria of MS and inflammation on the basis of NLR. Furthermore, there an increase in NLR as the severity of MS increases.Öğe Effect of Remote Ischemic Postconditioning on Left Ventricular Mechanics(Wiley, 2015) Nacar, Alper Bugra; Topcu, Selim; Kurt, Mustafa; Tanboga, Ibrahim Halil; Karakas, Mehmet Fatih; Buyukkaya, Eyup; Aksakal, EnbiyaBackgroundRemote ischemic postconditioning (RIPC) decreases infarct size and prevents left ventricular (LV) remodeling in patients with myocardial infarction. However, there is no study that evaluates the effect of RIPC on LV mechanics assessed by speckle tracking echocardiography. Therefore, we aimed to test the effects of RIPC on LV deformation parameters such as strain, strain rate, rotation, and twist in healthy subjects. MethodsThe study group consisted of 22 healthy subjects. To test the effects of RIPC, 3 cycles of reperfusion followed by ischemia (each lasting 10 or 30seconds) were applied immediately after 20minutes of nondominant arm ischemia. Transthoracic echocardiography (TTE) was obtained at baseline and repeated 30minutes after the completion of these cycles. In TTE images, apical 4-3-2 chamber longitudinal strain (LS)/strain rate, basal and apical circumferential strain/strain rate, and rotational parameters, such as basal rotation, apical rotation, and LV twist, were recorded. ResultsApical 4-3-2 chamber LS and apical circumferential strain/strain rate measurements were comparable before and after RIPC, whereas basal circumferential strain was significantly decreased after RIPC (-233.4 vs. -18.9 +/- 6.9, P=0.017). After RIPC, apical rotation was significantly increased (11.6 +/- 3.7 vs. 16.7 +/- 4.0, P<0.001) and basal rotation was significantly decreased (-6.1 +/- 2.1 vs. -4.7 +/- 2.4, P=0.03).Consequently, net LV twist was significantly increased (17.4 +/- 4.5 vs. 21.7 +/- 4.7). ConclusionsWe proposed that RIPC affects the rotational mechanics of the heart rather than longitudinal mechanics. These results might give new insights into understanding the favorable effects of the post- conditioning.Öğe Effect of Serum Gamma-Glutamyl Transferase Levels on Myocardial Perfusion and Long-Term Prognosis After Primary Angioplasty in Patients With Acute ST-Elevation Myocardial Infarction(Bmj Publishing Group, 2012) Ozcan, Firat; Karakas, Mehmet Fatih; Ozlu, Mehmet Fatih; Akcay, Adnan Burak; Buyukkaya, Eyup; Kurt, Mustafa; Erden, GonulBackground: Gamma-glutamyl transferase (GGT) level was found to be elevated in plasma of patients with cardiovascular risk factors. The aim of our study was to assess the relationship between serum GGT levels and the occurrence of no-reflow as well as to evaluate the prognostic value of GGT in ST-segment elevation myocardial infarction (STEMI) population. Methods and Results: One hundred sixty-eight consecutive patients with STEMI who underwent percutaneous coronary intervention (PCI) were enrolled in the study. Patients with STEMI were grouped into tertiles according to their admission serum GGT levels. No-reflow after PCI was assessed both angiographically (thrombolysis in myocardial infarction [TIMI] flow and myocardial blush grade) and electrocardiographically (ST resolution). Gamma-glutamyl transferase levels were higher in patients with STEMI compared to the elective PCI group subjects. Patients with angiographically (TIMI flow <= 2 or TIMI flow 3 with final myocardial bush grade <= 2 after PCI) and electrocardiographically (ST resolution <30%) detected no-reflow were increased in number across the GGT tertiles. In addition, 1-year mortality rates showed a significant increase across the tertile groups (4% vs 11% vs 23%, P<0.01). Multivariable logistic regression analysis revealed that GGT levels on admission were a significant predictor of long-term mortality of myocardial blush grade-detected no-reflow phenomenon. High GGT level on admission was a significant predictor for long-term mortality and major adverse cardiac events. Conclusions: In patients with STEMI undergoing primary PCI, high GGT levels at admission were found to be associated with no-reflow phenomenon and increased long-term mortality.Öğe Higher Pentraxin-3 Level in Patients with Metabolic Syndrome Reply(Karger, 2013) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Karakas, Esra; Buyukkaya, Sule[Abstract Not Available]Öğe Increased Epicardial Fat Tissue is a Marker of Subclinic Atherosclerosis in Patients with Psoriasis(Elsevier Science Inc, 2013) Sen, Bilge Buelbuel; Atci, Nesrin; Rifaioglu, Emine Nur; Ekiz, Oezlem; Kartal, Ismail; Buyukkaya, Eyup; Kurt, Mustafa[Abstract Not Available]Öğe Is there a relationship between disease duration and P-wave dispersion in patients with psoriasis?