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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, Eyup
    Background 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;21:608-614
  • Küçük Resim
    Öğe
    The impact of admission red cell distribution width on long-term cardiovascular events after primary percutaneous intervention: A four-year prospective study
    (Via Medica, 2016) Isik, Turgay; Kurt, Mustafa; Tanboga, Ibrahim Halil; Ayhan, Erkan; Gunaydin, Zeki Yuksel; Kaya, Ahmet; Uyarel, Huseyin
    Background: Red cell distribution width (RDW) is an indicator of erythrocyte in different size, and its prognostic value has been demonstrated in numerous cardiac and non-cardiac diseases. The purpose of this study was to evaluate the predictive value of RDW on the long-term cardiovascular events in patients undergoing primary percutaneous coronary intervention (PCI). Methods: Ninety-six consecutive patients (mean age 60.6 +/- 12.5 years, 77.1% male) with ST-segment elevation myocardial infarction (STEMI), who were treated with primary PCI, were analyzed prospectively. Baseline RDW and high sensitive C-reactive protein (hs-CRP) were measured. The patients were followed up for major adverse cardiac events (MACE) for up to 48 months after discharge. Results: There were 30 patients with long-term MACE (Group 1) and 66 patients without long-term MACE (Group 2). Age, admission RDW, hs-CRP and creatine kinase-MB levels, heart rate after PCI, previously used angiotensin converting enzyme inhibitor, left anterior descending artery lesion, and electrocardiographic no-reflow were higher in Group 1. Admission hemoglobin levels were lower in Group 1. An RDW level >= 13.85% measured on admission had 80% sensitivity and 64% specificity in predicting long-term MACE on receiver-operating characteristic curve analysis. In multivariate analyses, only admission RDW (HR 5.26, < 95% CI 1.71-16.10; p = 0.004) was an independent predictor of long-term MACE. Conclusions: A high baseline RDW value in patients with STEMI undergoing primary PCI is independently associated with increased risk for long term MACE.