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    Effects of acute hypoxia on left and right ventricular contractility in chronic obstructive pulmonary disease
    (2007) Akgül, Ferit; Batyraliev, Talantbek; Karben, Zarema; Pershukov, Igor
    The purpose of this investigation was to assess the effects of acute hypoxia on left (LV) and right ventricular (RV) contractility in clinically stable chronic obstructive pulmonary disease (COPD) patients. Eleven male patients (mean age 52.4 ± 12.6 years) who were diagnosed to have COPD were included into the study. All of the patients underwent left and right heart catheterization. RV contractility was measured according to the method of Ferlinz and LV contractility according to the method of Kennedy and colleagues using indirect digital substraction angiography. Mean pulmonary artery pressures (Mean PPA) and oxygen saturation of the pulmonary artery (SaO2) were measured before and at each stage of graded hypoxic exposure 14%, 12%, and 10% of O2. Right atrial pressures (PRA,syst, PRA,diast, PRA,mean), RV pressures (PRV,syst, PRV,diast, PRV,mean, PRV,end-diast), RV and LV end-diastolic volume index (EDVI), end-systolic volume index (ESVI), stroke volume index (SVI), cardiac index (CI), ejection fraction (EF), and heart rate (HR) were calculated before and after breathing a hypoxic mixture of 10% of O2 for 30 minutes. Acute hypoxia induced significant elevation of mean PPA, PRA,syst, PRA,diast, PRA,mean, PRV,syst, PRV,mean, PRV,end-diast, RV EDVI, RV ESVI, LV EDVI, LV ESVI, confidence interval, and HR (p<0.05). Whereas SaO2 decreased significantly after acute hypoxia (p<0.05). These findings suggest that the systolic performance of the fight and left ventricles were well-maintained during acute hypoxia in patients with COPD. © 2007 Dove Medical Press Limited. All rights reserved.
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    Emergency stenting of unprotected left main coronary artery after acute catheter-induced occlusive dissection
    (Texas Heart Inst, 2006) Akgul, Ferit; Batyraliev, Talantbek; Besnili, Fikret; Karben, Zarema
    Left main coronary artery dissection occurs very rarely during selective coronary angiography, but it generally progresses to complete coronary occlusion. The traditional treatment of occlusive dissection of the unprotected left main coronary artery has been surgical. Percutaneous treatment has been sporadic and controversial. We report a case of iatrogenic occlusive dissection of the unprotected left main coronary artery during diagnostic coronary angiography, followed by successful stenting of the lesion.
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    Predictors of improvement in left ventricular function after stent implantation of chronic coronary occlusion
    (2009) Akgül, Ferit; Batyraliev, Talantbek; Karben, Zarema; Serçelik, Alper; Vural, Aytaç; Fettser, Denis
    The effect of coronary stent implantation on left ventricular (LV) performance in patients with chronic coronary occlusion is not well known. The aim of this study was to assess the effect of bare metal and drug eluting stents implantation on LV ejection fraction (LVEF) and to examine what clinical and angiographic factors may have an effect on recovery of LVEF. Three hundred and four patients who underwent successful stent implantation for chronic occlusion of a major epicardial coronary artery existing for at least one month were included into the study. Echocardiographic examination was performed before and six months after stent implantation. A significant increase in LVEF (53.2±11.9% to 57.0±11.1%; p <0.0001) with a decrease in both LV end-diastolic volume index (85.6±18.9 ml/m2 to 80.1±17.1 ml/m2; p <0.001) and LV end-systolic volume index (40.0±15.8 ml/m2 to 34.1±14.3 ml/m2; p <0.0001) after stent implantation of chronic coronary occlusion was observed in the entire group. There was no significant difference in the increase of LVEF between bare metal stent and drug eluting stent groups. Multivariate analysis revealed that baseline LVEF 50%, occlusion duration <2 months and diabetes mellitus to be independent predictors of improvement in LVEF. Stent implantation for a chronic coronary occlusion has a beneficial effect on LVEF during the first 6 months after the stent implantation, especially in patients with depressed LV function and occlusion duration <2 months.