(Taylor & Francis Ltd, 2013) Sen, Bilge Bulbul; Rifaioglu, Emine Nur; Ekiz, Ozlem; Buyukkaya, Eyup; Sen, Nihat[Abstract Not Available]Öğe Left Ventricular Dyssynchrony is an Early Manifestation of Heart involvement in Sickle Cell Anemia(Wiley-Blackwell, 2012) Karakas, Mehmet Fatih; Buyukkaya, Eyup; Kurt, Mustafa; Celik, Murat; Karakas, Esra; Buyukkaya, Sule; Akcay, Adnan Burak[Abstract Not Available]Öğe Menopausal cardiomyopathy: Does it really exist? A case-control deformation imaging study(Wiley, 2014) Kurt, Raziye Keskin; Nacar, Alper B.; Guler, Ayse; Silfeler, Dilek B.; Buyukkaya, Eyup; Karateke, Atilla; Kurt, MustafaAim We aimed to evaluate and compare the left ventricular (LV) functions of pre- and postmenopausal women at similar ages with none of the known cardiovascular risk factors, by both conventional and advanced echocardiographic methods such as 2-D strain imaging via speckle tracking echocardiography. Methods The study population consisted of 40 healthy postmenopausal women aged 45-50 years and 40 healthy premenopausal women of the same age group. None of the subjects had any cardiovascular risk factors and were on hormone replacement therapy. LV strain and strain rate parameters were measured by 2-D strain imaging. The main outcome measure was effect of menopause on LV function. Results There were no significant differences between the pre- and postmenopausal groups with regard to conventional echocardiographic parameters. LV longitudinal strain and LV early diastolic strain rate values were significantly lower in the postmenopausal group when compared to the premenopausal group. Also, there was a significant negative correlation between LV global strain and serum follicle-stimulating hormone (r=-0.349, P=0.002). Conclusion Our study results demonstrated that healthy postmenopausal women had lower LV longitudinal strain values when compared to the healthy premenopausal women of the same age group by speckle tracking echocardiography.Öğe Mitral Valve Resistance Correlates More Closely with Left Atrial Deformation than with Conventional Indices of Rheumatic Mitral Stenosis(I C R Publishers, 2013) Kurt, Mustafa; Tanboga, Ibrahim Halil; Karakas, Mehmet Fatih; Buyukkaya, Eyup; Nacar, Alper Bugra; Akcay, Adnan Burak; Aksakal, EnbiyaBackground and aim of the study: The relationship between mitral valve (MV) resistance and left atrial (LA) mechanical function is unknown. Hence, the study aim was to investigate the relationship between LA mechanics and MV resistance, compared to conventional indices such as mitral valve area (MVA) and transmitral gradient, in patients with rheumatic mitral stenosis (MS). Methods: The study population consisted of 73 patients with MS and 30 age- and gender-matched controls. MV resistance was calculated and LA strain parameters were assessed from the apical four-chamber view by speckle tracking echocardiography (LA reservoir strain, LA pump strain, LA strain rate (SR)) in all subjects. Results: The MS group has a markedly higher MV resistance (94 +/- 46 versus 67 +/- 22 dynes.s.cm(-5), p = 0.003) and lower LA reservoir strain (24.5 +/- 7.4% versus 36.6 +/- 3.8%, p <0.001), LA pump strain (12.0 +/- 5.0% versus 17.1 +/- 3.4%, p <0.001) and SR (1.23 +/- 0.33 versus 1.4 +/- 0.29, p = 0.017) values compared to controls. Moreover, both LA reservoir strain and LA pump strain correlated with MV resistance more closely than did MVA and transmitral gradients. Multiple linear regression analysis revealed only MV resistance to be an independent predictor of LA reservoir strain, while MV resistance, indexed left atrial volume and mean gradient were independent predictors of LA pump strain. Conclusion: It can be concluded that, in patients with MS, mitral valve resistance was more closely related to LA mechanics measurements than were conventional indices of MS.Öğe The neutrophil to lymphocyte ratio was associated with impaired myocardial perfusion and long term adverse outcome in patients with ST-elevated myocardial infarction undergoing primary coronary intervention(Elsevier Ireland Ltd, 2013) Sen, Nihat; Afsar, Baris; Ozcan, Firat; Buyukkaya, Eyup; Isleyen, Ahmet; Akcay, Adnan Burak; Yuzgecer, HuseyinObjectives: In the present study we aimed to reveal any probable correlation between neutrophil-to-lymphocyte ratio (N/L ratio) and the occurrence of no-reflow, along with assessment of the prognostic value of N/L ratio in patients with ST-segment elevation myocardial infarction (STEMI). Background: The N/L ratio stands practically for the balance between neutrophil and lymphocyte counts in the body, which can also be utilized as an index for systemic inflammatory status. Methods: In our study, we included 204 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (PCI). Patients with STEMI were assigned into distinct tertiles based on their N/L ratios on admission. No-reflow encountered following PCI was evaluated through both angiography [Thrombolysis in Myocardial Infarction (TIMI) flow and myocardial blush grade (MBG)] and electrocardiography (as ST-segment resolution). Results: Patients featured with no ST-resolution were documented to have displayed significantly higher N/L ratio on admission compared to those with intermediate or complete ST-segment resolution. The number of the patients characterized with no-reflow, evident both angiographically (TIMI flow <= 2 or TIMI flow 3 with final myocardial bush grade <= 2 after PCI) and electrocardiographically (ST-resolution <30%), was encountered to depict increments throughout successive N/L ratio tertiles. Moreover, the same also held true for three-year mortality rates across the tertile groups (9% vs. 15% vs. 35%, p < 0.01). Multivariable logistic regression analysis disclosed that N/L ratio on admission stood for a significant indicator for long-term mortality in patients with no-reflow phenomenon detected with MBG. Elevated N/L ratio on admission was also found to be a significant indicator for three-year mortality and major adverse cardiac events. Conclusions: In patients with STEMI who underwent primary PCI, elevated N/L ratios on admission were revealed to be correlated with both no-reflow phenomenon and long-term prognosis. (C) 2013 Elsevier Ireland Ltd. All rights reserved.Öğe Relation of Angiographic Thrombus Burden With Electrocardiographic Grade III Ischemia in Patients With ST-Segment Elevation Myocardial Infarction(Sage Publications Inc, 2014) Kurt, Mustafa; Karakas, Mehmet Fatih; Buyukkaya, Eyup; Akcay, Adnan Burak; Sen, NihatBackground: We aimed to investigate the association between electrocardiographic (ECG) grade III ischemia and angiographic thrombus burden in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (pPCI). Methods: The study population consisted of 307 patients with STEMI. Baseline ECGs of the patients were analyzed for grade III ischemia; angiographic thrombus burden was assessed by thrombolysis in myocardial infarction thrombus classification. Results: A total of 108 (35%) patients had low thrombus burden whereas 199 (65%) patients had high thrombus burden. Grade III ischemia was more prevalent in patients with high thrombus burden (25.1% vs 11.1%, P = .004). Only grade III ischemia (odds ratio: 2.59, 95% confidence interval 1.24-5.39, P = .011) and history of coronary artery disease (CAD) were found to be the independent predictors of high thrombus burden. Conclusion: Grade III ischemia on ECG and previous history of CAD were independent predictors of coronary thrombus burden in patients with STEMI who underwent pPCI.Öğe Relation of Fragmented QRS to Tissue Doppler-Derived Parameters in Patients with Familial Mediterranean Fever(Elsevier Science Inc, 2013) Celik, Muhammet Murat; Buyukkaya, Eyup; Ustun, Nilgul; Nacar, Alper Bugra; Kurt, Mustafa; Karakas, Mehmet Fatih; Bilen, Perihan[Abstract Not Available]Öğe Relation of fragmented QRS to tissue Doppler-derived parametersin patients with familial Mediterranean fever(Springer Wien, 2015) Celik, Muhammet Murat; Buyukkaya, Eyup; Ustun, Nilgul; Nacar, Alper Bugra; Kurt, Mustafa; Karakas, Mehmet Fatih; Bilen, PerihanFamilial Mediterranean fever (FMF) may pose a risk for cardiovascular diseases due to continuous inflammatory status observed during the course of the disease. Recently, the presence of fragmented QRS (fQRS) has been recognized as a predictor of myocardial fibrosis. In this study, we aim to investigate the frequency of fQRS and its relation to Doppler-based indices. This study consisted of 80 FMF patients and 30 healthy control subjects. fQRS pattern was defined as the presence of additional R waves or RSR', evidenced by notched R or S wave on electrocardiography (ECG). The patient and the control groups underwent conventional echocardiography and tissue Doppler echocardiography. There was no significant difference between groups regarding age (29 +/- 12 vs 29 +/- 15). FMF patients exhibited a statistically higher frequency of fQRS (% 56 vs % 13) (p < 0.01). E/Em ratio showed a statistically significant increase in the FMF group with fQRS (p < 0.0001), while the mean Em value was markedly lower (p < 0.0001). FMF patients displayed a statistically significant increase in frequency of fQRS. Doppler-derived diastolic index was statistically significantly impaired in FMF patients with fQRS as compared with the patients without fQRS. In conclusion, fQRS might be a new noninvasive marker for cardiac involvement in FMF patients.
